BACKGROUND Posterior ankle impingement syndrome(PAIS)is a cause of ankle pain due to pinching of bony or soft tissue structures in the hindfoot.The diagnosis is primarily made based on detailed history and accurate cl...BACKGROUND Posterior ankle impingement syndrome(PAIS)is a cause of ankle pain due to pinching of bony or soft tissue structures in the hindfoot.The diagnosis is primarily made based on detailed history and accurate clinical examination.The delay in its diagnosis has not yet been described in the pediatric and adolescent population.AIM To identify and characterize misdiagnosed cases of PAIS in pediatric and adolescent patients.METHODS This descriptive prospective study at a tertiary children’s hospital included patients≤18 years who underwent posterior ankle arthroscopy after presenting with chronic posterior ankle pain after being diagnosed with PAIS.Collected data included:Demographics,prior diagnoses and treatments,providers seen,time to diagnosis from presentation,and prior imaging obtained.Visual Analogue Scale(VAS)for pain and American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scores were noted at initial presentation and follow-up.RESULTS 35 patients(46 ankles)with average age of 13 years had an average 19 mo(range 0-60 mo)delay in diagnosis from initial presentation.25(71%)patients had previously seen multiple medical providers and were given multiple other diagnoses.All 46(100%)ankles had tenderness to palpation over the posterior ankle joint.Radiographs were reported normal in 31/42(72%)exams.In 32 ankles who underwent MRI,the most common findings included os trigonum(47%)/Stieda process(47%).Conservative treatment had already been attempted in all patients.Ankle impingement pathology was confirmed during arthroscopy in 46(100%)ankles.At an average follow-up of 13.1 mo,there was an improvement of VAS(pre-op 7.0 to post-op 1.2)and AOFAS scores(pre-op 65.1 to post-op 94).CONCLUSION This is the first study which shows that PAIS is a clinically misdiagnosed cause of posterior ankle pain in pediatric and adolescent population;an increased awareness about this diagnosis is needed amongst providers treating young patients.展开更多
Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to distur...Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to disturbances the internal homeostasis of brain, raised intracranial pressure, cerebral edema, and 50% of cases will have venous infarction or venous hemorrhage (stroke). CVST although being a Rare disorder but may be more common in children than adults with greater risk in neonatal period i.e. first 28 days of life. Here we are discussing a case of Pediatric CVST in a 7-month-old baby boy who presented to Emergency Room (ER) with recurrent discrete episodes of vomiting, fever, seizures, drowsiness and respiratory distress. The fatal outcome in our child was attributed to delayed presentation in a tertiary care center, hence missed early diagnosis and treatment. In this child the CVST could be result of amalgamation of complex underlying ongoing multiple pathological processes: an acute systemic illness like sepsis, severe dehydration, undiagnosed and untreated complex congenital heart disease, tetralogy of fallot with osteum secondum atrial septal defect, worsening the coagulopathy. It takes this case even more unique. This discussion is to bring focus on the importance of knowledge about CVST amongst emergency physicians and primary care physicians, specially managing this rare disorder with flummox presentation mimicking other more common disorders, especially in pediatric and neonatal population where definitive history and chief complaints are often vague and difficult to obtain, making it more difficult to diagnose. We the authors hence reporting this case with intent to spread awareness of CVST, how to doubt it, detect it and then manage it, especially in places like Chhattisgarh, India, where CVST is not so uncommon. We believe early diagnosis, early presentation to tertiary care center with aggressive early treatment can significantly reduce the mortality. Should the parents brought the baby early to any tertiary care center owing to his complex deteriorating symptoms like high grade fever progressed to drowsiness and seizure episodes, could there be a different outcome for this child as well as his parents.展开更多
目的:目前尚不清楚m6A甲基化基因在结直肠癌分化中的作用。本研究结合生物信息学分析与实验验证,探讨这些基因在结直肠癌中的表达特征及其潜在机制。方法:利用生物信息学,我们发现YTHDF1、YTHDF2、ALKBH5、WTAP与结直肠癌表达异常显著(p...目的:目前尚不清楚m6A甲基化基因在结直肠癌分化中的作用。本研究结合生物信息学分析与实验验证,探讨这些基因在结直肠癌中的表达特征及其潜在机制。方法:利用生物信息学,我们发现YTHDF1、YTHDF2、ALKBH5、WTAP与结直肠癌表达异常显著(p Background: The role of m6A methylation genes in the differentiation of colorectal cancer is currently unclear. This study combines bioinformatics analysis and experimental validation to explore the expression patterns of these genes in colorectal cancer and their potential mechanisms. Methods: Using bioinformatics, we found that YTHDF1, YTHDF2, ALKBH5, and WTAP are significantly aberrantly expressed in colorectal cancer (p < 0.05). In a real-world cohort from Lishui, quantitative PCR (qPCR) was used to measure mRNA expression of these four genes in CRC tissues and adjacent normal tissues. Multivariable logistic regression analysis with SPSS identified YTHDF1 and WTAP mRNA expression levels as being associated with CRC differentiation. Immunohistochemistry (IHC) was performed to examine corresponding protein levels, quantified using ImageJ. Results showed that YTHDF1 protein expression negatively correlated with CRC differentiation, whereas WTAP protein expression positively correlated. Additionally, multivariable Cox regression analysis was conducted to identify potential factors influencing CRC development. Results: In Lishui, YTHDF1 protein expression was negatively associated with CRC differentiation, while WTAP protein expression was positively associated. Age and alcohol consumption were key risk factors for CRC development, while no significant associations were found with sex or smoking. GO enrichment analysis suggests that YTHDF1 and WTAP may regulate the differentiation process of colorectal cancer by participating in mechanisms such as mRNA modification, translation regulation, and RNA stability. For the poorly differentiated CRC group, time to progression rate (TTP) was 100% and overall survival rate (OS) was 0% within three years. Conclusions: In Lishui City, the YTHDF1 and WTAP genes influence the differentiation of colorectal cancer and may serve as important therapeutic targets and biomarkers for the diagnosis of patients with colorectal cancer.展开更多
Background:The medicinal material known as Os Draconis(Longgu)originates from fossilized remains of ancient mammals and is widely used in treating emotional and mental conditions.However,fossil resources are nonrenewa...Background:The medicinal material known as Os Draconis(Longgu)originates from fossilized remains of ancient mammals and is widely used in treating emotional and mental conditions.However,fossil resources are nonrenewable,and clinical demand is increasingly difficult to meet,leading to a proliferation of counterfeit products.During prolonged geological burial,static pressure from the surrounding strata severely compromises the microstructural integrity of osteons in Os Draconis,but Os Draconis still largely retains the structural features of mammalian bone.Methods:Using verified authentic Os Draconis samples over 10,000 years old as a baseline,this study summarizes the ultrastructural characteristics of genuine Os Draconis.Employing electron probe microanalysis and optical polarized light microscopy,we examined 28 batches of authentic Os Draconis and 31 batches of counterfeits to identify their ultrastructural differences.Key points for ultrastructural identification of Os Draconis were compiled,and a new identification approach was proposed based on these differences.Results:Authentic Os Draconis exhibited distinct ultrastructural markers:irregularly shaped osteons with traversing fissures,deformed/displaced Haversian canals,and secondary mineral infill(predominantly calcium carbonate).Counterfeits showed regular osteon arrangements,absent traversal fissures,and homogeneous hydroxyapatite composition.Lab-simulated samples lacked structural degradation features.EPMA confirmed calcium carbonate infill in fossilized Haversian canals,while elemental profiles differentiated lacunae types(void vs.mineral-packed).Conclusion:The study established ultrastructural criteria for authentic Os Draconis identification:osteon deformation,geological fissures penetrating bone units,and heterogenous mineral deposition.These features,unattainable in counterfeits or modern processed bones,provide a cost-effective,accurate identification method.This approach bridges gaps in TCM material standardization and supports quality control for clinical applications.展开更多
5年前,荣耀宣布独立,开启“重生”之旅:从重建供应链到重构产品力,从持续技术创新到品牌全球化。5年后的今天,已经再次回到舞台中央的荣耀有了更大的梦想。10月15日,荣耀以“开新局,见未来”为主题召开新品发布会,备受期待的年度旗舰新...5年前,荣耀宣布独立,开启“重生”之旅:从重建供应链到重构产品力,从持续技术创新到品牌全球化。5年后的今天,已经再次回到舞台中央的荣耀有了更大的梦想。10月15日,荣耀以“开新局,见未来”为主题召开新品发布会,备受期待的年度旗舰新品——荣耀Magic8系列正式亮相,并同时发布了自进化AI智能体操作系统——全新Magic OS 10。荣耀终端股份有限公司CEO李健说,之所以选择这个主题是因为荣耀正在开拓发展新局,迎接手机的未来。“随着AI时代到来,全球都在探索AI终端的未来形态,荣耀人希望能在这个过程中贡献我们的价值。”展开更多
售价:8.38万~10.38万元女神座驾再进化设计延续经典,新增点翠蓝等6款国风配色及3款名画灵感内饰。智能座舱升级Coffee OS 3系统,配10.25英寸仪表+14.6英寸中控屏,支持动态可见即可说及一语十意语音交互。新增小憩、乘风破浪、宠物等八...售价:8.38万~10.38万元女神座驾再进化设计延续经典,新增点翠蓝等6款国风配色及3款名画灵感内饰。智能座舱升级Coffee OS 3系统,配10.25英寸仪表+14.6英寸中控屏,支持动态可见即可说及一语十意语音交互。新增小憩、乘风破浪、宠物等八大全场景模式。泊车辅助算力提升80倍,支持超100种场景。除入门款外CLTC续航均达430 km,电池安全满足2026新国标。服务上,在任何情况下,承诺180s客服响应+300s服务介入。展开更多
Osteosarcoma(OS)is a prevalent primary bone malignancy with limited treatment options.Therefore,it is imperative to investigate and understand the mechanisms underlying OS pathogenesis.Cancer-associated fibroblasts(CA...Osteosarcoma(OS)is a prevalent primary bone malignancy with limited treatment options.Therefore,it is imperative to investigate and understand the mechanisms underlying OS pathogenesis.Cancer-associated fibroblasts(CAFs)are markedly abundant in tumor stromal cells and are essentially involved in the modulation of tumor occurrence and development.In recent years,CAFs have become a hotspot as researchers aim to elucidate CAF mechanisms that regulate tumor progression.However,most studies on CAFs are limited to a few common cancers,and their association with OS remains elusive.This review describes the role and current knowledge of CAFs in OS,focusing on their potential cellular origin,classification,and diverse functionality.It was found that CAFs influenced OS tumor cell signaling,proliferation,invasion,metastasis,epithelial-mesenchymal transition,stemness maintenance,angiogenesis,and the ability to modify immune system components.Furthermore,findings on other common cancers indicated that effective therapeutic strategies included the manipulation of CAF activation,targeting CAF-derived components,and depletion of CAFs by biomarkers.This review provides new insights and a theoretical basis for OS research.展开更多
文摘BACKGROUND Posterior ankle impingement syndrome(PAIS)is a cause of ankle pain due to pinching of bony or soft tissue structures in the hindfoot.The diagnosis is primarily made based on detailed history and accurate clinical examination.The delay in its diagnosis has not yet been described in the pediatric and adolescent population.AIM To identify and characterize misdiagnosed cases of PAIS in pediatric and adolescent patients.METHODS This descriptive prospective study at a tertiary children’s hospital included patients≤18 years who underwent posterior ankle arthroscopy after presenting with chronic posterior ankle pain after being diagnosed with PAIS.Collected data included:Demographics,prior diagnoses and treatments,providers seen,time to diagnosis from presentation,and prior imaging obtained.Visual Analogue Scale(VAS)for pain and American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scores were noted at initial presentation and follow-up.RESULTS 35 patients(46 ankles)with average age of 13 years had an average 19 mo(range 0-60 mo)delay in diagnosis from initial presentation.25(71%)patients had previously seen multiple medical providers and were given multiple other diagnoses.All 46(100%)ankles had tenderness to palpation over the posterior ankle joint.Radiographs were reported normal in 31/42(72%)exams.In 32 ankles who underwent MRI,the most common findings included os trigonum(47%)/Stieda process(47%).Conservative treatment had already been attempted in all patients.Ankle impingement pathology was confirmed during arthroscopy in 46(100%)ankles.At an average follow-up of 13.1 mo,there was an improvement of VAS(pre-op 7.0 to post-op 1.2)and AOFAS scores(pre-op 65.1 to post-op 94).CONCLUSION This is the first study which shows that PAIS is a clinically misdiagnosed cause of posterior ankle pain in pediatric and adolescent population;an increased awareness about this diagnosis is needed amongst providers treating young patients.
文摘Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to disturbances the internal homeostasis of brain, raised intracranial pressure, cerebral edema, and 50% of cases will have venous infarction or venous hemorrhage (stroke). CVST although being a Rare disorder but may be more common in children than adults with greater risk in neonatal period i.e. first 28 days of life. Here we are discussing a case of Pediatric CVST in a 7-month-old baby boy who presented to Emergency Room (ER) with recurrent discrete episodes of vomiting, fever, seizures, drowsiness and respiratory distress. The fatal outcome in our child was attributed to delayed presentation in a tertiary care center, hence missed early diagnosis and treatment. In this child the CVST could be result of amalgamation of complex underlying ongoing multiple pathological processes: an acute systemic illness like sepsis, severe dehydration, undiagnosed and untreated complex congenital heart disease, tetralogy of fallot with osteum secondum atrial septal defect, worsening the coagulopathy. It takes this case even more unique. This discussion is to bring focus on the importance of knowledge about CVST amongst emergency physicians and primary care physicians, specially managing this rare disorder with flummox presentation mimicking other more common disorders, especially in pediatric and neonatal population where definitive history and chief complaints are often vague and difficult to obtain, making it more difficult to diagnose. We the authors hence reporting this case with intent to spread awareness of CVST, how to doubt it, detect it and then manage it, especially in places like Chhattisgarh, India, where CVST is not so uncommon. We believe early diagnosis, early presentation to tertiary care center with aggressive early treatment can significantly reduce the mortality. Should the parents brought the baby early to any tertiary care center owing to his complex deteriorating symptoms like high grade fever progressed to drowsiness and seizure episodes, could there be a different outcome for this child as well as his parents.
文摘目的:目前尚不清楚m6A甲基化基因在结直肠癌分化中的作用。本研究结合生物信息学分析与实验验证,探讨这些基因在结直肠癌中的表达特征及其潜在机制。方法:利用生物信息学,我们发现YTHDF1、YTHDF2、ALKBH5、WTAP与结直肠癌表达异常显著(p Background: The role of m6A methylation genes in the differentiation of colorectal cancer is currently unclear. This study combines bioinformatics analysis and experimental validation to explore the expression patterns of these genes in colorectal cancer and their potential mechanisms. Methods: Using bioinformatics, we found that YTHDF1, YTHDF2, ALKBH5, and WTAP are significantly aberrantly expressed in colorectal cancer (p < 0.05). In a real-world cohort from Lishui, quantitative PCR (qPCR) was used to measure mRNA expression of these four genes in CRC tissues and adjacent normal tissues. Multivariable logistic regression analysis with SPSS identified YTHDF1 and WTAP mRNA expression levels as being associated with CRC differentiation. Immunohistochemistry (IHC) was performed to examine corresponding protein levels, quantified using ImageJ. Results showed that YTHDF1 protein expression negatively correlated with CRC differentiation, whereas WTAP protein expression positively correlated. Additionally, multivariable Cox regression analysis was conducted to identify potential factors influencing CRC development. Results: In Lishui, YTHDF1 protein expression was negatively associated with CRC differentiation, while WTAP protein expression was positively associated. Age and alcohol consumption were key risk factors for CRC development, while no significant associations were found with sex or smoking. GO enrichment analysis suggests that YTHDF1 and WTAP may regulate the differentiation process of colorectal cancer by participating in mechanisms such as mRNA modification, translation regulation, and RNA stability. For the poorly differentiated CRC group, time to progression rate (TTP) was 100% and overall survival rate (OS) was 0% within three years. Conclusions: In Lishui City, the YTHDF1 and WTAP genes influence the differentiation of colorectal cancer and may serve as important therapeutic targets and biomarkers for the diagnosis of patients with colorectal cancer.
基金supported by the Scientific and Technological Innovation Project of the China Academy of Chinese Medical Sciences(CI2021A04013)the National Natural Science Foundation of China(82204610)+1 种基金the Qihang Talent Program(L2022046)the Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ15-YQ-041 and L2021029).
文摘Background:The medicinal material known as Os Draconis(Longgu)originates from fossilized remains of ancient mammals and is widely used in treating emotional and mental conditions.However,fossil resources are nonrenewable,and clinical demand is increasingly difficult to meet,leading to a proliferation of counterfeit products.During prolonged geological burial,static pressure from the surrounding strata severely compromises the microstructural integrity of osteons in Os Draconis,but Os Draconis still largely retains the structural features of mammalian bone.Methods:Using verified authentic Os Draconis samples over 10,000 years old as a baseline,this study summarizes the ultrastructural characteristics of genuine Os Draconis.Employing electron probe microanalysis and optical polarized light microscopy,we examined 28 batches of authentic Os Draconis and 31 batches of counterfeits to identify their ultrastructural differences.Key points for ultrastructural identification of Os Draconis were compiled,and a new identification approach was proposed based on these differences.Results:Authentic Os Draconis exhibited distinct ultrastructural markers:irregularly shaped osteons with traversing fissures,deformed/displaced Haversian canals,and secondary mineral infill(predominantly calcium carbonate).Counterfeits showed regular osteon arrangements,absent traversal fissures,and homogeneous hydroxyapatite composition.Lab-simulated samples lacked structural degradation features.EPMA confirmed calcium carbonate infill in fossilized Haversian canals,while elemental profiles differentiated lacunae types(void vs.mineral-packed).Conclusion:The study established ultrastructural criteria for authentic Os Draconis identification:osteon deformation,geological fissures penetrating bone units,and heterogenous mineral deposition.These features,unattainable in counterfeits or modern processed bones,provide a cost-effective,accurate identification method.This approach bridges gaps in TCM material standardization and supports quality control for clinical applications.
文摘5年前,荣耀宣布独立,开启“重生”之旅:从重建供应链到重构产品力,从持续技术创新到品牌全球化。5年后的今天,已经再次回到舞台中央的荣耀有了更大的梦想。10月15日,荣耀以“开新局,见未来”为主题召开新品发布会,备受期待的年度旗舰新品——荣耀Magic8系列正式亮相,并同时发布了自进化AI智能体操作系统——全新Magic OS 10。荣耀终端股份有限公司CEO李健说,之所以选择这个主题是因为荣耀正在开拓发展新局,迎接手机的未来。“随着AI时代到来,全球都在探索AI终端的未来形态,荣耀人希望能在这个过程中贡献我们的价值。”
文摘售价:8.38万~10.38万元女神座驾再进化设计延续经典,新增点翠蓝等6款国风配色及3款名画灵感内饰。智能座舱升级Coffee OS 3系统,配10.25英寸仪表+14.6英寸中控屏,支持动态可见即可说及一语十意语音交互。新增小憩、乘风破浪、宠物等八大全场景模式。泊车辅助算力提升80倍,支持超100种场景。除入门款外CLTC续航均达430 km,电池安全满足2026新国标。服务上,在任何情况下,承诺180s客服响应+300s服务介入。
基金supported by the National Natural Science Foundation of China(grant number 81773285)Beijing Chao-Yang Hospital Golden Seeds Foundation(grant number CYJZ202341).
文摘Osteosarcoma(OS)is a prevalent primary bone malignancy with limited treatment options.Therefore,it is imperative to investigate and understand the mechanisms underlying OS pathogenesis.Cancer-associated fibroblasts(CAFs)are markedly abundant in tumor stromal cells and are essentially involved in the modulation of tumor occurrence and development.In recent years,CAFs have become a hotspot as researchers aim to elucidate CAF mechanisms that regulate tumor progression.However,most studies on CAFs are limited to a few common cancers,and their association with OS remains elusive.This review describes the role and current knowledge of CAFs in OS,focusing on their potential cellular origin,classification,and diverse functionality.It was found that CAFs influenced OS tumor cell signaling,proliferation,invasion,metastasis,epithelial-mesenchymal transition,stemness maintenance,angiogenesis,and the ability to modify immune system components.Furthermore,findings on other common cancers indicated that effective therapeutic strategies included the manipulation of CAF activation,targeting CAF-derived components,and depletion of CAFs by biomarkers.This review provides new insights and a theoretical basis for OS research.
