Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in s...Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.展开更多
Functional gastrointestinal disorders(FGIDs),including irritable bowel syndrome(IBS),functional dyspepsia(FD),and gastroesophageal reflux disease(GERD),present persistent diagnostic and therapeutic challenges due to s...Functional gastrointestinal disorders(FGIDs),including irritable bowel syndrome(IBS),functional dyspepsia(FD),and gastroesophageal reflux disease(GERD),present persistent diagnostic and therapeutic challenges due to symptom heterogeneity and the absence of reliable biomarkers.Artificial intelligence(AI)enables the integration of multimodal data to enhance FGID management through precision diagnostics and preventive healthcare.This minireview summarizes recent advancements in AI applications for FGIDs,highlighting progress in diagnostic accuracy,subtype classification,personalized interventions,and preventive strategies inspired by the traditional Chinese medicine concept of“treating the undiseased”.Machine learning and deep learning algorithms have demonstrated value in improving IBS diagnosis,refining FD neuro-gastrointestinal subtyping,and screening for GERD-related complications.Moreover,AI supports dietary,psychological,and integrative medicine-based interventions to improve patient adherence and quality of life.Nonetheless,key challenges remain,including data heterogeneity,limited model interpretability,and the need for robust clinical validation.Future directions emphasize interdisciplinary collaboration,the development of multimodal and explainable AI models,and the creation of patientcentered platforms to facilitate a shift from reactive treatment to proactive prevention.This review provides a systematic framework to guide the clinical application and theoretical innovation of AI in FGIDs.展开更多
BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major ...BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.展开更多
Flash Joule heating(FJH),as a high-efficiency and low-energy consumption technology for advanced materials synthesis,has shown significant potential in the synthesis of graphene and other functional carbon materials.B...Flash Joule heating(FJH),as a high-efficiency and low-energy consumption technology for advanced materials synthesis,has shown significant potential in the synthesis of graphene and other functional carbon materials.Based on the Joule effect,the solid carbon sources can be rapidly heated to ultra-high temperatures(>3000 K)through instantaneous high-energy current pulses during FJH,thus driving the rapid rearrangement and graphitization of carbon atoms.This technology demonstrates numerous advantages,such as solvent-and catalyst-free features,high energy conversion efficiency,and a short process cycle.In this review,we have systematically summarized the technology principle and equipment design for FJH,as well as its raw materials selection and pretreatment strategies.The research progress in the FJH synthesis of flash graphene,carbon nanotubes,graphene fibers,and anode hard carbon,as well as its by-products,is also presented.FJH can precisely optimize the microstructures of carbon materials(e.g.,interlayer spacing of turbostratic graphene,defect concentration,and heteroatom doping)by regulating its operation parameters like flash voltage and flash time,thereby enhancing their performances in various applications,such as composite reinforcement,metal-ion battery electrodes,supercapacitors,and electrocatalysts.However,this technology is still challenged by low process yield,macroscopic material uniformity,and green power supply system construction.More research efforts are also required to promote the transition of FJH from laboratory to industrial-scale applications,thus providing innovative solutions for advanced carbon materials manufacturing and waste management toward carbon neutrality.展开更多
AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:...AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:Totally 716 eyes of 716 patients with primary open angle glaucoma(POAG)with at least 5 reliable 24-2 test results and 2y of follow-up were selected.The functional GEE model was used to detect perimetric progression in the training dataset(501 eyes).In the testing dataset(215 eyes),progression was evaluated the functional GEE model,mean deviation(MD)and visual field index(VFI)rates of change,Advanced Glaucoma Intervention Study(AGIS)and Collaborative Initial Glaucoma Treatment Study(CIGTS)scores,and pointwise linear regression(PLR).RESULTS:The proposed method showed the highest proportion of eyes detected as progression(54.4%),followed by the VFI rate(34.4%),PLR(23.3%),and MD rate(21.4%).The CIGTS and AGIS scores had a lower proportion of eyes detected as progression(7.9%and 5.1%,respectively).The time to detection of progression was significantly shorter for the proposed method than that of other algorithms(adjusted P≤0.019).The VFI rate displayed moderate pairwise agreement with the proposed method(k=0.47).CONCLUSION:The functional GEE model shows the highest proportion of eyes detected as perimetric progression and the shortest time to detect perimetric progression in patients with POAG.展开更多
Carbon-based air cathodes offer low cost,high electrical conductivity,and structural tunability.However,they suffer from limited catalytic activity and inefficient gas transport,and they typically rely on noble metal ...Carbon-based air cathodes offer low cost,high electrical conductivity,and structural tunability.However,they suffer from limited catalytic activity and inefficient gas transport,and they typically rely on noble metal additives or complex multilayer configurations.To tackle these issues,this study devised a self-activated integrated carbon-based air cathode.By integrating in situ catalytic site construction with structural optimization,the strategy not only induces the formation of oxygen functional groups(─C─OH,─C═O,─COOH),hierarchical pores,and uniformly distributed active sites,but also establishes a favorable electronic and mass-transport environment.Furthermore,the roll-pressing-based integrated design streamlines electrode construction,reinforces interfacial bonding,and significantly enhances mechanical stability.Density functional theory(DFT)calculations show that oxygen functional groups initiate hydrogen bonding interaction and promote charge enrichment,which improves the activity of the cathode and facilitates intermediate adsorption/desorption in oxygen reduction and evolution reactions processes.As a result,the integrated air cathode-based rechargeable zinc-air batteries(RZABs)achieve a high specific capacity of 811 mAh g^(-1).It also performs well in quasi-solid-state RZABs and silicon-air batteries systems across a wide temperature range,demonstrating strong adaptability and application potential.This study provides a scalable and cost-effective design strategy for high-performance carbon-based air cathodes,offering new insights into advancing durable and practical metal-air energy systems.展开更多
Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathop...Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.展开更多
Invasive as well as non-invasive neurotechnologies conceptualized to interface the central and peripheral nervous system have been probed for the past decades,which refer to electroencephalography,electrocorticography...Invasive as well as non-invasive neurotechnologies conceptualized to interface the central and peripheral nervous system have been probed for the past decades,which refer to electroencephalography,electrocorticography and microelectrode arrays.The challenges of these mentioned approaches are characterized by the bandwidth of the spatiotemporal resolution,which in turn is essential for large-area neuron recordings(Abiri et al.,2019).展开更多
In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tum...In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tumors,or strokes,noting deficits,and inferring what functions certain brain regions may be responsible for.This approach exemplifies a deletion heuristic,where the absence of a specific function reveals insights about the underlying structures or mechanisms responsible for it.By observing what is lost when a particular brain region is damaged,throughout the history of the field,neurologists have pieced together the intricate relationship between anatomy and function.展开更多
BACKGROUND Occult hepatitis B virus infection(OBI)is defined by the detection of replication-competent hepatitis B virus(HBV)DNA in the liver and/or blood despite the ab-sence of detectable hepatitis B surface antigen...BACKGROUND Occult hepatitis B virus infection(OBI)is defined by the detection of replication-competent hepatitis B virus(HBV)DNA in the liver and/or blood despite the ab-sence of detectable hepatitis B surface antigen(HBsAg)using conventional ser-ological assays.Although OBI has been well-documented in individuals with resolved HBV infection or those receiving immunosuppressive therapy,reports of its occurrence during sequential antiviral treatment remain scarce.This report describes a case of chronic hepatitis B(CHB)transitioning through OBI during sequential combination therapy before ultimately achieving a functional cure.This case provides new insights into the emergence of OBI as a transitional phase during CHB treatment and emphasizes the importance of monitoring its clinical significance.CASE SUMMARY A 33-year-old Chinese male was diagnosed with HBV infection in 2001.The patient first presented in 2012 with abnormal liver function tests and received initial treatment with conventional interferon therapy,which failed to achieve a virological response.Antiviral therapy was subsequently switched to entecavir monotherapy.By August 2019,the patient exhibited an HBsAg level of 29.93 IU/mL with undetectable HBV DNA(<25 IU/mL).At this point,combination therapy with entecavir and pegylated interferonα(PEG-IFNα)was initiated.Remarkably,while HBsAg declined to 0.42 IU/mL by April 2020,a paradoxical HBV DNA rebound to 173 IU/mL was observed.The regimen was consequently modified to tenofovir alafenamide and PEG-IFNα.By October 2020,the patient achieved HBsAg seroconversion(HBsAg 0.01 IU/mL,hepatitis B surface antibody 52.18 mIU/mL)for the first time,while maintaining low-level viremia(37 IU/mL),consistent with transition to OBI.The patient was then switched to PEG-IFNαmonotherapy.In November 2021,he discontinued PEG-IFNαtherapy,and one month later,both HBV DNA(<10 IU/mL)and HBsAg(<0.05 IU/mL)were negative.This response has been sustained through follow-up.CONCLUSION This case study illustrates the efficacy of sequential combination therapy in achieving functional cure in CHB patients,including those with a prolonged infection history.It highlights OBI as a transitional yet underrecognized phase during sequential antiviral therapy.While the patient ultimately achieved functional cure,the transient persistence of HBV DNA despite HBsAg clearance suggests the need for continued monitoring.This case provides new insights into OBI development during treatment and underscores the importance of further research into its long-term implications.展开更多
The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzh...The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzheimer's or Parkinson's disease)or traumatic injuries(such as spinal cord lesions).In the last 20 years,the field has made significant progress in unlocking axon regrowth.展开更多
Background: Osteopathic manual treatment (OMT) has been reported to have positive initial results for subjects with chronic non-specific back pain in a rural safety-net hospital. However, the effects of OMT following ...Background: Osteopathic manual treatment (OMT) has been reported to have positive initial results for subjects with chronic non-specific back pain in a rural safety-net hospital. However, the effects of OMT following initial treatment have not been reported. Objective: To determine the effects of OMT for patients with chronic non-specific back pain in a rural safety-net hospital setting for an initial post-clinical and follow-up visit. Methods: A longitudinal, rolling admission, eleven-year study of cohort study with a primary complaint of chronic, non-specific back pain that had plateaued in improvement for a minimum of six months. One hundred and fifty-one subjects completed the first two study visits necessary for data collection, and fifty-nine subjects completed the follow-up visit after six months. Results: A two-way, mixed model, repeated measures ANOVA with pre- post1 and post2 (follow-up) treatment as the within variable and sex as the between subject variable showed a significant main effect from pre- to follow-up, (F (1, 57) = 21.171, P ηP2= 0.426), but not a significant interaction between time and sex (F (1, 57) = 0.279, P ηP2= 0.002). Conclusions: The results of this study support the hypothesis that OMT has a continued benefit in pain reduction and functional improvement beyond the initial treatment period. The rural, safety-net hospital setting made this study unique relative to the sample population.展开更多
Microglia,the resident immune cells of the central nervous system,exhibit a wide array of functional states,even in their so-called“homeostatic”condition,when they are not actively responding to overt pathological s...Microglia,the resident immune cells of the central nervous system,exhibit a wide array of functional states,even in their so-called“homeostatic”condition,when they are not actively responding to overt pathological stimuli.These functional states can be visualized using a combination of multi-omics techniques(e.g.,gene and protein expression,posttranslational modifications,mRNA profiling,and metabolomics),and,in the case of homeostatic microglia,are largely defined by the global(e.g.,genetic variations,organism’s age,sex,circadian rhythms,and gut microbiota)as well as local(specific area of the brain,immediate microglial surrounding,neuron-glia interactions and synaptic density/activity)signals(Paolicelli et al.,2022).While phenomics(i.e.,ultrastructural microglial morphology and motility)is also one of the key microglial state-defining parameters,it is known that cells with similar morphology can belong to different functional states.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
Objective Cancer remains a significant global health challenge, necessitating the development of effective treatment approaches. Developing synergistic therapy can provide a highly promising strategy for anti-cancer t...Objective Cancer remains a significant global health challenge, necessitating the development of effective treatment approaches. Developing synergistic therapy can provide a highly promising strategy for anti-cancer treatment through combining the benefits of various mechanisms.Methods In this study, we developed a synergistic strategy for chemo-photothermal therapy by constructing nanocomposites using gold nanorods(GNRs) and tetrahedral framework nucleic acids(tFNA) loaded with the anti-tumor drug doxorubicin(DOX).Results Our in vitro studies have systematically clarified the anti-cancer behaviors of tFNA-DOX@GNR nanocomposites, characterized by their enhanced cellular uptake and proficient lysosomal escape capabilities. It was found that the key role of tFNA-DOX@GNR nanocomposites in tumor ablation is primarily due to their capacity to induce cytotoxicity in tumor cells via a photothermal effect, which generates instantaneous high temperatures. This mechanism introduces various responses in tumor cells, facilitated by the thermal effect and the integrated chemotherapeutic action of DOX. These reactions include the induction of endoplasmic reticulum stress, characterized by elevated reactive oxygen species levels, the promotion of apoptotic cell death, and the suppression of tumor cell proliferation.Conclusion This work exhibits the potential of synergistic therapy utilizing nanocomposites for cancer treatment and offers a promising avenue for future therapeutic strategies.展开更多
Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indice...Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indices,has provided a fresh perspective and valuable insight into the study of freezing of gait in Parkinson's disease.It has been revealed that Parkinson's disease is accompanied by widespread irregularities in inherent brain network activity.However,the effective integration of the multi-level indices of resting-state functional magnetic resonance imaging into clinical settings for the diagnosis of freezing of gait in Parkinson's disease remains a challenge.Although previous studies have demonstrated that radiomics can extract optimal features as biomarkers to identify or predict diseases,a knowledge gap still exists in the field of freezing of gait in Parkinson's disease.This cross-sectional study aimed to evaluate the ability of radiomics features based on multi-level indices of resting-state functional magnetic resonance imaging,along with clinical features,to distinguish between Parkinson's disease patients with and without freezing of gait.We recruited 28 patients with Parkinson's disease who had freezing of gait(15 men and 13 women,average age 63 years)and 30 patients with Parkinson's disease who had no freezing of gait(16 men and 14 women,average age 64 years).Magnetic resonance imaging scans were obtained using a 3.0T scanner to extract the mean amplitude of low-frequency fluctuations,mean regional homogeneity,and degree centrality.Neurological and clinical characteristics were also evaluated.We used the least absolute shrinkage and selection operator algorithm to extract features and established feedforward neural network models based solely on resting-state functional magnetic resonance imaging indicators.We then performed predictive analysis of three distinct groups based on resting-state functional magnetic resonance imaging indicators indicators combined with clinical features.Subsequently,we conducted 100 additional five-fold cross-validations to determine the most effective model for each classification task and evaluated the performance of the model using the area under the receiver operating characteristic curve.The results showed that when differentiating patients with Parkinson's disease who had freezing of gait from those who did not have freezing of gait,or from healthy controls,the models using only the mean regional homogeneity values achieved the highest area under the receiver operating characteristic curve values of 0.750(with an accuracy of 70.9%)and 0.759(with an accuracy of 65.3%),respectively.When classifying patients with Parkinson's disease who had freezing of gait from those who had no freezing of gait,the model using the mean amplitude of low-frequency fluctuation values combined with two clinical features achieved the highest area under the receiver operating characteristic curve of 0.847(with an accuracy of 74.3%).The most significant features for patients with Parkinson's disease who had freezing of gait were amplitude of low-frequency fluctuation alterations in the left parahippocampal gyrus and two clinical characteristics:Montreal Cognitive Assessment and Hamilton Depression Scale scores.Our findings suggest that radiomics features derived from resting-state functional magnetic resonance imaging indices and clinical information can serve as valuable indices for the identification of freezing of gait in Parkinson's disease.展开更多
Sonodynamic therapy(SDT)is a new non-invasive treatment method,which uses low-intensity ultrasound(US)to activate specific sonosensitizers(SNs)to produce reactive oxygen species(ROS)for therapeutic purposes.However,tr...Sonodynamic therapy(SDT)is a new non-invasive treatment method,which uses low-intensity ultrasound(US)to activate specific sonosensitizers(SNs)to produce reactive oxygen species(ROS)for therapeutic purposes.However,traditional sonosensitizers have the defects of low generation efficiency of ROS and single treatment mode.Therefore,designing sonosensitizers with high efficiency to generate ROS,high stability,and multimodal therapy is an excellent alternative to achieve effective,safe,and intelligent therapy.Heterojunction nanosonosensitizers(NSNs),as novel type of SNs,combine different materials through heterojunction structures to improve the efficiency of ROS generation.In this review,the classification of heterojunction NSNs,the preparation methods and characterization methods of heterojunction NSNs and the possible mechanisms for enhancing SDT were firstly presented,followed by an in-depth discussion of the application of heterojunction NSNs in the treatment of bacterial infections and tumors,with a special emphasis on synergistic enhancement of therapeutic efficacy of heterojunction SNs in combination with different therapeutic models such as gas therapy,immunotherapy and nanocatalytic therapy.Finally,the challenges and perspectives of such heterojunction SNs-supported SDT were outlined and highlighted to facilitate their clinical translation.展开更多
Childhood adenotonsillar hypertrophy is associated with complications,including mouth breathing and obstructive sleep apnea hypopnea syndrome(OSAHS),which can lead to sleep-related ventilation problems that significan...Childhood adenotonsillar hypertrophy is associated with complications,including mouth breathing and obstructive sleep apnea hypopnea syndrome(OSAHS),which can lead to sleep-related ventilation problems that significantly impact the development of orofacial myofunctions as well as the physical and mental health of children.Orofacial myofunctional therapy(OMT)is based on the plasticity of neuromuscular systems to retrain the oral and maxillofacial system,effectively improving orofacial morphology,upper airway structure,and other aspects in pediatric patients.OMT is non-invasive and easy to implement,which can be promoted as an adjuvant therapy for children with adenotonsillar hypertrophy.This review mainly discusses the theoretical basis,training methods,and influencing factors of OMT.展开更多
Rational design of multifunctional nanoplatforms capable of combining therapeutic effects with real-time monitoring of drug distribution and tumor status is emerging as a promising approach in cancer nanomedicine.Here...Rational design of multifunctional nanoplatforms capable of combining therapeutic effects with real-time monitoring of drug distribution and tumor status is emerging as a promising approach in cancer nanomedicine.Here,we introduce pyropheophorbide a-bisaminoquinoline conjugate lipid nanoparticles(PPBC LNPs)as a bimodal system for image-guided phototherapy in bladder cancer treatment.PPBC LNPs not only demonstrate both powerful photodynamic and photothermal effects upon light activation,but also exhibit potent autophagy blockage,effectively inducing bladder cancer cell death.Furthermore,PPBC LNPs possess remarkable photoacoustic(PA)and fluorescence(FL)imaging capabilities,enabling imaging with high-resolution,deep tissue penetration and high sensitivity for tracking drug biodistribution and phototherapy efficacy.Specifically,PA imaging confirms the efficient accumulation of PPBC LNPs within tumor and predicts therapeutic outcomes of photodynamic therapy,while FL imaging confirms their prolonged retention at the tumor site for up to 6 days.PPBC LNPs significantly suppress bladder tumor growth,with several tumors completely ablated following just two doses of the nanoparticles and laser treatment.Additionally,PPBC LNPs were formulated with lipid-based excipients and assembled using microfluidic technology to enhance biocompatibility,stability,and scalability,showing potential for clinical translation.This versatile nanoparticle represents a promising candidate for further development in bladder cancer therapy.展开更多
Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this s...Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82072165 and 82272256(both to XM)the Key Project of Xiangyang Central Hospital,No.2023YZ03(to RM)。
文摘Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.
基金Supported by The Natural Science Foundation of China,No.82374292the Plans for Major Provincial Science and Technology Projects of Anhui Province,No.202303a07020003the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine,No.ZYYCXTD-C-202401.
文摘Functional gastrointestinal disorders(FGIDs),including irritable bowel syndrome(IBS),functional dyspepsia(FD),and gastroesophageal reflux disease(GERD),present persistent diagnostic and therapeutic challenges due to symptom heterogeneity and the absence of reliable biomarkers.Artificial intelligence(AI)enables the integration of multimodal data to enhance FGID management through precision diagnostics and preventive healthcare.This minireview summarizes recent advancements in AI applications for FGIDs,highlighting progress in diagnostic accuracy,subtype classification,personalized interventions,and preventive strategies inspired by the traditional Chinese medicine concept of“treating the undiseased”.Machine learning and deep learning algorithms have demonstrated value in improving IBS diagnosis,refining FD neuro-gastrointestinal subtyping,and screening for GERD-related complications.Moreover,AI supports dietary,psychological,and integrative medicine-based interventions to improve patient adherence and quality of life.Nonetheless,key challenges remain,including data heterogeneity,limited model interpretability,and the need for robust clinical validation.Future directions emphasize interdisciplinary collaboration,the development of multimodal and explainable AI models,and the creation of patientcentered platforms to facilitate a shift from reactive treatment to proactive prevention.This review provides a systematic framework to guide the clinical application and theoretical innovation of AI in FGIDs.
基金Supported by Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109Suzhou Key Laboratory,No.SZS2024016Multicenter Clinical Research on Major Diseases in Suzhou,No.DZXYJ202413.
文摘BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.
基金supported by the National Natural Science Foundation of China(52276196)the Foundation of State Key Laboratory of Coal Combustion(FSKLCCA2508)the High-level Talent Foundation of Anhui Agricultural University(rc412307).
文摘Flash Joule heating(FJH),as a high-efficiency and low-energy consumption technology for advanced materials synthesis,has shown significant potential in the synthesis of graphene and other functional carbon materials.Based on the Joule effect,the solid carbon sources can be rapidly heated to ultra-high temperatures(>3000 K)through instantaneous high-energy current pulses during FJH,thus driving the rapid rearrangement and graphitization of carbon atoms.This technology demonstrates numerous advantages,such as solvent-and catalyst-free features,high energy conversion efficiency,and a short process cycle.In this review,we have systematically summarized the technology principle and equipment design for FJH,as well as its raw materials selection and pretreatment strategies.The research progress in the FJH synthesis of flash graphene,carbon nanotubes,graphene fibers,and anode hard carbon,as well as its by-products,is also presented.FJH can precisely optimize the microstructures of carbon materials(e.g.,interlayer spacing of turbostratic graphene,defect concentration,and heteroatom doping)by regulating its operation parameters like flash voltage and flash time,thereby enhancing their performances in various applications,such as composite reinforcement,metal-ion battery electrodes,supercapacitors,and electrocatalysts.However,this technology is still challenged by low process yield,macroscopic material uniformity,and green power supply system construction.More research efforts are also required to promote the transition of FJH from laboratory to industrial-scale applications,thus providing innovative solutions for advanced carbon materials manufacturing and waste management toward carbon neutrality.
基金Supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(No.HR20C0026)the National Research Foundation of Korea(NRF)(No.RS-2023-00247504)the Patient-Centered Clinical Research Coordinating Center,funded by the Ministry of Health&Welfare,Republic of Korea(No.HC19C0276).
文摘AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:Totally 716 eyes of 716 patients with primary open angle glaucoma(POAG)with at least 5 reliable 24-2 test results and 2y of follow-up were selected.The functional GEE model was used to detect perimetric progression in the training dataset(501 eyes).In the testing dataset(215 eyes),progression was evaluated the functional GEE model,mean deviation(MD)and visual field index(VFI)rates of change,Advanced Glaucoma Intervention Study(AGIS)and Collaborative Initial Glaucoma Treatment Study(CIGTS)scores,and pointwise linear regression(PLR).RESULTS:The proposed method showed the highest proportion of eyes detected as progression(54.4%),followed by the VFI rate(34.4%),PLR(23.3%),and MD rate(21.4%).The CIGTS and AGIS scores had a lower proportion of eyes detected as progression(7.9%and 5.1%,respectively).The time to detection of progression was significantly shorter for the proposed method than that of other algorithms(adjusted P≤0.019).The VFI rate displayed moderate pairwise agreement with the proposed method(k=0.47).CONCLUSION:The functional GEE model shows the highest proportion of eyes detected as perimetric progression and the shortest time to detect perimetric progression in patients with POAG.
基金funded by the National Nature Science Foundation of China(62264006,62574102)“Thousand Talents Program”of Yunnan Province for Young Talents,Innovative Research Teams(in Science and Technology)in the University of Yunnan Province(IRTSTYN),XingDian Talent Support Program for Young Talents,and Frontier Research Team of Kunming University 2023,The Basic Research Project of Yunnan Province(Nos.202201AU070022)+2 种基金Kunming University Talent Introduction Fund(Nos.YJL20024)Yunnan Province Education Department Scientific Research Fund Project(Nos.2024Y759)Undergraduate Innovation and Entrepreneurship Training Program Project of Yunnan Provincial(202411393005)。
文摘Carbon-based air cathodes offer low cost,high electrical conductivity,and structural tunability.However,they suffer from limited catalytic activity and inefficient gas transport,and they typically rely on noble metal additives or complex multilayer configurations.To tackle these issues,this study devised a self-activated integrated carbon-based air cathode.By integrating in situ catalytic site construction with structural optimization,the strategy not only induces the formation of oxygen functional groups(─C─OH,─C═O,─COOH),hierarchical pores,and uniformly distributed active sites,but also establishes a favorable electronic and mass-transport environment.Furthermore,the roll-pressing-based integrated design streamlines electrode construction,reinforces interfacial bonding,and significantly enhances mechanical stability.Density functional theory(DFT)calculations show that oxygen functional groups initiate hydrogen bonding interaction and promote charge enrichment,which improves the activity of the cathode and facilitates intermediate adsorption/desorption in oxygen reduction and evolution reactions processes.As a result,the integrated air cathode-based rechargeable zinc-air batteries(RZABs)achieve a high specific capacity of 811 mAh g^(-1).It also performs well in quasi-solid-state RZABs and silicon-air batteries systems across a wide temperature range,demonstrating strong adaptability and application potential.This study provides a scalable and cost-effective design strategy for high-performance carbon-based air cathodes,offering new insights into advancing durable and practical metal-air energy systems.
文摘Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.
文摘Invasive as well as non-invasive neurotechnologies conceptualized to interface the central and peripheral nervous system have been probed for the past decades,which refer to electroencephalography,electrocorticography and microelectrode arrays.The challenges of these mentioned approaches are characterized by the bandwidth of the spatiotemporal resolution,which in turn is essential for large-area neuron recordings(Abiri et al.,2019).
文摘In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tumors,or strokes,noting deficits,and inferring what functions certain brain regions may be responsible for.This approach exemplifies a deletion heuristic,where the absence of a specific function reveals insights about the underlying structures or mechanisms responsible for it.By observing what is lost when a particular brain region is damaged,throughout the history of the field,neurologists have pieced together the intricate relationship between anatomy and function.
文摘BACKGROUND Occult hepatitis B virus infection(OBI)is defined by the detection of replication-competent hepatitis B virus(HBV)DNA in the liver and/or blood despite the ab-sence of detectable hepatitis B surface antigen(HBsAg)using conventional ser-ological assays.Although OBI has been well-documented in individuals with resolved HBV infection or those receiving immunosuppressive therapy,reports of its occurrence during sequential antiviral treatment remain scarce.This report describes a case of chronic hepatitis B(CHB)transitioning through OBI during sequential combination therapy before ultimately achieving a functional cure.This case provides new insights into the emergence of OBI as a transitional phase during CHB treatment and emphasizes the importance of monitoring its clinical significance.CASE SUMMARY A 33-year-old Chinese male was diagnosed with HBV infection in 2001.The patient first presented in 2012 with abnormal liver function tests and received initial treatment with conventional interferon therapy,which failed to achieve a virological response.Antiviral therapy was subsequently switched to entecavir monotherapy.By August 2019,the patient exhibited an HBsAg level of 29.93 IU/mL with undetectable HBV DNA(<25 IU/mL).At this point,combination therapy with entecavir and pegylated interferonα(PEG-IFNα)was initiated.Remarkably,while HBsAg declined to 0.42 IU/mL by April 2020,a paradoxical HBV DNA rebound to 173 IU/mL was observed.The regimen was consequently modified to tenofovir alafenamide and PEG-IFNα.By October 2020,the patient achieved HBsAg seroconversion(HBsAg 0.01 IU/mL,hepatitis B surface antibody 52.18 mIU/mL)for the first time,while maintaining low-level viremia(37 IU/mL),consistent with transition to OBI.The patient was then switched to PEG-IFNαmonotherapy.In November 2021,he discontinued PEG-IFNαtherapy,and one month later,both HBV DNA(<10 IU/mL)and HBsAg(<0.05 IU/mL)were negative.This response has been sustained through follow-up.CONCLUSION This case study illustrates the efficacy of sequential combination therapy in achieving functional cure in CHB patients,including those with a prolonged infection history.It highlights OBI as a transitional yet underrecognized phase during sequential antiviral therapy.While the patient ultimately achieved functional cure,the transient persistence of HBV DNA despite HBsAg clearance suggests the need for continued monitoring.This case provides new insights into OBI development during treatment and underscores the importance of further research into its long-term implications.
基金supported by ANR(ANR-21CE16-0008-01)ANR(ANR-21-CE16-0008-02 and ANR-23CE52-0007)+1 种基金UNADEV(A22018CS)(to HN)UNADEV(A22020CS)(to SB)。
文摘The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzheimer's or Parkinson's disease)or traumatic injuries(such as spinal cord lesions).In the last 20 years,the field has made significant progress in unlocking axon regrowth.
文摘Background: Osteopathic manual treatment (OMT) has been reported to have positive initial results for subjects with chronic non-specific back pain in a rural safety-net hospital. However, the effects of OMT following initial treatment have not been reported. Objective: To determine the effects of OMT for patients with chronic non-specific back pain in a rural safety-net hospital setting for an initial post-clinical and follow-up visit. Methods: A longitudinal, rolling admission, eleven-year study of cohort study with a primary complaint of chronic, non-specific back pain that had plateaued in improvement for a minimum of six months. One hundred and fifty-one subjects completed the first two study visits necessary for data collection, and fifty-nine subjects completed the follow-up visit after six months. Results: A two-way, mixed model, repeated measures ANOVA with pre- post1 and post2 (follow-up) treatment as the within variable and sex as the between subject variable showed a significant main effect from pre- to follow-up, (F (1, 57) = 21.171, P ηP2= 0.426), but not a significant interaction between time and sex (F (1, 57) = 0.279, P ηP2= 0.002). Conclusions: The results of this study support the hypothesis that OMT has a continued benefit in pain reduction and functional improvement beyond the initial treatment period. The rural, safety-net hospital setting made this study unique relative to the sample population.
基金supported by Deutsche Forschungsgemeinschaft,German Research Foundation grant GA 654/13-2 to OG.
文摘Microglia,the resident immune cells of the central nervous system,exhibit a wide array of functional states,even in their so-called“homeostatic”condition,when they are not actively responding to overt pathological stimuli.These functional states can be visualized using a combination of multi-omics techniques(e.g.,gene and protein expression,posttranslational modifications,mRNA profiling,and metabolomics),and,in the case of homeostatic microglia,are largely defined by the global(e.g.,genetic variations,organism’s age,sex,circadian rhythms,and gut microbiota)as well as local(specific area of the brain,immediate microglial surrounding,neuron-glia interactions and synaptic density/activity)signals(Paolicelli et al.,2022).While phenomics(i.e.,ultrastructural microglial morphology and motility)is also one of the key microglial state-defining parameters,it is known that cells with similar morphology can belong to different functional states.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
基金supported by the PLAGH Innovation Funds,(Grant No.22QNFC080)the Sichuan Science and Technology Program(Grant No.2023ZYD0064 and 2023YFG0220)+2 种基金the Fundamental Research Funds for the Central Universities(Grant No.YJ202242)the Research Funding from West China School/Hospital of Stomatology, Sichuan University(Grant No.QDJF2022-2)National Undergraduate Training Program for Innovation(Grant No.C2024129736)。
文摘Objective Cancer remains a significant global health challenge, necessitating the development of effective treatment approaches. Developing synergistic therapy can provide a highly promising strategy for anti-cancer treatment through combining the benefits of various mechanisms.Methods In this study, we developed a synergistic strategy for chemo-photothermal therapy by constructing nanocomposites using gold nanorods(GNRs) and tetrahedral framework nucleic acids(tFNA) loaded with the anti-tumor drug doxorubicin(DOX).Results Our in vitro studies have systematically clarified the anti-cancer behaviors of tFNA-DOX@GNR nanocomposites, characterized by their enhanced cellular uptake and proficient lysosomal escape capabilities. It was found that the key role of tFNA-DOX@GNR nanocomposites in tumor ablation is primarily due to their capacity to induce cytotoxicity in tumor cells via a photothermal effect, which generates instantaneous high temperatures. This mechanism introduces various responses in tumor cells, facilitated by the thermal effect and the integrated chemotherapeutic action of DOX. These reactions include the induction of endoplasmic reticulum stress, characterized by elevated reactive oxygen species levels, the promotion of apoptotic cell death, and the suppression of tumor cell proliferation.Conclusion This work exhibits the potential of synergistic therapy utilizing nanocomposites for cancer treatment and offers a promising avenue for future therapeutic strategies.
基金supported by the National Natural Science Foundation of China,No.82071909(to GF)the Natural Science Foundation of Liaoning Province,No.2023-MS-07(to HL)。
文摘Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indices,has provided a fresh perspective and valuable insight into the study of freezing of gait in Parkinson's disease.It has been revealed that Parkinson's disease is accompanied by widespread irregularities in inherent brain network activity.However,the effective integration of the multi-level indices of resting-state functional magnetic resonance imaging into clinical settings for the diagnosis of freezing of gait in Parkinson's disease remains a challenge.Although previous studies have demonstrated that radiomics can extract optimal features as biomarkers to identify or predict diseases,a knowledge gap still exists in the field of freezing of gait in Parkinson's disease.This cross-sectional study aimed to evaluate the ability of radiomics features based on multi-level indices of resting-state functional magnetic resonance imaging,along with clinical features,to distinguish between Parkinson's disease patients with and without freezing of gait.We recruited 28 patients with Parkinson's disease who had freezing of gait(15 men and 13 women,average age 63 years)and 30 patients with Parkinson's disease who had no freezing of gait(16 men and 14 women,average age 64 years).Magnetic resonance imaging scans were obtained using a 3.0T scanner to extract the mean amplitude of low-frequency fluctuations,mean regional homogeneity,and degree centrality.Neurological and clinical characteristics were also evaluated.We used the least absolute shrinkage and selection operator algorithm to extract features and established feedforward neural network models based solely on resting-state functional magnetic resonance imaging indicators.We then performed predictive analysis of three distinct groups based on resting-state functional magnetic resonance imaging indicators indicators combined with clinical features.Subsequently,we conducted 100 additional five-fold cross-validations to determine the most effective model for each classification task and evaluated the performance of the model using the area under the receiver operating characteristic curve.The results showed that when differentiating patients with Parkinson's disease who had freezing of gait from those who did not have freezing of gait,or from healthy controls,the models using only the mean regional homogeneity values achieved the highest area under the receiver operating characteristic curve values of 0.750(with an accuracy of 70.9%)and 0.759(with an accuracy of 65.3%),respectively.When classifying patients with Parkinson's disease who had freezing of gait from those who had no freezing of gait,the model using the mean amplitude of low-frequency fluctuation values combined with two clinical features achieved the highest area under the receiver operating characteristic curve of 0.847(with an accuracy of 74.3%).The most significant features for patients with Parkinson's disease who had freezing of gait were amplitude of low-frequency fluctuation alterations in the left parahippocampal gyrus and two clinical characteristics:Montreal Cognitive Assessment and Hamilton Depression Scale scores.Our findings suggest that radiomics features derived from resting-state functional magnetic resonance imaging indices and clinical information can serve as valuable indices for the identification of freezing of gait in Parkinson's disease.
基金supported by Key Research Project of the Educational Department of Liaoning Province,China(No.JYTZD2023139).
文摘Sonodynamic therapy(SDT)is a new non-invasive treatment method,which uses low-intensity ultrasound(US)to activate specific sonosensitizers(SNs)to produce reactive oxygen species(ROS)for therapeutic purposes.However,traditional sonosensitizers have the defects of low generation efficiency of ROS and single treatment mode.Therefore,designing sonosensitizers with high efficiency to generate ROS,high stability,and multimodal therapy is an excellent alternative to achieve effective,safe,and intelligent therapy.Heterojunction nanosonosensitizers(NSNs),as novel type of SNs,combine different materials through heterojunction structures to improve the efficiency of ROS generation.In this review,the classification of heterojunction NSNs,the preparation methods and characterization methods of heterojunction NSNs and the possible mechanisms for enhancing SDT were firstly presented,followed by an in-depth discussion of the application of heterojunction NSNs in the treatment of bacterial infections and tumors,with a special emphasis on synergistic enhancement of therapeutic efficacy of heterojunction SNs in combination with different therapeutic models such as gas therapy,immunotherapy and nanocatalytic therapy.Finally,the challenges and perspectives of such heterojunction SNs-supported SDT were outlined and highlighted to facilitate their clinical translation.
文摘Childhood adenotonsillar hypertrophy is associated with complications,including mouth breathing and obstructive sleep apnea hypopnea syndrome(OSAHS),which can lead to sleep-related ventilation problems that significantly impact the development of orofacial myofunctions as well as the physical and mental health of children.Orofacial myofunctional therapy(OMT)is based on the plasticity of neuromuscular systems to retrain the oral and maxillofacial system,effectively improving orofacial morphology,upper airway structure,and other aspects in pediatric patients.OMT is non-invasive and easy to implement,which can be promoted as an adjuvant therapy for children with adenotonsillar hypertrophy.This review mainly discusses the theoretical basis,training methods,and influencing factors of OMT.
文摘Rational design of multifunctional nanoplatforms capable of combining therapeutic effects with real-time monitoring of drug distribution and tumor status is emerging as a promising approach in cancer nanomedicine.Here,we introduce pyropheophorbide a-bisaminoquinoline conjugate lipid nanoparticles(PPBC LNPs)as a bimodal system for image-guided phototherapy in bladder cancer treatment.PPBC LNPs not only demonstrate both powerful photodynamic and photothermal effects upon light activation,but also exhibit potent autophagy blockage,effectively inducing bladder cancer cell death.Furthermore,PPBC LNPs possess remarkable photoacoustic(PA)and fluorescence(FL)imaging capabilities,enabling imaging with high-resolution,deep tissue penetration and high sensitivity for tracking drug biodistribution and phototherapy efficacy.Specifically,PA imaging confirms the efficient accumulation of PPBC LNPs within tumor and predicts therapeutic outcomes of photodynamic therapy,while FL imaging confirms their prolonged retention at the tumor site for up to 6 days.PPBC LNPs significantly suppress bladder tumor growth,with several tumors completely ablated following just two doses of the nanoparticles and laser treatment.Additionally,PPBC LNPs were formulated with lipid-based excipients and assembled using microfluidic technology to enhance biocompatibility,stability,and scalability,showing potential for clinical translation.This versatile nanoparticle represents a promising candidate for further development in bladder cancer therapy.
基金the staff of UUTH for their support during data collection.
文摘Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.
