Varicocele(VC)is widely recognized as a prevalent and clinically significant cause of male infertility.However,the comprehensive pathogenic mechanisms underlying VC development and progression remain incompletely unde...Varicocele(VC)is widely recognized as a prevalent and clinically significant cause of male infertility.However,the comprehensive pathogenic mechanisms underlying VC development and progression remain incompletely understood,creating an important knowledge gap in the field of andrology.This review establishes that VC pathogenesis centers on abnormal vascular remodeling and integrates multiple contributing elements,including anatomical abnormalities,biochemical disturbances,genetic factors,low body mass index(BMI),age,and specific sports habits,while secondary varicoceles are primarily induced by compressive pathologies.Through a systematic synthesis of current evidence and recent advances,this review aims to elucidate the complex pathogenic network of VC and provide valuable insights to guide future research directions and inform the development of targeted clinical applications.展开更多
Despite advances in surgery,chemotherapy,and radiotherapy,the treatment of colorectal cancer(CRC)requires more personalized approaches based on tumor biology and molecular profiling.While some relevant mutations have ...Despite advances in surgery,chemotherapy,and radiotherapy,the treatment of colorectal cancer(CRC)requires more personalized approaches based on tumor biology and molecular profiling.While some relevant mutations have been associated with differential response to immunotherapy,such as RAS and BRAF mutations limiting response to anti-epithelial growth factor receptor drugs or microsatellite instability predisposing susceptibility to immune checkpoint inhibitors,the role of inflammation in dictating tumor progression and treatment response is still under investigation.Several inflammatory biomarkers have been identified to guide patient prognosis.These include the neutrophil-lymphocyte ratio,Glasgow prognostic score(GPS)and its modified version,lymphocyte-Creactive protein ratio,and platelet-lymphocyte ratio.However,these markers are not yet included in the standard clinical management of patients with CRC,and further research is needed to evaluate their efficacy in different patient populations.A recent study by Wang et al,published in the World Journal of Gastroenterology,sheds light on the prognostic significance of pan-immune-inflammation value(PIV)in CRC,particularly concerning primary tumor location.Specifically,the authors found that a high PIV was strongly correlated with worse disease-free survival in patients with left-sided colon cancer,whereas no such association was observed in patients with right-sided colon cancer.Integrating tumor location into the prognostic assessment of CRC may improve our ability to more accurately identify high-risk patients and develop personalized treatment plans that are more likely to improve patient outcomes.展开更多
Trophectoderm(TE)biopsy has become the preferred approach in preimplantation genetic testing,providing clear advantages over polar body and cleavage-stage biopsy.However,the optimal timing and methodology for blastocy...Trophectoderm(TE)biopsy has become the preferred approach in preimplantation genetic testing,providing clear advantages over polar body and cleavage-stage biopsy.However,the optimal timing and methodology for blastocyst biopsy remain subjects of ongoing debate.McArthur et al in 2005 were the first to demonstrate the safety of TE biopsy at the hatching blastocyst stage with laser-assisted opening in the zona pellucida(ZP)on Day 3,reporting 100%survival of 1050 biopsied blastocysts,all of which re-expanded,with an implantation rate of 41%[1].Nearly a decade later,Capalbo et al in 2014 introduced a modified strategy,performing biopsy on fully expanded blastocysts by creating a laser-assisted ZP opening and immediately aspirating TE cells on Day 5.展开更多
Background: Brainwave entrainment using binaural beats has shown potential in treating tinnitus, but most studies have focused on one-month treatment durations. Objective: This study aimed to evaluate the time-bound e...Background: Brainwave entrainment using binaural beats has shown potential in treating tinnitus, but most studies have focused on one-month treatment durations. Objective: This study aimed to evaluate the time-bound efficacy of brainwave entrainment using binaural beats, comparing it to a standard tinnitus masker over a three-month duration. Method: Sixty-three individuals having tinnitus with normal hearing sensitivity were enrolled in the study. The participants were categorized into groups Ⅰ, Ⅱ, and Ⅲ. They were provided with delta(4 Hz) and alpha(10 Hz) frequency binaural beats and standard tinnitus masker, respectively, for a duration of three months. The tinnitus handicap inventory(THI) scores, Visual analogue scale(VAS) rating for tinnitus distress, and quality of life parameters were measured. The reductions obtained for each measure during the end of the first, second and third month were measured and compared across the groups. Results: All three groups showed considerable reductions in THI and VAS scores and improvements in the quality of life domains, focusing on physical and psychological health. However, groups Ⅰ and Ⅱ, who received binaural beats stimuli, showed higher benefits than those who received standard tinnitus masker. Conclusion: The results of the current study indicated that binaural beats can be an effective treatment technique for individuals with tinnitus having normal hearing sensitivity. Clinicians and otology/audiology practitioners shall adopt this innovative treatment after further validating these findings.展开更多
Clinical inertia(CI)is common in clinical practice.Sexual health issues are common in society,and CI is ubiquitous in sexual medicine practice.CI influences all aspects of healthcare,including prevention,diagnosis,and...Clinical inertia(CI)is common in clinical practice.Sexual health issues are common in society,and CI is ubiquitous in sexual medicine practice.CI influences all aspects of healthcare,including prevention,diagnosis,and treatment.In this short review,we briefly describe the various aspects of CI in sexual medicine practice and ways to tackle them.展开更多
Chronic suppurative otitis media(CSOM)is a prevalent condition in otolaryngology with significant medical and social implications,including hearing loss and severe intracranial complications.This article discusses the...Chronic suppurative otitis media(CSOM)is a prevalent condition in otolaryngology with significant medical and social implications,including hearing loss and severe intracranial complications.This article discusses the challenges in diagnosing cholesteatoma,a common complication of CSOM,particularly when using computed tomography(CT)and magnetic resonance imaging(MRI).We present three clinical cases where MRI,particularly in the non-EPI diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)modes,effectively identified the presence and extent of cholesteatoma that CT could not reliably distinguish due to overlapping features with other soft tissue formations.The high sensitivity of MRI,highlight its value in both primary diagnosis and assessment of recurrence.Our findings advocate for the incorporation of MRI into the diagnostic protocols for CSOM in the Republic of Kazakhstan,emphasizing the need for reliable epidemiological data to inform future research and prevent potential intracranial complications.展开更多
Assisted hatching(AH)is commonly performed before trophectoderm(TE)biopsy for preimplantation genetic testing for aneuploidy(PGT-A),yet whether AH timing influences the detection of chromosomal mosaicism remains uncer...Assisted hatching(AH)is commonly performed before trophectoderm(TE)biopsy for preimplantation genetic testing for aneuploidy(PGT-A),yet whether AH timing influences the detection of chromosomal mosaicism remains uncertain.Beyond timing,procedural choices in PGT-A must balance diagnostic yield against potential harm from additional handling(e.g.,repeat TE biopsy or cryopreservation steps),as underscored by a recent systematic review and meta-analysis[1].展开更多
BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing li...BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.展开更多
The cell cycle is a tightly coupled series of events that enable cells to grow and proliferate.Cyclin-dependent kinases(CDKs)play crucial roles in the cell cycle by enabling cells to transition between different phase...The cell cycle is a tightly coupled series of events that enable cells to grow and proliferate.Cyclin-dependent kinases(CDKs)play crucial roles in the cell cycle by enabling cells to transition between different phases when they are activated.Cell cycle proteins enhance the activity of CDKs,while natural CDK inhibitors(CDKIs)suppress them.The cell cycle continues in cycles under normal conditions,but when conditions change,cells halt or terminate the cell cycle.Tumors are tissues that grow out of control,and the mechanisms of various types of tumors are different;however,almost all tumor cells share several common characteristics,including proliferation,prevention of apoptosis and genomic instability.Cellular division is essential in the progression of cancer.A key characteristic of cancer is the uncontrolled growth of tumor cells,which is due to the erratic behavior of several proteins during the cell cycle.Therefore,cell cycle regulators are considered attractive targets for the treatment of cancer.The present analysis highlights proteins that play a direct role in controlling the tumor cell cycle,such as CDKs,and provides a brief overview of checkpoint kinases.The present review also discusses how cell cycle proteins contribute to cancer and describes some of the antitumor drugs that are being researched.展开更多
Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of t...Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.展开更多
The integration of academic research methodologies into design thinking processes presents a transformative approach to addressing complex challenges in group housing,fostering inclusive,sustainable,and user-centered ...The integration of academic research methodologies into design thinking processes presents a transformative approach to addressing complex challenges in group housing,fostering inclusive,sustainable,and user-centered solutions.This research explores how methodologies such as Participatory Action Research,post-occupancy evaluations,and Research through Design can be systematically embedded within design thinking to bridge the gap between academic rigor and empathy-driven,iterative design practices.By synthesizing these paradigms,the study proposes a framework for group housing design that prioritizes co-design processes,empathy-based data collection,and participatory evaluation,while emphasizing adaptability through sociocultural insights and user feedback.Case studies analysis demonstrate the effectiveness of flexible,community-driven design,while emerging technologies like IoT-enabled cohousing signal new opportunities for innovation.Challenges,including scalability,long-term validation,and reconciling user autonomy with professional expertise,are critically analyzed.Ultimately,this research advances a hybrid methodology to redefine the conceptualization,implementation,and assessment of group housing,offering actionable pathways to achieve affordable,inclusive,and context-sensitive housing solutions.展开更多
Background:Low cardiac output syndrome(LCOS)is a frequent and serious complication after pediatric cardiac surgery.Endothelial glycocalyx(EG)degradation,indicated by elevated syndecan-1,contributes to microvascular dy...Background:Low cardiac output syndrome(LCOS)is a frequent and serious complication after pediatric cardiac surgery.Endothelial glycocalyx(EG)degradation,indicated by elevated syndecan-1,contributes to microvascular dysfunction and postoperative instability.The relationship between syndecan-1 dynamics and surgical risk categories remains unclear.Objective:To examine the association between perioperative syndecan-1 levels and clinical outcomes across Risk Adjustment for Congenital Heart Surgery(RACHS-1)categories.Methods:We analyzed 106 children(RACHS-1 categories 2–4)undergoing elective cardiac surgery with cardiopulmonary bypass(CPB).Syndecan-1 was measured at baseline(T0),4 h(T4),and 72 h(T72).Outcomes included LCOS,vasoactive inotropic score(VIS),Pediatric Logistic Organ Dysfunction(PELOD-2),pediatric intensive care unit(PICU)stay,and mortality.Analyses used Kruskal–Wallis,Bonferroni post hoc tests,Spearman correlation,and multivariable regression adjusted for CPB duration,cross-clamp time,and pre-PICU status.Results:Syndecan-1 differed significantly across RACHS groups at T0(p=0.044)and T72(p=0.015).RACHS score was weakly correlated but significant with syndecan-1 at T72(r=0.238,p=0.019)and decline from T4–T72(r=0.249,p=0.013),indicating delayed recovery at higher risk.RACHS-4 patients had the highest VIS and PELOD-2 scores and longer PICU stay.In adjusted models,RACHS-3 was associated with higher syndecan-1 at T72(β=+51.9,p=0.016),higher VIS 0–4 h(β=+4.9,p=0.008),and increased LCOS risk(OR 5.99,95%CI 1.61–25.70,p=0.010).RACHS-4 showed greater organ dysfunction but LCOS risk was attenuated(OR 0.19 vs.RACHS-3,p=0.035).Mortality was highest in RACHS-4(17.6%)but not statistically significant(p=0.368).Conclusion:Higher RACHS categories are linked with delayed EG recovery,greater vasoactive support,and more severe organ dysfunction.Syndecan-1 kinetics at 72 h,alongside VIS and LCOS,may serve as adjunctive markers for postoperative risk stratification in pediatric cardiac surgery.展开更多
This study aimed to investigate the associations between the post-wash total progressively motile sperm count(TPMSC)in the first intrauterine insemination(IUI)cycle and pregnancy outcomes of the second IUI cycle.Data ...This study aimed to investigate the associations between the post-wash total progressively motile sperm count(TPMSC)in the first intrauterine insemination(IUI)cycle and pregnancy outcomes of the second IUI cycle.Data were retrieved from the clinical database at the Reproductive Center of Peking University Third Hospital(Beijing,China)between January 2011 and December 2022.Couples were included in this retrospective cohort study if they had unexplained or mild male factor infertility and were treated with IUI for two consecutive cycles using the same protocol.A total of 8290 couples were included in the analysis.The mean±standard deviation(s.d.)age of women was 32.0±3.5 years.We categorized groups based on the post-wash TPMSC(×10^(6))levels in the first IUI cycle:group 1(0<TPMSC<1,n=1290),group 2(1≤TPMSC<2,n=863),group 3(2≤TPMSC<3,n=800),group 4(3≤TPMSC<4,n=783),group 5(4≤TPMSC<5,n=1541),group 6(5≤TPMSC<6,n=522),group 7(6≤TPMSC<7,n=547),group 8(7≤TPMSC<8,n=175),group 9(8≤TPMSC<9,n=556),group 10(9≤TPMSC<10,n=192),and group 11(TPMSC≥10,n=1021).The primary outcome was live birth rate of the second IUI cycle.Live birth rates were 7.9%,5.8%,7.6%,7.4%,7.3%,8.4%,7.5%,7.4%,8.8%,8.9%,and 7.6%in each group,respectively.There were no statistically significant differences in clinical pregnancy rates or live birth rates between any groups and those with the post-wash TPMSC<1×10^(6).In an IUI program for unexplained and mild male factor infertility,the post-wash TPMSC in the first IUI cycle was not significantly associated with the live birth rate in the second IUI cycle.展开更多
Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with id...Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with idiopathic oligoasthenozoospermia were examined.The first group(n=125)received 100 mg/day of CoQ10 and the second group(n=125)received 200 mg/day of CoQ10 orally for 6 months.Semen parameters,DNA fragmentation index(DFI)and the partner pregnancy rate were analyzed at baseline and after 6 months of treatment.Results:Comparing with baseline data,treatment with CoQ10(100 mg/day or 200 mg/day)resulted in a significant increase in sperm concentration(both P<0.001),a significant improvement in progressive motility and total motile sperm count(P=0.05,P=0.001,respectively).The mean DFI was significantly improved after treatment with CoQ10 at 100 mg/day and at 200 mg/day,after 6 months of treatment(P<0.01).Moreover,CoQ10 significantly improved the partner pregnancy rate.A strongest correlation was found between seminal fluid parameters and DFI(P<0.001).Conclusions:CoQ10 is effective in improving semen parameters,DFI and on the partner pregnancy rate after 6 months with CoQ10 at two doses,with a greater improvement shown in men who took 200 mg/day than in those who took 100 mg/day.展开更多
The integration of artificial intelligence(AI)and multiomics has transformed clinical and life sciences,enabling precision medicine and redefining disease understanding.Scientific publications grew significantly from ...The integration of artificial intelligence(AI)and multiomics has transformed clinical and life sciences,enabling precision medicine and redefining disease understanding.Scientific publications grew significantly from 2.1 million in 2012 to 3.3 million in 2022,with AI research tripling during this period.Multiomics fields,including genomics and proteomics,also advanced,exemplified by the Human Proteome Project achieving a 90%complete blueprint by 2021.This growth highlights opportunities and challenges in integrating AI and multiomics into clinical reporting.A review of studies and case reports was conducted to evaluate AI and multiomics integration.Key areas analyzed included diagnostic accuracy,predictive modeling,and personalized treatment approaches driven by AI tools.Case examples were studied to assess impacts on clinical decision-making.AI and multiomics enhanced data integration,predictive insights,and treatment personalization.Fields like radiomics,genomics,and proteomics improved diagnostics and guided therapy.For instance,the“AI radiomics,geno-mics,oncopathomics,and surgomics project”combined radiomics and genomics for surgical decision-making,enabling preoperative,intraoperative,and post-operative interventions.AI applications in case reports predicted conditions like postoperative delirium and monitored cancer progression using genomic and imaging data.AI and multiomics enable standardized data analysis,dynamic updates,and predictive modeling in case reports.Traditional reports often lack objectivity,but AI enhances reproducibility and decision-making by processing large datasets.Challenges include data standardization,biases,and ethical concerns.Overcoming these barriers is vital for optimizing AI applications and advancing personalized medicine.AI and multiomics integration is revolutionizing clinical research and practice.Standardizing data reporting and addressing challenges in ethics and data quality will unlock their full potential.Emphasizing collaboration and transparency is essential for leveraging these tools to improve patient care and scientific communication.展开更多
BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in iden...BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.展开更多
Hepatic arterial infusion(HAI)chemotherapy,first introduced in the 1980s,has gained recognition as an effective locoregional treatment for colorectal liver metastasis(CRLM).Initially used for unresectable liver metast...Hepatic arterial infusion(HAI)chemotherapy,first introduced in the 1980s,has gained recognition as an effective locoregional treatment for colorectal liver metastasis(CRLM).Initially used for unresectable liver metastases,HAI’s app-lication has expanded to the adjuvant setting following hepatic resection,with early studies indicating improved hepatic disease-free survival.Recent research demonstrates that combining HAI with modern systemic therapies enhances conversion to resectability and prolongs both recurrence-free and overall survival,even in heavily pretreated patients with diverse RAS mutational statuses.Person-alization through approaches like microsatellite instability status and dose mo-difications further optimize outcomes.However,the complexity of HAI requires expertise across multidisciplinary teams,limiting its widespread adoption to specialized centers.Ongoing clinical trials continue to investigate HAI’s role in CRLM management,highlighting its potential to become a cornerstone of liver-directed therapy.We explore how HAI chemotherapy,in combination with personalized medicine,can advance treatment strategies for metastatic colorectal cancer.展开更多
基金funded by China Postdoctoral Science Foundation(Grant Number:2025M773939)NationalNatural Science Foundation of China(Grant Number:82205131)Sichuan Science and Technology Program(Grant Number:2025ZNSFSC1798).
文摘Varicocele(VC)is widely recognized as a prevalent and clinically significant cause of male infertility.However,the comprehensive pathogenic mechanisms underlying VC development and progression remain incompletely understood,creating an important knowledge gap in the field of andrology.This review establishes that VC pathogenesis centers on abnormal vascular remodeling and integrates multiple contributing elements,including anatomical abnormalities,biochemical disturbances,genetic factors,low body mass index(BMI),age,and specific sports habits,while secondary varicoceles are primarily induced by compressive pathologies.Through a systematic synthesis of current evidence and recent advances,this review aims to elucidate the complex pathogenic network of VC and provide valuable insights to guide future research directions and inform the development of targeted clinical applications.
文摘Despite advances in surgery,chemotherapy,and radiotherapy,the treatment of colorectal cancer(CRC)requires more personalized approaches based on tumor biology and molecular profiling.While some relevant mutations have been associated with differential response to immunotherapy,such as RAS and BRAF mutations limiting response to anti-epithelial growth factor receptor drugs or microsatellite instability predisposing susceptibility to immune checkpoint inhibitors,the role of inflammation in dictating tumor progression and treatment response is still under investigation.Several inflammatory biomarkers have been identified to guide patient prognosis.These include the neutrophil-lymphocyte ratio,Glasgow prognostic score(GPS)and its modified version,lymphocyte-Creactive protein ratio,and platelet-lymphocyte ratio.However,these markers are not yet included in the standard clinical management of patients with CRC,and further research is needed to evaluate their efficacy in different patient populations.A recent study by Wang et al,published in the World Journal of Gastroenterology,sheds light on the prognostic significance of pan-immune-inflammation value(PIV)in CRC,particularly concerning primary tumor location.Specifically,the authors found that a high PIV was strongly correlated with worse disease-free survival in patients with left-sided colon cancer,whereas no such association was observed in patients with right-sided colon cancer.Integrating tumor location into the prognostic assessment of CRC may improve our ability to more accurately identify high-risk patients and develop personalized treatment plans that are more likely to improve patient outcomes.
文摘Trophectoderm(TE)biopsy has become the preferred approach in preimplantation genetic testing,providing clear advantages over polar body and cleavage-stage biopsy.However,the optimal timing and methodology for blastocyst biopsy remain subjects of ongoing debate.McArthur et al in 2005 were the first to demonstrate the safety of TE biopsy at the hatching blastocyst stage with laser-assisted opening in the zona pellucida(ZP)on Day 3,reporting 100%survival of 1050 biopsied blastocysts,all of which re-expanded,with an implantation rate of 41%[1].Nearly a decade later,Capalbo et al in 2014 introduced a modified strategy,performing biopsy on fully expanded blastocysts by creating a laser-assisted ZP opening and immediately aspirating TE cells on Day 5.
文摘Background: Brainwave entrainment using binaural beats has shown potential in treating tinnitus, but most studies have focused on one-month treatment durations. Objective: This study aimed to evaluate the time-bound efficacy of brainwave entrainment using binaural beats, comparing it to a standard tinnitus masker over a three-month duration. Method: Sixty-three individuals having tinnitus with normal hearing sensitivity were enrolled in the study. The participants were categorized into groups Ⅰ, Ⅱ, and Ⅲ. They were provided with delta(4 Hz) and alpha(10 Hz) frequency binaural beats and standard tinnitus masker, respectively, for a duration of three months. The tinnitus handicap inventory(THI) scores, Visual analogue scale(VAS) rating for tinnitus distress, and quality of life parameters were measured. The reductions obtained for each measure during the end of the first, second and third month were measured and compared across the groups. Results: All three groups showed considerable reductions in THI and VAS scores and improvements in the quality of life domains, focusing on physical and psychological health. However, groups Ⅰ and Ⅱ, who received binaural beats stimuli, showed higher benefits than those who received standard tinnitus masker. Conclusion: The results of the current study indicated that binaural beats can be an effective treatment technique for individuals with tinnitus having normal hearing sensitivity. Clinicians and otology/audiology practitioners shall adopt this innovative treatment after further validating these findings.
文摘Clinical inertia(CI)is common in clinical practice.Sexual health issues are common in society,and CI is ubiquitous in sexual medicine practice.CI influences all aspects of healthcare,including prevention,diagnosis,and treatment.In this short review,we briefly describe the various aspects of CI in sexual medicine practice and ways to tackle them.
文摘Chronic suppurative otitis media(CSOM)is a prevalent condition in otolaryngology with significant medical and social implications,including hearing loss and severe intracranial complications.This article discusses the challenges in diagnosing cholesteatoma,a common complication of CSOM,particularly when using computed tomography(CT)and magnetic resonance imaging(MRI).We present three clinical cases where MRI,particularly in the non-EPI diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)modes,effectively identified the presence and extent of cholesteatoma that CT could not reliably distinguish due to overlapping features with other soft tissue formations.The high sensitivity of MRI,highlight its value in both primary diagnosis and assessment of recurrence.Our findings advocate for the incorporation of MRI into the diagnostic protocols for CSOM in the Republic of Kazakhstan,emphasizing the need for reliable epidemiological data to inform future research and prevent potential intracranial complications.
文摘Assisted hatching(AH)is commonly performed before trophectoderm(TE)biopsy for preimplantation genetic testing for aneuploidy(PGT-A),yet whether AH timing influences the detection of chromosomal mosaicism remains uncertain.Beyond timing,procedural choices in PGT-A must balance diagnostic yield against potential harm from additional handling(e.g.,repeat TE biopsy or cryopreservation steps),as underscored by a recent systematic review and meta-analysis[1].
文摘BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.
文摘The cell cycle is a tightly coupled series of events that enable cells to grow and proliferate.Cyclin-dependent kinases(CDKs)play crucial roles in the cell cycle by enabling cells to transition between different phases when they are activated.Cell cycle proteins enhance the activity of CDKs,while natural CDK inhibitors(CDKIs)suppress them.The cell cycle continues in cycles under normal conditions,but when conditions change,cells halt or terminate the cell cycle.Tumors are tissues that grow out of control,and the mechanisms of various types of tumors are different;however,almost all tumor cells share several common characteristics,including proliferation,prevention of apoptosis and genomic instability.Cellular division is essential in the progression of cancer.A key characteristic of cancer is the uncontrolled growth of tumor cells,which is due to the erratic behavior of several proteins during the cell cycle.Therefore,cell cycle regulators are considered attractive targets for the treatment of cancer.The present analysis highlights proteins that play a direct role in controlling the tumor cell cycle,such as CDKs,and provides a brief overview of checkpoint kinases.The present review also discusses how cell cycle proteins contribute to cancer and describes some of the antitumor drugs that are being researched.
文摘Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.
文摘The integration of academic research methodologies into design thinking processes presents a transformative approach to addressing complex challenges in group housing,fostering inclusive,sustainable,and user-centered solutions.This research explores how methodologies such as Participatory Action Research,post-occupancy evaluations,and Research through Design can be systematically embedded within design thinking to bridge the gap between academic rigor and empathy-driven,iterative design practices.By synthesizing these paradigms,the study proposes a framework for group housing design that prioritizes co-design processes,empathy-based data collection,and participatory evaluation,while emphasizing adaptability through sociocultural insights and user feedback.Case studies analysis demonstrate the effectiveness of flexible,community-driven design,while emerging technologies like IoT-enabled cohousing signal new opportunities for innovation.Challenges,including scalability,long-term validation,and reconciling user autonomy with professional expertise,are critically analyzed.Ultimately,this research advances a hybrid methodology to redefine the conceptualization,implementation,and assessment of group housing,offering actionable pathways to achieve affordable,inclusive,and context-sensitive housing solutions.
文摘Background:Low cardiac output syndrome(LCOS)is a frequent and serious complication after pediatric cardiac surgery.Endothelial glycocalyx(EG)degradation,indicated by elevated syndecan-1,contributes to microvascular dysfunction and postoperative instability.The relationship between syndecan-1 dynamics and surgical risk categories remains unclear.Objective:To examine the association between perioperative syndecan-1 levels and clinical outcomes across Risk Adjustment for Congenital Heart Surgery(RACHS-1)categories.Methods:We analyzed 106 children(RACHS-1 categories 2–4)undergoing elective cardiac surgery with cardiopulmonary bypass(CPB).Syndecan-1 was measured at baseline(T0),4 h(T4),and 72 h(T72).Outcomes included LCOS,vasoactive inotropic score(VIS),Pediatric Logistic Organ Dysfunction(PELOD-2),pediatric intensive care unit(PICU)stay,and mortality.Analyses used Kruskal–Wallis,Bonferroni post hoc tests,Spearman correlation,and multivariable regression adjusted for CPB duration,cross-clamp time,and pre-PICU status.Results:Syndecan-1 differed significantly across RACHS groups at T0(p=0.044)and T72(p=0.015).RACHS score was weakly correlated but significant with syndecan-1 at T72(r=0.238,p=0.019)and decline from T4–T72(r=0.249,p=0.013),indicating delayed recovery at higher risk.RACHS-4 patients had the highest VIS and PELOD-2 scores and longer PICU stay.In adjusted models,RACHS-3 was associated with higher syndecan-1 at T72(β=+51.9,p=0.016),higher VIS 0–4 h(β=+4.9,p=0.008),and increased LCOS risk(OR 5.99,95%CI 1.61–25.70,p=0.010).RACHS-4 showed greater organ dysfunction but LCOS risk was attenuated(OR 0.19 vs.RACHS-3,p=0.035).Mortality was highest in RACHS-4(17.6%)but not statistically significant(p=0.368).Conclusion:Higher RACHS categories are linked with delayed EG recovery,greater vasoactive support,and more severe organ dysfunction.Syndecan-1 kinetics at 72 h,alongside VIS and LCOS,may serve as adjunctive markers for postoperative risk stratification in pediatric cardiac surgery.
基金supported by National Key Research and Development Program(2022YFC2705305)clinical key project of Peking University Third Hospital(BYSYZD2023007)National Science Fund for Distinguished Young Scholars(81925013).
文摘This study aimed to investigate the associations between the post-wash total progressively motile sperm count(TPMSC)in the first intrauterine insemination(IUI)cycle and pregnancy outcomes of the second IUI cycle.Data were retrieved from the clinical database at the Reproductive Center of Peking University Third Hospital(Beijing,China)between January 2011 and December 2022.Couples were included in this retrospective cohort study if they had unexplained or mild male factor infertility and were treated with IUI for two consecutive cycles using the same protocol.A total of 8290 couples were included in the analysis.The mean±standard deviation(s.d.)age of women was 32.0±3.5 years.We categorized groups based on the post-wash TPMSC(×10^(6))levels in the first IUI cycle:group 1(0<TPMSC<1,n=1290),group 2(1≤TPMSC<2,n=863),group 3(2≤TPMSC<3,n=800),group 4(3≤TPMSC<4,n=783),group 5(4≤TPMSC<5,n=1541),group 6(5≤TPMSC<6,n=522),group 7(6≤TPMSC<7,n=547),group 8(7≤TPMSC<8,n=175),group 9(8≤TPMSC<9,n=556),group 10(9≤TPMSC<10,n=192),and group 11(TPMSC≥10,n=1021).The primary outcome was live birth rate of the second IUI cycle.Live birth rates were 7.9%,5.8%,7.6%,7.4%,7.3%,8.4%,7.5%,7.4%,8.8%,8.9%,and 7.6%in each group,respectively.There were no statistically significant differences in clinical pregnancy rates or live birth rates between any groups and those with the post-wash TPMSC<1×10^(6).In an IUI program for unexplained and mild male factor infertility,the post-wash TPMSC in the first IUI cycle was not significantly associated with the live birth rate in the second IUI cycle.
文摘Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with idiopathic oligoasthenozoospermia were examined.The first group(n=125)received 100 mg/day of CoQ10 and the second group(n=125)received 200 mg/day of CoQ10 orally for 6 months.Semen parameters,DNA fragmentation index(DFI)and the partner pregnancy rate were analyzed at baseline and after 6 months of treatment.Results:Comparing with baseline data,treatment with CoQ10(100 mg/day or 200 mg/day)resulted in a significant increase in sperm concentration(both P<0.001),a significant improvement in progressive motility and total motile sperm count(P=0.05,P=0.001,respectively).The mean DFI was significantly improved after treatment with CoQ10 at 100 mg/day and at 200 mg/day,after 6 months of treatment(P<0.01).Moreover,CoQ10 significantly improved the partner pregnancy rate.A strongest correlation was found between seminal fluid parameters and DFI(P<0.001).Conclusions:CoQ10 is effective in improving semen parameters,DFI and on the partner pregnancy rate after 6 months with CoQ10 at two doses,with a greater improvement shown in men who took 200 mg/day than in those who took 100 mg/day.
文摘The integration of artificial intelligence(AI)and multiomics has transformed clinical and life sciences,enabling precision medicine and redefining disease understanding.Scientific publications grew significantly from 2.1 million in 2012 to 3.3 million in 2022,with AI research tripling during this period.Multiomics fields,including genomics and proteomics,also advanced,exemplified by the Human Proteome Project achieving a 90%complete blueprint by 2021.This growth highlights opportunities and challenges in integrating AI and multiomics into clinical reporting.A review of studies and case reports was conducted to evaluate AI and multiomics integration.Key areas analyzed included diagnostic accuracy,predictive modeling,and personalized treatment approaches driven by AI tools.Case examples were studied to assess impacts on clinical decision-making.AI and multiomics enhanced data integration,predictive insights,and treatment personalization.Fields like radiomics,genomics,and proteomics improved diagnostics and guided therapy.For instance,the“AI radiomics,geno-mics,oncopathomics,and surgomics project”combined radiomics and genomics for surgical decision-making,enabling preoperative,intraoperative,and post-operative interventions.AI applications in case reports predicted conditions like postoperative delirium and monitored cancer progression using genomic and imaging data.AI and multiomics enable standardized data analysis,dynamic updates,and predictive modeling in case reports.Traditional reports often lack objectivity,but AI enhances reproducibility and decision-making by processing large datasets.Challenges include data standardization,biases,and ethical concerns.Overcoming these barriers is vital for optimizing AI applications and advancing personalized medicine.AI and multiomics integration is revolutionizing clinical research and practice.Standardizing data reporting and addressing challenges in ethics and data quality will unlock their full potential.Emphasizing collaboration and transparency is essential for leveraging these tools to improve patient care and scientific communication.
基金Supported by National Natural Science Foundation of China,No.82271546 and No.82301744The Shanxi Province Science and Technology Innovation Think Tank Construction Research Project,No.KXKT202317+1 种基金Fundamental Research Program of Shanxi Province,No.202303021222346 and No.202103021223224The Research Foundation of The First Hospital of Shanxi Medical University,No.YQ2208.
文摘BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.
文摘Hepatic arterial infusion(HAI)chemotherapy,first introduced in the 1980s,has gained recognition as an effective locoregional treatment for colorectal liver metastasis(CRLM).Initially used for unresectable liver metastases,HAI’s app-lication has expanded to the adjuvant setting following hepatic resection,with early studies indicating improved hepatic disease-free survival.Recent research demonstrates that combining HAI with modern systemic therapies enhances conversion to resectability and prolongs both recurrence-free and overall survival,even in heavily pretreated patients with diverse RAS mutational statuses.Person-alization through approaches like microsatellite instability status and dose mo-difications further optimize outcomes.However,the complexity of HAI requires expertise across multidisciplinary teams,limiting its widespread adoption to specialized centers.Ongoing clinical trials continue to investigate HAI’s role in CRLM management,highlighting its potential to become a cornerstone of liver-directed therapy.We explore how HAI chemotherapy,in combination with personalized medicine,can advance treatment strategies for metastatic colorectal cancer.
