Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and...Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.展开更多
BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma...BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.展开更多
The authors regret that the affiliation b and c are wrong.Affiliation b should be changed to“School of Civil and Environmental Engineering,Harbin Institute of Technology,Shenzhen,China;Department of Data Analysis and...The authors regret that the affiliation b and c are wrong.Affiliation b should be changed to“School of Civil and Environmental Engineering,Harbin Institute of Technology,Shenzhen,China;Department of Data Analysis and Mathematical Modelling,Ghent University,Belgium”.And affiliation c should be changed to“State Key Laboratory of Urban Water Resource and Environment(SKLUWRE),School of Environment,Harbin Institute of Technology,China”.展开更多
This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relations...This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relationship between psychological distress and treatment adherence.Next,it delves into the current status and risk factors for psychological distress among patients with CHB,and explores the challenges and risk factors related to treatment adherence.Subsequently,it explores the development and implementation of integrated nursing strategies,including psychological interventions and support,self-efficacy enhancement strategies,social support-system optimization,personalized medical care,and technological innovation.Finally,it highlights the limitations of current interventions and clarifies future research priorities.This minireview aims to provide a comprehensive theoretical basis and practical guidance for improving treatment outcomes and quality of life of patients with CHB.In summary,we reveal that psychological distress significantly impacts treatment adherence in patients with CHB and that it is essential to adopt integrated nursing strategies to address these challenges.These findings highlight the need to consider the psychological states of individuals and develop targeted interventions to improve treatment outcomes.展开更多
Pancreatitis is a prevalent inflammatory disorder of the pan-creas that poses a substantial global health burden.It is broadly categorized into acute pancreatitis(AP),chronic pancreatitis(CP),and other less common typ...Pancreatitis is a prevalent inflammatory disorder of the pan-creas that poses a substantial global health burden.It is broadly categorized into acute pancreatitis(AP),chronic pancreatitis(CP),and other less common types.The annual incidence of AP ranges from 13 to 49 cases per 100000 individuals[1].AP is character-ized by an abrupt onset and rapid disease progression.Approxi-mately 20%of patients develop moderate to severe AP,which are associated with a high risk of organ failure and mortality due to local and systemic complications[1].The global incidence of CP is approximately 10 cases per 100000 individuals annually.展开更多
Colorectal cancer(CRC)is the third most common malignancy worldwide and the second leading cause of cancer-related deaths,accounting for approximately 10%of all cancer cases.By 2050,CRC incidence is expected to rise s...Colorectal cancer(CRC)is the third most common malignancy worldwide and the second leading cause of cancer-related deaths,accounting for approximately 10%of all cancer cases.By 2050,CRC incidence is expected to rise substantially,driven by population aging and greater exposure to risk factors in developing countries.Despite advances in medicine and pharmacy,the effectiveness of available treatments remains limited,underscoring the urgent need for innovative therapeutic strategies.This review summarizes and critically evaluates currently available CRC therapies and explores new emerging directions.Particular attention is given to the role of immunotherapy,targeted therapies,nanotechnology-based approaches,metal-based compounds,PROTAC technology,and personalized medicine,with emphasis on their efficacy,safety,accessibility,and mechanisms of drug resistance.In conclusion,surgery and chemotherapy remain the backbone of CRC treatment,but novel therapeutic approaches are reshaping the treatment landscape.Emerging strategies may offer improved patient tolerability and survival outcomes by reducing the occurrence of burdensome adverse effects.Persistent challenges such as drug toxicity,the emergence of resistance mechanisms,and inequalities in access to innovative therapies underscore the need for further translational research.Integrating personalized therapeutic approaches will also be crucial to achieving more effective,safer,and accessible treatment strategies for CRC.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
Parkinson’s disease （PD） is caused by progressive degeneration of dopamine （DA） neurons in the substantia nigra pars compacta （SNpc）, resulting in the deficiency of DA in the striatum. Thus, symptoms are develo...Parkinson’s disease （PD） is caused by progressive degeneration of dopamine （DA） neurons in the substantia nigra pars compacta （SNpc）, resulting in the deficiency of DA in the striatum. Thus, symptoms are developed, such as akinesia, rigidity and tremor. The aetiology of neuronal death in PD still remains unclear. Several possible mechanisms of the degeneration of dopaminergic neurons are still elusive. Various mechanisms of neuronal degeneration in PD have been proposed, including formation of free radicals, oxidative stress, mitochondrial dysfunction, excitotoxicity, calcium cytotoxicity, trophic factor deficiency, inflammatory processes, genetic factors, environmental factors, toxic action of nitric oxide, and apoptosis. All these factors interact with each other, inducing a vicious cycle of toxicity causing neuronal dysfunction, atrophy and finally cell death. Considerable evidence suggests that free radicals and oxidative stress may play key roles in the pathogenesis of PD. However, currently, drug therapy cannot completely cure the disease. DA replacement therapy with levodopa （L-Dopa）, although still being a gold standard for symptomatic treatment of PD, only alleviates the clinical symptoms. Furthermore, patients usually experience severe side effects several years after the L-Dopa treatment. Until now, no therapy is available to stop or at least slow down the neurodegeneration in patients. Therefore, efforts are made not only to improve the effect of L-Dopa treatment for PD, but also to investigate new drugs with both antiparkinsonian and neuroprotective effects. Here, the advantages and limitations of current and future therapies for PD were dicussed. Current therapies include dopaminergic therapy, DA agonists, MAO-B inhibitor, COMT inhibitors, anticholinergic drugs, surgical procedures such as pallidotomy and more specifically deep brain stimulation of the globus pallidus pars interna （GPi） or subthalamic nucleus （STN）, and stem cell transplantation.展开更多
Sorafenib is used worldwide as a first-line standardsystemic agent for advanced hepatocellular carcinoma(HCC) on the basis of the results of two large-scale Phase Ⅲ trials. Conversely,hepatic arterial infusion chemot...Sorafenib is used worldwide as a first-line standardsystemic agent for advanced hepatocellular carcinoma(HCC) on the basis of the results of two large-scale Phase Ⅲ trials. Conversely,hepatic arterial infusion chemotherapy(HAIC) is one of the most recommended treatments in Japan. Although there have been no randomized controlled trials comparing sorafenib with HAIC,several retrospective analyses have shown no significant differences in survival between the two therapies. Outcomes are favorable for HCC patients exhibiting macroscopic vascular invasion when treated with HAIC rather than sorafenib,whereas in HCC patients exhibiting extrahepatic spread or resistance to transcatheter arterial chemoembolization,good outcomes are achieved by treatment with sorafenib rather than HAIC. Additionally,sorafenib is generally used to treat patients with Child-Pugh A,while HAIC is indicated for those with either Child-Pugh A or B. Based on these findings,we reviewed treatment strategies for advanced HCC. We propose that sorafenib might be used as a first-line treatment for advanced HCC patients without macroscopic vascular invasion or Child-Pugh A,while HAIC is recommended for those with macroscopic vascular invasion or Child-Pugh A or B. Additional research is required to determine the best second-line treatment for HAIC non-responders with Child-Pugh B through future clinical trials.展开更多
BACKGROUND Recent advances in endoscopic technology,especially magnifying endoscopy with narrow band imaging(ME-NBI)enable us to detect superficial esophageal squamous cell carcinoma(ESCC),but determining the appropri...BACKGROUND Recent advances in endoscopic technology,especially magnifying endoscopy with narrow band imaging(ME-NBI)enable us to detect superficial esophageal squamous cell carcinoma(ESCC),but determining the appropriate method of resection,endoscopic resection(ER)vs surgical resection,is often challenging.Recently,several studies have reported that 18F-fluorodeoxyglucose positron emission tomography(FDG-PET)is a useful indicator for decision-making regarding treatment for superficial ESCC.Although,there are not enough reports on association between FDG-PET uptake and clinicopathological characteristics of superficial ESCC.And,there are not enough reports on evaluating the usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.This study evaluated clinical relevance of FDG-PET and ME-NBI in decision-making regarding the treatment strategy for ESCC.AIM To investigate the association between FDG uptake and the clinicopathological characteristics of superficial ESCC and its usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.METHODS A database of all patients with superficial ESCC who had undergone both MENBI and FDG-PET for pre-treatment staging at Aichi Cancer Center Hospital between January 2008 and November 2018 was retrospectively analyzed.FDG uptake was defined positive or negative whether the primary lesion was visualized or could be distinguished from the background,or not.The invasion depth of ESCC was classified according to the Japan Esophageal Society.Primary endpoint is to evaluate the association between FDG uptake and clinicopathological characteristics of superficial ESCC.Secondary endpoint is to investigate the efficacy of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.RESULTS A total of 82 lesions in 82 patients were included.FDG-PET showed positive uptake in 29(35.4%)lesions.Univariate analysis showed that uptake of FDG-PET had significant correlations with circumferential extension(P=0.014),pathological depth of tumor invasion(P<0.001),infiltrative growth pattern(P<0.001),histological grade(P=0.002),vascular invasion(P=0.001),and lymphatic invasion(P<0.001).On multivariate analysis,only depth of tumor invasion was independently correlated with FDG-PET/computed tomography visibility(P=0.018).The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of Type B2 in ME-NBI for the invasion depth of T1a muscularis mucosae and T1b upper submucosal layer were 68.4%/79.4%/50.0%/89.3%/76.8%,respectively,and those of Type B3 for the depth of T1b middle and deeper submucosal layers(SM2 and SM3)were 46.7%/100%/100%/89.3%/90.2%,respectively.On the other hand,those of FDGPET for SM2 and SM3 were 93.3%/77.6%/48.2%/98.1%/80.5%,respectively,whereas,if the combination of positive FDG uptake and type B2 and B3 was defined as an indicator for radical esophagectomy or definitive chemoradiotherapy,the sensitivity,specificity,PPV,NPV,and accuracy were 78.3%/91.5%/78.3%/91.5%/87.8%,respectively.CONCLUSION FDG uptake was correlated with the invasion depth of superficial ESCC.Combined use of FDG-PET and ME-NBI,especially with the microvascular findings of Type B2 and B3,is useful to determine whether ER is indicated for the lesion.展开更多
In recent years,therapies for follicular lymphoma (FL) have steadily improved.A series of phase Ⅲ trials comparing the effect of rituximab with chemotherapy vs chemotherapy alone in treating FL have indicated signifi...In recent years,therapies for follicular lymphoma (FL) have steadily improved.A series of phase Ⅲ trials comparing the effect of rituximab with chemotherapy vs chemotherapy alone in treating FL have indicated significant improvements in progression-free survival (PFS) and overall survival.Recent studies have found that prolonged response durations and PFS were obtained with maintenance therapy using rituximab or interferon after completion of first line therapy.For patients with relapsed or refractory FL,phase Ⅱ studies have assessed the effectiveness of combination therapies using a Toll-like receptor-9 agonist (1018ISS),oblimersen sodium (a Bcl-2 antisense oligonucleotide),bendamustine,and rituximab,as well as veltuzumab,a new humanized anti-CD20 antibody,and epratuzumab.In addition,the effectiveness of yttrium-90 ibritumomab tiuxetan and iodine-131 tositumomab as radioimmunotherapies has been reported.Furthermore,three phase Ⅲ studies on an idiotype vaccine are near completion.Unfortunately,these vaccines,which appeared highly effective in phase Ⅰ and Ⅱ trials,do not appear to result in prolonged PFS.This report will summarize the current knowledge on therapies for treatment of FL,and will conclude with a brief discussion of feasiblefuture options for effective treatments.Lastly,we added descriptions of the management of gastrointestinal FL,which is considered to be controversial because it is rare.展开更多
Obstructive jaundice(OJ)is a common problem in daily clinical practice.However,completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management.The effects o...Obstructive jaundice(OJ)is a common problem in daily clinical practice.However,completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management.The effects of OJ are widespread,affecting the biliary tree,hepatic cells,liver function,and causing systemic complications.The lack of bile in the intestine,destruction of the intestinal mucosal barrier,and increased absorption of endotoxins can lead to endotoxemia,production of proinflammatory cytokines,and induce systemic inflammatory response syndrome,ultimately leading to multiple organ dysfunction syndrome.Proper management of OJ includes adequate water supply and electrolyte replacement,nutritional support,preventive antibiotics,pain relief,and itching relief.The surgical treatment of OJ depends on the cause,location,and severity of the obstruction.Biliary drainage,surgery,and endoscopic intervention are potential treatment options depending on the patient's condition.In addition to modern medical treatments,Traditional Chinese medicine may offer therapeutic benefits for OJ.A comprehensive search was conducted on PubMed for relevant articles published up to August 1970.This review discusses in detail the pathophysiological changes associated with OJ and presents effective strategies for managing the condition.展开更多
Objective To investigate the etiology,clinical characteristics,diagnosis,and treatment strategies and efficacy of pulsatile tinnitus(PT)caused by vascular anatomy abnormality.Methods The clinical data of 45 patients w...Objective To investigate the etiology,clinical characteristics,diagnosis,and treatment strategies and efficacy of pulsatile tinnitus(PT)caused by vascular anatomy abnormality.Methods The clinical data of 45 patients with PT in our hospital from 2012 to 2019 were collected and retrospectively analyzed.Results All 45 patients had vascular anatomical abnormalities.The patients were divided into 10 categories according to the different locations of vascular abnormalities:sigmoid sinus diverticulum(SSD),sigmoid sinus wall dehiscence(SSWD),SSWD with high jugular bulb,pure dilated mastoid emissary vein,aberrant internal carotid artery(ICA)in the middle ear,transverse-sigmoid sinus(TSS)transition stenosis,TSS transition stenosis with SSD,persistent occipital sinus stenosis,petrous segment stenosis of ICA,and dural arteriovenous fistula.All patients complained of PT synchronous with heartbeat rhythm.Endovascular interventional therapy and extravascular open surgery were used according to the location of the vascular lesions.Tinnitus disappeared in 41 patients,was significantly relieved in 3 patients,and was unchanged in 1 patient postoperatively.Except for one patient with transient headache postoperatively,no obvious complications occurred.Conclusion PT caused by vascular anatomy abnormalities can be identified by detailed medical history and physical and imaging examination.PT can be relieved or even completely alleviated after appropriate surgical treatments.展开更多
The infection and drug resistance rates of Helicobacter pylori(H.pylori)are high and must be prevented and treated by better strategies.Based on recent research advances in this field as well as the results from our t...The infection and drug resistance rates of Helicobacter pylori(H.pylori)are high and must be prevented and treated by better strategies.Based on recent research advances in this field as well as the results from our team and those on traditional Chinese medicine,we review the causes of drug resistance,and prevention and treatment strategies for drug-resistant H.pylori infection,with an aim to make suggestions for the development of new drugs,such as establishment of new target identification and screening systems,modification of existing drug structures,use of new technologies,application of natural products,and using a commercial compound library.This article may provide reference for eradication of drug-resistant H.pylori.展开更多
Brain ischemic stroke is the leading cause of long-lasting injury,disability,and death in adults.Although the brain represents only about 2%of the total body mass,it consumes almost 20%of the body＇s oxygen.As a resul...Brain ischemic stroke is the leading cause of long-lasting injury,disability,and death in adults.Although the brain represents only about 2%of the total body mass,it consumes almost 20%of the body＇s oxygen.As a result,brain cells are extremely sensitive to hypoxia.Once cerebral ischemia occurs.展开更多
Spinal cord injury （SCI） continues to be a pressing health and social problem. The injury leads to neuronal and glial cell death accompanied by degeneration of nerve fibers. There are currently no particularly effec...Spinal cord injury （SCI） continues to be a pressing health and social problem. The injury leads to neuronal and glial cell death accompanied by degeneration of nerve fibers. There are currently no particularly effective treatments. SCI causes profound disabil- ity of people affected and has attracted increased attention in the international field of neuroregeneration. For the past two decades, much hope has been placed in cell therapies for the restoration of both structure and function of the injured spinal cord. Embryonic and neural stem cells, olfactory ensheathing cells, microglia-like cells, Schwann cells, mesenchymal stem cells.展开更多
Inflammatory bowel diseases(IBD)significantly contribute to high mortality globally and negatively affect patients’qualifications of life.The gastrointestinal tract has unique anatomical characteristics and physiolog...Inflammatory bowel diseases(IBD)significantly contribute to high mortality globally and negatively affect patients’qualifications of life.The gastrointestinal tract has unique anatomical characteristics and physiological environment limitations.Moreover,certain natural or synthetic anti-inflammatory drugs are associated with poor targeting,low drug accumulation at the lesion site,and other side effects,hindering them from exerting their therapeutic effects.Colon-targeted drug delivery systems represent attractive alternatives as novel carriers for IBD treatment.This review mainly discusses the treatment status of IBD,obstacles to drug delivery,design strategies of colon-targeted delivery systems,and perspectives on the existing complementary therapies.Moreover,based on recent reports,we summarized the therapeutic mechanism of colon-targeted drug delivery.Finally,we addressed the challenges and future directions to facilitate the exploitation of advanced nanomedicine for IBD therapy.展开更多
Control of clarifier in the activated sludge process is critical for ensuring effective wastewater treatment. This paper is to study appropriate control strategies for a clarifier in an industrial wastewater treatment...Control of clarifier in the activated sludge process is critical for ensuring effective wastewater treatment. This paper is to study appropriate control strategies for a clarifier in an industrial wastewater treatment plant. Five control strategies are proposed, implemented and evaluated in a simulation software （West ＋＋）. The sludge blanket height and the effluent suspended solids concentration were proposed as the measured variable. The manipulated variable was the quantity of polymer added to the system. The strategies were evaluated in terms of their ability to maintain the sludge blanket height below 1.5m, their polymer requirements, their sensitivity to poor tuning and the required control action.展开更多
Traumatic brain injury（TBI）remains one of the leading causes of disability and death in infants and children.Studies have demonstrated that the youngest age group（especially≤4 years old）exhibit worse functional o...Traumatic brain injury（TBI）remains one of the leading causes of disability and death in infants and children.Studies have demonstrated that the youngest age group（especially≤4 years old）exhibit worse functional outcome following moderate to severe TBI compared to older children or adults（Anderson et al.,2005;Emami et al.,2017）.These data suggest that age-at-injury may be an important determinant of outcome,展开更多
The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of trauma...The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of traumatic brain injury.Traumatic skull base fracture is one of the causes of traumatic internal carotid artery occlusion.If not detected early and treated in time,the prognosis of patients is poor.This editorial makes a relevant analysis of this disease.展开更多
文摘Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.
文摘BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.
文摘The authors regret that the affiliation b and c are wrong.Affiliation b should be changed to“School of Civil and Environmental Engineering,Harbin Institute of Technology,Shenzhen,China;Department of Data Analysis and Mathematical Modelling,Ghent University,Belgium”.And affiliation c should be changed to“State Key Laboratory of Urban Water Resource and Environment(SKLUWRE),School of Environment,Harbin Institute of Technology,China”.
文摘This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relationship between psychological distress and treatment adherence.Next,it delves into the current status and risk factors for psychological distress among patients with CHB,and explores the challenges and risk factors related to treatment adherence.Subsequently,it explores the development and implementation of integrated nursing strategies,including psychological interventions and support,self-efficacy enhancement strategies,social support-system optimization,personalized medical care,and technological innovation.Finally,it highlights the limitations of current interventions and clarifies future research priorities.This minireview aims to provide a comprehensive theoretical basis and practical guidance for improving treatment outcomes and quality of life of patients with CHB.In summary,we reveal that psychological distress significantly impacts treatment adherence in patients with CHB and that it is essential to adopt integrated nursing strategies to address these challenges.These findings highlight the need to consider the psychological states of individuals and develop targeted interventions to improve treatment outcomes.
文摘Pancreatitis is a prevalent inflammatory disorder of the pan-creas that poses a substantial global health burden.It is broadly categorized into acute pancreatitis(AP),chronic pancreatitis(CP),and other less common types.The annual incidence of AP ranges from 13 to 49 cases per 100000 individuals[1].AP is character-ized by an abrupt onset and rapid disease progression.Approxi-mately 20%of patients develop moderate to severe AP,which are associated with a high risk of organ failure and mortality due to local and systemic complications[1].The global incidence of CP is approximately 10 cases per 100000 individuals annually.
文摘Colorectal cancer(CRC)is the third most common malignancy worldwide and the second leading cause of cancer-related deaths,accounting for approximately 10%of all cancer cases.By 2050,CRC incidence is expected to rise substantially,driven by population aging and greater exposure to risk factors in developing countries.Despite advances in medicine and pharmacy,the effectiveness of available treatments remains limited,underscoring the urgent need for innovative therapeutic strategies.This review summarizes and critically evaluates currently available CRC therapies and explores new emerging directions.Particular attention is given to the role of immunotherapy,targeted therapies,nanotechnology-based approaches,metal-based compounds,PROTAC technology,and personalized medicine,with emphasis on their efficacy,safety,accessibility,and mechanisms of drug resistance.In conclusion,surgery and chemotherapy remain the backbone of CRC treatment,but novel therapeutic approaches are reshaping the treatment landscape.Emerging strategies may offer improved patient tolerability and survival outcomes by reducing the occurrence of burdensome adverse effects.Persistent challenges such as drug toxicity,the emergence of resistance mechanisms,and inequalities in access to innovative therapies underscore the need for further translational research.Integrating personalized therapeutic approaches will also be crucial to achieving more effective,safer,and accessible treatment strategies for CRC.
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Parkinson’s disease （PD） is caused by progressive degeneration of dopamine （DA） neurons in the substantia nigra pars compacta （SNpc）, resulting in the deficiency of DA in the striatum. Thus, symptoms are developed, such as akinesia, rigidity and tremor. The aetiology of neuronal death in PD still remains unclear. Several possible mechanisms of the degeneration of dopaminergic neurons are still elusive. Various mechanisms of neuronal degeneration in PD have been proposed, including formation of free radicals, oxidative stress, mitochondrial dysfunction, excitotoxicity, calcium cytotoxicity, trophic factor deficiency, inflammatory processes, genetic factors, environmental factors, toxic action of nitric oxide, and apoptosis. All these factors interact with each other, inducing a vicious cycle of toxicity causing neuronal dysfunction, atrophy and finally cell death. Considerable evidence suggests that free radicals and oxidative stress may play key roles in the pathogenesis of PD. However, currently, drug therapy cannot completely cure the disease. DA replacement therapy with levodopa （L-Dopa）, although still being a gold standard for symptomatic treatment of PD, only alleviates the clinical symptoms. Furthermore, patients usually experience severe side effects several years after the L-Dopa treatment. Until now, no therapy is available to stop or at least slow down the neurodegeneration in patients. Therefore, efforts are made not only to improve the effect of L-Dopa treatment for PD, but also to investigate new drugs with both antiparkinsonian and neuroprotective effects. Here, the advantages and limitations of current and future therapies for PD were dicussed. Current therapies include dopaminergic therapy, DA agonists, MAO-B inhibitor, COMT inhibitors, anticholinergic drugs, surgical procedures such as pallidotomy and more specifically deep brain stimulation of the globus pallidus pars interna （GPi） or subthalamic nucleus （STN）, and stem cell transplantation.
基金Supported by the Japan Society for the Promotion of Science,KIBAN-B,No.16H05287
文摘Sorafenib is used worldwide as a first-line standardsystemic agent for advanced hepatocellular carcinoma(HCC) on the basis of the results of two large-scale Phase Ⅲ trials. Conversely,hepatic arterial infusion chemotherapy(HAIC) is one of the most recommended treatments in Japan. Although there have been no randomized controlled trials comparing sorafenib with HAIC,several retrospective analyses have shown no significant differences in survival between the two therapies. Outcomes are favorable for HCC patients exhibiting macroscopic vascular invasion when treated with HAIC rather than sorafenib,whereas in HCC patients exhibiting extrahepatic spread or resistance to transcatheter arterial chemoembolization,good outcomes are achieved by treatment with sorafenib rather than HAIC. Additionally,sorafenib is generally used to treat patients with Child-Pugh A,while HAIC is indicated for those with either Child-Pugh A or B. Based on these findings,we reviewed treatment strategies for advanced HCC. We propose that sorafenib might be used as a first-line treatment for advanced HCC patients without macroscopic vascular invasion or Child-Pugh A,while HAIC is recommended for those with macroscopic vascular invasion or Child-Pugh A or B. Additional research is required to determine the best second-line treatment for HAIC non-responders with Child-Pugh B through future clinical trials.
文摘BACKGROUND Recent advances in endoscopic technology,especially magnifying endoscopy with narrow band imaging(ME-NBI)enable us to detect superficial esophageal squamous cell carcinoma(ESCC),but determining the appropriate method of resection,endoscopic resection(ER)vs surgical resection,is often challenging.Recently,several studies have reported that 18F-fluorodeoxyglucose positron emission tomography(FDG-PET)is a useful indicator for decision-making regarding treatment for superficial ESCC.Although,there are not enough reports on association between FDG-PET uptake and clinicopathological characteristics of superficial ESCC.And,there are not enough reports on evaluating the usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.This study evaluated clinical relevance of FDG-PET and ME-NBI in decision-making regarding the treatment strategy for ESCC.AIM To investigate the association between FDG uptake and the clinicopathological characteristics of superficial ESCC and its usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.METHODS A database of all patients with superficial ESCC who had undergone both MENBI and FDG-PET for pre-treatment staging at Aichi Cancer Center Hospital between January 2008 and November 2018 was retrospectively analyzed.FDG uptake was defined positive or negative whether the primary lesion was visualized or could be distinguished from the background,or not.The invasion depth of ESCC was classified according to the Japan Esophageal Society.Primary endpoint is to evaluate the association between FDG uptake and clinicopathological characteristics of superficial ESCC.Secondary endpoint is to investigate the efficacy of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.RESULTS A total of 82 lesions in 82 patients were included.FDG-PET showed positive uptake in 29(35.4%)lesions.Univariate analysis showed that uptake of FDG-PET had significant correlations with circumferential extension(P=0.014),pathological depth of tumor invasion(P<0.001),infiltrative growth pattern(P<0.001),histological grade(P=0.002),vascular invasion(P=0.001),and lymphatic invasion(P<0.001).On multivariate analysis,only depth of tumor invasion was independently correlated with FDG-PET/computed tomography visibility(P=0.018).The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of Type B2 in ME-NBI for the invasion depth of T1a muscularis mucosae and T1b upper submucosal layer were 68.4%/79.4%/50.0%/89.3%/76.8%,respectively,and those of Type B3 for the depth of T1b middle and deeper submucosal layers(SM2 and SM3)were 46.7%/100%/100%/89.3%/90.2%,respectively.On the other hand,those of FDGPET for SM2 and SM3 were 93.3%/77.6%/48.2%/98.1%/80.5%,respectively,whereas,if the combination of positive FDG uptake and type B2 and B3 was defined as an indicator for radical esophagectomy or definitive chemoradiotherapy,the sensitivity,specificity,PPV,NPV,and accuracy were 78.3%/91.5%/78.3%/91.5%/87.8%,respectively.CONCLUSION FDG uptake was correlated with the invasion depth of superficial ESCC.Combined use of FDG-PET and ME-NBI,especially with the microvascular findings of Type B2 and B3,is useful to determine whether ER is indicated for the lesion.
文摘In recent years,therapies for follicular lymphoma (FL) have steadily improved.A series of phase Ⅲ trials comparing the effect of rituximab with chemotherapy vs chemotherapy alone in treating FL have indicated significant improvements in progression-free survival (PFS) and overall survival.Recent studies have found that prolonged response durations and PFS were obtained with maintenance therapy using rituximab or interferon after completion of first line therapy.For patients with relapsed or refractory FL,phase Ⅱ studies have assessed the effectiveness of combination therapies using a Toll-like receptor-9 agonist (1018ISS),oblimersen sodium (a Bcl-2 antisense oligonucleotide),bendamustine,and rituximab,as well as veltuzumab,a new humanized anti-CD20 antibody,and epratuzumab.In addition,the effectiveness of yttrium-90 ibritumomab tiuxetan and iodine-131 tositumomab as radioimmunotherapies has been reported.Furthermore,three phase Ⅲ studies on an idiotype vaccine are near completion.Unfortunately,these vaccines,which appeared highly effective in phase Ⅰ and Ⅱ trials,do not appear to result in prolonged PFS.This report will summarize the current knowledge on therapies for treatment of FL,and will conclude with a brief discussion of feasiblefuture options for effective treatments.Lastly,we added descriptions of the management of gastrointestinal FL,which is considered to be controversial because it is rare.
基金Tianjin Municipal Education Commission Scientific Research Program,China,No.2022KJ271。
文摘Obstructive jaundice(OJ)is a common problem in daily clinical practice.However,completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management.The effects of OJ are widespread,affecting the biliary tree,hepatic cells,liver function,and causing systemic complications.The lack of bile in the intestine,destruction of the intestinal mucosal barrier,and increased absorption of endotoxins can lead to endotoxemia,production of proinflammatory cytokines,and induce systemic inflammatory response syndrome,ultimately leading to multiple organ dysfunction syndrome.Proper management of OJ includes adequate water supply and electrolyte replacement,nutritional support,preventive antibiotics,pain relief,and itching relief.The surgical treatment of OJ depends on the cause,location,and severity of the obstruction.Biliary drainage,surgery,and endoscopic intervention are potential treatment options depending on the patient's condition.In addition to modern medical treatments,Traditional Chinese medicine may offer therapeutic benefits for OJ.A comprehensive search was conducted on PubMed for relevant articles published up to August 1970.This review discusses in detail the pathophysiological changes associated with OJ and presents effective strategies for managing the condition.
基金supported by the Medical Science and Technology Project of Zhejiang Province(No.2019KY584)Traditional Chinese Medicine Science and Technology Project of Zhejiang Province(No.2023ZL648).
文摘Objective To investigate the etiology,clinical characteristics,diagnosis,and treatment strategies and efficacy of pulsatile tinnitus(PT)caused by vascular anatomy abnormality.Methods The clinical data of 45 patients with PT in our hospital from 2012 to 2019 were collected and retrospectively analyzed.Results All 45 patients had vascular anatomical abnormalities.The patients were divided into 10 categories according to the different locations of vascular abnormalities:sigmoid sinus diverticulum(SSD),sigmoid sinus wall dehiscence(SSWD),SSWD with high jugular bulb,pure dilated mastoid emissary vein,aberrant internal carotid artery(ICA)in the middle ear,transverse-sigmoid sinus(TSS)transition stenosis,TSS transition stenosis with SSD,persistent occipital sinus stenosis,petrous segment stenosis of ICA,and dural arteriovenous fistula.All patients complained of PT synchronous with heartbeat rhythm.Endovascular interventional therapy and extravascular open surgery were used according to the location of the vascular lesions.Tinnitus disappeared in 41 patients,was significantly relieved in 3 patients,and was unchanged in 1 patient postoperatively.Except for one patient with transient headache postoperatively,no obvious complications occurred.Conclusion PT caused by vascular anatomy abnormalities can be identified by detailed medical history and physical and imaging examination.PT can be relieved or even completely alleviated after appropriate surgical treatments.
基金Supported by National Natural Science Foundation of China,No.81760739 and No.31460023.
文摘The infection and drug resistance rates of Helicobacter pylori(H.pylori)are high and must be prevented and treated by better strategies.Based on recent research advances in this field as well as the results from our team and those on traditional Chinese medicine,we review the causes of drug resistance,and prevention and treatment strategies for drug-resistant H.pylori infection,with an aim to make suggestions for the development of new drugs,such as establishment of new target identification and screening systems,modification of existing drug structures,use of new technologies,application of natural products,and using a commercial compound library.This article may provide reference for eradication of drug-resistant H.pylori.
文摘Brain ischemic stroke is the leading cause of long-lasting injury,disability,and death in adults.Although the brain represents only about 2%of the total body mass,it consumes almost 20%of the body＇s oxygen.As a result,brain cells are extremely sensitive to hypoxia.Once cerebral ischemia occurs.
基金supported by grants 15-04-07527(AAR) and 16-34-60101(YOM) from Russian Foundation for Basic Researchsupported by a Presidential Grant for government support of young scientists(PhD) from the Russian Federation(MK-4020.2015.7)+1 种基金performed in accordance with Program of Competitive Growth of Kazan Federal Universitya subsidy allocated to Kazan Federal University for the state assignment in the sphere of scientific activities
文摘Spinal cord injury （SCI） continues to be a pressing health and social problem. The injury leads to neuronal and glial cell death accompanied by degeneration of nerve fibers. There are currently no particularly effective treatments. SCI causes profound disabil- ity of people affected and has attracted increased attention in the international field of neuroregeneration. For the past two decades, much hope has been placed in cell therapies for the restoration of both structure and function of the injured spinal cord. Embryonic and neural stem cells, olfactory ensheathing cells, microglia-like cells, Schwann cells, mesenchymal stem cells.
基金supported by CACMS Innovation Fund(CI2021B016,CI2021A04801)National Natural Science Foundation of China(82192913,82174073)+2 种基金Qihuang Scholar ProgramCACMS Foundation(ZZ13-035-10)China Postdoctoral Science Foundation(2023M733913).
文摘Inflammatory bowel diseases(IBD)significantly contribute to high mortality globally and negatively affect patients’qualifications of life.The gastrointestinal tract has unique anatomical characteristics and physiological environment limitations.Moreover,certain natural or synthetic anti-inflammatory drugs are associated with poor targeting,low drug accumulation at the lesion site,and other side effects,hindering them from exerting their therapeutic effects.Colon-targeted drug delivery systems represent attractive alternatives as novel carriers for IBD treatment.This review mainly discusses the treatment status of IBD,obstacles to drug delivery,design strategies of colon-targeted delivery systems,and perspectives on the existing complementary therapies.Moreover,based on recent reports,we summarized the therapeutic mechanism of colon-targeted drug delivery.Finally,we addressed the challenges and future directions to facilitate the exploitation of advanced nanomedicine for IBD therapy.
文摘Control of clarifier in the activated sludge process is critical for ensuring effective wastewater treatment. This paper is to study appropriate control strategies for a clarifier in an industrial wastewater treatment plant. Five control strategies are proposed, implemented and evaluated in a simulation software （West ＋＋）. The sludge blanket height and the effluent suspended solids concentration were proposed as the measured variable. The manipulated variable was the quantity of polymer added to the system. The strategies were evaluated in terms of their ability to maintain the sludge blanket height below 1.5m, their polymer requirements, their sensitivity to poor tuning and the required control action.
文摘Traumatic brain injury（TBI）remains one of the leading causes of disability and death in infants and children.Studies have demonstrated that the youngest age group（especially≤4 years old）exhibit worse functional outcome following moderate to severe TBI compared to older children or adults（Anderson et al.,2005;Emami et al.,2017）.These data suggest that age-at-injury may be an important determinant of outcome,
基金Supported by the Science and Technology Program of Nantong Health Committee,No.MA2019003 and No.MA2021017Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD019,and No.KD2022KYJJZD022.
文摘The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of traumatic brain injury.Traumatic skull base fracture is one of the causes of traumatic internal carotid artery occlusion.If not detected early and treated in time,the prognosis of patients is poor.This editorial makes a relevant analysis of this disease.
