Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass patho...Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.展开更多
Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated ...Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.展开更多
Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accoun...Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accounting for 80%of the overall noncutaneous melanomas.Clinically,it remains silent in about 30%of the cases;when symptomatic,it generally causes metamorphopsia(painless loss or distortion of vision)and/or photopsia(flashing or flickering of light in the visual field).Discoloration of the iris,astigmatism,glaucoma,and even blindness are other,less common clinical manifestations.Several pathophysiological mechanisms underlie the development of UM.Genetic mutations,involving especially the G protein subunit alpha q(GNAQ),guanine nucleotide-binding protein subunit alpha-11(GNA11),BRCA1 associated deubiquitinase 1(BAP1),splicing factor 3b subunit 1(SF3B1),and eukaryotic translation initiation factor 1A,X-linked(EIF1AX)genes as well as the MAPK/ERK signaling pathway genes,have been largely associated with the development of UM.Chromosomal aberrations,inflammatory and immunological alterations are often concurrent factors for the development and progression of UM.Therapies targeting specific genetic alterations and immunotherapy agents have been recently developed and introduced in clinical practice for the management of advanced-stage UMs.This review aims to present the latest advances in the clinical molecular pathology of UM,along with the resulting targeted,immunological,and other therapies that have been introduced or are currently under investigation.展开更多
Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have...Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.展开更多
BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(...BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(LC)before adulthood.AIM To identify clinical and pathological characteristics of pediatric HBV-related LC.METHODS A total of 1332 pediatric patients with chronic HBV infection from the Fifth Medical Center of PLA General Hospital from January 2010 to January 2023 were included in this study.We identified 62 pediatric HBV-related LC by liver biopsy from the group.Subsequently,we described the clinical and pathological characteristics of pediatric LC.And 64 pediatric chronic hepatitis B(CHB;age and sex were matched with pediatric LC group)and 69 adult HBV-related LC(sex were matched with pediatric LC group)were enrolled to further demonstrate clinical and pathological differences between pediatric LC,pediatric CHB and adult LC.RESULTS We enrolled 62 pediatric LC,including 54(87.1%)males and 8(12.9%)females.The median age was 11(4-14)years old.The pediatric LC group showed significantly lower median quantitative HBV DNA loads(log10IU/mL:6.3 vs 17.4,P<0.001),reduced HBsAg titers(log10IU/mL:3.11 vs 8.956,P<0.0001),and diminished hepatitis B e antigen-positive positive rate(81.4%vs 93.8%,P<0.05)compared with pediatric CHB.A higher proportion of pediatric patients were asymptomatic(77.4%)compared to adult patients(11.6%)as they first diagnosed as LC,pediatric LC showed milder initial symptoms compared with adult patients such as fatigue(4.8%vs 27.5%),abdominal discomfort(9.7%vs 23.2%),nausea(0%vs 10.1%),and poor appetite(6.5%vs 8.7%;all P<0.0001).Notably,pediatric LC can achieve a significant percentage of functional cure compared with adult LC as 17.4%and 0%.The incidence of progression of LC in children after antiviral therapy continues to be much lower than that in adult LC(hazard ratio=6.102,95%confidence interval:1.72-21.65,P=0.00051).While the incidence of LC remission in children after antiviral therapy continues to be much higher than that in adult LC(hazard ratio=0.055,95%confidence interval:0.07128-0.2802,P<0.0001).CONCLUSION Pediatric patients with HBV-related cirrhosis exhibit elevated virological parameters and heightened transaminase levels than adult patients.However,the frequent paucity of overt clinical symptoms contributes to diagnostic challenges.Notably,early initiation of antiviral therapy in this population substantially improved clinical outcomes.展开更多
Alzheimer’s disease(AD),as the predominant form of neurodegenerative disorders,exerts a profound impact on the health of the global elderly population.For decades,the elucidation of AD pathogenesis and the developmen...Alzheimer’s disease(AD),as the predominant form of neurodegenerative disorders,exerts a profound impact on the health of the global elderly population.For decades,the elucidation of AD pathogenesis and the development of diagnostic and therapeutic approaches have been the focus of extensive research.Over recent years,a fundamental shift has occurred in AD diagnostics—transitioning from reliance on clinical diagnosis alone to biomarker-supported frameworks.AD biomarker research has transitioned from postmortem histopathology to in vivo detection paradigms,enabling precision diagnosis and intervention.This review synthesizes recent advances in molecular biomarkers across three domains:Fluid biomarkers,Molecular imaging and Innovative detection platforms,and also evaluates the challenges and prospects of the clinical transformation of molecular markers for AD.展开更多
Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed ...Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.展开更多
Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide sup...Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.展开更多
Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of stan...Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of standardization and uni-formity in current model building methods,which led us to conduct this study.Background:The aim was to investigate the time-and dose-related changes in the behavioral and pathological characteristics in the MIA-induced KOA model rat.Methods:MIA(40,50,and 60 mg/mL)was injected into the left joint of male Sprague-Dawley rats.After 2 weeks,the changes in the KOA rat model were observed by be-havioral evaluation,imaging-level evaluation,and histological-level evaluation.The changes were also compared after 40-mg/mL MIA injection for 2 and 6 weeks.Results:MIA-induced bone surface defects,osteophyte hyperplasia around the artic-ular rim,increased subchondral bone density,thinning of the sparse trabecular bone,structural disorder,and local clustering were observed.The degree of injury gradually increased with the increase in MIA concentration.After 6 weeks,subchondral bone density and sparse trabecular bone increased in the KOA model.Conclusions:The severity of the model also increased significantly with the changes in dose and time.In dose-dependent experiments,this study revealed that 40 mg/mL was the optimal dose to induce significant pathological changes without causing undue discomfort or death in animals.This dose may induce pathological changes stably and is suitable for long-term observation.展开更多
[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to t...[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.展开更多
BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate se...BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.展开更多
Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergrad...Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergraduate nursing students.Methods From April to July 2023,second-year nursing students who undertaking a nine-week clinical placement in a cardiology ward in northern Portugal were selected.Following a two-week diagnostic phase,students participated in a six-week gamified supervision programme comprising weekly 60-min sessions:infection-control decision-making;technical-procedural reasoning;guided emotional and ethical reflection;and clinical reasoning quiz on cardiology topics.Students completed weekly Structured Reflection Guide entries;supervisors recorded structured field notes after each session;and,after the intervention,students answered a post-intervention questionnaire and participated in focus groups.Qualitative data(reflections,field notes,open-ended questionnaire items,and focus-group transcripts)were analyzed using Bardin’s content analysis;quantitative questionnaire items were summarized descriptively.Results All seven students completed the six gamified sessions and submitted weekly reflection entries.Five students(71.4%)completed the questionnaire.Across data sources,students reported that gamified activities supported knowledge consolidation,teamwork,and clinical reasoning.Questionnaire data showed that all respondents(n=5,100%)strongly agreed that gamification enhanced their learning and should be maintained in clinical training.Reflections and focus groups revealed recurring themes related to emotional expression,sense of belonging,and difficulties using structured reflection tools,particularly in terms of comprehension and timing.Conclusion The gamified supervision strategy integrated into clinical training provided structured opportunities for practical engagement,collaborative work,and guided reflection.These findings suggest that gamification may support the development of reflective and critical-thinking processes in authentic clinical environments.展开更多
Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this ...Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this end,we herein develop a portable self-calibrating platform namely carbon dots(C-dots)-embedded hydrogel sensors with a smartphone-assisted high-throughput imaging device,for DOX sensing.The prepared green-emitting(λ_(em)=508 nm)and negatively-charged C-dots(−11.40±1.21 mV),which have sufficient spectral overlap with the absorption band of DOX(∼500 nm),can strongly bind with positively-charged DOX molecules by electrostatic attraction effects.As a result,DOX molecules are selectively and rapid(20 s)determined with a detection limit of 10.26 nmol/L via Förster resonance energy transfer processes,demonstrating a remarkably chromatic shift from green to red.Further integrated with a 3D-printed smartphone-assisted device,the platform enabled high-throughput quantification,achieving recoveries of 96.40%-101.85%in human urine/serum(RSDs<2.94%,n=3).Notably,the dual linear detection ranges of the platform align with the reported clinical DOX concentrations in urine and plasma(0-4 h post-administration),validating their capability for direct quantification of DOX in clinical samples without special pre-treatment processes.By virtue of attractive analytical performances and robust feasibility,this platform bridges laboratory precision and point-of-care testing needs,offering promising potential for personalized chemotherapy and multiplexed analyte screening.展开更多
AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital ...AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital IMT based on histopathological examination.The patients were followed up to assess their prognosis.Clinical data from patients,including age,gender,course of disease,past medical history,primary symptoms,ophthalmologic examination findings,general condition,as well as imaging,laboratory,histopathological,and immunohistochemical results from digital records were collected.Orbital magnetic resonance imaging(MRI)and(or)computed tomography(CT)scans were performed to assess bone destruction of the mass,invasion of surrounding tissues,and any inflammatory changes in periorbital areas.RESULTS:The mean age of patients with orbital IMT was 28.24±3.30y,with a male-to-female ratio of 1.2:1.Main clinical manifestations were proptosis,blurred vision,palpable mass,and pain.Bone destruction and surrounding tissue invasion occurred in 72.73%and 54.55%of cases,respectively.Inflammatory changes in the periorbital site were observed in 77.27%of the patients.Hematoxylin and eosin staining showed proliferation of fibroblasts and myofibroblasts,accompanied by infiltration of lymphocytes and plasma cells.Immunohistochemical staining revealed that smooth muscle actin(SMA)and vimentin were positive in 100%of cases,while anaplastic lymphoma kinase(ALK)showed positivity in 47.37%.The recurrence rate of orbital IMT was 27.27%,and sarcomatous degeneration could occur.There were no significant correlations between recurrence and factors such as age,gender,laterality,duration of the disease,periorbital tissue invasion,bone destruction,periorbital inflammation,tumor size,fever,leukocytosis,or treatment(P>0.05).However,lymphadenopathy and a Ki-67 index of 10%or higher may be risk factors for recurrence(P=0.046;P=0.023).CONCLUSION:Orbital IMT is a locally invasive disease that may recur or lead to sarcomatoid degeneration,primarily affecting young and middle-aged patients.The presence of lymphadenopathy and a Ki-67 index of 10%or higher may signify a poor prognosis.展开更多
Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal ...Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.展开更多
Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate...Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.展开更多
This article reviews the research advances in traditional Chinese medicine rhubarb and its compound formulations in the treatment of sepsis,with particular emphasis on elucidating their mechanisms of action and clinic...This article reviews the research advances in traditional Chinese medicine rhubarb and its compound formulations in the treatment of sepsis,with particular emphasis on elucidating their mechanisms of action and clinical application value.Research has demonstrated that rhubarb and its compound formulations exert therapeutic effects via multiple targets and mechanisms,including anti-inflammatory actions,protection of the intestinal barrier,modulation of immune balance,inhibition of oxidative stress,and regulation of associated signaling pathways.Clinically,rhubarb has shown distinct advantages in enhancing gastrointestinal function,mitigating systemic inflammatory responses,and reducing mortality rates among patients with sepsis.These findings provide a foundational reference for the integrated prevention and treatment of sepsis through the combined use of traditional Chinese and Western medicine.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the fi...Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.展开更多
BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association betwee...BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association between the expression of splicing factor 3b subunit 4(SF3B4)and high mobility group box 1(HMGB1)with the clinical characteristics and prognostic outcomes of gastric cancer patients.METHODS A retrospective cohort study was conducted involving 114 individuals diagnosed with gastric cancer and admitted to our institution from January 2020 to December 2021.A comparison group of 90 patients diagnosed with benign gastric disorders during the same period was also included.Expression levels of SF3B4 and HMGB1 were assessed using real-time quantitative polymerase chain reaction.Expression patterns were analyzed in relation to various clinicopathological features.Receiver operating characteristic curves were constructed to evaluate the ability of SF3B4 and HMGB1,alone and in combination,to predict unfavorable one-year outcomes.Multivariate logistic regression was utilized to identify independent predictors of mortality.Kaplan-Meier survival curves were generated to examine survival differences based on SF3B4 and HMGB1 expression levels.RESULTS Both SF3B4 and HMGB1 were markedly upregulated in tumor tissues of gastric cancer patients compared to adjacent normal tissues and to tissues from nonmalignant gastric disease patients(^(a)P<0.05).Higher expression levels of these two genes were significantly associated with aggressive pathological features,including poor differentiation,tumor size>5 cm,deep infiltration(T3-T4),lymph node involvement,and advanced clinical stage(III–IV)(^(a)P<0.05).Receiver operating characteristic analysis revealed that the combined use of SF3B4 and HMGB1 yielded an area under the curve of 0.914,surpassing the predictive performance of either marker alone(SF3B4:0.776;HMGB1:0.757).Multivariate analysis identified SF3B4≥1.45,HMGB1≥0.93,poor differentiation,larger tumor size,deeper invasion,lymph node metastasis,and advanced clinical tumor-node-metastasis staging as independent factors contributing to one-year mortality(^(a)P<0.05).Survival analysis indicated that patients with elevated SF3B4 and HMGB1 levels had a shorter median survival(25.74±5.46 months)compared to those with lower expression levels(33.29±6.71 months,log-rank=10.534,^(a)P<0.05).CONCLUSION Elevated SF3B4 and HMGB1 expression in gastric cancer tissue is significantly associated with tumor aggressiveness,worse prognosis,and reduced survival.These biomarkers may offer clinical value in stratifying patients by risk and in forecasting outcomes.Their combined assessment improves predictive accuracy for poor prognosis and may serve as a more effective tool than individual evaluation.展开更多
文摘Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.
基金Supported by National High-Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022,and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.CIFMS 2021-1-I2M-003Undergraduate Innovation Program,No.2024dcxm025.
文摘Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.
文摘Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accounting for 80%of the overall noncutaneous melanomas.Clinically,it remains silent in about 30%of the cases;when symptomatic,it generally causes metamorphopsia(painless loss or distortion of vision)and/or photopsia(flashing or flickering of light in the visual field).Discoloration of the iris,astigmatism,glaucoma,and even blindness are other,less common clinical manifestations.Several pathophysiological mechanisms underlie the development of UM.Genetic mutations,involving especially the G protein subunit alpha q(GNAQ),guanine nucleotide-binding protein subunit alpha-11(GNA11),BRCA1 associated deubiquitinase 1(BAP1),splicing factor 3b subunit 1(SF3B1),and eukaryotic translation initiation factor 1A,X-linked(EIF1AX)genes as well as the MAPK/ERK signaling pathway genes,have been largely associated with the development of UM.Chromosomal aberrations,inflammatory and immunological alterations are often concurrent factors for the development and progression of UM.Therapies targeting specific genetic alterations and immunotherapy agents have been recently developed and introduced in clinical practice for the management of advanced-stage UMs.This review aims to present the latest advances in the clinical molecular pathology of UM,along with the resulting targeted,immunological,and other therapies that have been introduced or are currently under investigation.
基金supported by the Canadian Institutes of Health Research Project grant (PJT-169197) to QYsupported by a CGS-M fellowship from the Canadian Institutes of Health Research
文摘Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.
基金Supported by National Key R&D Program of China,No.2023YFC2308104Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZLRK202301National Natural Science Foundation of China,No.92159305.
文摘BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(LC)before adulthood.AIM To identify clinical and pathological characteristics of pediatric HBV-related LC.METHODS A total of 1332 pediatric patients with chronic HBV infection from the Fifth Medical Center of PLA General Hospital from January 2010 to January 2023 were included in this study.We identified 62 pediatric HBV-related LC by liver biopsy from the group.Subsequently,we described the clinical and pathological characteristics of pediatric LC.And 64 pediatric chronic hepatitis B(CHB;age and sex were matched with pediatric LC group)and 69 adult HBV-related LC(sex were matched with pediatric LC group)were enrolled to further demonstrate clinical and pathological differences between pediatric LC,pediatric CHB and adult LC.RESULTS We enrolled 62 pediatric LC,including 54(87.1%)males and 8(12.9%)females.The median age was 11(4-14)years old.The pediatric LC group showed significantly lower median quantitative HBV DNA loads(log10IU/mL:6.3 vs 17.4,P<0.001),reduced HBsAg titers(log10IU/mL:3.11 vs 8.956,P<0.0001),and diminished hepatitis B e antigen-positive positive rate(81.4%vs 93.8%,P<0.05)compared with pediatric CHB.A higher proportion of pediatric patients were asymptomatic(77.4%)compared to adult patients(11.6%)as they first diagnosed as LC,pediatric LC showed milder initial symptoms compared with adult patients such as fatigue(4.8%vs 27.5%),abdominal discomfort(9.7%vs 23.2%),nausea(0%vs 10.1%),and poor appetite(6.5%vs 8.7%;all P<0.0001).Notably,pediatric LC can achieve a significant percentage of functional cure compared with adult LC as 17.4%and 0%.The incidence of progression of LC in children after antiviral therapy continues to be much lower than that in adult LC(hazard ratio=6.102,95%confidence interval:1.72-21.65,P=0.00051).While the incidence of LC remission in children after antiviral therapy continues to be much higher than that in adult LC(hazard ratio=0.055,95%confidence interval:0.07128-0.2802,P<0.0001).CONCLUSION Pediatric patients with HBV-related cirrhosis exhibit elevated virological parameters and heightened transaminase levels than adult patients.However,the frequent paucity of overt clinical symptoms contributes to diagnostic challenges.Notably,early initiation of antiviral therapy in this population substantially improved clinical outcomes.
基金funded by the Science and Technology Plan Project in the Medical and Health Field of Maanshan City(YL-2023-43).
文摘Alzheimer’s disease(AD),as the predominant form of neurodegenerative disorders,exerts a profound impact on the health of the global elderly population.For decades,the elucidation of AD pathogenesis and the development of diagnostic and therapeutic approaches have been the focus of extensive research.Over recent years,a fundamental shift has occurred in AD diagnostics—transitioning from reliance on clinical diagnosis alone to biomarker-supported frameworks.AD biomarker research has transitioned from postmortem histopathology to in vivo detection paradigms,enabling precision diagnosis and intervention.This review synthesizes recent advances in molecular biomarkers across three domains:Fluid biomarkers,Molecular imaging and Innovative detection platforms,and also evaluates the challenges and prospects of the clinical transformation of molecular markers for AD.
基金ACKNOWLEDGMENTS This study was supported by the National Natural Science Foundation of China （Grants 81472683 and 81202275）, Tianjin Natural Science fund （Grant 13JCQNJC 11000） and Research Seed Foundation of Tianjin Medical University Gancer Hospital and Institute （Grant 1421）.
文摘Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.
文摘Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.
基金Construction Project of High-Level Traditional Chinese Medicine Key Discipline of National Administration of Traditional Chinese Medicine,Grant/Award Number:zyyzdxk-2023022Key Team of Scientific and Technological Innovation Talents of Shanxi Province with Integrated Traditional Chinese and Western Medicine for Preventing and Treating Rheumatological Diseases,Grant/Award Number:202204051002033+4 种基金Traditional Chinese Medicine+Stem Cell Innovation Project,Grant/Award Number:2024KJZY0062023 Shanxi Graduate Research Practice Project,Grant/Award Number:2023KY6762023 Graduate Innovation and Entrepreneurship Project of Shanxi University of Traditional Chinese Medicine,Grant/Award Number:2023CX023 and 2023CX027Science and Technology Innovation Project for University in Shanxi Province,Grant/Award Number:2022L358Key Laboratory of Rheumatological and Immunological Diseases Treated by Integrated Chinese and Western Medicine,Grant/Award Number:zyyyjs2024021。
文摘Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of standardization and uni-formity in current model building methods,which led us to conduct this study.Background:The aim was to investigate the time-and dose-related changes in the behavioral and pathological characteristics in the MIA-induced KOA model rat.Methods:MIA(40,50,and 60 mg/mL)was injected into the left joint of male Sprague-Dawley rats.After 2 weeks,the changes in the KOA rat model were observed by be-havioral evaluation,imaging-level evaluation,and histological-level evaluation.The changes were also compared after 40-mg/mL MIA injection for 2 and 6 weeks.Results:MIA-induced bone surface defects,osteophyte hyperplasia around the artic-ular rim,increased subchondral bone density,thinning of the sparse trabecular bone,structural disorder,and local clustering were observed.The degree of injury gradually increased with the increase in MIA concentration.After 6 weeks,subchondral bone density and sparse trabecular bone increased in the KOA model.Conclusions:The severity of the model also increased significantly with the changes in dose and time.In dose-dependent experiments,this study revealed that 40 mg/mL was the optimal dose to induce significant pathological changes without causing undue discomfort or death in animals.This dose may induce pathological changes stably and is suitable for long-term observation.
文摘[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.
基金Supported by China Health&Medical Development Foundation,No.M2021551.
文摘BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.
文摘Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergraduate nursing students.Methods From April to July 2023,second-year nursing students who undertaking a nine-week clinical placement in a cardiology ward in northern Portugal were selected.Following a two-week diagnostic phase,students participated in a six-week gamified supervision programme comprising weekly 60-min sessions:infection-control decision-making;technical-procedural reasoning;guided emotional and ethical reflection;and clinical reasoning quiz on cardiology topics.Students completed weekly Structured Reflection Guide entries;supervisors recorded structured field notes after each session;and,after the intervention,students answered a post-intervention questionnaire and participated in focus groups.Qualitative data(reflections,field notes,open-ended questionnaire items,and focus-group transcripts)were analyzed using Bardin’s content analysis;quantitative questionnaire items were summarized descriptively.Results All seven students completed the six gamified sessions and submitted weekly reflection entries.Five students(71.4%)completed the questionnaire.Across data sources,students reported that gamified activities supported knowledge consolidation,teamwork,and clinical reasoning.Questionnaire data showed that all respondents(n=5,100%)strongly agreed that gamification enhanced their learning and should be maintained in clinical training.Reflections and focus groups revealed recurring themes related to emotional expression,sense of belonging,and difficulties using structured reflection tools,particularly in terms of comprehension and timing.Conclusion The gamified supervision strategy integrated into clinical training provided structured opportunities for practical engagement,collaborative work,and guided reflection.These findings suggest that gamification may support the development of reflective and critical-thinking processes in authentic clinical environments.
基金supported by the National NaturalScience Foundation of China(No.22274001)the Key Project of Natural Science Research of the Education Department of Anhui Province(No.2022AH051032)the Excellent Research and Innovation Team of Universities in Anhui Province(No.2024AH010016).
文摘Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this end,we herein develop a portable self-calibrating platform namely carbon dots(C-dots)-embedded hydrogel sensors with a smartphone-assisted high-throughput imaging device,for DOX sensing.The prepared green-emitting(λ_(em)=508 nm)and negatively-charged C-dots(−11.40±1.21 mV),which have sufficient spectral overlap with the absorption band of DOX(∼500 nm),can strongly bind with positively-charged DOX molecules by electrostatic attraction effects.As a result,DOX molecules are selectively and rapid(20 s)determined with a detection limit of 10.26 nmol/L via Förster resonance energy transfer processes,demonstrating a remarkably chromatic shift from green to red.Further integrated with a 3D-printed smartphone-assisted device,the platform enabled high-throughput quantification,achieving recoveries of 96.40%-101.85%in human urine/serum(RSDs<2.94%,n=3).Notably,the dual linear detection ranges of the platform align with the reported clinical DOX concentrations in urine and plasma(0-4 h post-administration),validating their capability for direct quantification of DOX in clinical samples without special pre-treatment processes.By virtue of attractive analytical performances and robust feasibility,this platform bridges laboratory precision and point-of-care testing needs,offering promising potential for personalized chemotherapy and multiplexed analyte screening.
基金Supported by the National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202503).
文摘AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital IMT based on histopathological examination.The patients were followed up to assess their prognosis.Clinical data from patients,including age,gender,course of disease,past medical history,primary symptoms,ophthalmologic examination findings,general condition,as well as imaging,laboratory,histopathological,and immunohistochemical results from digital records were collected.Orbital magnetic resonance imaging(MRI)and(or)computed tomography(CT)scans were performed to assess bone destruction of the mass,invasion of surrounding tissues,and any inflammatory changes in periorbital areas.RESULTS:The mean age of patients with orbital IMT was 28.24±3.30y,with a male-to-female ratio of 1.2:1.Main clinical manifestations were proptosis,blurred vision,palpable mass,and pain.Bone destruction and surrounding tissue invasion occurred in 72.73%and 54.55%of cases,respectively.Inflammatory changes in the periorbital site were observed in 77.27%of the patients.Hematoxylin and eosin staining showed proliferation of fibroblasts and myofibroblasts,accompanied by infiltration of lymphocytes and plasma cells.Immunohistochemical staining revealed that smooth muscle actin(SMA)and vimentin were positive in 100%of cases,while anaplastic lymphoma kinase(ALK)showed positivity in 47.37%.The recurrence rate of orbital IMT was 27.27%,and sarcomatous degeneration could occur.There were no significant correlations between recurrence and factors such as age,gender,laterality,duration of the disease,periorbital tissue invasion,bone destruction,periorbital inflammation,tumor size,fever,leukocytosis,or treatment(P>0.05).However,lymphadenopathy and a Ki-67 index of 10%or higher may be risk factors for recurrence(P=0.046;P=0.023).CONCLUSION:Orbital IMT is a locally invasive disease that may recur or lead to sarcomatoid degeneration,primarily affecting young and middle-aged patients.The presence of lymphadenopathy and a Ki-67 index of 10%or higher may signify a poor prognosis.
基金supported by the Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.
文摘Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.
基金Supported by National Natural Science Foundation of China(82374346)Double Hundred Outstanding Young and Middle-aged Medical and Health Talents of Wuxi City(BJ2023071)Scientific Research Project of Wuxi Municipal Health Commission(Q202358).
文摘This article reviews the research advances in traditional Chinese medicine rhubarb and its compound formulations in the treatment of sepsis,with particular emphasis on elucidating their mechanisms of action and clinical application value.Research has demonstrated that rhubarb and its compound formulations exert therapeutic effects via multiple targets and mechanisms,including anti-inflammatory actions,protection of the intestinal barrier,modulation of immune balance,inhibition of oxidative stress,and regulation of associated signaling pathways.Clinically,rhubarb has shown distinct advantages in enhancing gastrointestinal function,mitigating systemic inflammatory responses,and reducing mortality rates among patients with sepsis.These findings provide a foundational reference for the integrated prevention and treatment of sepsis through the combined use of traditional Chinese and Western medicine.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
文摘Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.
文摘BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association between the expression of splicing factor 3b subunit 4(SF3B4)and high mobility group box 1(HMGB1)with the clinical characteristics and prognostic outcomes of gastric cancer patients.METHODS A retrospective cohort study was conducted involving 114 individuals diagnosed with gastric cancer and admitted to our institution from January 2020 to December 2021.A comparison group of 90 patients diagnosed with benign gastric disorders during the same period was also included.Expression levels of SF3B4 and HMGB1 were assessed using real-time quantitative polymerase chain reaction.Expression patterns were analyzed in relation to various clinicopathological features.Receiver operating characteristic curves were constructed to evaluate the ability of SF3B4 and HMGB1,alone and in combination,to predict unfavorable one-year outcomes.Multivariate logistic regression was utilized to identify independent predictors of mortality.Kaplan-Meier survival curves were generated to examine survival differences based on SF3B4 and HMGB1 expression levels.RESULTS Both SF3B4 and HMGB1 were markedly upregulated in tumor tissues of gastric cancer patients compared to adjacent normal tissues and to tissues from nonmalignant gastric disease patients(^(a)P<0.05).Higher expression levels of these two genes were significantly associated with aggressive pathological features,including poor differentiation,tumor size>5 cm,deep infiltration(T3-T4),lymph node involvement,and advanced clinical stage(III–IV)(^(a)P<0.05).Receiver operating characteristic analysis revealed that the combined use of SF3B4 and HMGB1 yielded an area under the curve of 0.914,surpassing the predictive performance of either marker alone(SF3B4:0.776;HMGB1:0.757).Multivariate analysis identified SF3B4≥1.45,HMGB1≥0.93,poor differentiation,larger tumor size,deeper invasion,lymph node metastasis,and advanced clinical tumor-node-metastasis staging as independent factors contributing to one-year mortality(^(a)P<0.05).Survival analysis indicated that patients with elevated SF3B4 and HMGB1 levels had a shorter median survival(25.74±5.46 months)compared to those with lower expression levels(33.29±6.71 months,log-rank=10.534,^(a)P<0.05).CONCLUSION Elevated SF3B4 and HMGB1 expression in gastric cancer tissue is significantly associated with tumor aggressiveness,worse prognosis,and reduced survival.These biomarkers may offer clinical value in stratifying patients by risk and in forecasting outcomes.Their combined assessment improves predictive accuracy for poor prognosis and may serve as a more effective tool than individual evaluation.
