Albumin has been widely applied for rational design of drug delivery complexes as natural carriers in cancer therapy due to its distinct advantages of biocompatibility,abundance,low toxicity and versatile property.Hen...Albumin has been widely applied for rational design of drug delivery complexes as natural carriers in cancer therapy due to its distinct advantages of biocompatibility,abundance,low toxicity and versatile property.Hence,various types of multifunctional albumin-based nanoplatforms(MAlb-NPs)that adopt multiple imaging and therapeutic techniques have been developed for cancer diagnosis and treatment.Stimuli-responsive release,including reduction-sensitive,p H-responsive,concentration-dependent and photodynamic-triggered,is important to achieve low-toxicity cancer therapy.Several types of imaging techniques can synergistically improve the effectiveness of cancer therapy.Therefore,combinational theranostic is considered to be a prospective strategy to improve treatment efficiency,minimize side effects and reduce drug resistance,which has received tremendous attentions in recent years.In this review,we highlight several stimuli-responsive albumin nanoplatforms for combinational theranostic.展开更多
Prostate cancer(PCa)is characterized by high incidence and propensity for easy metastasis,presenting significant challenges in clinical diagnosis and treatment.Tumor microenvironment(TME)-responsive nanomaterials prov...Prostate cancer(PCa)is characterized by high incidence and propensity for easy metastasis,presenting significant challenges in clinical diagnosis and treatment.Tumor microenvironment(TME)-responsive nanomaterials provide a promising prospect for imaging-guided precision therapy.Considering that tumor-derived alkaline phosphatase(ALP)is over-expressed in metastatic PCa,it makes a great chance to develop a theranostics system with ALP responsive in the TME.Herein,an ALP-responsive aggregationinduced emission luminogens(AIEgens)nanoprobe AMNF self-assembly was designed for enhancing the diagnosis and treatment of metastatic PCa.The nanoprobe exhibited self-aggregation in the presence of ALP resulted in aggregation-induced fluorescence,and enhanced accumulation and prolonged retention period at the tumor site.In terms of detection,the fluorescence(FL)/computed tomography(CT)/magnetic resonance(MR)multi-mode imaging effect of nanoprobe was significantly improved post-aggregation,enabling precise diagnosis through the amalgamation of multiple imaging modes.Enhanced CT/MR imaging can achieve assist preoperative tumor diagnosis,and enhanced FL imaging technology can achieve“intraoperative visual navigation”,showing its potential application value in clinical tumor detection and surgical guidance.In terms of treatment,AMNF showed strong absorption in the near infrared region after aggregation,which improved the photothermal treatment effect.Overall,our work developed an effective aggregation-enhanced theranostic strategy for ALP-related cancers.展开更多
Carbon dots(CDs)-based composites have shown impressive performance in fields of information encryption and sensing,however,a great challenge is to simultaneously implement multi-mode luminescence and room-temperature...Carbon dots(CDs)-based composites have shown impressive performance in fields of information encryption and sensing,however,a great challenge is to simultaneously implement multi-mode luminescence and room-temperature phosphorescence(RTP)detection in single system due to the formidable synthesis.Herein,a multifunctional composite of Eu&CDs@p RHO has been designed by co-assembly strategy and prepared via a facile calcination and impregnation treatment.Eu&CDs@p RHO exhibits intense fluorescence(FL)and RTP coming from two individual luminous centers,Eu3+in the free pores and CDs in the interrupted structure of RHO zeolite.Unique four-mode color outputs including pink(Eu^(3+),ex.254 nm),light violet(CDs,ex.365 nm),blue(CDs,254 nm off),and green(CDs,365 nm off)could be realized,on the basis of it,a preliminary application of advanced information encoding has been demonstrated.Given the free pores of matrix and stable RTP in water of confined CDs,a visual RTP detection of Fe^(3+)ions is achieved with the detection limit as low as 9.8μmol/L.This work has opened up a new perspective for the strategic amalgamation of luminous vips with porous zeolite to construct the advanced functional materials.展开更多
This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individua...This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individuals with mild-to-moderate traumatic brain injury (TBI). A total of 15 participants (7 males, 8 females, ages ranging from 20 to 78 years) diagnosed with mild-to-moderate TBI underwent 10 sessions of combined therapy. Cognitive performance was assessed using standardized neuropsychological tests before and after treatment, measuring cognitive processing speed, neural responsiveness, and executive function. The results demonstrated significant improvements across all metrics, including a 28.3 ms reduction in P300 latency, a 1.2 mV increase in P300 voltage, and reductions in completion times for the Trail-Making Tests A (14 seconds) and B (19 seconds). These findings suggest that multi-modality therapy may enhance cognitive recovery in TBI patients, with notable benefits across age and gender groups. Further research with larger sample sizes and extended follow-up is required to validate these results and explore their broader clinical applications.展开更多
Low-carbon smart parks achieve selfbalanced carbon emission and absorption through the cooperative scheduling of direct current(DC)-based distributed photovoltaic,energy storage units,and loads.Direct current power li...Low-carbon smart parks achieve selfbalanced carbon emission and absorption through the cooperative scheduling of direct current(DC)-based distributed photovoltaic,energy storage units,and loads.Direct current power line communication(DC-PLC)enables real-time data transmission on DC power lines.With traffic adaptation,DC-PLC can be integrated with other complementary media such as 5G to reduce transmission delay and improve reliability.However,traffic adaptation for DC-PLC and 5G integration still faces the challenges such as coupling between traffic admission control and traffic partition,dimensionality curse,and the ignorance of extreme event occurrence.To address these challenges,we propose a deep reinforcement learning(DRL)-based delay sensitive and reliable traffic adaptation algorithm(DSRTA)to minimize the total queuing delay under the constraints of traffic admission control,queuing delay,and extreme events occurrence probability.DSRTA jointly optimizes traffic admission control and traffic partition,and enables learning-based intelligent traffic adaptation.The long-term constraints are incorporated into both state and bound of drift-pluspenalty to achieve delay awareness and enforce reliability guarantee.Simulation results show that DSRTA has lower queuing delay and more reliable quality of service(QoS)guarantee than other state-of-the-art algorithms.展开更多
Cardiovascular disease remains the leading global cause of mortality,projected to increase by 73.4%from 2025 to 2050 despite declining age-standardized rates.Contemporary interventions,such as percutaneous coronary in...Cardiovascular disease remains the leading global cause of mortality,projected to increase by 73.4%from 2025 to 2050 despite declining age-standardized rates.Contemporary interventions,such as percutaneous coronary intervention and statins,reduce major adverse cardiovascular events(MACE)by 25%-30%,yet a 20%five-year MACE risk persists in high-risk cohorts.These approaches,histor-ically focused on luminal stenosis,fail to address systemic atherogenesis drivers like endothelial dysfunction and inflammation.Specifically,dietary linoleic acid restriction(<5 g/day)reduces oxidized low-density lipoprotein by approximately 15%by limiting peroxidation-prone bisallylic bonds,mitigating arterial inflam-mation,a key atherogenic trigger.Enhanced external counterpulsation,through pulsatile shear stress,enhances nitric oxide-mediated coronary perfusion,alle-viating angina in approximately 70%of refractory cases unresponsive to revascu-larization.Nanoparticle-facilitated chelation targets atherosclerotic plaques with precision,reducing calcium content by up to 30%in preclinical models,offering a novel avenue for lesion reversal.These innovations collectively address residual risk by tackling root causes,oxidative stress,endothelial dysfunction,and plaque instability,potentially halving MACE rates with widespread adoption.Despite promising preliminary data,gaps remain in long-term safety and scalability.Robust clinical trials are needed to validate these approaches,which collectively aim to transform cardiovascular disease management by prioritizing prevention and vascular restoration,potentially reducing coronary events to a public health rarity.展开更多
The all-wheel drive(AWD)hybrid system is a research focus on high-performance new energy vehicles that can meet the demands of dynamic performance and passing ability.Simultaneous optimization of the power and economy...The all-wheel drive(AWD)hybrid system is a research focus on high-performance new energy vehicles that can meet the demands of dynamic performance and passing ability.Simultaneous optimization of the power and economy of hybrid vehicles becomes an issue.A unique multi-mode coupling(MMC)AWD hybrid system is presented to realize the distributed and centralized driving of the front and rear axles to achieve vectored distribution and full utilization of the system power between the axles of vehicles.Based on the parameters of the benchmarking model of a hybrid vehicle,the best model-predictive control-based energy management strategy is proposed.First,the drive system model was built after the analysis of the MMC-AWD’s drive modes.Next,three fundamental strategies were established to address power distribution adjustment and battery SOC maintenance when the SOC changed,which was followed by the design of a road driving force observer.Then,the energy consumption rate in the average time domain was processed before designing the minimum fuel consumption controller based on the equivalent fuel consumption coefficient.Finally,the advantage of the MMC-AWD was confirmed by comparison with the dynamic performance and economy of the BYD Song PLUS DMI-AWD.The findings indicate that,in comparison to the comparative hybrid system at road adhesion coefficients of 0.8 and 0.6,the MMC-AWD’s capacity to accelerate increases by 5.26%and 7.92%,respectively.When the road adhesion coefficient is 0.8,0.6,and 0.4,the maximum climbing ability increases by 14.22%,12.88%,and 4.55%,respectively.As a result,the dynamic performance is greatly enhanced,and the fuel savings rate per 100 km of mileage reaches 12.06%,which is also very economical.The proposed control strategies for the new hybrid AWD vehicle can optimize the power and economy simultaneously.展开更多
This work evaluates the viability of a cutting-edge flexible wing prototype actuated by Shape Memory Alloy(SMA)wire actuators.Such flexible wings have garnered significant interest for their potential to enhance aerod...This work evaluates the viability of a cutting-edge flexible wing prototype actuated by Shape Memory Alloy(SMA)wire actuators.Such flexible wings have garnered significant interest for their potential to enhance aerodynamic efficiency by mitigating noise and delaying flow separation.SMA actuators are particularly advantageous due to their superior power-to-weight ratio and adaptive response,making them increasingly favored in morphing aircraft applications.Our methodology begins with a detailed delineation of the fishbone camber morphing wing rib structure,followed by the construction of a multi-mode morphing wing segment through 3D-printed rib assembly.Comprehensive testing of the SMA wire actuators’actuation capacity and efficiency was conducted to establish their operational parameters.Subsequent experimental analyses focused on the bi-directional and reciprocating morphing performance of the fishbone wing rib,which incorporates SMA wires on the upper and lower sides.These experiments confirmed the segment’s multi-mode morphing abilities.Aerodynamic assessments have demonstrated that our design substantially improves the Lift-to-Drag ratio(L/D)when compared to conventional rigid wings.Finally,two phases of flight tests demonstrated the feasibility of SMA as an aircraft actuator and the validity of flexible wing structures to adjust the aircraft attitude,respectively.展开更多
In recent years,how to efficiently and accurately identify multi-model fake news has become more challenging.First,multi-model data provides more evidence but not all are equally important.Secondly,social structure in...In recent years,how to efficiently and accurately identify multi-model fake news has become more challenging.First,multi-model data provides more evidence but not all are equally important.Secondly,social structure information has proven to be effective in fake news detection and how to combine it while reducing the noise information is critical.Unfortunately,existing approaches fail to handle these problems.This paper proposes a multi-model fake news detection framework based on Tex-modal Dominance and fusing Multiple Multi-model Cues(TD-MMC),which utilizes three valuable multi-model clues:text-model importance,text-image complementary,and text-image inconsistency.TD-MMC is dominated by textural content and assisted by image information while using social network information to enhance text representation.To reduce the irrelevant social structure’s information interference,we use a unidirectional cross-modal attention mechanism to selectively learn the social structure’s features.A cross-modal attention mechanism is adopted to obtain text-image cross-modal features while retaining textual features to reduce the loss of important information.In addition,TD-MMC employs a new multi-model loss to improve the model’s generalization ability.Extensive experiments have been conducted on two public real-world English and Chinese datasets,and the results show that our proposed model outperforms the state-of-the-art methods on classification evaluation metrics.展开更多
Lanthanum-doped double halide perovskite has attracted increasing interest due to its distinctive upconversion and near-infrared(NIR) luminous characteristics.Here,erbium ion(Er^(3+)) doped Cs_(2)(Na/Ag)BiCl_(6) micro...Lanthanum-doped double halide perovskite has attracted increasing interest due to its distinctive upconversion and near-infrared(NIR) luminous characteristics.Here,erbium ion(Er^(3+)) doped Cs_(2)(Na/Ag)BiCl_(6) microcrystals(MCs) were synthesized and proved to be one of the most prospective candidates for optical thermometry.The enhancement of both white light from self-trapped exciton emission and NIR emission from Er^(3+) ion of Cs_(2)AgBiCl_(6) microcrystals is caused by lattice distortion due to Na^(+) ion doping.Fluorescence intensity ratio and lifetime methods provide self-referenced and sensitive thermometry under 405 and/or 980 nm laser excitation at the temperatures from 80 to 480 K.Besides,the maximum values of relative and absolute sensitivity of 3.62%/K and 27//K can be achieved in the low to high temperature range under 980 and 405 nm laser co-excitation.Through the experimental analysis,Er^(3+)doped Cs_(2)(Na/Ag)BiCl_(6) double perovskite is considered to be an ideal self-calibrating thermometric material due to its good long-term stability and multi-mode function of excitation and detection.展开更多
Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopi...Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.展开更多
Recent advancements in radiotherapy for esophageal cancer have significantly improved treatment outcomes and patient quality of life.Traditional radiotherapy techniques have been enhanced by the integration of advance...Recent advancements in radiotherapy for esophageal cancer have significantly improved treatment outcomes and patient quality of life.Traditional radiotherapy techniques have been enhanced by the integration of advanced imaging and precision targeting technologies,such as intensity-modulated radiotherapy and proton therapy,which allow for more accurate tumor targeting while minimizing damage to surrounding healthy tissues.Additionally,combining radiotherapy with immunotherapy has shown promising results,leveraging the body’s im-mune response to enhance the effectiveness of cancer treatment.Studies have also highlighted the benefits of neoadjuvant chemoradiation followed by surgical resection,which has been associated with improved overall survival rates com-pared to radiotherapy alone.These innovations are paving the way for more effe-ctive and personalized treatment strategies,offering new hope for patients with esophageal cancer.展开更多
BACKGROUND Depression is a widespread psychological disorder that has substantial effects on public health and society.Conventional therapies include medication and psycho-therapy,recent investigations have highlighte...BACKGROUND Depression is a widespread psychological disorder that has substantial effects on public health and society.Conventional therapies include medication and psycho-therapy,recent investigations have highlighted the possible advantages of multi-modal treatments,such as physical therapy,for improving depression.AIM To perform a meta-analysis of how multimodal physical therapy can help treat depression.METHODS We searched for collection of articles that satisfied the inclusion and exclusion criteria,encompassing randomized controlled research-related sources.We incorporated these studies into the meta-analysis using terms such as“findings”,“intervention”,and“population attributes”.We used statistical examination to measure the total impact magnitude and evaluate study variability.RESULTS The encouraging aspect is that multi-modal physical therapy is being considered for its effectiveness in treating symptoms related to depression.Sensitivity analysis was conducted to identify key factors and determine their impact on quality.CONCLUSION Regarding treatment for depression,this meta-analysis extends the increasing number of studies demonstrating the effectiveness of multimodal physical therapy.展开更多
Objective To develop a non-invasive predictive model for coronary artery stenosis severity based on adaptive multi-modal integration of traditional Chinese and western medicine data.Methods Clinical indicators,echocar...Objective To develop a non-invasive predictive model for coronary artery stenosis severity based on adaptive multi-modal integration of traditional Chinese and western medicine data.Methods Clinical indicators,echocardiographic data,traditional Chinese medicine(TCM)tongue manifestations,and facial features were collected from patients who underwent coro-nary computed tomography angiography(CTA)in the Cardiac Care Unit(CCU)of Shanghai Tenth People's Hospital between May 1,2023 and May 1,2024.An adaptive weighted multi-modal data fusion(AWMDF)model based on deep learning was constructed to predict the severity of coronary artery stenosis.The model was evaluated using metrics including accura-cy,precision,recall,F1 score,and the area under the receiver operating characteristic(ROC)curve(AUC).Further performance assessment was conducted through comparisons with six ensemble machine learning methods,data ablation,model component ablation,and various decision-level fusion strategies.Results A total of 158 patients were included in the study.The AWMDF model achieved ex-cellent predictive performance(AUC=0.973,accuracy=0.937,precision=0.937,recall=0.929,and F1 score=0.933).Compared with model ablation,data ablation experiments,and various traditional machine learning models,the AWMDF model demonstrated superior per-formance.Moreover,the adaptive weighting strategy outperformed alternative approaches,including simple weighting,averaging,voting,and fixed-weight schemes.Conclusion The AWMDF model demonstrates potential clinical value in the non-invasive prediction of coronary artery disease and could serve as a tool for clinical decision support.展开更多
BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive di...BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.展开更多
Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied fo...Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.展开更多
Pancreatic cancer remains one of the most challenging malignancies to treat,with a poor prognosis and limited therapeutic options.Despite the success of immunotherapy and targeted therapies for other cancers,these app...Pancreatic cancer remains one of the most challenging malignancies to treat,with a poor prognosis and limited therapeutic options.Despite the success of immunotherapy and targeted therapies for other cancers,these approaches have not yet transformed the treatment landscape for pancreatic cancer.The unique tumor microenvironment(TME)of pancreatic cancer,characterized by dense fibrotic stroma and immunosuppressive myeloid cells,poses significant barriers to effective immunotherapy.Current research highlights the need for an in-depth understanding of the TME and the development of strategies to overcome its immunosuppressive properties.Recent studies have explored various immunotherapeutic approaches,including immune checkpoint inhibitors,cancer vaccines,and adoptive cell therapies,some of which have shown promising results in preclinical and early clinical trials.Furthermore,combining immunotherapy with traditional treatments,such as chemotherapy and radiotherapy,has shown potential for enhancing antitumor efficacy,although targeted therapies for pancreatic cancer are still in their early stages and are being investigated for their ability to disrupt specific molecular pathways involved in tumor growth and survival.This review provides a comprehensive overview of the advances in immunotherapy and targeted therapies for pancreatic cancer,discussing the current state of research,clinical outcomes,and future directions for improving patient prognosis.展开更多
BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and ...BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.展开更多
BACKGROUND While existing literature on ischiofemoral impingement syndrome(IFI)predominantly emphasizes surgical interventions or generalized physical therapy approaches,there remains a paucity of evidence regarding s...BACKGROUND While existing literature on ischiofemoral impingement syndrome(IFI)predominantly emphasizes surgical interventions or generalized physical therapy approaches,there remains a paucity of evidence regarding structured,multimodal rehabilitation programs targeting biomechanical deficits in IFI.This case report evaluates the efficacy of a multimodal rehabilitation program addressing a critical gap in conservative management strategies.CASE SUMMARY The patient underwent comprehensive physical and clinical examination,including hip X-ray and magnetic resonance imaging investigations.The patient completed the Musculoskeletal Health Questionnaire(MSK-HQ)and numerical pain rating scale(NPRS).The patient underwent a two-month tailored structured physical therapy intervention and repeated the same assessment afterwards.The patient's substantial reduction in pain,reflected by a significant decrease in the patient’s NPRS score from 9 to 3 points,signifies a positive clinical response.This outcome,coupled with the significant improvement in the patient's health-related quality of life according to the MSK-HQ score,which increased from 12 to 48 points,underscores the success of our research.CONCLUSION The study highlights the importance of a comprehensive approach to diagnosing and managing IFI,combining clinical assessment with imaging and implementing a multimodal rehabilitation program for optimal outcomes.展开更多
Metal complexes hold significant promise in tumor diagnosis and treatment.However,their potential applications in photodynamic therapy(PDT)are hindered by issues such as poor photostability,low yield of reactive oxyge...Metal complexes hold significant promise in tumor diagnosis and treatment.However,their potential applications in photodynamic therapy(PDT)are hindered by issues such as poor photostability,low yield of reactive oxygen species(ROS),and aggregation-induced ROS quenching.To address these challenges,we present a molecular self-assembly strategy utilizing aggregation-induced emission(AIE)conjugates for metal complexes.As a proof of concept,we synthesized a mitochondrial-targeting cyclometalated Ir(Ⅲ)photosensitizer Ir-TPE.This approach significantly enhances the photodynamic effect while mitigating the dark toxicity associated with AIE groups.Ir-TPE readily self-assembles into nanoaggregates in aqueous solution,leading to a significant production of ROS upon light irradiation.Photoirradiated Ir-TPE triggers multiple modes of death by excessively accumulating ROS in the mitochondria,resulting in mitochondrial DNA damage.This damage can lead to ferroptosis and autophagy,two forms of cell death that are highly cytotoxic to cancer cells.The aggregation-enhanced photodynamic effect of Ir-TPE significantly enhances the production of ROS,leading to a more pronounced cytotoxic effect.In vitro and in vivo experiments demonstrate this aggregation-enhanced PDT approach achieves effective in situ tumor eradication.This study not only addresses the limitations of metal complexes in terms of low ROS production due to aggregation but also highlights the potential of this strategy for enhancing ROS production in PDT.展开更多
文摘Albumin has been widely applied for rational design of drug delivery complexes as natural carriers in cancer therapy due to its distinct advantages of biocompatibility,abundance,low toxicity and versatile property.Hence,various types of multifunctional albumin-based nanoplatforms(MAlb-NPs)that adopt multiple imaging and therapeutic techniques have been developed for cancer diagnosis and treatment.Stimuli-responsive release,including reduction-sensitive,p H-responsive,concentration-dependent and photodynamic-triggered,is important to achieve low-toxicity cancer therapy.Several types of imaging techniques can synergistically improve the effectiveness of cancer therapy.Therefore,combinational theranostic is considered to be a prospective strategy to improve treatment efficiency,minimize side effects and reduce drug resistance,which has received tremendous attentions in recent years.In this review,we highlight several stimuli-responsive albumin nanoplatforms for combinational theranostic.
基金supported by Natural Science Foundation of Jilin Province(No.SKL202302002)Key Research and Development project of Jilin Provincial Science and Technology Department(No.20210204142YY)+2 种基金The Science and Technology Development Program of Jilin Province(No.2020122256JC)Beijing Kechuang Medical Development Foundation Fund of China(No.KC2023-JX-0186BQ079)Talent Reserve Program(TRP),the First Hospital of Jilin University(No.JDYY-TRP-2024007)。
文摘Prostate cancer(PCa)is characterized by high incidence and propensity for easy metastasis,presenting significant challenges in clinical diagnosis and treatment.Tumor microenvironment(TME)-responsive nanomaterials provide a promising prospect for imaging-guided precision therapy.Considering that tumor-derived alkaline phosphatase(ALP)is over-expressed in metastatic PCa,it makes a great chance to develop a theranostics system with ALP responsive in the TME.Herein,an ALP-responsive aggregationinduced emission luminogens(AIEgens)nanoprobe AMNF self-assembly was designed for enhancing the diagnosis and treatment of metastatic PCa.The nanoprobe exhibited self-aggregation in the presence of ALP resulted in aggregation-induced fluorescence,and enhanced accumulation and prolonged retention period at the tumor site.In terms of detection,the fluorescence(FL)/computed tomography(CT)/magnetic resonance(MR)multi-mode imaging effect of nanoprobe was significantly improved post-aggregation,enabling precise diagnosis through the amalgamation of multiple imaging modes.Enhanced CT/MR imaging can achieve assist preoperative tumor diagnosis,and enhanced FL imaging technology can achieve“intraoperative visual navigation”,showing its potential application value in clinical tumor detection and surgical guidance.In terms of treatment,AMNF showed strong absorption in the near infrared region after aggregation,which improved the photothermal treatment effect.Overall,our work developed an effective aggregation-enhanced theranostic strategy for ALP-related cancers.
基金supported by the National Natural Science Foundation of China(No.22288101)the 111 Project(No.B17020)。
文摘Carbon dots(CDs)-based composites have shown impressive performance in fields of information encryption and sensing,however,a great challenge is to simultaneously implement multi-mode luminescence and room-temperature phosphorescence(RTP)detection in single system due to the formidable synthesis.Herein,a multifunctional composite of Eu&CDs@p RHO has been designed by co-assembly strategy and prepared via a facile calcination and impregnation treatment.Eu&CDs@p RHO exhibits intense fluorescence(FL)and RTP coming from two individual luminous centers,Eu3+in the free pores and CDs in the interrupted structure of RHO zeolite.Unique four-mode color outputs including pink(Eu^(3+),ex.254 nm),light violet(CDs,ex.365 nm),blue(CDs,254 nm off),and green(CDs,365 nm off)could be realized,on the basis of it,a preliminary application of advanced information encoding has been demonstrated.Given the free pores of matrix and stable RTP in water of confined CDs,a visual RTP detection of Fe^(3+)ions is achieved with the detection limit as low as 9.8μmol/L.This work has opened up a new perspective for the strategic amalgamation of luminous vips with porous zeolite to construct the advanced functional materials.
文摘This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individuals with mild-to-moderate traumatic brain injury (TBI). A total of 15 participants (7 males, 8 females, ages ranging from 20 to 78 years) diagnosed with mild-to-moderate TBI underwent 10 sessions of combined therapy. Cognitive performance was assessed using standardized neuropsychological tests before and after treatment, measuring cognitive processing speed, neural responsiveness, and executive function. The results demonstrated significant improvements across all metrics, including a 28.3 ms reduction in P300 latency, a 1.2 mV increase in P300 voltage, and reductions in completion times for the Trail-Making Tests A (14 seconds) and B (19 seconds). These findings suggest that multi-modality therapy may enhance cognitive recovery in TBI patients, with notable benefits across age and gender groups. Further research with larger sample sizes and extended follow-up is required to validate these results and explore their broader clinical applications.
基金supported by the Science and Technology Project of State Grid Corporation of China under grant 52094021N010(5400-202199534A-0-5-ZN)。
文摘Low-carbon smart parks achieve selfbalanced carbon emission and absorption through the cooperative scheduling of direct current(DC)-based distributed photovoltaic,energy storage units,and loads.Direct current power line communication(DC-PLC)enables real-time data transmission on DC power lines.With traffic adaptation,DC-PLC can be integrated with other complementary media such as 5G to reduce transmission delay and improve reliability.However,traffic adaptation for DC-PLC and 5G integration still faces the challenges such as coupling between traffic admission control and traffic partition,dimensionality curse,and the ignorance of extreme event occurrence.To address these challenges,we propose a deep reinforcement learning(DRL)-based delay sensitive and reliable traffic adaptation algorithm(DSRTA)to minimize the total queuing delay under the constraints of traffic admission control,queuing delay,and extreme events occurrence probability.DSRTA jointly optimizes traffic admission control and traffic partition,and enables learning-based intelligent traffic adaptation.The long-term constraints are incorporated into both state and bound of drift-pluspenalty to achieve delay awareness and enforce reliability guarantee.Simulation results show that DSRTA has lower queuing delay and more reliable quality of service(QoS)guarantee than other state-of-the-art algorithms.
文摘Cardiovascular disease remains the leading global cause of mortality,projected to increase by 73.4%from 2025 to 2050 despite declining age-standardized rates.Contemporary interventions,such as percutaneous coronary intervention and statins,reduce major adverse cardiovascular events(MACE)by 25%-30%,yet a 20%five-year MACE risk persists in high-risk cohorts.These approaches,histor-ically focused on luminal stenosis,fail to address systemic atherogenesis drivers like endothelial dysfunction and inflammation.Specifically,dietary linoleic acid restriction(<5 g/day)reduces oxidized low-density lipoprotein by approximately 15%by limiting peroxidation-prone bisallylic bonds,mitigating arterial inflam-mation,a key atherogenic trigger.Enhanced external counterpulsation,through pulsatile shear stress,enhances nitric oxide-mediated coronary perfusion,alle-viating angina in approximately 70%of refractory cases unresponsive to revascu-larization.Nanoparticle-facilitated chelation targets atherosclerotic plaques with precision,reducing calcium content by up to 30%in preclinical models,offering a novel avenue for lesion reversal.These innovations collectively address residual risk by tackling root causes,oxidative stress,endothelial dysfunction,and plaque instability,potentially halving MACE rates with widespread adoption.Despite promising preliminary data,gaps remain in long-term safety and scalability.Robust clinical trials are needed to validate these approaches,which collectively aim to transform cardiovascular disease management by prioritizing prevention and vascular restoration,potentially reducing coronary events to a public health rarity.
基金Supported by Hebei Provincial Natural Science Foundation of China(Grant Nos.E2020203174,E2020203078)S&T Program of Hebei Province of China(Grant No.226Z2202G)Science Research Project of Hebei Provincial Education Department of China(Grant No.ZD2022029).
文摘The all-wheel drive(AWD)hybrid system is a research focus on high-performance new energy vehicles that can meet the demands of dynamic performance and passing ability.Simultaneous optimization of the power and economy of hybrid vehicles becomes an issue.A unique multi-mode coupling(MMC)AWD hybrid system is presented to realize the distributed and centralized driving of the front and rear axles to achieve vectored distribution and full utilization of the system power between the axles of vehicles.Based on the parameters of the benchmarking model of a hybrid vehicle,the best model-predictive control-based energy management strategy is proposed.First,the drive system model was built after the analysis of the MMC-AWD’s drive modes.Next,three fundamental strategies were established to address power distribution adjustment and battery SOC maintenance when the SOC changed,which was followed by the design of a road driving force observer.Then,the energy consumption rate in the average time domain was processed before designing the minimum fuel consumption controller based on the equivalent fuel consumption coefficient.Finally,the advantage of the MMC-AWD was confirmed by comparison with the dynamic performance and economy of the BYD Song PLUS DMI-AWD.The findings indicate that,in comparison to the comparative hybrid system at road adhesion coefficients of 0.8 and 0.6,the MMC-AWD’s capacity to accelerate increases by 5.26%and 7.92%,respectively.When the road adhesion coefficient is 0.8,0.6,and 0.4,the maximum climbing ability increases by 14.22%,12.88%,and 4.55%,respectively.As a result,the dynamic performance is greatly enhanced,and the fuel savings rate per 100 km of mileage reaches 12.06%,which is also very economical.The proposed control strategies for the new hybrid AWD vehicle can optimize the power and economy simultaneously.
基金co-supported by the National Key R&D Program of China(No.2022YFB3402200)the National Natural Science Foundation of China(Nos.12372123,12272305 and 12372156)+2 种基金the Key Project of NSFC,China(Nos.92271205,12032018 and 12220101002)the Fundamental Research Funds for the Central Universities of China(No.G2022KY0606)the Basic Research Program of China(No.JCKY2022603C016).
文摘This work evaluates the viability of a cutting-edge flexible wing prototype actuated by Shape Memory Alloy(SMA)wire actuators.Such flexible wings have garnered significant interest for their potential to enhance aerodynamic efficiency by mitigating noise and delaying flow separation.SMA actuators are particularly advantageous due to their superior power-to-weight ratio and adaptive response,making them increasingly favored in morphing aircraft applications.Our methodology begins with a detailed delineation of the fishbone camber morphing wing rib structure,followed by the construction of a multi-mode morphing wing segment through 3D-printed rib assembly.Comprehensive testing of the SMA wire actuators’actuation capacity and efficiency was conducted to establish their operational parameters.Subsequent experimental analyses focused on the bi-directional and reciprocating morphing performance of the fishbone wing rib,which incorporates SMA wires on the upper and lower sides.These experiments confirmed the segment’s multi-mode morphing abilities.Aerodynamic assessments have demonstrated that our design substantially improves the Lift-to-Drag ratio(L/D)when compared to conventional rigid wings.Finally,two phases of flight tests demonstrated the feasibility of SMA as an aircraft actuator and the validity of flexible wing structures to adjust the aircraft attitude,respectively.
基金This research was funded by the General Project of Philosophy and Social Science of Heilongjiang Province,Grant Number:20SHB080.
文摘In recent years,how to efficiently and accurately identify multi-model fake news has become more challenging.First,multi-model data provides more evidence but not all are equally important.Secondly,social structure information has proven to be effective in fake news detection and how to combine it while reducing the noise information is critical.Unfortunately,existing approaches fail to handle these problems.This paper proposes a multi-model fake news detection framework based on Tex-modal Dominance and fusing Multiple Multi-model Cues(TD-MMC),which utilizes three valuable multi-model clues:text-model importance,text-image complementary,and text-image inconsistency.TD-MMC is dominated by textural content and assisted by image information while using social network information to enhance text representation.To reduce the irrelevant social structure’s information interference,we use a unidirectional cross-modal attention mechanism to selectively learn the social structure’s features.A cross-modal attention mechanism is adopted to obtain text-image cross-modal features while retaining textual features to reduce the loss of important information.In addition,TD-MMC employs a new multi-model loss to improve the model’s generalization ability.Extensive experiments have been conducted on two public real-world English and Chinese datasets,and the results show that our proposed model outperforms the state-of-the-art methods on classification evaluation metrics.
基金Project supported by the Heilongjiang Provincial Key Laboratory of Micro-nano Sensitive Devices and SystemsBasic Research Project for Outstanding Young Teachers of Heilongjiang Province (YQJH2023128)Cultivation Project of Double First-class Initiative Discipline by Heilongjiang Province(LJGXCG2022-061)。
文摘Lanthanum-doped double halide perovskite has attracted increasing interest due to its distinctive upconversion and near-infrared(NIR) luminous characteristics.Here,erbium ion(Er^(3+)) doped Cs_(2)(Na/Ag)BiCl_(6) microcrystals(MCs) were synthesized and proved to be one of the most prospective candidates for optical thermometry.The enhancement of both white light from self-trapped exciton emission and NIR emission from Er^(3+) ion of Cs_(2)AgBiCl_(6) microcrystals is caused by lattice distortion due to Na^(+) ion doping.Fluorescence intensity ratio and lifetime methods provide self-referenced and sensitive thermometry under 405 and/or 980 nm laser excitation at the temperatures from 80 to 480 K.Besides,the maximum values of relative and absolute sensitivity of 3.62%/K and 27//K can be achieved in the low to high temperature range under 980 and 405 nm laser co-excitation.Through the experimental analysis,Er^(3+)doped Cs_(2)(Na/Ag)BiCl_(6) double perovskite is considered to be an ideal self-calibrating thermometric material due to its good long-term stability and multi-mode function of excitation and detection.
文摘Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.
文摘Recent advancements in radiotherapy for esophageal cancer have significantly improved treatment outcomes and patient quality of life.Traditional radiotherapy techniques have been enhanced by the integration of advanced imaging and precision targeting technologies,such as intensity-modulated radiotherapy and proton therapy,which allow for more accurate tumor targeting while minimizing damage to surrounding healthy tissues.Additionally,combining radiotherapy with immunotherapy has shown promising results,leveraging the body’s im-mune response to enhance the effectiveness of cancer treatment.Studies have also highlighted the benefits of neoadjuvant chemoradiation followed by surgical resection,which has been associated with improved overall survival rates com-pared to radiotherapy alone.These innovations are paving the way for more effe-ctive and personalized treatment strategies,offering new hope for patients with esophageal cancer.
基金Supported by Pharmaceutical Science and Technology Project in Zhejiang Province,No.2023RC266Natural Science Foundation of Ningbo,No.202003N4266.
文摘BACKGROUND Depression is a widespread psychological disorder that has substantial effects on public health and society.Conventional therapies include medication and psycho-therapy,recent investigations have highlighted the possible advantages of multi-modal treatments,such as physical therapy,for improving depression.AIM To perform a meta-analysis of how multimodal physical therapy can help treat depression.METHODS We searched for collection of articles that satisfied the inclusion and exclusion criteria,encompassing randomized controlled research-related sources.We incorporated these studies into the meta-analysis using terms such as“findings”,“intervention”,and“population attributes”.We used statistical examination to measure the total impact magnitude and evaluate study variability.RESULTS The encouraging aspect is that multi-modal physical therapy is being considered for its effectiveness in treating symptoms related to depression.Sensitivity analysis was conducted to identify key factors and determine their impact on quality.CONCLUSION Regarding treatment for depression,this meta-analysis extends the increasing number of studies demonstrating the effectiveness of multimodal physical therapy.
基金Construction Program of the Key Discipline of State Administration of Traditional Chinese Medicine of China(ZYYZDXK-2023069)Research Project of Shanghai Municipal Health Commission (2024QN018)Shanghai University of Traditional Chinese Medicine Science and Technology Development Program (23KFL005)。
文摘Objective To develop a non-invasive predictive model for coronary artery stenosis severity based on adaptive multi-modal integration of traditional Chinese and western medicine data.Methods Clinical indicators,echocardiographic data,traditional Chinese medicine(TCM)tongue manifestations,and facial features were collected from patients who underwent coro-nary computed tomography angiography(CTA)in the Cardiac Care Unit(CCU)of Shanghai Tenth People's Hospital between May 1,2023 and May 1,2024.An adaptive weighted multi-modal data fusion(AWMDF)model based on deep learning was constructed to predict the severity of coronary artery stenosis.The model was evaluated using metrics including accura-cy,precision,recall,F1 score,and the area under the receiver operating characteristic(ROC)curve(AUC).Further performance assessment was conducted through comparisons with six ensemble machine learning methods,data ablation,model component ablation,and various decision-level fusion strategies.Results A total of 158 patients were included in the study.The AWMDF model achieved ex-cellent predictive performance(AUC=0.973,accuracy=0.937,precision=0.937,recall=0.929,and F1 score=0.933).Compared with model ablation,data ablation experiments,and various traditional machine learning models,the AWMDF model demonstrated superior per-formance.Moreover,the adaptive weighting strategy outperformed alternative approaches,including simple weighting,averaging,voting,and fixed-weight schemes.Conclusion The AWMDF model demonstrates potential clinical value in the non-invasive prediction of coronary artery disease and could serve as a tool for clinical decision support.
基金Supported by Qilu Health Outstanding Young Talent Cultivation Project,No.QDFY-3839。
文摘BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.
文摘Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.
文摘Pancreatic cancer remains one of the most challenging malignancies to treat,with a poor prognosis and limited therapeutic options.Despite the success of immunotherapy and targeted therapies for other cancers,these approaches have not yet transformed the treatment landscape for pancreatic cancer.The unique tumor microenvironment(TME)of pancreatic cancer,characterized by dense fibrotic stroma and immunosuppressive myeloid cells,poses significant barriers to effective immunotherapy.Current research highlights the need for an in-depth understanding of the TME and the development of strategies to overcome its immunosuppressive properties.Recent studies have explored various immunotherapeutic approaches,including immune checkpoint inhibitors,cancer vaccines,and adoptive cell therapies,some of which have shown promising results in preclinical and early clinical trials.Furthermore,combining immunotherapy with traditional treatments,such as chemotherapy and radiotherapy,has shown potential for enhancing antitumor efficacy,although targeted therapies for pancreatic cancer are still in their early stages and are being investigated for their ability to disrupt specific molecular pathways involved in tumor growth and survival.This review provides a comprehensive overview of the advances in immunotherapy and targeted therapies for pancreatic cancer,discussing the current state of research,clinical outcomes,and future directions for improving patient prognosis.
基金Supported by National High Level Hospital Clinical Research Funding(Youth Clinical Research Project of Peking University First Hospital),No.2023YC27Capital’s Funds for Health Improvement and Research,No.2022-2-40711National High Level Hospital Clinical Research Funding(Interdepartmental Research Project of Peking University First Hospital),No.2024IR20.
文摘BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.
文摘BACKGROUND While existing literature on ischiofemoral impingement syndrome(IFI)predominantly emphasizes surgical interventions or generalized physical therapy approaches,there remains a paucity of evidence regarding structured,multimodal rehabilitation programs targeting biomechanical deficits in IFI.This case report evaluates the efficacy of a multimodal rehabilitation program addressing a critical gap in conservative management strategies.CASE SUMMARY The patient underwent comprehensive physical and clinical examination,including hip X-ray and magnetic resonance imaging investigations.The patient completed the Musculoskeletal Health Questionnaire(MSK-HQ)and numerical pain rating scale(NPRS).The patient underwent a two-month tailored structured physical therapy intervention and repeated the same assessment afterwards.The patient's substantial reduction in pain,reflected by a significant decrease in the patient’s NPRS score from 9 to 3 points,signifies a positive clinical response.This outcome,coupled with the significant improvement in the patient's health-related quality of life according to the MSK-HQ score,which increased from 12 to 48 points,underscores the success of our research.CONCLUSION The study highlights the importance of a comprehensive approach to diagnosing and managing IFI,combining clinical assessment with imaging and implementing a multimodal rehabilitation program for optimal outcomes.
基金support from the National Natural Science Foundation of China(Nos.22277056,21977052)the Distinguished Young Scholars of Jiangsu Province(No.BK20230006)+2 种基金the Natural Science Foundation of Jiangsu Province(Nos.BK20230977,BK20231090)the Natural Science Foundation of the Higher Education Institutions of Jiangsu Province(No.23KJB150020)the Jiangsu Excellent Postdoctoral Program(No.2022ZB758)。
文摘Metal complexes hold significant promise in tumor diagnosis and treatment.However,their potential applications in photodynamic therapy(PDT)are hindered by issues such as poor photostability,low yield of reactive oxygen species(ROS),and aggregation-induced ROS quenching.To address these challenges,we present a molecular self-assembly strategy utilizing aggregation-induced emission(AIE)conjugates for metal complexes.As a proof of concept,we synthesized a mitochondrial-targeting cyclometalated Ir(Ⅲ)photosensitizer Ir-TPE.This approach significantly enhances the photodynamic effect while mitigating the dark toxicity associated with AIE groups.Ir-TPE readily self-assembles into nanoaggregates in aqueous solution,leading to a significant production of ROS upon light irradiation.Photoirradiated Ir-TPE triggers multiple modes of death by excessively accumulating ROS in the mitochondria,resulting in mitochondrial DNA damage.This damage can lead to ferroptosis and autophagy,two forms of cell death that are highly cytotoxic to cancer cells.The aggregation-enhanced photodynamic effect of Ir-TPE significantly enhances the production of ROS,leading to a more pronounced cytotoxic effect.In vitro and in vivo experiments demonstrate this aggregation-enhanced PDT approach achieves effective in situ tumor eradication.This study not only addresses the limitations of metal complexes in terms of low ROS production due to aggregation but also highlights the potential of this strategy for enhancing ROS production in PDT.
