Primary systemic treatment is a fundamental part of breast cancer therapy, and it is applied to non-surgical and locally advanced tumours as well as surgical tumours to increase the likelihood of conservative treatmen...Primary systemic treatment is a fundamental part of breast cancer therapy, and it is applied to non-surgical and locally advanced tumours as well as surgical tumours to increase the likelihood of conservative treatment. Its aim is to achieve the best possible survival with better cosmetic results and with the lowest number of treatment-related secondary effects. Before treatment is started, it is necessary to attain the best knowledge of the biological features and locoregional extension of the tumour. To do so, it is necessary to obtain a biopsy of the lesion with a wide bore needle,as well as good radiological knowledge of the disease.Therefore, currently, the use of a dynamic magnetic resonance imaging(MRI) of the breast should be included in all cases. In addition, before it is started,especially in those tumours in which conservative treatment is considered, one or several radiopaque markers should be put into place to make it possible to locate the area to be treated if there is a considerable or complete response. Systemic treatment is mainly based on combined chemotherapy with anthracyclins and taxanes, in addition to some biological agents with demonstrated efficiency for increasing the likelihood of complete disease response(trastuzumab in patients with Her-2/neu overexpression). However, there is room for neoadjuvant hormone treatment, in patients with hormone receptor overexpression, especially in those cases in which chemotherapy is contraindicated as well as in elderly patients with a relatively short life expectancy. The assessment of preoperative treatment should be based on adequate radiological tests, and nowad these should include MRI before taking decisions about adequate surgical treatment. The objective of primary treatment is to be able to increase survival and improve the chances of local treatment in the case of locally advanced treatment, achieving results that are at least equal to those of adjuvant treatment in the case of surgical tumours, but with greater chances of conservative surgery. Although the objective is survival, achieving complete pathological response seems to be a reasonable related objective, although these are more closely linked in some tumour subtypes.展开更多
BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right...BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right heart.Late diagnosis mimics common cardiac ailments,leading to poor prognosis.AIM To systematically review the efficacy of rituximab in treating PCL either alone or in various chemotherapeutic regimens.Secondary objectives include evaluating morphological subtypes,assessing treatment regimens,and analyzing outcomes focusing on remission and adverse events.METHODS Following PRISMA guidelines,a comprehensive literature search was conducted across multiple databases,including PubMed,Hinari,Web of Science,and Scopus.English-language studies reporting the use of rituximab in treating PCL in humans were included.Study selection involved initial screening of titles and abstracts followed by full-text examination and data extraction.RESULTS Thirty-three case reports involving 36 patients were included in this systematic review.Diffuse large B-cell lymphoma was the predominant morphological subtype observed.The rituximab,cyclophosphamide,doxorubicin,oncovin,and prednisolone regimen emerged as the most commonly employed treatment strategy,indicating widespread acceptance and efficacy in PCL management.Combination therapies,including surgical intervention,showed promise in achieving complete remission,while some studies reported mortality despite aggressive treatment approaches.CONCLUSION Rituximab,particularly in combination with chemotherapy regimens,represents a significant advancement in PCL management,offering hope for improved patient outcomes.However,challenges such as variable treatment responses and adverse events underscore the complexity of managing PCL.Further research is warranted to refine therapeutic strategies and enhance diagnostic approaches for this rare cardiac malignancy.展开更多
Casein kinase 1(CK1)is an important member of the serine/threonine protein kinase family,playing a crucial role in various cellular processes,including cell cycle regulation,signal transduction,DNA repair,and circadia...Casein kinase 1(CK1)is an important member of the serine/threonine protein kinase family,playing a crucial role in various cellular processes,including cell cycle regulation,signal transduction,DNA repair,and circadian rhythm control.CK1 is also essential in the nervous system,where it regulates neuronal growth,differentiation,and synaptic plasticity.Studies have shown that CK1δ phosphorylates neuron-specific proteins to regulate axonal growth and synaptogenesis.Primary cilia are non-motile microtubule structures present on the surface of most mammalian cells.Recent studies have revealed their multiple roles in cellular physiology and development,and dysfunction of cilia can impact the development and function of the nervous system.CK1 has an important role in the formation and function of primary cilia.By regulating various signaling pathways and the phosphorylation status of proteins,CK1 affects the generation,maintenance,and signaling transduction of cilia.In this review,the relationship between CK1,primary cilia,and the nervous system was explored,focusing on how CK1 influences cilia to regulate the structure and function of the nervous system.展开更多
In the current era of digitalization sweeping the education field,primary school English education is facing new challenges and opportunities of deep integration with artificial intelligence.This study focuses on prim...In the current era of digitalization sweeping the education field,primary school English education is facing new challenges and opportunities of deep integration with artificial intelligence.This study focuses on primary school English teachers and uses various methods such as questionnaire surveys,visits,and interviews to conduct an in-depth exploration of their artificial intelligence literacy.After data analysis,optimization strategies are proposed to further improve the artificial intelligence literacy of primary school English teachers and promote the development of educational soft power.展开更多
Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipien...Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.展开更多
BACKGROUND Primary hyperparathyroidism(PHPT)-induced acute pancreatitis(AP)during pregnancy has rarely been described.Due to this rarity,there are no diagnostic or treatment algorithms for pregnant patients.AIM To det...BACKGROUND Primary hyperparathyroidism(PHPT)-induced acute pancreatitis(AP)during pregnancy has rarely been described.Due to this rarity,there are no diagnostic or treatment algorithms for pregnant patients.AIM To determine appropriate diagnostic methods,therapeutic options,and factors related to maternal and fetal outcomes for PHPT-induced AP in pregnancy.METHODS A literature search of articles in English,Japanese,German,Spanish,and Italian was performed using PubMed(1946-2023),PubMed Central(1900-2023),and Google Scholar.The Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)protocol was followed.The search terms included“pancreatite acuta,”“iperparatiroidismo primario,”“gravidanza,”“travaglio,”“puerperio,”“postpartum,”“akute pankreatitis,”“primärer hyperparathyreoidismus,”“Schwangerschaft,”“Wehen,”“Wochenbett,”“pancreatitis aguda,”“hiperparatiroidismo primario,”“embarazo,”“parto,”“puerperio,”“posparto,”“acute pancreatitis,”“primary hyperparathyroidism,”“pregnancy,”“labor,”“puerperium,”and“postpartum.”Additional studies were identified by reviewing the reference lists of retrieved studies.Demographic,imaging,surgical,obstetric,and outcome data were obtained.RESULTS Fifty-four cases were collected from the 51 studies.The median maternal age was 29 years.PHPT-induced AP starts at the 20th gestational week;higher gestational weeks were seen in mothers who died(mean gestational week 28).Median values of amylase(1399,Q1-Q3=519-2072),lipase(2072,Q1-Q3=893-2804),serum calcium(3.5,Q1-Q3=3.1-3.9),and parathormone(PTH)(384,Q1-Q3=123-910)were reported.In 46 cases,adenoma was the cause of PHPT,followed by 2 cases of carcinoma and 1 case of hyperplasia.In the remaining 5 cases,the diagnosis was not reported.Neck ultrasound was positive in 34 cases,whereas sestamibi was performed in 3 cases,and neck computed tomography or magnetic resonance imaging was performed in 9 cases(the enlarged parathyroid gland was not localized in 3 cases).Surgery was the preferred treatment during pregnancy in 33 cases(median week of gestation 25,Q1-Q3=20-30)and postpartum in 12 cases.The timing was not reported in the remaining 9 cases,or surgery was not performed.AP was managed surgically in 11 cases and conservatively in 43(79.6%)cases.Maternal and fetal mortality was 9.3%(5 cases).Surgery was more common in deceased mothers(60.0%vs 16.3%;P=0.052),and PTH values tended to be higher in this group(910 pg/mL vs 302 pg/mL;P=0.059).Maternal mortality was higher with higher serum lipase levels and earlier delivery week.Higher calcium(4.1 mmol/L vs 3.3 mmol/L;P=0.009)and PTH(1914 pg/mL vs 302 pg/mL;P=0.003)values increased fetal/child mortality,as well as abortions(40.0%vs 0.0%;P=0.007)and complex deliveries(60.0%vs 8.2%;P=0.01).CONCLUSION If serum calcium is not tested during admission,definitive diagnosis of PHPT-induced AP in pregnancy is delayed,while early diagnosis and immediate intervention lead to excellent maternal and fetal outcomes.展开更多
Offshore wind farms are becoming increasingly distant from onshore centralized control centers,and the communication delays between them inevitably introduce time delays in the measurement signal of the primary freque...Offshore wind farms are becoming increasingly distant from onshore centralized control centers,and the communication delays between them inevitably introduce time delays in the measurement signal of the primary frequency control.This causes a deterioration in the performance of the primary frequency control and,in some cases,may even result in frequency instability within the power system.Therefore,a frequency response model that incorporates communication delays was established for power systems that integrate offshore wind power.The Padéapproximation was used to model the time delays,and a linearized frequency response model of the power system was derived to investigate the frequency stability under different time delays.The influences of the wind power proportion and frequency control parameters on the system frequency stability were explored.In addition,a Smith delay compensation control strategy was devised to mitigate the effects of communication delays on the system frequency dynamics.Finally,a power system incorporating offshore wind power was constructed using the MATLAB/Simulink platform.The simulation results demonstrate the effectiveness and robustness of the proposed delay compensation control strategy.展开更多
BACKGROUND Primary central nervous system lymphoma(PCNSL)is a non-Hodgkin lymphoma that originates in the central nervous system(CNS)and is exclusively limited to the CNS.Although most PCNSLs are diffuse large B-cell ...BACKGROUND Primary central nervous system lymphoma(PCNSL)is a non-Hodgkin lymphoma that originates in the central nervous system(CNS)and is exclusively limited to the CNS.Although most PCNSLs are diffuse large B-cell lymphomas,primary CNS T-cell lymphomas(PCNSTLs)are rare.PCNSTLs typically demonstrate some degree of enhancement on contrast-enhanced magnetic resonance imaging(MRI).To the best of our knowledge,non-enhancing PCNSTL has not been reported previously.CASE SUMMARY A 69-year-old male presented to the neurology department with complaints of mild cognitive impairment and gradual onset of left lower leg weakness over a span of two weeks.Initial MRI showed asymmetric T2-hyperintense lesions within the brain.No enhancement was observed on the contrast-enhanced T1 image.The initial diagnosis was neuro-Behçet’s disease.Despite high-dose steroid therapy,no alterations in the lesions were identified on initial MRI.The patient’s symptoms deteriorated further.An MRI performed one month after the initial scan revealed an increased lesion extent.Subsequently,brain biopsy confirmed the diagnosis of PCNSTL.The patient underwent definitive combined chemoradiotherapy.However,the patient developed bacteremia and died of septic shock approximately three months after diagnosis.CONCLUSION The absence of enhancement in the lesion did not rule out PCNSTL.A biopsy approach is advisable for pathological confirmation.展开更多
In this editorial,we comment on the article by Wang et al.This manuscript explores the potential synergistic effects of combining zanubrutinib,a novel oral inhibitor of Bruton’s tyrosine kinase,with high-dose methotr...In this editorial,we comment on the article by Wang et al.This manuscript explores the potential synergistic effects of combining zanubrutinib,a novel oral inhibitor of Bruton’s tyrosine kinase,with high-dose methotrexate(HD-MTX)as a therapeutic intervention for primary central nervous system lymphoma(PCNSL).The study involves a retrospective analysis of 19 PCNSL patients,highlighting clinicopathological characteristics,treatment outcomes,and genomic biomarkers.The results indicate the combination’s good tolerance and strong antitumor activity,with an 84.2%overall response rate.The authors emphasize the potential of zanubrutinib to modulate key genomic features of PCNSL,particularly mutations in myeloid differentiation primary response 88 and cluster of differentiation 79B.Furthermore,the study investigates the role of circulating tumor DNA in cerebrospinal fluid for disease surveillance and treatment response monitoring.In essence,the study provides valuable insights into the potential of combining zanubrutinib with HD-MTX as a frontline therapeutic regimen for PCNSL.The findings underscore the importance of exploring alternative treatment modalities and monitoring genomic and liquid biopsy markers to optimize patient outcomes.While the findings suggest promise,the study’s limitations should be considered,and further research is needed to establish the clinical relevance of this therapeutic approach for PCNSL.展开更多
In this editorial I comment on the article,published in the current issue of the World Journal of Clinical Oncology.Primary central nervous system lymphoma(PCNSL)is a disease of elderly and immunocompromised patients....In this editorial I comment on the article,published in the current issue of the World Journal of Clinical Oncology.Primary central nervous system lymphoma(PCNSL)is a disease of elderly and immunocompromised patients.The authors reported clinical results of 19 patients with PCNSL treated with zanubrutinib/high dose methotrexate(HD-MTX)until disease progression.They demonstrated that the combination of zanubrutinib with HD-MTX led to a marked clinical response and tolerability among these patients.They also observed that cerebrospinal fluid liquid biopsy to detect circulating tumor DNA may be a good option for evaluating treatment response and tumor burden in patients with PCNSL.PCNSL is a challenging disease for treatment as these patients present with different neurological states and comorbidities.Treatment has evolved over the years from whole brain radiotherapy to HD-MTX followed by autologous stem cell transplant.Gradually,treatment of patients with PCNSL is going to become individualized.展开更多
Objective:To summarize the clinical features,imaging manifestations,therapeutic options,and prognosis of the primary angiitis of the central nervous system(PACNS)and to explore the role of high-resolution magnetic res...Objective:To summarize the clinical features,imaging manifestations,therapeutic options,and prognosis of the primary angiitis of the central nervous system(PACNS)and to explore the role of high-resolution magnetic resonance imaging(HR-MRI)in the PACNS diagnosis and treatment.Methods:One patient with PACNS treated by HR-MRI was retrospectively analyzed and summarized by combining relevant literature.Results:The patient was a young female who was hospitalized with progressive cerebral infarction and multiple intracranial arterial stenosis.HR-MRI indicated vasculitic changes.After excluding other diseases,hormone shock combined with immunosuppression was given,followed by long-term rehabilitation treatment.The patient’s condition tended to stabilize,and the prognosis was satisfactory.Conclusion PACNS is challenging to diagnose and is characterized by poor prognosis and easy recurrence.HR-MRI plays an important role in the clinical diagnosis and treatment adjustment for PACNS.展开更多
Knowledge of the etiological and pathogenetic mechanisms of the development of any disease is essential for its treatment.Because the cause of primary biliary cholangitis(PBC),a chronic,slowly progressive cholestatic ...Knowledge of the etiological and pathogenetic mechanisms of the development of any disease is essential for its treatment.Because the cause of primary biliary cholangitis(PBC),a chronic,slowly progressive cholestatic liver disease,is still unknown,treatment remains symptomatic.Knowledge of the physicochemical properties of various bile acids and the adaptive responses of cholangiocytes and hepatocytes to them has provided an important basis for the development of relatively effective drugs based on hydrophilic bile acids that can potentially slow the progression of the disease.Advances in the use of hydrophilic bile acids for the treatment of PBC are also associated with the discovery of pathogenetic mechanisms of the development of cholangiocyte damage and the appearance of the first signs of this disease.For 35 years,ursodeoxycholic acid(UDCA)has been the unique drug of choice for the treatment of patients with PBC.In recent years,the list of hydrophilic bile acids used to treat cholestatic liver diseases,including PBC,has expanded.In addition to UDCA,the use of obeticholic acid,tauroursodeoxycholic acid and norursodeoxycholic acid as drugs is discussed.The pathogenetic rationale for treatment of PBC with various bile acid drugs is discussed in this review.Emphasis is made on the mechanisms explaining the beneficial therapeutic effects and potential of each of the bile acid as a drug,based on the understanding of the pathogenesis of the initial stages of PBC.展开更多
BACKGROUND Primary biliary cholangitis(PBC)is a chronic autoimmune-mediated cholestatic liver disease.Nanoparticles encapsulating rapamycin(ImmTOR)suppress adaptive immune responses and induce the hepatic tolerogenic ...BACKGROUND Primary biliary cholangitis(PBC)is a chronic autoimmune-mediated cholestatic liver disease.Nanoparticles encapsulating rapamycin(ImmTOR)suppress adaptive immune responses and induce the hepatic tolerogenic immune response.AIM To investigate the effects of ImmTOR in PBC mouse models.METHODS PBC models were induced in C57BL/6 mice by two immunizations of 2-octynoic acid-coupled bovine serum albumin at two-week intervals,and polycytidylic acid every three days.The PBC mouse models were separated into the treatment group and the control group.The levels of alkaline phosphatase(ALP)and alanine aminotransferase in the mice were detected using an automatic biochemical analyzer.Liver and spleen mononuclear cells were analyzed by flow cytometry,and serum anti-mitochondrial antibodies(AMA)and the related cytokines were analyzed by enzyme-linked immunosorbent assay.Liver histopathology was examined by hematoxylin and eosin staining and scored.RESULTS After treatment with ImmTOR,the ALP level was significantly decreased(189.60 U/L±27.25 U/L vs 156.00 U/L±17.21 U/L,P<0.05),the level of AMA was reduced(1.28 ng/mL±0.27 ng/mL vs 0.56 ng/mL±0.07 ng/mL,P<0.001)and the expression levels of interferon gamma and tumor necrosis factorαwere significantly decreased(48.29 pg/mL±10.84 pg/mL vs 25.01 pg/mL±1.49 pg/mL,P<0.0001)and(84.24 pg/mL±23.47 pg/mL vs 40.66 pg/mL±14.65 pg/mL,P<0.001).The CD4+T lymphocytes,CD8+T lymphocytes and B lymphocytes in the liver were significantly reduced,with statistically significant differences(24.21%±6.55%vs 15.98%±3.03%,P<0.05;9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The expression of CD8+T lymphocytes and B lymphocytes in the ImmTOR treatment group also decreased(9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The liver pathology of PBC mice in the treatment group showed reduced inflammation and a decreased total pathology score,and the difference in the scores was statistically significant(4.50±2.88 vs 1.75±1.28,P<0.05).CONCLUSION ImmTOR can improve biochemistry and pathology of liver obvious by inhibiting the expression of CD8+T cells and B cells,and reducing the titer of AMA.展开更多
BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple pri...BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.展开更多
Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities...Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.展开更多
Under warming conditions and with increasing human perturbations,rivers across the globe are facing drastic shifts in their hydrologic regime,resulting in fragmentation and disconnection from the catchment.Subsequentl...Under warming conditions and with increasing human perturbations,rivers across the globe are facing drastic shifts in their hydrologic regime,resulting in fragmentation and disconnection from the catchment.Subsequently,a dependency on in situ primary productivity as the source of organic matter increases and warrants detailed investigation of the nature of primary production in urbanized river systems.In this study,primary productivity was estimated at multiple locations along the continuum of an engineered(Sabarmati)and a free flowing(Mahi)river systems in India using^(13)C tracer incubation method.Significantly enhanced primary productivity in the riverfront(engineered construction along the Sabarmati that holds water supplied by a canal)and polluted downstream of the Sabarmati compared to free flowing Mahi was observed.It was also observed that water stagnancy,temperature,and nutrient availability were the key factors regulating the rates of primary productivity in the urban river system.The study highlights the salient features of riverine primary productivity associated with engineered modifications,which needs to be considered for future river development projects.展开更多
BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastat...BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.展开更多
Li/MnO_(2) primary batteries are widely used in industry for their high specific capacity and safety.However,a deep comprehension of the Li^(+)insertion mechanism and the high self-discharge rate of the batteries is s...Li/MnO_(2) primary batteries are widely used in industry for their high specific capacity and safety.However,a deep comprehension of the Li^(+)insertion mechanism and the high self-discharge rate of the batteries is still needed.Here,the storage mechanism of Li^(+)in the tunnel structure of MnO_(2) as well as the dissolution and migration of Mn-ions were investigated based on multi-scale approaches.The Li/Mn ratio(at%)is determined at about 0.82 when the discharge voltage decreases to 2 V.The limited Li-ions transport rate in the bulk MnO_(2) restrains the reduction reaction,resulting in a low practical specific capacity.Moreover,utilizing spherical aberration-corrected transmission electron microscopy(TEM)coupled with electron energy loss spectroscopy(EELS),the presence of a mixed valence state layer of Mn^(2+)/Mn^(3+)/Mn^(4+)on the surface of the original 20 nm MnO_(2) particles was identified,which could contribute to the initial dissolution of Mn-ions.The battery separator exhibited channels for Mn-ions migration and diffusion and aggregated Mn particles.We put forward the discharge and degradation route in the ways of Mn-ions trajectories,and our findings provide a deep understanding of the high self-discharge rates and the capacity decay of Li-Mn primary batteries.展开更多
Parental educational anxiety has become a social symptom in China,and rural primary school students’mothers exhibit unique educational anxieties due to their special living environment.Based on interviews with 10 rur...Parental educational anxiety has become a social symptom in China,and rural primary school students’mothers exhibit unique educational anxieties due to their special living environment.Based on interviews with 10 rural primary school students’mothers,five typical educational anxiety experiences were selected for analysis,and themes such as rural life burden,children’s learning habits,mothers’educational expectations,mothers’educational methods,mothers’emotional state,deviation between reality and expectations,homework guidance ability,mothers’educational level,and attitudes towards children’s future development were refined.The root causes of educational anxiety among rural primary school students’mothers include the deviation between children’s actual performance and mothers’educational expectations,the sense of disparity under social comparison,physical and mental exhaustion caused by role overload,anxiety triggered by excessive economic burden,and a sense of powerlessness towards children’s educational outcomes.To alleviate the educational anxiety of rural primary school students’mothers,mothers should actively adjust themselves,fathers should actively participate in their children’s education,society should create a healthy atmosphere,and schools should strengthen family education guidance.展开更多
AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 ...AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023.These participants then completed a general information questionnaire and the Decision Conflict Scale.Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.RESULTS:The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01,with 99.1%of these individuals reporting experiencing decisional conflict.Multiple linear regression analysis revealed that females(P=0.002)and patients with a shorter duration of the disease(P=0.006)had higher levels of decisional conflict.Additionally,patients diagnosed during medical visits(P=0.049),those who refused LPI treatment(P=0.032),and individuals facing significant economic burdens related to medical expenses(P=0.005)exhibited higher levels of decisional conflict.Furthermore,patients who preferred to make medical decisions independently(P=0.023)and those who favored involving family members in decisionmaking(P=0.005)experienced increased levels of decisional conflict.CONCLUSION:Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict.Healthcare professionals should thoroughly assess a range of factors that influence this conflict,including gender,duration of disease,method of diagnosis acquisition,LPI treatment,economic burden of medical expenses,and patient preferences regarding medical decision-making.By considering these variables,tailored decision support can be developed to address individual patient needs,ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.展开更多
文摘Primary systemic treatment is a fundamental part of breast cancer therapy, and it is applied to non-surgical and locally advanced tumours as well as surgical tumours to increase the likelihood of conservative treatment. Its aim is to achieve the best possible survival with better cosmetic results and with the lowest number of treatment-related secondary effects. Before treatment is started, it is necessary to attain the best knowledge of the biological features and locoregional extension of the tumour. To do so, it is necessary to obtain a biopsy of the lesion with a wide bore needle,as well as good radiological knowledge of the disease.Therefore, currently, the use of a dynamic magnetic resonance imaging(MRI) of the breast should be included in all cases. In addition, before it is started,especially in those tumours in which conservative treatment is considered, one or several radiopaque markers should be put into place to make it possible to locate the area to be treated if there is a considerable or complete response. Systemic treatment is mainly based on combined chemotherapy with anthracyclins and taxanes, in addition to some biological agents with demonstrated efficiency for increasing the likelihood of complete disease response(trastuzumab in patients with Her-2/neu overexpression). However, there is room for neoadjuvant hormone treatment, in patients with hormone receptor overexpression, especially in those cases in which chemotherapy is contraindicated as well as in elderly patients with a relatively short life expectancy. The assessment of preoperative treatment should be based on adequate radiological tests, and nowad these should include MRI before taking decisions about adequate surgical treatment. The objective of primary treatment is to be able to increase survival and improve the chances of local treatment in the case of locally advanced treatment, achieving results that are at least equal to those of adjuvant treatment in the case of surgical tumours, but with greater chances of conservative surgery. Although the objective is survival, achieving complete pathological response seems to be a reasonable related objective, although these are more closely linked in some tumour subtypes.
文摘BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right heart.Late diagnosis mimics common cardiac ailments,leading to poor prognosis.AIM To systematically review the efficacy of rituximab in treating PCL either alone or in various chemotherapeutic regimens.Secondary objectives include evaluating morphological subtypes,assessing treatment regimens,and analyzing outcomes focusing on remission and adverse events.METHODS Following PRISMA guidelines,a comprehensive literature search was conducted across multiple databases,including PubMed,Hinari,Web of Science,and Scopus.English-language studies reporting the use of rituximab in treating PCL in humans were included.Study selection involved initial screening of titles and abstracts followed by full-text examination and data extraction.RESULTS Thirty-three case reports involving 36 patients were included in this systematic review.Diffuse large B-cell lymphoma was the predominant morphological subtype observed.The rituximab,cyclophosphamide,doxorubicin,oncovin,and prednisolone regimen emerged as the most commonly employed treatment strategy,indicating widespread acceptance and efficacy in PCL management.Combination therapies,including surgical intervention,showed promise in achieving complete remission,while some studies reported mortality despite aggressive treatment approaches.CONCLUSION Rituximab,particularly in combination with chemotherapy regimens,represents a significant advancement in PCL management,offering hope for improved patient outcomes.However,challenges such as variable treatment responses and adverse events underscore the complexity of managing PCL.Further research is warranted to refine therapeutic strategies and enhance diagnostic approaches for this rare cardiac malignancy.
文摘Casein kinase 1(CK1)is an important member of the serine/threonine protein kinase family,playing a crucial role in various cellular processes,including cell cycle regulation,signal transduction,DNA repair,and circadian rhythm control.CK1 is also essential in the nervous system,where it regulates neuronal growth,differentiation,and synaptic plasticity.Studies have shown that CK1δ phosphorylates neuron-specific proteins to regulate axonal growth and synaptogenesis.Primary cilia are non-motile microtubule structures present on the surface of most mammalian cells.Recent studies have revealed their multiple roles in cellular physiology and development,and dysfunction of cilia can impact the development and function of the nervous system.CK1 has an important role in the formation and function of primary cilia.By regulating various signaling pathways and the phosphorylation status of proteins,CK1 affects the generation,maintenance,and signaling transduction of cilia.In this review,the relationship between CK1,primary cilia,and the nervous system was explored,focusing on how CK1 influences cilia to regulate the structure and function of the nervous system.
文摘In the current era of digitalization sweeping the education field,primary school English education is facing new challenges and opportunities of deep integration with artificial intelligence.This study focuses on primary school English teachers and uses various methods such as questionnaire surveys,visits,and interviews to conduct an in-depth exploration of their artificial intelligence literacy.After data analysis,optimization strategies are proposed to further improve the artificial intelligence literacy of primary school English teachers and promote the development of educational soft power.
基金supported by grants from the National Nat-ural Science Foundation of China (81570587 and 81700557)the Guangdong Provincial Key Laboratory Construction Projection on Organ Donation and Transplant Immunology (2013A061401007 and 2017B030314018)+3 种基金Guangdong Provincial Natural Science Funds for Major Basic Science Culture Project (2015A030308010)Science and Technology Program of Guangzhou (201704020150)the Natural Science Foundations of Guangdong province (2016A030310141 and 2020A1515010091)Young Teachers Training Project of Sun Yat-sen University (K0401068) and the Guangdong Science and Technology Innovation Strategy (pdjh2022b0010 and pdjh2023a0002)。
文摘Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.
文摘BACKGROUND Primary hyperparathyroidism(PHPT)-induced acute pancreatitis(AP)during pregnancy has rarely been described.Due to this rarity,there are no diagnostic or treatment algorithms for pregnant patients.AIM To determine appropriate diagnostic methods,therapeutic options,and factors related to maternal and fetal outcomes for PHPT-induced AP in pregnancy.METHODS A literature search of articles in English,Japanese,German,Spanish,and Italian was performed using PubMed(1946-2023),PubMed Central(1900-2023),and Google Scholar.The Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)protocol was followed.The search terms included“pancreatite acuta,”“iperparatiroidismo primario,”“gravidanza,”“travaglio,”“puerperio,”“postpartum,”“akute pankreatitis,”“primärer hyperparathyreoidismus,”“Schwangerschaft,”“Wehen,”“Wochenbett,”“pancreatitis aguda,”“hiperparatiroidismo primario,”“embarazo,”“parto,”“puerperio,”“posparto,”“acute pancreatitis,”“primary hyperparathyroidism,”“pregnancy,”“labor,”“puerperium,”and“postpartum.”Additional studies were identified by reviewing the reference lists of retrieved studies.Demographic,imaging,surgical,obstetric,and outcome data were obtained.RESULTS Fifty-four cases were collected from the 51 studies.The median maternal age was 29 years.PHPT-induced AP starts at the 20th gestational week;higher gestational weeks were seen in mothers who died(mean gestational week 28).Median values of amylase(1399,Q1-Q3=519-2072),lipase(2072,Q1-Q3=893-2804),serum calcium(3.5,Q1-Q3=3.1-3.9),and parathormone(PTH)(384,Q1-Q3=123-910)were reported.In 46 cases,adenoma was the cause of PHPT,followed by 2 cases of carcinoma and 1 case of hyperplasia.In the remaining 5 cases,the diagnosis was not reported.Neck ultrasound was positive in 34 cases,whereas sestamibi was performed in 3 cases,and neck computed tomography or magnetic resonance imaging was performed in 9 cases(the enlarged parathyroid gland was not localized in 3 cases).Surgery was the preferred treatment during pregnancy in 33 cases(median week of gestation 25,Q1-Q3=20-30)and postpartum in 12 cases.The timing was not reported in the remaining 9 cases,or surgery was not performed.AP was managed surgically in 11 cases and conservatively in 43(79.6%)cases.Maternal and fetal mortality was 9.3%(5 cases).Surgery was more common in deceased mothers(60.0%vs 16.3%;P=0.052),and PTH values tended to be higher in this group(910 pg/mL vs 302 pg/mL;P=0.059).Maternal mortality was higher with higher serum lipase levels and earlier delivery week.Higher calcium(4.1 mmol/L vs 3.3 mmol/L;P=0.009)and PTH(1914 pg/mL vs 302 pg/mL;P=0.003)values increased fetal/child mortality,as well as abortions(40.0%vs 0.0%;P=0.007)and complex deliveries(60.0%vs 8.2%;P=0.01).CONCLUSION If serum calcium is not tested during admission,definitive diagnosis of PHPT-induced AP in pregnancy is delayed,while early diagnosis and immediate intervention lead to excellent maternal and fetal outcomes.
基金the support of the National Natural Science Foundation of China(52077061)Fundamental Research Funds for the Central Universities(B240201121).
文摘Offshore wind farms are becoming increasingly distant from onshore centralized control centers,and the communication delays between them inevitably introduce time delays in the measurement signal of the primary frequency control.This causes a deterioration in the performance of the primary frequency control and,in some cases,may even result in frequency instability within the power system.Therefore,a frequency response model that incorporates communication delays was established for power systems that integrate offshore wind power.The Padéapproximation was used to model the time delays,and a linearized frequency response model of the power system was derived to investigate the frequency stability under different time delays.The influences of the wind power proportion and frequency control parameters on the system frequency stability were explored.In addition,a Smith delay compensation control strategy was devised to mitigate the effects of communication delays on the system frequency dynamics.Finally,a power system incorporating offshore wind power was constructed using the MATLAB/Simulink platform.The simulation results demonstrate the effectiveness and robustness of the proposed delay compensation control strategy.
文摘BACKGROUND Primary central nervous system lymphoma(PCNSL)is a non-Hodgkin lymphoma that originates in the central nervous system(CNS)and is exclusively limited to the CNS.Although most PCNSLs are diffuse large B-cell lymphomas,primary CNS T-cell lymphomas(PCNSTLs)are rare.PCNSTLs typically demonstrate some degree of enhancement on contrast-enhanced magnetic resonance imaging(MRI).To the best of our knowledge,non-enhancing PCNSTL has not been reported previously.CASE SUMMARY A 69-year-old male presented to the neurology department with complaints of mild cognitive impairment and gradual onset of left lower leg weakness over a span of two weeks.Initial MRI showed asymmetric T2-hyperintense lesions within the brain.No enhancement was observed on the contrast-enhanced T1 image.The initial diagnosis was neuro-Behçet’s disease.Despite high-dose steroid therapy,no alterations in the lesions were identified on initial MRI.The patient’s symptoms deteriorated further.An MRI performed one month after the initial scan revealed an increased lesion extent.Subsequently,brain biopsy confirmed the diagnosis of PCNSTL.The patient underwent definitive combined chemoradiotherapy.However,the patient developed bacteremia and died of septic shock approximately three months after diagnosis.CONCLUSION The absence of enhancement in the lesion did not rule out PCNSTL.A biopsy approach is advisable for pathological confirmation.
文摘In this editorial,we comment on the article by Wang et al.This manuscript explores the potential synergistic effects of combining zanubrutinib,a novel oral inhibitor of Bruton’s tyrosine kinase,with high-dose methotrexate(HD-MTX)as a therapeutic intervention for primary central nervous system lymphoma(PCNSL).The study involves a retrospective analysis of 19 PCNSL patients,highlighting clinicopathological characteristics,treatment outcomes,and genomic biomarkers.The results indicate the combination’s good tolerance and strong antitumor activity,with an 84.2%overall response rate.The authors emphasize the potential of zanubrutinib to modulate key genomic features of PCNSL,particularly mutations in myeloid differentiation primary response 88 and cluster of differentiation 79B.Furthermore,the study investigates the role of circulating tumor DNA in cerebrospinal fluid for disease surveillance and treatment response monitoring.In essence,the study provides valuable insights into the potential of combining zanubrutinib with HD-MTX as a frontline therapeutic regimen for PCNSL.The findings underscore the importance of exploring alternative treatment modalities and monitoring genomic and liquid biopsy markers to optimize patient outcomes.While the findings suggest promise,the study’s limitations should be considered,and further research is needed to establish the clinical relevance of this therapeutic approach for PCNSL.
文摘In this editorial I comment on the article,published in the current issue of the World Journal of Clinical Oncology.Primary central nervous system lymphoma(PCNSL)is a disease of elderly and immunocompromised patients.The authors reported clinical results of 19 patients with PCNSL treated with zanubrutinib/high dose methotrexate(HD-MTX)until disease progression.They demonstrated that the combination of zanubrutinib with HD-MTX led to a marked clinical response and tolerability among these patients.They also observed that cerebrospinal fluid liquid biopsy to detect circulating tumor DNA may be a good option for evaluating treatment response and tumor burden in patients with PCNSL.PCNSL is a challenging disease for treatment as these patients present with different neurological states and comorbidities.Treatment has evolved over the years from whole brain radiotherapy to HD-MTX followed by autologous stem cell transplant.Gradually,treatment of patients with PCNSL is going to become individualized.
基金Basic and Applied Basic Research Fund Project of Guangdong Province(2022A1515220161).
文摘Objective:To summarize the clinical features,imaging manifestations,therapeutic options,and prognosis of the primary angiitis of the central nervous system(PACNS)and to explore the role of high-resolution magnetic resonance imaging(HR-MRI)in the PACNS diagnosis and treatment.Methods:One patient with PACNS treated by HR-MRI was retrospectively analyzed and summarized by combining relevant literature.Results:The patient was a young female who was hospitalized with progressive cerebral infarction and multiple intracranial arterial stenosis.HR-MRI indicated vasculitic changes.After excluding other diseases,hormone shock combined with immunosuppression was given,followed by long-term rehabilitation treatment.The patient’s condition tended to stabilize,and the prognosis was satisfactory.Conclusion PACNS is challenging to diagnose and is characterized by poor prognosis and easy recurrence.HR-MRI plays an important role in the clinical diagnosis and treatment adjustment for PACNS.
文摘Knowledge of the etiological and pathogenetic mechanisms of the development of any disease is essential for its treatment.Because the cause of primary biliary cholangitis(PBC),a chronic,slowly progressive cholestatic liver disease,is still unknown,treatment remains symptomatic.Knowledge of the physicochemical properties of various bile acids and the adaptive responses of cholangiocytes and hepatocytes to them has provided an important basis for the development of relatively effective drugs based on hydrophilic bile acids that can potentially slow the progression of the disease.Advances in the use of hydrophilic bile acids for the treatment of PBC are also associated with the discovery of pathogenetic mechanisms of the development of cholangiocyte damage and the appearance of the first signs of this disease.For 35 years,ursodeoxycholic acid(UDCA)has been the unique drug of choice for the treatment of patients with PBC.In recent years,the list of hydrophilic bile acids used to treat cholestatic liver diseases,including PBC,has expanded.In addition to UDCA,the use of obeticholic acid,tauroursodeoxycholic acid and norursodeoxycholic acid as drugs is discussed.The pathogenetic rationale for treatment of PBC with various bile acid drugs is discussed in this review.Emphasis is made on the mechanisms explaining the beneficial therapeutic effects and potential of each of the bile acid as a drug,based on the understanding of the pathogenesis of the initial stages of PBC.
基金Supported by Cultivation Project of Hebei Natural Science Foundation-Precision Medicine Joint Fund,No.H2021206239.
文摘BACKGROUND Primary biliary cholangitis(PBC)is a chronic autoimmune-mediated cholestatic liver disease.Nanoparticles encapsulating rapamycin(ImmTOR)suppress adaptive immune responses and induce the hepatic tolerogenic immune response.AIM To investigate the effects of ImmTOR in PBC mouse models.METHODS PBC models were induced in C57BL/6 mice by two immunizations of 2-octynoic acid-coupled bovine serum albumin at two-week intervals,and polycytidylic acid every three days.The PBC mouse models were separated into the treatment group and the control group.The levels of alkaline phosphatase(ALP)and alanine aminotransferase in the mice were detected using an automatic biochemical analyzer.Liver and spleen mononuclear cells were analyzed by flow cytometry,and serum anti-mitochondrial antibodies(AMA)and the related cytokines were analyzed by enzyme-linked immunosorbent assay.Liver histopathology was examined by hematoxylin and eosin staining and scored.RESULTS After treatment with ImmTOR,the ALP level was significantly decreased(189.60 U/L±27.25 U/L vs 156.00 U/L±17.21 U/L,P<0.05),the level of AMA was reduced(1.28 ng/mL±0.27 ng/mL vs 0.56 ng/mL±0.07 ng/mL,P<0.001)and the expression levels of interferon gamma and tumor necrosis factorαwere significantly decreased(48.29 pg/mL±10.84 pg/mL vs 25.01 pg/mL±1.49 pg/mL,P<0.0001)and(84.24 pg/mL±23.47 pg/mL vs 40.66 pg/mL±14.65 pg/mL,P<0.001).The CD4+T lymphocytes,CD8+T lymphocytes and B lymphocytes in the liver were significantly reduced,with statistically significant differences(24.21%±6.55%vs 15.98%±3.03%,P<0.05;9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The expression of CD8+T lymphocytes and B lymphocytes in the ImmTOR treatment group also decreased(9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The liver pathology of PBC mice in the treatment group showed reduced inflammation and a decreased total pathology score,and the difference in the scores was statistically significant(4.50±2.88 vs 1.75±1.28,P<0.05).CONCLUSION ImmTOR can improve biochemistry and pathology of liver obvious by inhibiting the expression of CD8+T cells and B cells,and reducing the titer of AMA.
基金Supported by Gansu Provincial Natural Science Foundation,No.21JR1RA010In-Hospital Research Fund of Gansu Provincial Hospital,No.23GSSYD-5.
文摘BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.
基金supported by the China Postdoctoral Science Foundation Grant(2023M734294)Jiangsu Provincial Medical Key Discipline Cultivation Unit(JSDW202215)the National Natural Science Foundation of China(No.82001618).
文摘Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.
文摘Under warming conditions and with increasing human perturbations,rivers across the globe are facing drastic shifts in their hydrologic regime,resulting in fragmentation and disconnection from the catchment.Subsequently,a dependency on in situ primary productivity as the source of organic matter increases and warrants detailed investigation of the nature of primary production in urbanized river systems.In this study,primary productivity was estimated at multiple locations along the continuum of an engineered(Sabarmati)and a free flowing(Mahi)river systems in India using^(13)C tracer incubation method.Significantly enhanced primary productivity in the riverfront(engineered construction along the Sabarmati that holds water supplied by a canal)and polluted downstream of the Sabarmati compared to free flowing Mahi was observed.It was also observed that water stagnancy,temperature,and nutrient availability were the key factors regulating the rates of primary productivity in the urban river system.The study highlights the salient features of riverine primary productivity associated with engineered modifications,which needs to be considered for future river development projects.
文摘BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.
基金supported by the National Natural Science Foundation of China(Nos.U2030206,12104022,52271014 and 22075003)the Presidential Foundation of CAEP(No.YZJJZL2023173)Sichuan Science and Technology Program(No.2021YFH0092).
文摘Li/MnO_(2) primary batteries are widely used in industry for their high specific capacity and safety.However,a deep comprehension of the Li^(+)insertion mechanism and the high self-discharge rate of the batteries is still needed.Here,the storage mechanism of Li^(+)in the tunnel structure of MnO_(2) as well as the dissolution and migration of Mn-ions were investigated based on multi-scale approaches.The Li/Mn ratio(at%)is determined at about 0.82 when the discharge voltage decreases to 2 V.The limited Li-ions transport rate in the bulk MnO_(2) restrains the reduction reaction,resulting in a low practical specific capacity.Moreover,utilizing spherical aberration-corrected transmission electron microscopy(TEM)coupled with electron energy loss spectroscopy(EELS),the presence of a mixed valence state layer of Mn^(2+)/Mn^(3+)/Mn^(4+)on the surface of the original 20 nm MnO_(2) particles was identified,which could contribute to the initial dissolution of Mn-ions.The battery separator exhibited channels for Mn-ions migration and diffusion and aggregated Mn particles.We put forward the discharge and degradation route in the ways of Mn-ions trajectories,and our findings provide a deep understanding of the high self-discharge rates and the capacity decay of Li-Mn primary batteries.
基金Hunan Provincial Social Science Foundation“A Phenomenological Study on the Educational Life Experiences of Rural Young Teachers”(20YBA017)。
文摘Parental educational anxiety has become a social symptom in China,and rural primary school students’mothers exhibit unique educational anxieties due to their special living environment.Based on interviews with 10 rural primary school students’mothers,five typical educational anxiety experiences were selected for analysis,and themes such as rural life burden,children’s learning habits,mothers’educational expectations,mothers’educational methods,mothers’emotional state,deviation between reality and expectations,homework guidance ability,mothers’educational level,and attitudes towards children’s future development were refined.The root causes of educational anxiety among rural primary school students’mothers include the deviation between children’s actual performance and mothers’educational expectations,the sense of disparity under social comparison,physical and mental exhaustion caused by role overload,anxiety triggered by excessive economic burden,and a sense of powerlessness towards children’s educational outcomes.To alleviate the educational anxiety of rural primary school students’mothers,mothers should actively adjust themselves,fathers should actively participate in their children’s education,society should create a healthy atmosphere,and schools should strengthen family education guidance.
基金Supported by Basic Scientific Research Projects of Wenzhou(No.Y20220155).
文摘AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023.These participants then completed a general information questionnaire and the Decision Conflict Scale.Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.RESULTS:The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01,with 99.1%of these individuals reporting experiencing decisional conflict.Multiple linear regression analysis revealed that females(P=0.002)and patients with a shorter duration of the disease(P=0.006)had higher levels of decisional conflict.Additionally,patients diagnosed during medical visits(P=0.049),those who refused LPI treatment(P=0.032),and individuals facing significant economic burdens related to medical expenses(P=0.005)exhibited higher levels of decisional conflict.Furthermore,patients who preferred to make medical decisions independently(P=0.023)and those who favored involving family members in decisionmaking(P=0.005)experienced increased levels of decisional conflict.CONCLUSION:Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict.Healthcare professionals should thoroughly assess a range of factors that influence this conflict,including gender,duration of disease,method of diagnosis acquisition,LPI treatment,economic burden of medical expenses,and patient preferences regarding medical decision-making.By considering these variables,tailored decision support can be developed to address individual patient needs,ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.
