The global prevalence of metabolic-associated fatty liver disease(MAFLD)is on the rise,seriously threatening human health.Currently,no specific approved drugs are available for its treatment.This paper reviews the pat...The global prevalence of metabolic-associated fatty liver disease(MAFLD)is on the rise,seriously threatening human health.Currently,no specific approved drugs are available for its treatment.This paper reviews the pathogenesis of MAFLD,covering aspects like lipid accumulation and insulin resistance,oxidative stress,endoplasmic reticulum stress(ERS),lipotoxicity-induced hepatocyte damage,and fibrosis.It also elaborates on multiple treatment approaches for MAFLD,including metabolic regulation,improvement of the gut-liver axis interaction,modulation of immune and inflammatory pathways,enhancement of the adipose tissue-liver interaction,alleviation of fibrosis,prevention of hepatocyte injury,and traditional Chinese medicine(TCM)external therapies.Additionally,natural product research advancements,individual Chinese medicine components,and mixed herbal formulas for MAFLD treatment is provided.Many natural products and traditional Chinese medicines exhibit favorable effects in regulating lipid metabolism,anti-inflammation,and anti-oxidation,offering new directions and potential drug options for MAFLD treatment.This is expected to provide a reference for future clinical treatment and drug development.展开更多
AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current resea...AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.展开更多
Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by...Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.展开更多
Rural domestic sewage treatment is critical for environmental protection.This study defines the spatial pattern of villages from the perspective of rural sewage treatment and develops an integrated decision-making sys...Rural domestic sewage treatment is critical for environmental protection.This study defines the spatial pattern of villages from the perspective of rural sewage treatment and develops an integrated decision-making system to propose a sewage treatment mode and scheme suitable for local conditions.By considering the village spatial layout and terrain factors,a decision tree model of residential density and terrain type was constructed with accuracies of 76.47%and 96.00%,respectively.Combined with binary classification probability unit regression,an appropriate sewage treatment mode for the village was determined with 87.00%accuracy.The Analytic Hierarchy Process(AHP),combined with the Technique for Order Preference(TOPSIS)by Similarity to an Ideal Solution model,formed the basis for optimal treatment process selection under different emission standards.Verification was conducted in 542 villages across three counties of the Inner Mongolia Autonomous Region,focusing on the standard effluent effect(0.3773),low investment cost(0.3196),and high standard effluent effect(0.5115)to determine the best treatment process for the same emission standard under different needs.The annual environmental and carbon emission benefits of sewage treatment in these villages were estimated.This model matches village density,geographic feature,and social development level,and provides scientific support and a theoretical basis for rural sewage treatment decision-making.展开更多
Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predicto...Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predictors of treatment failure.Methods:This retrospective cohort study included patients who received DAA therapy at Hospital Kuala Lumpur between January 2020 and December 2023.Sustained virologic response(SVR)was assessed at least 12 weeks post-treatment by reverse transcription-polymerase chain reaction for hepatitis C virus(HCV)RNA.Demographic,clinical,and laboratory data were collected and analyzed.Multiple logistic regression analysis was performed to identify independent predictors of treatment failure.Results:A total of 335 patients in the study.The overall SVR rate was 89%.After achieving SVR,significant improvements were observed in liver enzyme levels and non-invasive liver fibrosis scores,whereas the overall Model for End-Stage Liver Disease(MELD)scores remained unchanged.Significant independent predictors of treatment failure included non-compliance with DAA therapy[adjusted odds ratio(aOR)68.3;95%confidence interval(95%CI)16.3-285.0;P<0.001],treatment with sofosbuvir/velpatasvir(aOR 6.1;95%CI 1.4-26.5;P=0.015),MELD score of 10-15(aOR 4.6;95%CI 1.1-18.2;P=0.031),HCV genotype 3 infection(aOR 4.5;95%CI 1.1-17.6;P=0.031),and elevated serum total bilirubin level(aOR 1.1;95%CI 1.0-1.1;P=0.003).Conclusions:DAA therapy yielded a high SVR rate,and treatment failure was strongly associated with non-adherence to therapy and advanced liver disease.These findings underscore the necessity of adherence support,early diagnosis,and individualized clinical management to optimize treatment outcomes in patients with chronic hepatitis C.展开更多
Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult ...Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases.Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits.This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment.Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment,including cerebrovascular diseases,Alzheimer's disease,aging-related conditions,and issues related to anesthesia and surgery.The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized,and targeting AHN is considered a promising approach for treating cognitive impairment.However,the underlying mechanisms of this role are not yet fully understood,and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited,with a need for further development of treatment methods and detection techniques.By reviewing recent studies,we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories:immunity,energy metabolism,aging,and pathological states.In immunity-related mechanisms,abnormalities in meningeal,brain,and peripheral immunity can disrupt normal adult hippocampal neurogenesis.Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis.During aging,the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients.Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis.Among the current strategies used to enhance this form of neurogenesis,physical therapies such as exercise,transcutaneous electrical nerve stimulation,and enriched environments have proven effective.Dietary interventions,including energy intake restriction and nutrient optimization,have shown efficacy in both basic research and clinical trials.However,drug treatments,such as antidepressants and stem cell therapy,are primarily reported in basic research,with limited clinical application.The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention,and targeting the former may be an important strategy for treating the latter.However,the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear,and treatments are lacking.This highlights the need for greater focus on translating research findings into clinical practice.展开更多
Mitophagy is closely associated with the pathogenesis of secondary spinal cord injury.Abnormal mitophagy may contribute significantly to secondary spinal cord injury,leading to the impaired production of adenosine tri...Mitophagy is closely associated with the pathogenesis of secondary spinal cord injury.Abnormal mitophagy may contribute significantly to secondary spinal cord injury,leading to the impaired production of adenosine triphosphate,ion imbalance,the excessive production of reactive oxygen species,neuroinflammation,and neuronal cell death.Therefore,maintaining an appropriate balance of mitophagy is crucial when treating spinal cord injury,as both excessive and insufficient mitophagy can impede recovery.In this review,we summarize the pathological changes associated with spinal cord injury,the mechanisms of mitophagy,and the direct and indirect relationships between mitophagy and spinal cord injury.We also consider therapeutic approaches that target mitophagy for the treatment of spinal cord injury,including ongoing clinical trials and other innovative therapies,such as use of stem cells,nanomaterials,and small molecule polymers.Finally,we highlight the current challenges facing this field and suggest potential directions for future research.The aim of our review is to provide a theoretical reference for future studies targeting mitophagy in the treatment of spinal cord injury.展开更多
Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including ...Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including computed tomography(CT),magnetic resonance imaging(MRI),endoscopic imaging,and genomic profiles-to enable intelligent decision-making for individualized therapy.This approach leverages AI algorithms to fuse imaging,endoscopic,and omics data,facilitating comprehensive characterization of tumor biology,prediction of treatment response,and optimization of therapeutic strategies.By combining CT and MRI for structural assessment,endoscopic data for real-time visual inspection,and genomic information for molecular profiling,multimodal AI enhances the accuracy of patient stratification and treatment personalization.The clinical implementation of this technology demonstrates potential for improving patient outcomes,advancing precision oncology,and supporting individualized care in gastrointestinal cancers.Ultimately,multimodal AI serves as a transformative tool in oncology,bridging data integration with clinical application to effectively tailor therapies.展开更多
Background:This study focused on developing and optimizing a self-microemulsifying drug delivery system(SMEDDS)to improve Lafutidine’s solubility and bioavailability,thereby enhancing its effectiveness in treating ga...Background:This study focused on developing and optimizing a self-microemulsifying drug delivery system(SMEDDS)to improve Lafutidine’s solubility and bioavailability,thereby enhancing its effectiveness in treating gastric ulcers.Traditional formulations are less effective due to their limited water solubility and bioavailability.Methods:The study used solubility tests,pseudo-ternary phase diagrams,and central composite design(CCD)to optimize.The formulation was optimized by varying the oil concentration(10–40%)and surfactant/cosurfactant ratio(0.33–3.00),and then tested for droplet size,drug content,emulsification,phase stability,and in vitro dissolution.Results:The study found that the optimized formulation contained 14%Capmul PG 8NF oil,62%Labrasol surfactant,and 24%Tween 80 cosurfactant.This combination generated an average droplet size of 111.02 nm and improved drug release properties.Furthermore,the formulation was stable without phase separation,with a drug content of 88.2–99.8%.Conclusion:SMEDDS significantly improves lafutidine delivery by increasing solubility and absorption,thereby overcoming oral administration challenges.The system quickly formed small droplets in water and released the drug in 15 min.Enhancing lafutidine’s bioavailability may improve its efficacy in treating gastric ulcers,resulting in better patient outcomes and potentially lower dosing frequency.展开更多
Active inflammation in“inactive”progressive multiple sclerosis:Traditionally,the distinction between relapsing-remitting multiple sclerosis and progressive multiple sclerosis(PMS)has been framed as an inflammatory v...Active inflammation in“inactive”progressive multiple sclerosis:Traditionally,the distinction between relapsing-remitting multiple sclerosis and progressive multiple sclerosis(PMS)has been framed as an inflammatory versus degenerative dichotomy.This was based on a broad misconception regarding essentially all neurodegenerative conditions,depicting the degenerative process as passive and immune-independent occurring as a late byproduct of active inflammation in the central nervous system(CNS),which is(solely)systemically driven.展开更多
Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The ...Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.展开更多
The effect of different intermediate annealing heat treatments on the surface microstructures and anodic oxide film structures of rolled Al-5.6Mg sheets was studied.The results show that when the continuous annealing ...The effect of different intermediate annealing heat treatments on the surface microstructures and anodic oxide film structures of rolled Al-5.6Mg sheets was studied.The results show that when the continuous annealing is used to control microstructures of the sheets instead of the static state annealing in the intermediate annealing process,the surface grain size of the sheets can be reduced by about 65.7%,and the size of the Mg precipitation phase(Mg_(2)Al_(3))can be reduced by about 67%.Under the combined influence of grain size,precipitation phase,and texture,the highest glossiness can be obtained,which is attributed to continuous intermediate annealing and stabilization annealing at low temperature.The uniform grain and precipitation structures is beneficial to reducing the inhomogeneous dissolution of the oxide film and to obtain the anodic oxide film with uniform thickness and high glossiness.展开更多
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
Cancer poses a serious threat to human health worldwide and is a leading cause of death1.The analysis of radiological imaging is crucial in early detection,accurate diagnosis,effective treatment planning,and ongoing m...Cancer poses a serious threat to human health worldwide and is a leading cause of death1.The analysis of radiological imaging is crucial in early detection,accurate diagnosis,effective treatment planning,and ongoing monitoring of patients with cancer.However,several challenges impede the effectiveness of cancer imaging analysis in clinical practice.One difficulty is that healthcare professionals’immense clinical workloads can result in time constraints and increase pressure,thereby hindering their ability to maintain high accuracy and thoroughness in image analysis.Additionally,subjective variability among radiologists can lead to inconsistent interpretations and diagnoses.Because this variability is often influenced by personal biases,standardized assessments are often difficult to achieve.Moreover,the inherent complexity of cancer imaging necessitates extensive clinical experience;this aspect can also be a limiting factor,particularly if expertise or resources are limited.The application of artificial intelligence(AI)can alleviate these problems by enhancing the accuracy,objectivity,and efficiency of cancer imaging analysis while assisting physicians.Therefore,the advancement of AI research is crucial for achieving progress in radiology.展开更多
BACKGROUND There are few clinicopathologic characteristics and clinical results for oesophageal gastrointestinal stromal tumours(GISTs).Thus,the objective of this study was to identify the clinicopathologic characteri...BACKGROUND There are few clinicopathologic characteristics and clinical results for oesophageal gastrointestinal stromal tumours(GISTs).Thus,the objective of this study was to identify the clinicopathologic characteristics and clinical results of oesophageal GISTs.AIM To investigate endoscopic treatment effective of oesophageal GISTs.METHODS It was retrospective research that collected 32 patients with oesophageal GISTs treated by endoscopic resection(ER)between January 2012 and January 2023 in two Hospital.Clinicopathologic,endoscopic records,and follow-up data were collected and analysed.RESULTS Thirty-one patients underwent en bloc resection and 24(75.0%)lesions underwent R0 resection.The size of GISTs was 2.12±1.88 cm.The overall complication rate was 25.0%,including hydrothorax and post-endoscopic submucosal dissection electrocoagulation syndrome.The mean mitotic index was 3.34±5.04(median,1.50;range,1.00-4.00).Eighteen(56.3%),6(18.8%),2(6.3%),and 6(18.8%)patients were identified as very low,low,intermediate,and high risk,respectively.Three patients developed recurrence after a median follow-up of 64.69±33.13 months.The 5-year overall survival rate was 100%,and the disease-free survival rate was 90.6%.CONCLUSION ER is safe and effective for patients with low-risk oesophageal GISTs.Early detection of oesophageal GISTs is essential to achieve a favourable prognosis.展开更多
Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsul...Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsulated by a fibrous wall, it is classified as a pancreatic pseudocyst. While PPC is generally asymptomatic in many patients, it can manifest with persistent abdominal pain, dyspepsia, intra-cystic infection, and potentially lead to gastrointestinal obstruction in some cases. Although smaller PPCs may resolve spontaneously, larger PPCs tend to be refractory to absorption and often necessitate surgical intervention to prevent complications such as intracystic hemorrhage. Objective: To explore the efficacy of percutaneous catheterization with negative pressure in the treatment of large pancreatic pseudocysts. Methods: The cases of large pancreatic pseudocysts treated in our hospital from 2004 to 2022 were retrospectively collected, and the general condition, operation time, drainage time, feeding time, postoperative complications, hospital stay, cost and follow-up of the patients were analyzed. Results: A total of 132 patients with large pancreatic pseudocysts were collected. The average operation time was 32.4 ± 2.1 min;The retention time of the drainage tube was 30 ± 1.8 days in the percutaneous negative pressure drainage group;The postoperative feeding time was no fasting after local anesthesia drainage;Postoperative complications (bleeding, infection, pancreatic leakage, recurrence, anastomotic leakage, etc.): Two of the 132 patients had recurrent cysts, which were cured by re-puncture and negative pressure drainage. The length of hospital stay was 6 ± 1.1 days;The cost was 11,200 ± 1300 yuan;Follow-up: The follow-up time ranged from 1 to 3 years, and the patients had no discomfort. Conclusion: Percutaneous catheterization and negative pressure drainage can effectively treat large pancreatic pseudocysts. Compared with other treatment methods, it is simple and effective, the postoperative recovery of patients is faster, the physical damage is less, the hospital stay is shorter, and the cost is lower.展开更多
BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient ...BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient data from the Chinese population.AIM To demonstrate the efficacy,safety,and treatment satisfaction associated with the transition to IDegAsp in type 2 diabetes mellitus(T2DM).METHODS In this 12-week open-label,non-randomized,single-center,pilot study,patients with T2DM receiving thrice-daily insulin or intensive insulin treatment were transitioned to twice-daily injections of insulin IDegAsp.Insulin doses,hemoglobin A1c(HbA1c)levels,fasting blood glucose(FBG),hypoglycemic events,a Diabetes Treatment Satisfaction Questionnaire,and other parameters were assessed at baseline and 12-weeks.RESULTS This study included 21 participants.A marked enhancement was observed in the FBG level(P=0.02),daily total insulin dose(P=0.03),and overall diabetes treatment satisfaction(P<0.01)in the participants who switched to IDegAsp.There was a decrease in HbA1c levels(7.6±1.1 vs 7.4±0.9,P=0.31)and the frequency of hypoglycemic events of those who switched to IDegAsp decreased,however,there was no statistically significant difference.CONCLUSION The present findings suggest that treatment with IDegAsp enhances clinical outcomes,particularly FBG levels,daily cumulative insulin dose,and overall satisfaction with diabetes treatment.展开更多
Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards f...Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC;however,advances in imaging and minimally invasive techniques have improved patient selection and outcomes.Additionally,the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC.This review highlights the efficacy of agents such as tyrosine kinase inhibitors,alongside emerging options like immune checkpoint inhibitors,which have shown promise in clinical trials.Furthermore,the role of locoregional therapies,including ablation in the setting of combined treatment,transar-terial chemoembolization and transarterial radioembolization with flow catheters,cone-beam computed tomo-graphy and 4D navigation guidance,is examined in the context of bridging therapies for patients awaiting surgical intervention.The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes.Future directions for HCC treatment are discussed,including the potential of novel biomarkers in prognosis and treatment response.This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.展开更多
INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depres...INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depression leads to social and occupational impairment,diminished quality of life and an elevated risk of death by suicide.展开更多
Neuroendocrine neoplasms(NENs)are relatively rare tumors that arise from peptidergic neurons and neuroendocrine cells.NENs are highly heterogeneous and can occur in any part of the body,with a particular prevalence in...Neuroendocrine neoplasms(NENs)are relatively rare tumors that arise from peptidergic neurons and neuroendocrine cells.NENs are highly heterogeneous and can occur in any part of the body,with a particular prevalence in the digestive system.NENs consist of a range of tumor types and the biological behaviors exhibit significant differences.NENs are classified into well-differentiated neuroendocrine tumors(NETs)and poorly differentiated neuroendocrine carcinomas(NECs).NETs can be further classified and graded into the following three categories:low-grade NETs,grade 1(NET G1);intermediate-grade NET G2;and high-grade NET G3.NECs include large cell-type NEC(LCNEC)and small cell-type NEC(SCNEC),both of which are considered high grade.Currently,the main treatments for advanced NENs are biological treatments,targeted therapy,chemotherapy,and newer treatments that are still under development,such as immunotherapy and peptide receptor radionuclide therapy(PRRT).However,owing to the rarity of NENs,pharmaceutical company investment is limited and few phase Ⅲ studies have targeted advanced NENs.Most current research consists of investigator-initiated phase Ⅰ and Ⅱ clinical trials or largescale retrospective studies.NEN treatment should be chosen carefully because it is cumbersome and complicated,as indicated above.Herein,we comprehensively summarize the clinical application status and research progress for advanced NEN treatment regimens,especially for advanced NETs,which may help to create awareness on NENs among medical professionals across specialties.展开更多
基金supported by the National Natural Science Foundation of China(82574477)the Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan(QN202426)+5 种基金Jiangsu Province“333 High-level Talents Training Project”((2024)3-0189)Youth Talent Support Project of the Jiangsu Association for Science and Technology(TJ-2023-053)Shanxi Provincial Department-Municipal Key Laboratory Cultivation Base for Quality Enhancement and Utilization of Shangdang Chinese Medicinal Materials(KF202401)Fundamental Research Program of Shanxi Province(202403021221211)the research project supported by the Shanxi Scholarship Council of China(No.2023-158)Open Project of Key Laboratory of Tibetan Medicine Basic Research,Ministry of Education.
文摘The global prevalence of metabolic-associated fatty liver disease(MAFLD)is on the rise,seriously threatening human health.Currently,no specific approved drugs are available for its treatment.This paper reviews the pathogenesis of MAFLD,covering aspects like lipid accumulation and insulin resistance,oxidative stress,endoplasmic reticulum stress(ERS),lipotoxicity-induced hepatocyte damage,and fibrosis.It also elaborates on multiple treatment approaches for MAFLD,including metabolic regulation,improvement of the gut-liver axis interaction,modulation of immune and inflammatory pathways,enhancement of the adipose tissue-liver interaction,alleviation of fibrosis,prevention of hepatocyte injury,and traditional Chinese medicine(TCM)external therapies.Additionally,natural product research advancements,individual Chinese medicine components,and mixed herbal formulas for MAFLD treatment is provided.Many natural products and traditional Chinese medicines exhibit favorable effects in regulating lipid metabolism,anti-inflammation,and anti-oxidation,offering new directions and potential drug options for MAFLD treatment.This is expected to provide a reference for future clinical treatment and drug development.
基金Suppotred by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-3-004A-2).
文摘AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.
基金the 2026 Health Commission Fund of Guizhou Province,China.the freestatistics suite for its technical support.
文摘Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.
基金supported by the Central Government Guiding Local Science and Technology Development Fund Project(No.2024SZY0343)the Joint Research Program for Ecological Conservation and High Quality Development of the Yellow River Basin(No.2022-YRUC-01-050205)+2 种基金the Higher Education Scientific Research Project of Inner Mongolia Autonomous Region(No.NJZZ23078)the project of Inner Mongolia"Prairie Talents"Engineering Innovation Entrepreneurship Talent Team,the Major Projects of Erdos Science and Technology(No.2022EEDSKJZDZX015)the Innovation Team of the Inner Mongolia Academy of Science and Technology(No.CXTD2023-01-016).
文摘Rural domestic sewage treatment is critical for environmental protection.This study defines the spatial pattern of villages from the perspective of rural sewage treatment and develops an integrated decision-making system to propose a sewage treatment mode and scheme suitable for local conditions.By considering the village spatial layout and terrain factors,a decision tree model of residential density and terrain type was constructed with accuracies of 76.47%and 96.00%,respectively.Combined with binary classification probability unit regression,an appropriate sewage treatment mode for the village was determined with 87.00%accuracy.The Analytic Hierarchy Process(AHP),combined with the Technique for Order Preference(TOPSIS)by Similarity to an Ideal Solution model,formed the basis for optimal treatment process selection under different emission standards.Verification was conducted in 542 villages across three counties of the Inner Mongolia Autonomous Region,focusing on the standard effluent effect(0.3773),low investment cost(0.3196),and high standard effluent effect(0.5115)to determine the best treatment process for the same emission standard under different needs.The annual environmental and carbon emission benefits of sewage treatment in these villages were estimated.This model matches village density,geographic feature,and social development level,and provides scientific support and a theoretical basis for rural sewage treatment decision-making.
文摘Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predictors of treatment failure.Methods:This retrospective cohort study included patients who received DAA therapy at Hospital Kuala Lumpur between January 2020 and December 2023.Sustained virologic response(SVR)was assessed at least 12 weeks post-treatment by reverse transcription-polymerase chain reaction for hepatitis C virus(HCV)RNA.Demographic,clinical,and laboratory data were collected and analyzed.Multiple logistic regression analysis was performed to identify independent predictors of treatment failure.Results:A total of 335 patients in the study.The overall SVR rate was 89%.After achieving SVR,significant improvements were observed in liver enzyme levels and non-invasive liver fibrosis scores,whereas the overall Model for End-Stage Liver Disease(MELD)scores remained unchanged.Significant independent predictors of treatment failure included non-compliance with DAA therapy[adjusted odds ratio(aOR)68.3;95%confidence interval(95%CI)16.3-285.0;P<0.001],treatment with sofosbuvir/velpatasvir(aOR 6.1;95%CI 1.4-26.5;P=0.015),MELD score of 10-15(aOR 4.6;95%CI 1.1-18.2;P=0.031),HCV genotype 3 infection(aOR 4.5;95%CI 1.1-17.6;P=0.031),and elevated serum total bilirubin level(aOR 1.1;95%CI 1.0-1.1;P=0.003).Conclusions:DAA therapy yielded a high SVR rate,and treatment failure was strongly associated with non-adherence to therapy and advanced liver disease.These findings underscore the necessity of adherence support,early diagnosis,and individualized clinical management to optimize treatment outcomes in patients with chronic hepatitis C.
基金supported by Technological Innovation 2030-Major Projects of“Brain Science and Brain-like Research,”No.2022ZD0206200(to XG)the National Natural Science Foundation of China,No.82371245(to SJ),82102246(to XD),81701092(to XG)+2 种基金the Natural Science Foundation of Shandong Province,No.ZR2020MH129(to SJ)Shanghai Municipal Key Clinical Specialty,No.shslczdzk03601Shanghai Engineering Research Center of Peri-operative Organ Support and Function Preservation,No.20DZ2254200。
文摘Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases.Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits.This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment.Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment,including cerebrovascular diseases,Alzheimer's disease,aging-related conditions,and issues related to anesthesia and surgery.The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized,and targeting AHN is considered a promising approach for treating cognitive impairment.However,the underlying mechanisms of this role are not yet fully understood,and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited,with a need for further development of treatment methods and detection techniques.By reviewing recent studies,we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories:immunity,energy metabolism,aging,and pathological states.In immunity-related mechanisms,abnormalities in meningeal,brain,and peripheral immunity can disrupt normal adult hippocampal neurogenesis.Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis.During aging,the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients.Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis.Among the current strategies used to enhance this form of neurogenesis,physical therapies such as exercise,transcutaneous electrical nerve stimulation,and enriched environments have proven effective.Dietary interventions,including energy intake restriction and nutrient optimization,have shown efficacy in both basic research and clinical trials.However,drug treatments,such as antidepressants and stem cell therapy,are primarily reported in basic research,with limited clinical application.The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention,and targeting the former may be an important strategy for treating the latter.However,the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear,and treatments are lacking.This highlights the need for greater focus on translating research findings into clinical practice.
基金supported by the National Natural Science Foundation of China,Nos.82371389,82071382(to MZ)the Priority Academic Program Development of Jiangsu Higher Education Institutions,PAPD(to MZ)+4 种基金Jiangsu Maternal and Child Health Research Key Project,No.F202013(to HS)Jiangsu 333 High Level Talent Training Project,2022(to HS)Gusu District Health Talent Training Project,No.2024145(to HS)Suzhou BenQ Medical Center Project,No.H220918(to MZ)Undergraduate Training Program for Innovation and Entrepreneurship,Soochow University,No.202410285091Z(to MZ)。
文摘Mitophagy is closely associated with the pathogenesis of secondary spinal cord injury.Abnormal mitophagy may contribute significantly to secondary spinal cord injury,leading to the impaired production of adenosine triphosphate,ion imbalance,the excessive production of reactive oxygen species,neuroinflammation,and neuronal cell death.Therefore,maintaining an appropriate balance of mitophagy is crucial when treating spinal cord injury,as both excessive and insufficient mitophagy can impede recovery.In this review,we summarize the pathological changes associated with spinal cord injury,the mechanisms of mitophagy,and the direct and indirect relationships between mitophagy and spinal cord injury.We also consider therapeutic approaches that target mitophagy for the treatment of spinal cord injury,including ongoing clinical trials and other innovative therapies,such as use of stem cells,nanomaterials,and small molecule polymers.Finally,we highlight the current challenges facing this field and suggest potential directions for future research.The aim of our review is to provide a theoretical reference for future studies targeting mitophagy in the treatment of spinal cord injury.
基金Supported by Xuhui District Health Commission,No.SHXH202214.
文摘Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including computed tomography(CT),magnetic resonance imaging(MRI),endoscopic imaging,and genomic profiles-to enable intelligent decision-making for individualized therapy.This approach leverages AI algorithms to fuse imaging,endoscopic,and omics data,facilitating comprehensive characterization of tumor biology,prediction of treatment response,and optimization of therapeutic strategies.By combining CT and MRI for structural assessment,endoscopic data for real-time visual inspection,and genomic information for molecular profiling,multimodal AI enhances the accuracy of patient stratification and treatment personalization.The clinical implementation of this technology demonstrates potential for improving patient outcomes,advancing precision oncology,and supporting individualized care in gastrointestinal cancers.Ultimately,multimodal AI serves as a transformative tool in oncology,bridging data integration with clinical application to effectively tailor therapies.
文摘Background:This study focused on developing and optimizing a self-microemulsifying drug delivery system(SMEDDS)to improve Lafutidine’s solubility and bioavailability,thereby enhancing its effectiveness in treating gastric ulcers.Traditional formulations are less effective due to their limited water solubility and bioavailability.Methods:The study used solubility tests,pseudo-ternary phase diagrams,and central composite design(CCD)to optimize.The formulation was optimized by varying the oil concentration(10–40%)and surfactant/cosurfactant ratio(0.33–3.00),and then tested for droplet size,drug content,emulsification,phase stability,and in vitro dissolution.Results:The study found that the optimized formulation contained 14%Capmul PG 8NF oil,62%Labrasol surfactant,and 24%Tween 80 cosurfactant.This combination generated an average droplet size of 111.02 nm and improved drug release properties.Furthermore,the formulation was stable without phase separation,with a drug content of 88.2–99.8%.Conclusion:SMEDDS significantly improves lafutidine delivery by increasing solubility and absorption,thereby overcoming oral administration challenges.The system quickly formed small droplets in water and released the drug in 15 min.Enhancing lafutidine’s bioavailability may improve its efficacy in treating gastric ulcers,resulting in better patient outcomes and potentially lower dosing frequency.
文摘Active inflammation in“inactive”progressive multiple sclerosis:Traditionally,the distinction between relapsing-remitting multiple sclerosis and progressive multiple sclerosis(PMS)has been framed as an inflammatory versus degenerative dichotomy.This was based on a broad misconception regarding essentially all neurodegenerative conditions,depicting the degenerative process as passive and immune-independent occurring as a late byproduct of active inflammation in the central nervous system(CNS),which is(solely)systemically driven.
基金supported by the National Natural Science Foundation of China,No.32130060(to XG).
文摘Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.
文摘The effect of different intermediate annealing heat treatments on the surface microstructures and anodic oxide film structures of rolled Al-5.6Mg sheets was studied.The results show that when the continuous annealing is used to control microstructures of the sheets instead of the static state annealing in the intermediate annealing process,the surface grain size of the sheets can be reduced by about 65.7%,and the size of the Mg precipitation phase(Mg_(2)Al_(3))can be reduced by about 67%.Under the combined influence of grain size,precipitation phase,and texture,the highest glossiness can be obtained,which is attributed to continuous intermediate annealing and stabilization annealing at low temperature.The uniform grain and precipitation structures is beneficial to reducing the inhomogeneous dissolution of the oxide film and to obtain the anodic oxide film with uniform thickness and high glossiness.
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.
基金funded by grants from the National Natural Science Foundation of China(Grant Nos.82171932 and 82302180)the Ministry of Science and Technology of China(Grant No.2024ZD0520002)+3 种基金the Chinese National Key Research and Development Project(Grant Nos.2021YFC2500402 and 2021YFC2500400)the National Health Commission Capacity Building and Continuing Education Center(Grant No.YXFSC2022JJSJ011)the Tianjin Key Medical Discipline(Specialty)Construction Project(Grant No.TJYXZDXK-010A)the Scientific Developing Foundation of Tianjin Education Commission(Grant No.2024KJ182).
文摘Cancer poses a serious threat to human health worldwide and is a leading cause of death1.The analysis of radiological imaging is crucial in early detection,accurate diagnosis,effective treatment planning,and ongoing monitoring of patients with cancer.However,several challenges impede the effectiveness of cancer imaging analysis in clinical practice.One difficulty is that healthcare professionals’immense clinical workloads can result in time constraints and increase pressure,thereby hindering their ability to maintain high accuracy and thoroughness in image analysis.Additionally,subjective variability among radiologists can lead to inconsistent interpretations and diagnoses.Because this variability is often influenced by personal biases,standardized assessments are often difficult to achieve.Moreover,the inherent complexity of cancer imaging necessitates extensive clinical experience;this aspect can also be a limiting factor,particularly if expertise or resources are limited.The application of artificial intelligence(AI)can alleviate these problems by enhancing the accuracy,objectivity,and efficiency of cancer imaging analysis while assisting physicians.Therefore,the advancement of AI research is crucial for achieving progress in radiology.
基金Supported by National Natural Science Foundation of China,No.82002515,No.82273025 and No.82203460China Postdoctoral Science Foundation,No.2022TQ0070 and No.2022M710759Shanghai Municipal Commission of Science and Technology,No.22JC1403003,No.22XD1402200,No.19140901902 and No.22S31903800.
文摘BACKGROUND There are few clinicopathologic characteristics and clinical results for oesophageal gastrointestinal stromal tumours(GISTs).Thus,the objective of this study was to identify the clinicopathologic characteristics and clinical results of oesophageal GISTs.AIM To investigate endoscopic treatment effective of oesophageal GISTs.METHODS It was retrospective research that collected 32 patients with oesophageal GISTs treated by endoscopic resection(ER)between January 2012 and January 2023 in two Hospital.Clinicopathologic,endoscopic records,and follow-up data were collected and analysed.RESULTS Thirty-one patients underwent en bloc resection and 24(75.0%)lesions underwent R0 resection.The size of GISTs was 2.12±1.88 cm.The overall complication rate was 25.0%,including hydrothorax and post-endoscopic submucosal dissection electrocoagulation syndrome.The mean mitotic index was 3.34±5.04(median,1.50;range,1.00-4.00).Eighteen(56.3%),6(18.8%),2(6.3%),and 6(18.8%)patients were identified as very low,low,intermediate,and high risk,respectively.Three patients developed recurrence after a median follow-up of 64.69±33.13 months.The 5-year overall survival rate was 100%,and the disease-free survival rate was 90.6%.CONCLUSION ER is safe and effective for patients with low-risk oesophageal GISTs.Early detection of oesophageal GISTs is essential to achieve a favourable prognosis.
文摘Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsulated by a fibrous wall, it is classified as a pancreatic pseudocyst. While PPC is generally asymptomatic in many patients, it can manifest with persistent abdominal pain, dyspepsia, intra-cystic infection, and potentially lead to gastrointestinal obstruction in some cases. Although smaller PPCs may resolve spontaneously, larger PPCs tend to be refractory to absorption and often necessitate surgical intervention to prevent complications such as intracystic hemorrhage. Objective: To explore the efficacy of percutaneous catheterization with negative pressure in the treatment of large pancreatic pseudocysts. Methods: The cases of large pancreatic pseudocysts treated in our hospital from 2004 to 2022 were retrospectively collected, and the general condition, operation time, drainage time, feeding time, postoperative complications, hospital stay, cost and follow-up of the patients were analyzed. Results: A total of 132 patients with large pancreatic pseudocysts were collected. The average operation time was 32.4 ± 2.1 min;The retention time of the drainage tube was 30 ± 1.8 days in the percutaneous negative pressure drainage group;The postoperative feeding time was no fasting after local anesthesia drainage;Postoperative complications (bleeding, infection, pancreatic leakage, recurrence, anastomotic leakage, etc.): Two of the 132 patients had recurrent cysts, which were cured by re-puncture and negative pressure drainage. The length of hospital stay was 6 ± 1.1 days;The cost was 11,200 ± 1300 yuan;Follow-up: The follow-up time ranged from 1 to 3 years, and the patients had no discomfort. Conclusion: Percutaneous catheterization and negative pressure drainage can effectively treat large pancreatic pseudocysts. Compared with other treatment methods, it is simple and effective, the postoperative recovery of patients is faster, the physical damage is less, the hospital stay is shorter, and the cost is lower.
基金Supported by CAMS Innovation Fund for Medical Sciences,No.2023-I2M-C&T-B-043National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-015+1 种基金CAMS Innovation Fund for Medical Sciences,No.2021-1-12M-002Beijing Municipal Natural Science Foundation,No.M22014.
文摘BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient data from the Chinese population.AIM To demonstrate the efficacy,safety,and treatment satisfaction associated with the transition to IDegAsp in type 2 diabetes mellitus(T2DM).METHODS In this 12-week open-label,non-randomized,single-center,pilot study,patients with T2DM receiving thrice-daily insulin or intensive insulin treatment were transitioned to twice-daily injections of insulin IDegAsp.Insulin doses,hemoglobin A1c(HbA1c)levels,fasting blood glucose(FBG),hypoglycemic events,a Diabetes Treatment Satisfaction Questionnaire,and other parameters were assessed at baseline and 12-weeks.RESULTS This study included 21 participants.A marked enhancement was observed in the FBG level(P=0.02),daily total insulin dose(P=0.03),and overall diabetes treatment satisfaction(P<0.01)in the participants who switched to IDegAsp.There was a decrease in HbA1c levels(7.6±1.1 vs 7.4±0.9,P=0.31)and the frequency of hypoglycemic events of those who switched to IDegAsp decreased,however,there was no statistically significant difference.CONCLUSION The present findings suggest that treatment with IDegAsp enhances clinical outcomes,particularly FBG levels,daily cumulative insulin dose,and overall satisfaction with diabetes treatment.
文摘Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC;however,advances in imaging and minimally invasive techniques have improved patient selection and outcomes.Additionally,the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC.This review highlights the efficacy of agents such as tyrosine kinase inhibitors,alongside emerging options like immune checkpoint inhibitors,which have shown promise in clinical trials.Furthermore,the role of locoregional therapies,including ablation in the setting of combined treatment,transar-terial chemoembolization and transarterial radioembolization with flow catheters,cone-beam computed tomo-graphy and 4D navigation guidance,is examined in the context of bridging therapies for patients awaiting surgical intervention.The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes.Future directions for HCC treatment are discussed,including the potential of novel biomarkers in prognosis and treatment response.This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.
基金funded by the Construction Project of the"Flagship"Department of Chinese and Western Medicine Coordination(LiuL/2024-221)the 2024 Medical Service and Security Capacity Improvement Project(National Clinical Key Specialty Construction)(LiuL/Huwei Medical/2024-65)+5 种基金the Shanghai Traditional Chinese Medicine Standardization Project(LiuL/No.2023JSP03)the Shanghai Key Discipline Construction Project of Traditional Chinese Medicine(Clinical)(LiuL/2024-No.3)the Shanghai Technical Standardization Management and Promotion Project(LiuL/No.SHDC22023212)the Shanghai Municipal Health Commission Traditional Chinese Medicine Research Project(2022)(LiuL/No.2022Cx004)Clinical research project of Shanghai Health Commission-Youth Project(LW/No.20214Y0056)Shanghai Institute of Traditional Chinese Medicine for Mental Health(LW/No.SZB2023201).
文摘INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depression leads to social and occupational impairment,diminished quality of life and an elevated risk of death by suicide.
文摘Neuroendocrine neoplasms(NENs)are relatively rare tumors that arise from peptidergic neurons and neuroendocrine cells.NENs are highly heterogeneous and can occur in any part of the body,with a particular prevalence in the digestive system.NENs consist of a range of tumor types and the biological behaviors exhibit significant differences.NENs are classified into well-differentiated neuroendocrine tumors(NETs)and poorly differentiated neuroendocrine carcinomas(NECs).NETs can be further classified and graded into the following three categories:low-grade NETs,grade 1(NET G1);intermediate-grade NET G2;and high-grade NET G3.NECs include large cell-type NEC(LCNEC)and small cell-type NEC(SCNEC),both of which are considered high grade.Currently,the main treatments for advanced NENs are biological treatments,targeted therapy,chemotherapy,and newer treatments that are still under development,such as immunotherapy and peptide receptor radionuclide therapy(PRRT).However,owing to the rarity of NENs,pharmaceutical company investment is limited and few phase Ⅲ studies have targeted advanced NENs.Most current research consists of investigator-initiated phase Ⅰ and Ⅱ clinical trials or largescale retrospective studies.NEN treatment should be chosen carefully because it is cumbersome and complicated,as indicated above.Herein,we comprehensively summarize the clinical application status and research progress for advanced NEN treatment regimens,especially for advanced NETs,which may help to create awareness on NENs among medical professionals across specialties.
