Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhib...Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhibiting uropathogenic Escherichia coli.Methods:A pH-responsive chitosan(CS)-sodium alginate(SA)-hydrogel microsphere loaded with potassium sodium hydrogen citrate and fosfomycin(CS/SA@PSHC@CS@F)was constructed using ionic cross-linking.In vitro stone dissolution experiments were conducted to determine drug release kinetics and stone mass reduction rate under different pH environments,and the antibacterial activity against E.coli ATCC 25922 was evaluated using the plate counting method.A rat model of kidney stone combined with infection was established.Stone volume changes were quantified via micro-CT,urinary interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)levels were measured by ELISA,and renal tissue inflammation was scored via histopathological evaluation.Results:The 24-hour cumulative release rate of CS/SA@PSHC@CS@F at pH 5.8 reached 92.3%±4.1%,significantly higher than at pH 7.4(31.2%±3.7%,P<0.01).At 72 h,the mass reduction rate of calcium oxalate stones in CS/SA@PSHC@CS@F was 68.9%±5.2%,significantly higher than that of the PSHC+F mixture(P<0.01).Antibacterial experiments confirmed that the inhibition rate of biofilm colonies by CS/SA@PSHC@CS@F could reach 82.4%±6.7%,compared to 58.2%±5.3%for F,with a statistically significant difference(P<0.01).Animal experiments showed that the stone volume reduction rate in the CS/SA@PSHC@CS@F group was62.3%±8.1%,higher than that in the PSHC+F group,and the decrease in urinary IL-6 level after administration was more significant,while there was no significant difference in TNF-αlevel compared with the other two groups(P>0.05).The renal tissue inflammation score decreased to 2(1,2)points,showing a significant reduction compared with the other two groups(P<0.05).Conclusion:The novel controlled-release system designed in this study achieves targeted drug release in the stone infection microenvironment through the ion exchange mechanism,simultaneously enhancing stone dissolution efficiency and antibacterial effect,thereby providing a new drug delivery strategy for the treatment of urinary stones combined with infection.展开更多
Objective:This article reviews the latest updates and outcomes of kidney-sparing surgery(KSS)in patients with upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the Pu...Objective:This article reviews the latest updates and outcomes of kidney-sparing surgery(KSS)in patients with upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the PubMed and Embase databases to identify related English-language studies published within the last 10 years.Key search words included“upper urinary tract tumour/cancer/carcinoma”,“kidney-sparing surgery or approach”,“endoscopic treatment for upper tract tumour/cancer/carcinoma”,“topical instillation in the upper urinary tract”,and“urinary marker for urothelial carcinoma”.References within the identified literature were explored and evaluated for relevance.Results:KSS is recommended for both low-risk and selected high-risk UTUC with imperative indications such as solitary kidney.Studies have shown comparable oncological outcomes after KSS including endoscopic ablation,segmental ureterectomy,and topical instillation of novel agents when compared to radical nephroureterectomy in well-selected cases.The development of novel diagnostic tools and risk-stratifying models allows optimal case selection for KSS without compromising oncological outcomes.Conclusion:Kidney-sparing approach for UTUC is an evolving and promising area in urologic oncology,driven by advances in technology,better diagnostic tools,and novel therapeutic agents.Our article provides a comprehensive review of the latest advancements and clinical recommendations.While current evidence is mainly based on retrospective studies,prospective trials are required to address important but unanswered clinical questions in this field.展开更多
In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin famil...In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.展开更多
Background:Immune checkpoint inhibitors(ICIs)are effective in a subset of patients with metastatic solid tumors.However,the patients who would benefit most from ICIs in biliary tract cancer(BTC)are still controversial...Background:Immune checkpoint inhibitors(ICIs)are effective in a subset of patients with metastatic solid tumors.However,the patients who would benefit most from ICIs in biliary tract cancer(BTC)are still controversial.Materials and methods:We molecularly characterized tissues and blood from 32 patients with metastatic BTC treated with the ICI pembrolizumab as second-line therapy.Results:All patients had microsatellite stable(MSS)type tumors.Three of the 32 patients achieved partial response(PR),with an objective response rate(ORR)of 9.4%(95%confidence interval[CI],2.0–25.2)and nine showed stable disease(SD),exhibiting a disease control rate(DCR)of 37.5%(95%CI,21.1–56.3).For the 31 patients who had access to PD-1 ligand 1(PD-L1)combined positive score(CPS)testing(cut-off value≥1%),the ORR was not different between those who had PD-L1-positive(PD-L1+;1/11,9.1%)and PDL1-(2/20,10.0%)tumors(p=1.000).The tumor mutational burden(TMB)of PD-L1+BTC was comparable to that of PD-L1-BTC(p=0.630).TMB and any exonic somatic mutations were also not predictive of pembrolizumab response.Molecular analysis of blood and tumor samples demonstrated a relatively high natural killer(NK)cell proportion in the peripheral blood before pembrolizumab treatment in patients who achieved tumor response.Moreover,the tumors of these patients presented high enrichment scores for NK cells,antitumor cytokines,and Th1 signatures,and a low enrichment score for cancer-associated fibroblasts.Conclusions:This study shows the molecular characteristics associated with the efficacy of pembrolizumab in BTC of the MSS type.展开更多
Spinal cord injury typically causes corticospinal tract disruption.Although the disrupted corticospinal tract can self-regenerate to a certain degree,the underlying mechanism of this process is still unclear.N6-methyl...Spinal cord injury typically causes corticospinal tract disruption.Although the disrupted corticospinal tract can self-regenerate to a certain degree,the underlying mechanism of this process is still unclear.N6-methyladenosine(m^(6)A)modifications are the most common form of epigenetic regulation at the RNA level and play an essential role in biological processes.However,whether m^(6)A modifications participate in corticospinal tract regeneration after spinal cord injury remains unknown.We found that expression of methyltransferase 14 protein(METTL14)in the locomotor cortex was high after spinal cord injury and accompanied by elevated m^(6)A levels.Knockdown of Mettl14 in the locomotor cortex was not favorable for corticospinal tract regeneration and neurological recovery after spinal cord injury.Through bioinformatics analysis and methylated RNA immunoprecipitation-quantitative polymerase chain reaction,we found that METTL14 regulated Trib2 expression in an m^(6)A-regulated manner,thereby activating the mitogen-activated protein kinase pathway and promoting corticospinal tract regeneration.Finally,we administered syringin,a stabilizer of METTL14,using molecular docking.Results confirmed that syringin can promote corticospinal tract regeneration and facilitate neurological recovery by stabilizing METTL14.Findings from this study reveal that m^(6)A modification is involved in the regulation of corticospinal tract regeneration after spinal cord injury.展开更多
BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial fo...BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.展开更多
A clinical trial of nab-paclitaxel plus capecitabine as a first-line treatment for advanced biliary tract cancers was conducted.We analyzed the development of systemic therapy recommended by the National Comprehensive...A clinical trial of nab-paclitaxel plus capecitabine as a first-line treatment for advanced biliary tract cancers was conducted.We analyzed the development of systemic therapy recommended by the National Comprehensive Cancer Network guidelines and the development of nab-paclitaxel combination chemotherapy for advanced biliary tract cancers(BTCs)and concluded that nab-paclitaxel plus capecitabine is a promising first-line regimen for advanced BTCs.展开更多
Biliary tract cancer(BTC)is a rare group of malignancies that develop from the epithelial lining of the biliary tree and have a poor prognosis.Although chemotherapy is the standard of care for patients with advanced B...Biliary tract cancer(BTC)is a rare group of malignancies that develop from the epithelial lining of the biliary tree and have a poor prognosis.Although chemotherapy is the standard of care for patients with advanced BTC in China,its clinical benefits are moderate.In recent years,the approval of targeted therapies and immunotherapies has provided new avenues for the management of advanced BTC.Nonetheless,the increasing number of personalized medicine approaches has created a challenge for clinicians choosing individualized treatment strategies based on tumor characteristics.In this article,we discuss recent progress in implementing precision medicine approaches for advanced BTC in China and examine genomic profiling studies in Chinese patients with advanced BTC.We also discuss the challenges and opportunities of using precision medicine approaches,as well as the importance of considering population-specific factors and tailoring treatment approaches to improve outcomes for patients with BTC.In addition to providing a comprehensive overview of current and emerging precision medicine approaches for the management of advanced BTC in China,this review article will support clinicians outside of China by serving as a reference regarding the role of patient-and population-specific factors in clinical decision-making for patients with this rare malignancy.展开更多
Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which...Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which reduce the effectiveness of conventional treatments.This study aims to evaluate the antibiofilm activity of the homeopathic medicine Terebinthinae oleum in potencies 30C,200C,and 1M against UTI-causing E.coli,and to compare its effectiveness with the standard antibiotic Gentamycin.Methods:An in-vitro biofilm model was employed.E.coli biofilms were cultivated in microtiter plates and treated with Terebinthinae oleum(30C,200C,1M)and Gentamycin.Biofilm biomass was assessed through crystal violet staining,and optical density(OD)was measured using an ELISA microplate reader.Results:Among the tested potencies,Terebinthinae oleum 30C showed the most prominent inhibitory activity on E.coli biofilms.The inhibition percentage was compared with Gentamycin as a control.Terebinthinae oleum 30C demonstrated 41.88%inhibition of biofilm biomass,while Gentamycin exhibited up to 78.98%inhibition.Higher potencies of Terebinthinae oleum(200C and 1M)showed reduced activity(30.15%and 24.81%,respectively).Conclusion:Terebinthinae oleum,especially at 30C potency,exhibits measurable antibiofilm activity against E.coli,although less effective than Gentamycin.These findings support its use as a complementary therapy in managing biofilm-associated UTIs,justifying further clinical and immunological research.展开更多
Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The d...Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.展开更多
Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring ...Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.展开更多
Understanding mixed infections in the female lower genital tract is a critical challenge in modern infection research.The interplay of multiple pathogens complicates disease progression,often resulting in treatment fa...Understanding mixed infections in the female lower genital tract is a critical challenge in modern infection research.The interplay of multiple pathogens complicates disease progression,often resulting in treatment failure,recurrent infections,and significant public health and economic burdens.These infections are further exacerbated by disrupted host immune responses,which hinder the recovery of the vaginal microecosystem.Additionally,microbial biofilms—a fundamental mode of pathogen coexistence—contribute to the persistence and drug resistance of these infections,complicating management strategies.This review examines the pathogenesis,diagnosis,and treatment of mixed infections in the female lower genital tract while exploring potential avenues for future research.These findings emphasize the need for greater focus on these infections and offer insights to enhance further research in this area.展开更多
Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor...Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor has already spread to nearby organs at the time of diagnosis,with the small intestine and bladder being common sites of invasion.[1,2]The diagnosis of colorectal cancer that has spread to the bladder can be challenging.Aside from a few patients who experience urinary symptoms due to invasion of the bladder trigone or the entire bladder wall,there are no distinct clinical signs,which often leads to misdiagnosis.The following case report details one such instance.展开更多
BACKGROUND Biliary tract cancer(BTC)is a rare,aggressive malignancy with increasing inci-dence and poor prognosis.Identifying preoperative prognostic factors is crucial for effective risk-benefit assessments and patie...BACKGROUND Biliary tract cancer(BTC)is a rare,aggressive malignancy with increasing inci-dence and poor prognosis.Identifying preoperative prognostic factors is crucial for effective risk-benefit assessments and patient stratification.The prognostic nutritional index(PNI),which reflects immune-inflammatory and nutritional status,has shown prognostic value in various cancers,but its significance in BTC remains unclear.AIM To assess the prognostic value of the preoperative PNI in BTC patients,with a focus on overall survival(OS)and disease-free survival(DFS).METHODS Comprehensive searches were conducted in the PubMed,EMBASE,and Web of Science databases from inception to April 2024.The primary outcomes of interest focused on the associations between the preoperative PNI and the prognosis of BTC patients,specifically OS and disease-free survival(DFS).Statistical analyses were conducted via STATA 17.0 software.RESULTS Seventeen studies encompassing 4645 patients met the inclusion criteria.Meta-analysis revealed that a low PNI was significantly associated with poorer OS[hazard ratio(HR)1.91,95%CI:1.59-2.29;P<0.001]and DFS(HR 1.93,95%CI:1.39-2.67;P<0.001).Subgroup analyses revealed consistent results across BTC subtypes(cholangiocarcinoma and gallbladder cancer)and stages(resectable and advanced).Sensitivity analyses confirmed the robustness of these findings,and no significant publication bias was detected.CONCLUSION This study demonstrated that a low preoperative PNI predicts poor OS and DFS in BTC patients,highlighting its potential as a valuable prognostic tool.Further prospective studies are needed to validate these findings and enhance BTC patient management.展开更多
The gastrointestinal(GI)tract is essential for digestion,absorption,excretion,and protection,supported by a diverse microbial ecosystem.Traditional in-vitro models often fall short in capturing the physiological compl...The gastrointestinal(GI)tract is essential for digestion,absorption,excretion,and protection,supported by a diverse microbial ecosystem.Traditional in-vitro models often fall short in capturing the physiological complexity of the GI tract,limiting their translational applications.A comprehensive approach is needed to bridge the gap between simple cell cultures and more complex systems used in translational research.This review explores the limitations of conventional twodimensional cell cultures and emphasizes the emerging use of three-dimensional and microfluidic systems that better replicate the GI tract’s structure and functions.It highlights the importance of incorporating patient-derived cells and engineered microenvironments to enhance model relevance and support personalized medicine.The review also discusses advanced fabrication techniques such as micro-extrusion and laser-assisted bioprinting,which enable the creation of sophisticated tissue models capable of simulating critical GI processes,including molecular transport,peristalsis,and liver coupling.Advancing the complexity of in-vitro systems will help replicate the GI tract’s interactions and physiological phenomena,thus improving the translational potential of GI research.This review provides valuable insights into the advancements and challenges in GI modeling,serving as a comprehensive guide for developing models that bridge the gap between basic cell cultures and clinically relevant systems.展开更多
BACKGROUND For patients with advanced gastric cancer,surgical resection remains the main treatment option.Total gastrectomy combined with radical resection of gastric cancer lesions and sentinel lymph nodes can signif...BACKGROUND For patients with advanced gastric cancer,surgical resection remains the main treatment option.Total gastrectomy combined with radical resection of gastric cancer lesions and sentinel lymph nodes can significantly prolong the survival of patients.Digestive tract reconstruction after total gastrectomy is essential to maintain gastrointestinal function and optimize postoperative recovery.Therefore,it is very important to choose a suitable reconstruction method to improve the quality of life of total gastrectomy patients.AIM To evaluate the effects of different digestive tract reconstruction methods in gastric cancer patients undergoing total gastrectomy.METHODS This retrospective study included 172 patients who underwent total gastrectomy for gastric cancer at The First Hospital of Hebei Medical University for analysis.The patients were categorized into two groups:Group A,consisting of 90 patients who underwent modified Roux-en-Y gastrojejunostomy,and group B,consisting of 82 patients who underwent uncut Roux-en-Y gastrojejunostomy.The general patient characteristics,perioperative indicators,postoperative gastrointestinal mucosal barrier function,nutritional status,immunological markers,and occurrence of complications were compared between the two groups.RESULTS Group A showed shorter digestive tract reconstruction time than group B(P<0.05).On the first postoperative day,group A showed lower serum levels of D-lactate,diamine oxidase,and endotoxin than group B(P<0.05).One month postoperatively,group A showed higher prognostic nutritional index,serum albumin,total protein,and body weight than group B(P<0.05).One month postoperatively,the levels of cluster of differentiation(CD)3+,CD4+,and CD8+cells were not significantly different between two groups(P>0.05).The complication rates were 10.00%in group A and 24.39%in group B;group A had a significantly lower complication rate than group B(P<0.05).CONCLUSION Using modified Roux-en-Y gastrojejunostomy during total gastrectomy shortens the time required for gastrointestinal anastomosis,reduces surgery-induced gastrointestinal mucosal damage,and mitigates postoperative declines in nutritional status.展开更多
Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted t...Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.展开更多
ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted usin...ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.ResultsA total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.ConclusionKetamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.展开更多
BACKGROUND Indolent NK-cell lymphoproliferative disorder of the gastrointestinal tract(iNKLPD)is a rare and recently defined entity,recognized in the 2022 WHO classification of hematolymphoid tumors.iNKLPD typically e...BACKGROUND Indolent NK-cell lymphoproliferative disorder of the gastrointestinal tract(iNKLPD)is a rare and recently defined entity,recognized in the 2022 WHO classification of hematolymphoid tumors.iNKLPD typically exhibits a benign or slowly progressive clinical course,with disease localized to the gastrointestinal tract.Here,we present what we believe to be the first reported case of iNKLPD associated with protein-losing enteropathy(PLE),characterized by a poor response to chemotherapy and rapid clinical deterioration,culminating in death within a few months.CASE SUMMARY We report the case of a 64-year-old man who presented with bilateral lower-extremity edema and fatigue.Laboratory tests revealed marked hypoalbuminemia,while other liver function parameters remained within normal limits.Renal and cardiac function assessments were unremarkable.Histopathological examination of endoscopic biopsies confirmed a diagnosis of iNKLPD of the gastrointestinal tract.The patient was treated with oral prednisone and cyclosporine,which led to temporary improvement in both symptoms and serum albumin levels.However,disease relapse occurred during corticosteroid tapering,accompanied by worsening hypoalbu-minemia and refractory diarrhea.The patient died eight months after diagnosis,likely due to disease progression or severe treatment-related complications.CONCLUSION iNKLPD generally exhibits an indolent course;nonetheless,the prognosis may be poor if secondary PLE is involved.展开更多
BACKGROUND Proximal gastrectomy(PG)with double tract reconstruction(DTR)has recently emerged as a function-preserving alternative to total gastrectomy(TG)with Rouxen-Y(RNY)reconstruction in patients with proximally lo...BACKGROUND Proximal gastrectomy(PG)with double tract reconstruction(DTR)has recently emerged as a function-preserving alternative to total gastrectomy(TG)with Rouxen-Y(RNY)reconstruction in patients with proximally located gastric cancer.AIM To evaluate the current evidence comparing PG-DTR with TG-RNY in terms of perioperative outcomes,long-term survival,complication rates,nutritional status and reflux esophagitis.METHODS A systematic literature search was conducted using PubMed,MEDLINE,Web of Science and the Cochrane Library for studies published between 2010 and January 2025.Search terms included gastric cancer,DTR and TG.Trials comparing PGDTR with TG-RNY or PG-esophagogastrostomy(EG)were included.Data on operative details,lymph node yield,complications(Clavien-Dindo≥III),nutritional markers and incidence of reflux were extracted.Nineteen trials met the inclusion criteria.The review followed the PRISMA guidelines.RESULTS PG-DTR was found to have comparable long-term oncological outcomes to TGRNY,despite a lower extent of lymph node dissection.Operative time and intraoperative blood loss were generally similar,with some studies favouring PGDTR.Rates of major postoperative complications were comparable between techniques.Notably,PG-DTR showed a significantly lower incidence of reflux esophagitis than PG-EG and was comparable or superior to TG-RNY in reflux control.Nutritionally,PG-DTR was associated with better post-operative weight maintenance and biochemical parameters such as haemoglobin,albumin and vitamin B12 levels compared to TG-RNY.No significant nutritional differences were observed between PG-DTR and PG-EG.PG-DTR appears to offer a balanced approach to the surgical treatment of proximal gastric cancer,combining oncological safety with functional and nutritional benefits.CONCLUSION Its superiority over TG-RNY in postoperative nutrition and reflux prevention,together with comparable complication rates and survival,supports its consideration as a preferred reconstruction method in selected patients.展开更多
文摘Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhibiting uropathogenic Escherichia coli.Methods:A pH-responsive chitosan(CS)-sodium alginate(SA)-hydrogel microsphere loaded with potassium sodium hydrogen citrate and fosfomycin(CS/SA@PSHC@CS@F)was constructed using ionic cross-linking.In vitro stone dissolution experiments were conducted to determine drug release kinetics and stone mass reduction rate under different pH environments,and the antibacterial activity against E.coli ATCC 25922 was evaluated using the plate counting method.A rat model of kidney stone combined with infection was established.Stone volume changes were quantified via micro-CT,urinary interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)levels were measured by ELISA,and renal tissue inflammation was scored via histopathological evaluation.Results:The 24-hour cumulative release rate of CS/SA@PSHC@CS@F at pH 5.8 reached 92.3%±4.1%,significantly higher than at pH 7.4(31.2%±3.7%,P<0.01).At 72 h,the mass reduction rate of calcium oxalate stones in CS/SA@PSHC@CS@F was 68.9%±5.2%,significantly higher than that of the PSHC+F mixture(P<0.01).Antibacterial experiments confirmed that the inhibition rate of biofilm colonies by CS/SA@PSHC@CS@F could reach 82.4%±6.7%,compared to 58.2%±5.3%for F,with a statistically significant difference(P<0.01).Animal experiments showed that the stone volume reduction rate in the CS/SA@PSHC@CS@F group was62.3%±8.1%,higher than that in the PSHC+F group,and the decrease in urinary IL-6 level after administration was more significant,while there was no significant difference in TNF-αlevel compared with the other two groups(P>0.05).The renal tissue inflammation score decreased to 2(1,2)points,showing a significant reduction compared with the other two groups(P<0.05).Conclusion:The novel controlled-release system designed in this study achieves targeted drug release in the stone infection microenvironment through the ion exchange mechanism,simultaneously enhancing stone dissolution efficiency and antibacterial effect,thereby providing a new drug delivery strategy for the treatment of urinary stones combined with infection.
文摘Objective:This article reviews the latest updates and outcomes of kidney-sparing surgery(KSS)in patients with upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the PubMed and Embase databases to identify related English-language studies published within the last 10 years.Key search words included“upper urinary tract tumour/cancer/carcinoma”,“kidney-sparing surgery or approach”,“endoscopic treatment for upper tract tumour/cancer/carcinoma”,“topical instillation in the upper urinary tract”,and“urinary marker for urothelial carcinoma”.References within the identified literature were explored and evaluated for relevance.Results:KSS is recommended for both low-risk and selected high-risk UTUC with imperative indications such as solitary kidney.Studies have shown comparable oncological outcomes after KSS including endoscopic ablation,segmental ureterectomy,and topical instillation of novel agents when compared to radical nephroureterectomy in well-selected cases.The development of novel diagnostic tools and risk-stratifying models allows optimal case selection for KSS without compromising oncological outcomes.Conclusion:Kidney-sparing approach for UTUC is an evolving and promising area in urologic oncology,driven by advances in technology,better diagnostic tools,and novel therapeutic agents.Our article provides a comprehensive review of the latest advancements and clinical recommendations.While current evidence is mainly based on retrospective studies,prospective trials are required to address important but unanswered clinical questions in this field.
基金Supported by the 2023 Government-funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731D+1 种基金Natural Science Foundation of Hebei Province,No.H202423105Hebei Provincial Administration of Traditional Chinese Medicine,Scientific Research Project,No.2020014.
文摘In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.
基金supported by the MISP program at Merck Sharp&Dohme Corp.,USAa grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&Welfare,Republic of Korea(Grant Number:HR20C0025).
文摘Background:Immune checkpoint inhibitors(ICIs)are effective in a subset of patients with metastatic solid tumors.However,the patients who would benefit most from ICIs in biliary tract cancer(BTC)are still controversial.Materials and methods:We molecularly characterized tissues and blood from 32 patients with metastatic BTC treated with the ICI pembrolizumab as second-line therapy.Results:All patients had microsatellite stable(MSS)type tumors.Three of the 32 patients achieved partial response(PR),with an objective response rate(ORR)of 9.4%(95%confidence interval[CI],2.0–25.2)and nine showed stable disease(SD),exhibiting a disease control rate(DCR)of 37.5%(95%CI,21.1–56.3).For the 31 patients who had access to PD-1 ligand 1(PD-L1)combined positive score(CPS)testing(cut-off value≥1%),the ORR was not different between those who had PD-L1-positive(PD-L1+;1/11,9.1%)and PDL1-(2/20,10.0%)tumors(p=1.000).The tumor mutational burden(TMB)of PD-L1+BTC was comparable to that of PD-L1-BTC(p=0.630).TMB and any exonic somatic mutations were also not predictive of pembrolizumab response.Molecular analysis of blood and tumor samples demonstrated a relatively high natural killer(NK)cell proportion in the peripheral blood before pembrolizumab treatment in patients who achieved tumor response.Moreover,the tumors of these patients presented high enrichment scores for NK cells,antitumor cytokines,and Th1 signatures,and a low enrichment score for cancer-associated fibroblasts.Conclusions:This study shows the molecular characteristics associated with the efficacy of pembrolizumab in BTC of the MSS type.
基金supported by the National Natural Science Foundation of China,Nos.82030071(to JH),82272495(to YC)Science and Technology Major Project of Changsha,No.kh2103008(to JH)Graduate Students’Independent Innovative Projects of Hunan Province,No.CX20230311(to YJ)。
文摘Spinal cord injury typically causes corticospinal tract disruption.Although the disrupted corticospinal tract can self-regenerate to a certain degree,the underlying mechanism of this process is still unclear.N6-methyladenosine(m^(6)A)modifications are the most common form of epigenetic regulation at the RNA level and play an essential role in biological processes.However,whether m^(6)A modifications participate in corticospinal tract regeneration after spinal cord injury remains unknown.We found that expression of methyltransferase 14 protein(METTL14)in the locomotor cortex was high after spinal cord injury and accompanied by elevated m^(6)A levels.Knockdown of Mettl14 in the locomotor cortex was not favorable for corticospinal tract regeneration and neurological recovery after spinal cord injury.Through bioinformatics analysis and methylated RNA immunoprecipitation-quantitative polymerase chain reaction,we found that METTL14 regulated Trib2 expression in an m^(6)A-regulated manner,thereby activating the mitogen-activated protein kinase pathway and promoting corticospinal tract regeneration.Finally,we administered syringin,a stabilizer of METTL14,using molecular docking.Results confirmed that syringin can promote corticospinal tract regeneration and facilitate neurological recovery by stabilizing METTL14.Findings from this study reveal that m^(6)A modification is involved in the regulation of corticospinal tract regeneration after spinal cord injury.
文摘BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.
文摘A clinical trial of nab-paclitaxel plus capecitabine as a first-line treatment for advanced biliary tract cancers was conducted.We analyzed the development of systemic therapy recommended by the National Comprehensive Cancer Network guidelines and the development of nab-paclitaxel combination chemotherapy for advanced biliary tract cancers(BTCs)and concluded that nab-paclitaxel plus capecitabine is a promising first-line regimen for advanced BTCs.
基金funded by MSD China.Editorial support for this manuscript was provided by Dr.Jake Burrell(Rude Health Consulting Limited)Dr.Christos Evangelou(on behalf of Rude Health Consulting Limited)and this support was funded by MSD China.
文摘Biliary tract cancer(BTC)is a rare group of malignancies that develop from the epithelial lining of the biliary tree and have a poor prognosis.Although chemotherapy is the standard of care for patients with advanced BTC in China,its clinical benefits are moderate.In recent years,the approval of targeted therapies and immunotherapies has provided new avenues for the management of advanced BTC.Nonetheless,the increasing number of personalized medicine approaches has created a challenge for clinicians choosing individualized treatment strategies based on tumor characteristics.In this article,we discuss recent progress in implementing precision medicine approaches for advanced BTC in China and examine genomic profiling studies in Chinese patients with advanced BTC.We also discuss the challenges and opportunities of using precision medicine approaches,as well as the importance of considering population-specific factors and tailoring treatment approaches to improve outcomes for patients with BTC.In addition to providing a comprehensive overview of current and emerging precision medicine approaches for the management of advanced BTC in China,this review article will support clinicians outside of China by serving as a reference regarding the role of patient-and population-specific factors in clinical decision-making for patients with this rare malignancy.
文摘Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which reduce the effectiveness of conventional treatments.This study aims to evaluate the antibiofilm activity of the homeopathic medicine Terebinthinae oleum in potencies 30C,200C,and 1M against UTI-causing E.coli,and to compare its effectiveness with the standard antibiotic Gentamycin.Methods:An in-vitro biofilm model was employed.E.coli biofilms were cultivated in microtiter plates and treated with Terebinthinae oleum(30C,200C,1M)and Gentamycin.Biofilm biomass was assessed through crystal violet staining,and optical density(OD)was measured using an ELISA microplate reader.Results:Among the tested potencies,Terebinthinae oleum 30C showed the most prominent inhibitory activity on E.coli biofilms.The inhibition percentage was compared with Gentamycin as a control.Terebinthinae oleum 30C demonstrated 41.88%inhibition of biofilm biomass,while Gentamycin exhibited up to 78.98%inhibition.Higher potencies of Terebinthinae oleum(200C and 1M)showed reduced activity(30.15%and 24.81%,respectively).Conclusion:Terebinthinae oleum,especially at 30C potency,exhibits measurable antibiofilm activity against E.coli,although less effective than Gentamycin.These findings support its use as a complementary therapy in managing biofilm-associated UTIs,justifying further clinical and immunological research.
基金financially supported by the Natural Science Foundation of China(No.82003766)Taishan Scholars Program(NO.tsqn202211219)+1 种基金the Key Research and Development Project of Shandong Province(No.2021ZDSYS27)Shandong Province nature fund surface project(Grant No.ZR2024MH088)。
文摘Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.
基金supported by the Capital’s Funds for Health Improvement and Research(CFH,shoufa-2022-1G-1131 and shoufa 2022-4G-1133)the High Level Technical Talent Construction Project of Beijing Municipal Health Commission(Discipline Leader-02-20)+1 种基金Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(JYY2023-10)the Pathogen Spectrum and Host Marker Analysis in Children with Respiratory Tract Infections of Children(Grant 2024-0040).
文摘Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.
基金supported by a grant from the National Natural Science Foundation of China(No.81874483).
文摘Understanding mixed infections in the female lower genital tract is a critical challenge in modern infection research.The interplay of multiple pathogens complicates disease progression,often resulting in treatment failure,recurrent infections,and significant public health and economic burdens.These infections are further exacerbated by disrupted host immune responses,which hinder the recovery of the vaginal microecosystem.Additionally,microbial biofilms—a fundamental mode of pathogen coexistence—contribute to the persistence and drug resistance of these infections,complicating management strategies.This review examines the pathogenesis,diagnosis,and treatment of mixed infections in the female lower genital tract while exploring potential avenues for future research.These findings emphasize the need for greater focus on these infections and offer insights to enhance further research in this area.
基金supported by the Project of National Natural Science Foundation(82372206)the Project of Jiangsu Provincial Health Commission(H2023107)the Project of Basic and Clinical Research on Cardiac Arrest in the Emergency and Critical Care Department of the Second Affi liated Hospital of Soochow University(XKTJ-XK202408-2).
文摘Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor has already spread to nearby organs at the time of diagnosis,with the small intestine and bladder being common sites of invasion.[1,2]The diagnosis of colorectal cancer that has spread to the bladder can be challenging.Aside from a few patients who experience urinary symptoms due to invasion of the bladder trigone or the entire bladder wall,there are no distinct clinical signs,which often leads to misdiagnosis.The following case report details one such instance.
文摘BACKGROUND Biliary tract cancer(BTC)is a rare,aggressive malignancy with increasing inci-dence and poor prognosis.Identifying preoperative prognostic factors is crucial for effective risk-benefit assessments and patient stratification.The prognostic nutritional index(PNI),which reflects immune-inflammatory and nutritional status,has shown prognostic value in various cancers,but its significance in BTC remains unclear.AIM To assess the prognostic value of the preoperative PNI in BTC patients,with a focus on overall survival(OS)and disease-free survival(DFS).METHODS Comprehensive searches were conducted in the PubMed,EMBASE,and Web of Science databases from inception to April 2024.The primary outcomes of interest focused on the associations between the preoperative PNI and the prognosis of BTC patients,specifically OS and disease-free survival(DFS).Statistical analyses were conducted via STATA 17.0 software.RESULTS Seventeen studies encompassing 4645 patients met the inclusion criteria.Meta-analysis revealed that a low PNI was significantly associated with poorer OS[hazard ratio(HR)1.91,95%CI:1.59-2.29;P<0.001]and DFS(HR 1.93,95%CI:1.39-2.67;P<0.001).Subgroup analyses revealed consistent results across BTC subtypes(cholangiocarcinoma and gallbladder cancer)and stages(resectable and advanced).Sensitivity analyses confirmed the robustness of these findings,and no significant publication bias was detected.CONCLUSION This study demonstrated that a low preoperative PNI predicts poor OS and DFS in BTC patients,highlighting its potential as a valuable prognostic tool.Further prospective studies are needed to validate these findings and enhance BTC patient management.
基金Supported by Javna Agencija za Raziskovalno in Inovacijsko Dejavnost RS,No.P3-0036,No.I0-0029,No.J3-50098,and No.N1-0305University medical center Maribor,No.IRP-2021/02-05Swiss National Science Foundation(SNF)Postdoctoral Fellowship,No.P500PM217647/1.
文摘The gastrointestinal(GI)tract is essential for digestion,absorption,excretion,and protection,supported by a diverse microbial ecosystem.Traditional in-vitro models often fall short in capturing the physiological complexity of the GI tract,limiting their translational applications.A comprehensive approach is needed to bridge the gap between simple cell cultures and more complex systems used in translational research.This review explores the limitations of conventional twodimensional cell cultures and emphasizes the emerging use of three-dimensional and microfluidic systems that better replicate the GI tract’s structure and functions.It highlights the importance of incorporating patient-derived cells and engineered microenvironments to enhance model relevance and support personalized medicine.The review also discusses advanced fabrication techniques such as micro-extrusion and laser-assisted bioprinting,which enable the creation of sophisticated tissue models capable of simulating critical GI processes,including molecular transport,peristalsis,and liver coupling.Advancing the complexity of in-vitro systems will help replicate the GI tract’s interactions and physiological phenomena,thus improving the translational potential of GI research.This review provides valuable insights into the advancements and challenges in GI modeling,serving as a comprehensive guide for developing models that bridge the gap between basic cell cultures and clinically relevant systems.
文摘BACKGROUND For patients with advanced gastric cancer,surgical resection remains the main treatment option.Total gastrectomy combined with radical resection of gastric cancer lesions and sentinel lymph nodes can significantly prolong the survival of patients.Digestive tract reconstruction after total gastrectomy is essential to maintain gastrointestinal function and optimize postoperative recovery.Therefore,it is very important to choose a suitable reconstruction method to improve the quality of life of total gastrectomy patients.AIM To evaluate the effects of different digestive tract reconstruction methods in gastric cancer patients undergoing total gastrectomy.METHODS This retrospective study included 172 patients who underwent total gastrectomy for gastric cancer at The First Hospital of Hebei Medical University for analysis.The patients were categorized into two groups:Group A,consisting of 90 patients who underwent modified Roux-en-Y gastrojejunostomy,and group B,consisting of 82 patients who underwent uncut Roux-en-Y gastrojejunostomy.The general patient characteristics,perioperative indicators,postoperative gastrointestinal mucosal barrier function,nutritional status,immunological markers,and occurrence of complications were compared between the two groups.RESULTS Group A showed shorter digestive tract reconstruction time than group B(P<0.05).On the first postoperative day,group A showed lower serum levels of D-lactate,diamine oxidase,and endotoxin than group B(P<0.05).One month postoperatively,group A showed higher prognostic nutritional index,serum albumin,total protein,and body weight than group B(P<0.05).One month postoperatively,the levels of cluster of differentiation(CD)3+,CD4+,and CD8+cells were not significantly different between two groups(P>0.05).The complication rates were 10.00%in group A and 24.39%in group B;group A had a significantly lower complication rate than group B(P<0.05).CONCLUSION Using modified Roux-en-Y gastrojejunostomy during total gastrectomy shortens the time required for gastrointestinal anastomosis,reduces surgery-induced gastrointestinal mucosal damage,and mitigates postoperative declines in nutritional status.
文摘Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.
文摘ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.ResultsA total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.ConclusionKetamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.
基金Supported by The National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-132.
文摘BACKGROUND Indolent NK-cell lymphoproliferative disorder of the gastrointestinal tract(iNKLPD)is a rare and recently defined entity,recognized in the 2022 WHO classification of hematolymphoid tumors.iNKLPD typically exhibits a benign or slowly progressive clinical course,with disease localized to the gastrointestinal tract.Here,we present what we believe to be the first reported case of iNKLPD associated with protein-losing enteropathy(PLE),characterized by a poor response to chemotherapy and rapid clinical deterioration,culminating in death within a few months.CASE SUMMARY We report the case of a 64-year-old man who presented with bilateral lower-extremity edema and fatigue.Laboratory tests revealed marked hypoalbuminemia,while other liver function parameters remained within normal limits.Renal and cardiac function assessments were unremarkable.Histopathological examination of endoscopic biopsies confirmed a diagnosis of iNKLPD of the gastrointestinal tract.The patient was treated with oral prednisone and cyclosporine,which led to temporary improvement in both symptoms and serum albumin levels.However,disease relapse occurred during corticosteroid tapering,accompanied by worsening hypoalbu-minemia and refractory diarrhea.The patient died eight months after diagnosis,likely due to disease progression or severe treatment-related complications.CONCLUSION iNKLPD generally exhibits an indolent course;nonetheless,the prognosis may be poor if secondary PLE is involved.
文摘BACKGROUND Proximal gastrectomy(PG)with double tract reconstruction(DTR)has recently emerged as a function-preserving alternative to total gastrectomy(TG)with Rouxen-Y(RNY)reconstruction in patients with proximally located gastric cancer.AIM To evaluate the current evidence comparing PG-DTR with TG-RNY in terms of perioperative outcomes,long-term survival,complication rates,nutritional status and reflux esophagitis.METHODS A systematic literature search was conducted using PubMed,MEDLINE,Web of Science and the Cochrane Library for studies published between 2010 and January 2025.Search terms included gastric cancer,DTR and TG.Trials comparing PGDTR with TG-RNY or PG-esophagogastrostomy(EG)were included.Data on operative details,lymph node yield,complications(Clavien-Dindo≥III),nutritional markers and incidence of reflux were extracted.Nineteen trials met the inclusion criteria.The review followed the PRISMA guidelines.RESULTS PG-DTR was found to have comparable long-term oncological outcomes to TGRNY,despite a lower extent of lymph node dissection.Operative time and intraoperative blood loss were generally similar,with some studies favouring PGDTR.Rates of major postoperative complications were comparable between techniques.Notably,PG-DTR showed a significantly lower incidence of reflux esophagitis than PG-EG and was comparable or superior to TG-RNY in reflux control.Nutritionally,PG-DTR was associated with better post-operative weight maintenance and biochemical parameters such as haemoglobin,albumin and vitamin B12 levels compared to TG-RNY.No significant nutritional differences were observed between PG-DTR and PG-EG.PG-DTR appears to offer a balanced approach to the surgical treatment of proximal gastric cancer,combining oncological safety with functional and nutritional benefits.CONCLUSION Its superiority over TG-RNY in postoperative nutrition and reflux prevention,together with comparable complication rates and survival,supports its consideration as a preferred reconstruction method in selected patients.
