Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main o...Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main obstacles are associated with the quality of samples used for genomic analysis。展开更多
Introduction: Demons-Meigs syndrome combines a benign tumor of the ovary with ascites and pleural effusion. It is a rare disease and the pathophysiological mechanism is not yet well understood. The aim of our study is...Introduction: Demons-Meigs syndrome combines a benign tumor of the ovary with ascites and pleural effusion. It is a rare disease and the pathophysiological mechanism is not yet well understood. The aim of our study is to report a case of Demons-Meigs syndrome, to determine its different characteristics and to make clinicians aware of the malignant predictive value of CA 125 in front of an ovarian tumor. Observation: The patient was 42 years old and had no previous history. She presented with intense abdominal pain of sudden onset, prompting a medical consultation. On clinical examination, the abdomen was distended with signs of peritoneal effusion and right pleural effusion. Ultrasound revealed a well-circumscribed, ovarian mass with an internal fluid component and hypervascularization on Doppler. The CA 125 level was elevated (293.9 U/ml). Exploratory laparotomy revealed two bilateral, firm, solid ovarian tumors without vegetation or peritoneal lesions. Macroscopically, one of the tumors was well circumscribed, lobulated with a smooth outer surface. It measured 20 × 17 × 8 cm and weighed 1400 g. The other tumor measured 19 × 11 × 5 cm, weighed 1090 g and had the same characteristics as the other tumor. Histologically, both tumors were a proliferation of fibroblastic spindle cells organized in short intersecting or storiform bundles, without cyto-nuclear atypia or excess mitoses. The diagnosis retained was bilateral ovarian fibroma in the context of a Demons-Meigs syndrome. Conclusion: Demons-Meigs syndrome is a rare entity. The concomitant elevation of the CA 125 level is not always an indicator of ovarian cancer. The curative treatment is surgical based on tumor removal ensuring the disappearance of peritoneal and pleural effusions.展开更多
Patients living with chronic kidney disease (CKD) are at high risk of cardiovascular events. Our aim in this study was to assess the cut-off value for lipoprotein (a) (Lp(a)) in CKD patients with a history of cardiova...Patients living with chronic kidney disease (CKD) are at high risk of cardiovascular events. Our aim in this study was to assess the cut-off value for lipoprotein (a) (Lp(a)) in CKD patients with a history of cardiovascular disease (CVD). This was a cross-sectional study. Variables including age, sex, history of CVD, body mass index and CKD stage, were collected during CKD patient’s first admission in the nephrology dialysis department. Blood samples were collected for quantitative determination of Lp(a) by immunoturbidimetric method. They were divided into two groups: CKD patients without history of CVD and CKD patients with history of CVD. Fisher’s exact test was used to assess associations with a significance level of 0.05%. Area under the curve (AUC) and new cut-off value for Lp(a) were identified by drawing Receiver Operating Characteristic (ROC) curve. A total of seventy CKD patients with median age of 43 years [minimum-maximum = 15 - 78 years] were included. Patients with history of CVD were 65.71% (46/70). New Lp(a) cut-off point in CKD patients with history of CVD was 66.50 nmol/L [sensitivity, 87.00%;specificity, 58.30%;AUC = 0.727;p = 0.000]. ROC curve demonstrated good performance of Lp(a) to screen CKD patients with history of CVD. Further research is needed to determine an LPA gene polymorphism’s contribution to increasing risk for CVD at each kidney disease stage.展开更多
BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term so...BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term socioeconomic challenges for families and communities.Although its impact on child growth and development is a pressing concern,research remains limited particularly in multicenter settings.AIM To examine the long-term consequences of unintended pregnancy on the critical years of early childhood growth and development.METHODS This analytical observational study employed a case-control design and was conducted in research centers across Indonesia,encompassing those located in Central Java,Lampung,Bali,and West Nusa Tenggara.A total of 700 children aged≤5 years with histories of intended or unintended pregnancies participated.Data collection involved structured interviews and direct anthropometric and developmental assessments.Data analyses were conducted using multivariate statistics and partial least squares structural equation modeling.RESULTS Unintended pregnancy was found to have a statistically significant effect on both child growth(t=8.178;P<0.001)and child development(t=25.688;P<0.001).Key growth problems identified included underweight,undernutrition,abnormal head circumference,and stunting.Developmental challenges prominently associated with unintended pregnancy included behavioral and emotional disorders,autism spectrum disorder,attentiondeficit/hyperactivity disorder,social and motor skill deficits,as well as visual and hearing impairments.CONCLUSION Unintended pregnancy significantly affects child growth and development,underscoring the need for early intervention,quality prenatal care,and strengthened family planning policies.展开更多
Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarte...Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarterial chemoembolization(TACE)as an adjuvant therapy in HCC patients with high risk of recurrence.Methods:Patients were enrolled from eight hepatobiliary centers in China.The primary endpoint was disease-free survival(DFS).The secondary endpoints were overall survival(OS)and safety.Additionally,propensity score matching(PSM)and other three propensity score analyses were performed to balance the potential baseline bias to validate the conclusion.The adverse events(AEs)were recorded throughout the study.The study was registered at Clinical Trials.gov(NCT03838796).Results:A total of 297 patients were enrolled,with 147 in the LEN+TACE group and 150 in the TACE group.Before PSM,the LEN+TACE group achieved significantly better DFS than the TACE group(19.0 vs.10.0 months,P=0.011).PSM analysis identified 111 matched pairs.After PSM,the LEN+TACE group also showed better DFS(19.0 vs.9.0 months,P=0.018).Other three propensity score analyses yielded similar DFS benefit tendency.Furthermore,favorable OS was also obtained in the LEN+TACE group before PSM.Lenvatinib related AEs of grade 3 or 4 occurred in 28.6%of the patients in the LEN+TACE group.Conclusions:Adjuvant lenvatinib plus TACE might be a promising adjuvant approach for HCC patients with high risk of recurrence,which could significantly prolong DFS and potentially OS with a manageable safety profile.展开更多
The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alteration...The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.展开更多
Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objecti...Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.展开更多
Summary: The aim of this work was to determine the frequency of rectal prolapse and to describe the therapeutic aspects. Material and Methods: A descriptive study with a retrospective collection was carried out betwee...Summary: The aim of this work was to determine the frequency of rectal prolapse and to describe the therapeutic aspects. Material and Methods: A descriptive study with a retrospective collection was carried out between January 2013 and May 2016 in 29 months in the pediatric surgery department at the Center University Hospital of Brazzaville. Children between the ages of 1 and 15 years of age, treated for rectal prolapse and whose records were exploitable were included. The variables studied were: age, gender, parental socio-economic status, consultation time, preference factors, pre-admission treatment, treatment initiated and progression. Results: In 29 months, 22 cases of rectal prolapse were collected, i.e. a hospital frequency of 0.96%. The mean age was 4.5 years extremes (1 and 11 years). The average time of consultation was 5 days extremes (1 and 21 days). Diarrhea 5 cases (23%), constipation diarrhea 3 cases (14%), constipation 10 cases (45%), bronchopneumopathy 4 cases (18%). The treatment was surgical according to the Thiersch technique in all cases. The evolution was favorable. Conclusion: Rectal prolapse, a benign pathology, is relatively uncommon. Constipation remains the main factor favoring the need to take care of upstream. Treatment by the Thiersch method remains the first choice in children.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)has been a pervasive malignancy throughout the world with elevated mortality.Efficient therapeutic targets are beneficial to treat and predict the disease.Currently,the exact mo...BACKGROUND Hepatocellular carcinoma(HCC)has been a pervasive malignancy throughout the world with elevated mortality.Efficient therapeutic targets are beneficial to treat and predict the disease.Currently,the exact molecular mechanisms leading to the progression of HCC are still unclear.Research has shown that the microRNA-142-3p level decreases in HCC,whereas bioinformatics analysis of the cancer genome atlas database shows the ASH1L expression increased among liver tumor tissues.In this paper,we will explore the effects and mechanisms of microRNA-142-3p and ASH1L affect the prognosis of HCC patients and HCC cell bioactivity,and the association between them.AIM To investigate the effects and mechanisms of microRNA-142-3p and ASH1L on the HCC cell bioactivity and prognosis of HCC patients.METHODS In this study,we grouped HCC patients according to their immunohistochemistry results of ASH1L with pathological tissues,and retrospectively analyzed the prognosis of HCC patients.Furthermore,explored the roles and mechanisms of microRNA-142-3p and ASH1L by cellular and animal experiments,which involved the following experimental methods:Immunohistochemical staining,western blot,quantitative real-time-polymerase chain reaction,flow cytometric analysis,tumor xenografts in nude mice,etc.The statistical methods involved in this study contained t-test,one-way analysis of variance,theχ^(2)test,the Kaplan-Meier approach and the log-rank test.RESULTS In this study,we found that HCC patients with high expression of ASH1L possess a more recurrence rate as well as a decreased overall survival rate.ASH1L promotes the tumorigenicity of HCC and microRNA-142-3p exhibits reduced expression in HCC tissues and interacts with ASH1L through targeting the ASH1L 3′untranslated region.Furthermore,microRNA-142-3p promotes apoptosis and inhibits proliferation,invasion,and migration of HCC cell lines in vitro via ASH1L.For the exploration mechanism,we found ASH1L may promote an immunosuppressive microenvironment in HCC and ASH1L affects the expression of the cell junction protein zonula occludens-1,which is potentially relevant to the immune system.CONCLUSION Loss function of microRNA-142-3p induces cancer progression and immune evasion through upregulation of ASH1L in HCC.Both microRNA-142-3p and ASH1L can feature as new biomarker for HCC in the future.展开更多
BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis ...BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.展开更多
Malignant tumours always threaten human health.For tumour diagnosis,positron emission tomography(PET)is the most sensitive and advanced imaging technique by radiotracers,such as radioactive^(18)F,^(11)C,^(64)Cu,^(68)G...Malignant tumours always threaten human health.For tumour diagnosis,positron emission tomography(PET)is the most sensitive and advanced imaging technique by radiotracers,such as radioactive^(18)F,^(11)C,^(64)Cu,^(68)Ga,and^(89)Zr.Among the radiotracers,the radioactive^(18)F-labelled chemical agent as PET probes plays a predominant role in monitoring,detecting,treating,and predicting tumours due to its perfect half-life.In this paper,the^(18)F-labelled chemical materials as PET probes are systematically summarized.First,we introduce various radionuclides of PET and elaborate on the mechanism of PET imaging.It highlights the^(18)F-labelled chemical agents used as PET probes,including[^(18)F]-2-deoxy-2-[^(18)F]fluoro-D-glucose([^(18)F]-FDG),^(18)F-labelled amino acids,^(18)F-labelled nucleic acids,^(18)F-labelled receptors,^(18)F-labelled reporter genes,and^(18)F-labelled hypoxia agents.In addition,some PET probes with metal as a supplementary element are introduced briefly.Meanwhile,the^(18)F-labelled nanoparticles for the PET probe and the multi-modality imaging probe are summarized in detail.The approach and strategies for the fabrication of^(18)F-labelled PET probes are also described briefly.The future development of the PET probe is also prospected.The development and application of^(18)F-labelled PET probes will expand our knowledge and shed light on the diagnosis and theranostics of tumours.展开更多
BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare condition that causes ischaemic colitis,has various clinical manifestations,and may even be asymptomatic,often resulting in clinical misdiagnosis.CASE SUM...BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare condition that causes ischaemic colitis,has various clinical manifestations,and may even be asymptomatic,often resulting in clinical misdiagnosis.CASE SUMMARY We report the case of a 44-year-old woman with chief complaints of abdominal pain,vomiting and decreased defecation.One year prior,the patient was asymptomatic and therefore misdiagnosed with inflammatory bowel disease based on incidental findings on an abdominal computed tomography(CT)scan.The present abdominal CT scan revealed an intestinal obstruction,diffuse thickening of the entire colon wall and calcification of the mesenteric and colonic veins.Colonoscopy revealed multiple ulcerations and extensive dark purple discolouration of the oedematous mucosa.Colonic transit studies suggested a decrease in colonic motility.IMP was considered the underlying cause of her pseudoileus,which was potentially linked to her consumption of Chinese medicinal teas for more than 30 years.The patient underwent conservative medical treatment,and her symptoms gradually improved.She exhibited no signs of ileus or other significant discomfort at the outpatient follow-up one year after the discontinuation of Chinese herbal tea consumption.CONCLUSION IMP can present with symptoms of pseudoileus as initial complication.Clinicians can use CT and colonoscopy for differential diagnoses.展开更多
BACKGROUND Pseudomyxoma peritonei(PMP)is a distinct form of peritoneal malignancy characterized by diffuse intra-abdominal gelatinous ascites,with an estimated incidence of 1-3 per 1000000.PMP is predominantly seconda...BACKGROUND Pseudomyxoma peritonei(PMP)is a distinct form of peritoneal malignancy characterized by diffuse intra-abdominal gelatinous ascites,with an estimated incidence of 1-3 per 1000000.PMP is predominantly secondary to appendiceal mucinous neoplasms,with rarer origins including the ovaries,colon,and urachus.However,PMP originating from small intestine is extremely rare.CASE SUMMARY A 60-year-old male patient presented with anorexia and abdominal distension.Computed tomography revealed the presence of abdominopelvic effusions and multiple intra-abdominal space-occupying lesions.Ultrasound-guided aspiration indicated that the aspirated tissue was mucinous.Exploratory laparoscopy and tissue biopsy identified diffuse tumor nodules in peritoneum,omentum,pelvic region,intestinal walls,and mesentery.Histopathological analysis of the resected tumors confirmed the presence of mucinous adenocarcinoma,but the primary lesion was difficult to determine.The patient was referred to our center for further treatment and underwent cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)under general anesthesia.The intraoperative peritoneal cancer index was 30.The surgery lasted 8 hours,with a blood loss of about 600 mL.A complete cytoreduction(CCR0)was achieved.No serious complications occurred after surgery,and the patient’s condition was good during the telephone follow-up.Postoperative pathology confirmed the diagnosis of small intestinal mucinous adenocarcinoma at proximal jejunum,which was complicated by high-grade PMP.CONCLUSIONPMP originating from small intestine is an exceptionally rare entity that exhibits non-specific clinical features. Thepreferred treatment is CRS + HIPEC.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving out...BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving outcomes in cancer management,but its role in patients with HCC undergoing liver transplantation(LT)remains underexplored.AIM To evaluate the impact of an MDTB on survival outcomes in patients with HCC undergoing LT.METHODS We retrospectively analyzed 393 patients with HCC who underwent LT at our institution from October 2015 to October 2021.Patients were categorized into the MDTB and non-MDTB groups.We compared preoperative and postoperative characteristics,overall survival(OS),and disease-free survival(DFS)between the two groups.RESULTS Within the University of California,San Francisco(UCSF)criteria,no significant differences in OS and DFS were noted between the MDTB and non-MDTB groups.However,for patients who exceeded the UCSF criteria,the MDTB group exhibited a substantial improvement in both OS and DFS.The 1-year,3-year,and 5-year OS rates for the MDTB group in this subgroup were 88.68%,75.29%,and 61.78%,respectively,compared to 83.02%,64.07%,and 38.25%,respectively in the non-MDTB group.Similarly,DFS rates were 89.47%,71.35%,and 63.52%,respectively,vs 82.18%,53.78%,and 34.04%,respectively.CONCLUSION The MDTB approach was particularly beneficial for patients with HCC exceeding the UCSF criteria,significantly improving OS and DFS.These findings advocate for integrating MDTB into clinical practice for optimizing the management of high-risk patients with HCC undergoing LT.展开更多
Operative management of humeral shaft fractures demonstrates superior early functional recovery(6-month Disabilities of the Arm,Shoulder,and Hand scores)and significantly lower nonunion rates(63.9%reduction)compared t...Operative management of humeral shaft fractures demonstrates superior early functional recovery(6-month Disabilities of the Arm,Shoulder,and Hand scores)and significantly lower nonunion rates(63.9%reduction)compared to functional bracing,particularly in complex cases,while conservative treatment remains viable for low-demand patients.Surgical techniques,including open reduction internal fixation,intramedullary nailing,and minimally invasive plate osteosynthesis,offer trade-offs between anatomic precision and complication risks(e.g.,radial nerve injury vs rotator cuff damage),with over 90%of radial nerve injuries resolving spontaneously.Ultrasound-guided diagnosis(89%sensitivity,95%specificity)optimizes decision-making for nerve entrapment.Individualized treatment selection,prioritizing fracture complexity and patient needs,is critical to balance accelerated rehabilitation with minimized complications.展开更多
BACKGROUND Gastric adenocarcinoma with enteroblastic differentiation(GAED)is one of the common subtypes of alpha-foetoprotein(AFP)-producing gastric cancer.GAED frequently results in venous invasion and liver metastas...BACKGROUND Gastric adenocarcinoma with enteroblastic differentiation(GAED)is one of the common subtypes of alpha-foetoprotein(AFP)-producing gastric cancer.GAED frequently results in venous invasion and liver metastasis,the latter being particularly linked to a poor prognosis.So far,the evidence for liver metastases from AFP-producing gastric cancer is only focused on those from gastric hepatoid adenocarcinoma,owing to their imaging similarities with hepatocellular carcinoma.This case report describes the characteristic diagnostic imaging findings of liver metastasis from GAED.CASE SUMMARY A 65-year-old man who had undergone a pyloric gastrectomy for GAED two years ago was found to have a liver tumor in the hepatic segment 7,accompanied by elevated serum AFP levels.Dynamic contrast-enhanced computed tomography revealed the tumor showing peripheral-dominant enhancement in the arterial phase with persistent central enhancement in the delayed phase.Gadoliniumethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced magnetic resonance imaging demonstrated a signal drop in the tumor periphery in chemical shift imaging,along with arterial enhancement.Additionally,rim-like hypointensity surrounding the tumor was observed in the hepatobiliary phase.Postresection examination confirmed the tumor to be a metastasis from GAED.Histopathological examination revealed severe invasion of the tumor into the portal vein and hepatic vein surrounding the tumor,which explained the imaging features.CONCLUSION The imaging features of blood flow alternations resulting from vascular invasion may be crucial to diagnosing liver metastases from GAED.展开更多
Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosom...Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosome 11q13.As main etiology of MEN1 is genetic mutations,clinical symptoms may vary.In this editorial,we comment on the article by Yuan et al.This article describes a case of(MEN1)characterized by low incidence and diagnostic complexity.MEN1 co-mmonly presents as parathyroid,pancreatic,and pituitary tumors.Diagnosis requires a combination of serologic tests,magnetic resonance imaging,computed tomography,endoscopic ultrasonography,immunologic and pathology.The diagnosis is unique depending on the site of disease.Surgical resection is the treatment of choice for MEN1.The prognosis depends on the site of origin,but early detection and intervention is the most effective.展开更多
BACKGROUND Pancreatic carcinoma is recognized as one of the most prothrombotic malig-nancies,carrying a high risk of thrombotic events,which may even precede the diagnosis of the underlying occult tumor.Acute renal in...BACKGROUND Pancreatic carcinoma is recognized as one of the most prothrombotic malig-nancies,carrying a high risk of thrombotic events,which may even precede the diagnosis of the underlying occult tumor.Acute renal infarction(ARI)as the initial presenting feature in patients with pancreatic cancer is a rare occurrence,and misdiagnosis is common during early evaluation.CASE SUMMARY We report a patient who presented with ARI as the initial manifestation prior to the diagnosis of pancreatic cancer.The 50-year-old male was admitted to our emergency department with sharp,left-sided abdominal pain and was subse-quently transferred to our department following the detection of a pancreatic space-occupying lesion on computed tomography(CT).CT angiography prom-ptly identified the cause of his pain,confirming right renal infarction.Urgent interventional treatment was initiated to alleviate symptoms and restore renal perfusion.Despite aggressive thrombolytic and anticoagulant therapy,the thrombotic event rapidly worsened,leading to multiple cerebral infarctions.The patient’s condition ultimately deteriorated under palliative care.CONCLUSION This case illustrates that arterial thromboembolism,when diagnosed at an ad-vanced stage of pancreatic cancer,appears to be a terminal event that portends a poor prognosis.Establishing an arterial thrombosis prediction model will po-tentially identify the profile of high-risk patients with thrombotic consequences for primary prevention.展开更多
Background Diabetic cardiomyopathy(DCM)represents a severe cardiovascular complication of diabetes mellitus,characterized by insidious onset,diagnostic challenges in early stages,and poor prognosis.Current diagnosis o...Background Diabetic cardiomyopathy(DCM)represents a severe cardiovascular complication of diabetes mellitus,characterized by insidious onset,diagnostic challenges in early stages,and poor prognosis.Current diagnosis of DCM primarily relies on imaging techniques,lacking convenient and effective early biomarkers.Method Using a case-control study design,we enrolled 50 DCM patients(DCM group)and 50 diabetes-only patients(control group)diagnosed at our hospital between January 2023 and January 2025.Demographic data were collected from all participants.Serum levels of hemoglobinA1c(HbAlc),interleukin-1β(IL-1β),and superoxide dismutase(SOD)were measured and compared between groups.Logistic regression analysis was performed to identify DCM risk factors,while receiver operating characteristic(ROC)curve analysis evaluated the diagnostic value of individual and combined biomarkers for DCM screening.Results The levels of HbAlc and IL-1βin the DCM group were higher than those in the control group,and the level of SOD was lower than that in the control group(P<0.05).Multivariate Logistic regression analysis showed that HbAlc,IL-1βand SOD were all independent risk factors for DCM.The results of the ROC curve showed that the areas under curve(AUC)of HbA1c,IL-1β,and SOD levels in diagnosing DCM patients were 0.673,0.783,and 0.728,respectively.The AUC predicted by the combination of the three was 0.836,which was higher than that detected by any above single index(P<0.05).Conclusions DCM patients exhibited significantly higher HbAlc and IL-1βlevels but lower SOD activity compared to the controls.Each biomarker demonstrated significant diagnostic value for DCM,and their combination yielded superior diagnostic performance compared to any single marker.展开更多
Early diagnosis of rapidly progressive osteoarthritis of the hip(RPOH)remains clinically challenging due to the lack of unified guidelines and standardized diagnostic criteria.Current diagnostic criteria(chondrolysis&...Early diagnosis of rapidly progressive osteoarthritis of the hip(RPOH)remains clinically challenging due to the lack of unified guidelines and standardized diagnostic criteria.Current diagnostic criteria(chondrolysis>2 mm/year)require follow-up for at least 12 months.This review characterizes two types of earlystage RPOH progression:Chondrolysis with or without subsequent femoral head destruction within 12 months of onset.Based on their association with early disease progression in RPOH,elevated serum matrix metalloproteinase-3 levels and spinopelvic malalignment may serve as predictive factors for subsequent bone destruction when only joint space narrowing is observed.This review also proposes potential mechanisms of pathogenesis and intervention strategies for RPOH at its initial stage.Cartilage matrix fragments generated by stress concentrations on the hip joint,resulting from spinopelvic malalignment,may trigger inflammatory pathways involving proinflammatory cytokines and inflammasome activation,ultimately leading to joint destruction in the initial phase of RPOH.Suppression of these early pathological events may prevent joint destruction caused by RPOH.However,further elucidation of the cellular and molecular pathways involved in rapid joint destruction is necessary to identify specific biomarkers for early diagnosis and to facilitate the development of targeted therapies in the initial phase of RPOH.展开更多
基金the Japan Agency for Medical Research and Development(Grant Nos.20lk0201002j0001,21lk0201005j0001,and 22lk0201007j0001)。
文摘Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main obstacles are associated with the quality of samples used for genomic analysis。
文摘Introduction: Demons-Meigs syndrome combines a benign tumor of the ovary with ascites and pleural effusion. It is a rare disease and the pathophysiological mechanism is not yet well understood. The aim of our study is to report a case of Demons-Meigs syndrome, to determine its different characteristics and to make clinicians aware of the malignant predictive value of CA 125 in front of an ovarian tumor. Observation: The patient was 42 years old and had no previous history. She presented with intense abdominal pain of sudden onset, prompting a medical consultation. On clinical examination, the abdomen was distended with signs of peritoneal effusion and right pleural effusion. Ultrasound revealed a well-circumscribed, ovarian mass with an internal fluid component and hypervascularization on Doppler. The CA 125 level was elevated (293.9 U/ml). Exploratory laparotomy revealed two bilateral, firm, solid ovarian tumors without vegetation or peritoneal lesions. Macroscopically, one of the tumors was well circumscribed, lobulated with a smooth outer surface. It measured 20 × 17 × 8 cm and weighed 1400 g. The other tumor measured 19 × 11 × 5 cm, weighed 1090 g and had the same characteristics as the other tumor. Histologically, both tumors were a proliferation of fibroblastic spindle cells organized in short intersecting or storiform bundles, without cyto-nuclear atypia or excess mitoses. The diagnosis retained was bilateral ovarian fibroma in the context of a Demons-Meigs syndrome. Conclusion: Demons-Meigs syndrome is a rare entity. The concomitant elevation of the CA 125 level is not always an indicator of ovarian cancer. The curative treatment is surgical based on tumor removal ensuring the disappearance of peritoneal and pleural effusions.
文摘Patients living with chronic kidney disease (CKD) are at high risk of cardiovascular events. Our aim in this study was to assess the cut-off value for lipoprotein (a) (Lp(a)) in CKD patients with a history of cardiovascular disease (CVD). This was a cross-sectional study. Variables including age, sex, history of CVD, body mass index and CKD stage, were collected during CKD patient’s first admission in the nephrology dialysis department. Blood samples were collected for quantitative determination of Lp(a) by immunoturbidimetric method. They were divided into two groups: CKD patients without history of CVD and CKD patients with history of CVD. Fisher’s exact test was used to assess associations with a significance level of 0.05%. Area under the curve (AUC) and new cut-off value for Lp(a) were identified by drawing Receiver Operating Characteristic (ROC) curve. A total of seventy CKD patients with median age of 43 years [minimum-maximum = 15 - 78 years] were included. Patients with history of CVD were 65.71% (46/70). New Lp(a) cut-off point in CKD patients with history of CVD was 66.50 nmol/L [sensitivity, 87.00%;specificity, 58.30%;AUC = 0.727;p = 0.000]. ROC curve demonstrated good performance of Lp(a) to screen CKD patients with history of CVD. Further research is needed to determine an LPA gene polymorphism’s contribution to increasing risk for CVD at each kidney disease stage.
文摘BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term socioeconomic challenges for families and communities.Although its impact on child growth and development is a pressing concern,research remains limited particularly in multicenter settings.AIM To examine the long-term consequences of unintended pregnancy on the critical years of early childhood growth and development.METHODS This analytical observational study employed a case-control design and was conducted in research centers across Indonesia,encompassing those located in Central Java,Lampung,Bali,and West Nusa Tenggara.A total of 700 children aged≤5 years with histories of intended or unintended pregnancies participated.Data collection involved structured interviews and direct anthropometric and developmental assessments.Data analyses were conducted using multivariate statistics and partial least squares structural equation modeling.RESULTS Unintended pregnancy was found to have a statistically significant effect on both child growth(t=8.178;P<0.001)and child development(t=25.688;P<0.001).Key growth problems identified included underweight,undernutrition,abnormal head circumference,and stunting.Developmental challenges prominently associated with unintended pregnancy included behavioral and emotional disorders,autism spectrum disorder,attentiondeficit/hyperactivity disorder,social and motor skill deficits,as well as visual and hearing impairments.CONCLUSION Unintended pregnancy significantly affects child growth and development,underscoring the need for early intervention,quality prenatal care,and strengthened family planning policies.
基金supported by grants from the National Natural Science Foundation of China(91959203,82272836 and 82373017)。
文摘Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarterial chemoembolization(TACE)as an adjuvant therapy in HCC patients with high risk of recurrence.Methods:Patients were enrolled from eight hepatobiliary centers in China.The primary endpoint was disease-free survival(DFS).The secondary endpoints were overall survival(OS)and safety.Additionally,propensity score matching(PSM)and other three propensity score analyses were performed to balance the potential baseline bias to validate the conclusion.The adverse events(AEs)were recorded throughout the study.The study was registered at Clinical Trials.gov(NCT03838796).Results:A total of 297 patients were enrolled,with 147 in the LEN+TACE group and 150 in the TACE group.Before PSM,the LEN+TACE group achieved significantly better DFS than the TACE group(19.0 vs.10.0 months,P=0.011).PSM analysis identified 111 matched pairs.After PSM,the LEN+TACE group also showed better DFS(19.0 vs.9.0 months,P=0.018).Other three propensity score analyses yielded similar DFS benefit tendency.Furthermore,favorable OS was also obtained in the LEN+TACE group before PSM.Lenvatinib related AEs of grade 3 or 4 occurred in 28.6%of the patients in the LEN+TACE group.Conclusions:Adjuvant lenvatinib plus TACE might be a promising adjuvant approach for HCC patients with high risk of recurrence,which could significantly prolong DFS and potentially OS with a manageable safety profile.
文摘The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.
文摘Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.
文摘Summary: The aim of this work was to determine the frequency of rectal prolapse and to describe the therapeutic aspects. Material and Methods: A descriptive study with a retrospective collection was carried out between January 2013 and May 2016 in 29 months in the pediatric surgery department at the Center University Hospital of Brazzaville. Children between the ages of 1 and 15 years of age, treated for rectal prolapse and whose records were exploitable were included. The variables studied were: age, gender, parental socio-economic status, consultation time, preference factors, pre-admission treatment, treatment initiated and progression. Results: In 29 months, 22 cases of rectal prolapse were collected, i.e. a hospital frequency of 0.96%. The mean age was 4.5 years extremes (1 and 11 years). The average time of consultation was 5 days extremes (1 and 21 days). Diarrhea 5 cases (23%), constipation diarrhea 3 cases (14%), constipation 10 cases (45%), bronchopneumopathy 4 cases (18%). The treatment was surgical according to the Thiersch technique in all cases. The evolution was favorable. Conclusion: Rectal prolapse, a benign pathology, is relatively uncommon. Constipation remains the main factor favoring the need to take care of upstream. Treatment by the Thiersch method remains the first choice in children.
基金Supported by the Haihe Laboratory of Cell Ecosystem Innovation Fund,No.22HHXBJC00001the Key Discipline Special Project of Tianjin Municipal Health Commission,No.TJWJ2022XK016.
文摘BACKGROUND Hepatocellular carcinoma(HCC)has been a pervasive malignancy throughout the world with elevated mortality.Efficient therapeutic targets are beneficial to treat and predict the disease.Currently,the exact molecular mechanisms leading to the progression of HCC are still unclear.Research has shown that the microRNA-142-3p level decreases in HCC,whereas bioinformatics analysis of the cancer genome atlas database shows the ASH1L expression increased among liver tumor tissues.In this paper,we will explore the effects and mechanisms of microRNA-142-3p and ASH1L affect the prognosis of HCC patients and HCC cell bioactivity,and the association between them.AIM To investigate the effects and mechanisms of microRNA-142-3p and ASH1L on the HCC cell bioactivity and prognosis of HCC patients.METHODS In this study,we grouped HCC patients according to their immunohistochemistry results of ASH1L with pathological tissues,and retrospectively analyzed the prognosis of HCC patients.Furthermore,explored the roles and mechanisms of microRNA-142-3p and ASH1L by cellular and animal experiments,which involved the following experimental methods:Immunohistochemical staining,western blot,quantitative real-time-polymerase chain reaction,flow cytometric analysis,tumor xenografts in nude mice,etc.The statistical methods involved in this study contained t-test,one-way analysis of variance,theχ^(2)test,the Kaplan-Meier approach and the log-rank test.RESULTS In this study,we found that HCC patients with high expression of ASH1L possess a more recurrence rate as well as a decreased overall survival rate.ASH1L promotes the tumorigenicity of HCC and microRNA-142-3p exhibits reduced expression in HCC tissues and interacts with ASH1L through targeting the ASH1L 3′untranslated region.Furthermore,microRNA-142-3p promotes apoptosis and inhibits proliferation,invasion,and migration of HCC cell lines in vitro via ASH1L.For the exploration mechanism,we found ASH1L may promote an immunosuppressive microenvironment in HCC and ASH1L affects the expression of the cell junction protein zonula occludens-1,which is potentially relevant to the immune system.CONCLUSION Loss function of microRNA-142-3p induces cancer progression and immune evasion through upregulation of ASH1L in HCC.Both microRNA-142-3p and ASH1L can feature as new biomarker for HCC in the future.
文摘BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.
文摘Malignant tumours always threaten human health.For tumour diagnosis,positron emission tomography(PET)is the most sensitive and advanced imaging technique by radiotracers,such as radioactive^(18)F,^(11)C,^(64)Cu,^(68)Ga,and^(89)Zr.Among the radiotracers,the radioactive^(18)F-labelled chemical agent as PET probes plays a predominant role in monitoring,detecting,treating,and predicting tumours due to its perfect half-life.In this paper,the^(18)F-labelled chemical materials as PET probes are systematically summarized.First,we introduce various radionuclides of PET and elaborate on the mechanism of PET imaging.It highlights the^(18)F-labelled chemical agents used as PET probes,including[^(18)F]-2-deoxy-2-[^(18)F]fluoro-D-glucose([^(18)F]-FDG),^(18)F-labelled amino acids,^(18)F-labelled nucleic acids,^(18)F-labelled receptors,^(18)F-labelled reporter genes,and^(18)F-labelled hypoxia agents.In addition,some PET probes with metal as a supplementary element are introduced briefly.Meanwhile,the^(18)F-labelled nanoparticles for the PET probe and the multi-modality imaging probe are summarized in detail.The approach and strategies for the fabrication of^(18)F-labelled PET probes are also described briefly.The future development of the PET probe is also prospected.The development and application of^(18)F-labelled PET probes will expand our knowledge and shed light on the diagnosis and theranostics of tumours.
文摘BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare condition that causes ischaemic colitis,has various clinical manifestations,and may even be asymptomatic,often resulting in clinical misdiagnosis.CASE SUMMARY We report the case of a 44-year-old woman with chief complaints of abdominal pain,vomiting and decreased defecation.One year prior,the patient was asymptomatic and therefore misdiagnosed with inflammatory bowel disease based on incidental findings on an abdominal computed tomography(CT)scan.The present abdominal CT scan revealed an intestinal obstruction,diffuse thickening of the entire colon wall and calcification of the mesenteric and colonic veins.Colonoscopy revealed multiple ulcerations and extensive dark purple discolouration of the oedematous mucosa.Colonic transit studies suggested a decrease in colonic motility.IMP was considered the underlying cause of her pseudoileus,which was potentially linked to her consumption of Chinese medicinal teas for more than 30 years.The patient underwent conservative medical treatment,and her symptoms gradually improved.She exhibited no signs of ileus or other significant discomfort at the outpatient follow-up one year after the discontinuation of Chinese herbal tea consumption.CONCLUSION IMP can present with symptoms of pseudoileus as initial complication.Clinicians can use CT and colonoscopy for differential diagnoses.
基金Supported by 2024 Aerospace Center Hospital Scientific Research Fund,No.YN202410.
文摘BACKGROUND Pseudomyxoma peritonei(PMP)is a distinct form of peritoneal malignancy characterized by diffuse intra-abdominal gelatinous ascites,with an estimated incidence of 1-3 per 1000000.PMP is predominantly secondary to appendiceal mucinous neoplasms,with rarer origins including the ovaries,colon,and urachus.However,PMP originating from small intestine is extremely rare.CASE SUMMARY A 60-year-old male patient presented with anorexia and abdominal distension.Computed tomography revealed the presence of abdominopelvic effusions and multiple intra-abdominal space-occupying lesions.Ultrasound-guided aspiration indicated that the aspirated tissue was mucinous.Exploratory laparoscopy and tissue biopsy identified diffuse tumor nodules in peritoneum,omentum,pelvic region,intestinal walls,and mesentery.Histopathological analysis of the resected tumors confirmed the presence of mucinous adenocarcinoma,but the primary lesion was difficult to determine.The patient was referred to our center for further treatment and underwent cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)under general anesthesia.The intraoperative peritoneal cancer index was 30.The surgery lasted 8 hours,with a blood loss of about 600 mL.A complete cytoreduction(CCR0)was achieved.No serious complications occurred after surgery,and the patient’s condition was good during the telephone follow-up.Postoperative pathology confirmed the diagnosis of small intestinal mucinous adenocarcinoma at proximal jejunum,which was complicated by high-grade PMP.CONCLUSIONPMP originating from small intestine is an exceptionally rare entity that exhibits non-specific clinical features. Thepreferred treatment is CRS + HIPEC.
基金Supported by Natural Science Foundation of Tianjin,No.21JCYBJC01140Key Project of Tianjin Science and Technology Bureau Applied Basic Research,No.23JCZDJC01200+1 种基金Key Project of Scientific Research Plan of Tianjin Municipal Education Commission,No.2023YXZD07Project of Tianjin Science and Technology Bureau Applied Basic Research,No.23JCYBJC01800.
文摘BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving outcomes in cancer management,but its role in patients with HCC undergoing liver transplantation(LT)remains underexplored.AIM To evaluate the impact of an MDTB on survival outcomes in patients with HCC undergoing LT.METHODS We retrospectively analyzed 393 patients with HCC who underwent LT at our institution from October 2015 to October 2021.Patients were categorized into the MDTB and non-MDTB groups.We compared preoperative and postoperative characteristics,overall survival(OS),and disease-free survival(DFS)between the two groups.RESULTS Within the University of California,San Francisco(UCSF)criteria,no significant differences in OS and DFS were noted between the MDTB and non-MDTB groups.However,for patients who exceeded the UCSF criteria,the MDTB group exhibited a substantial improvement in both OS and DFS.The 1-year,3-year,and 5-year OS rates for the MDTB group in this subgroup were 88.68%,75.29%,and 61.78%,respectively,compared to 83.02%,64.07%,and 38.25%,respectively in the non-MDTB group.Similarly,DFS rates were 89.47%,71.35%,and 63.52%,respectively,vs 82.18%,53.78%,and 34.04%,respectively.CONCLUSION The MDTB approach was particularly beneficial for patients with HCC exceeding the UCSF criteria,significantly improving OS and DFS.These findings advocate for integrating MDTB into clinical practice for optimizing the management of high-risk patients with HCC undergoing LT.
文摘Operative management of humeral shaft fractures demonstrates superior early functional recovery(6-month Disabilities of the Arm,Shoulder,and Hand scores)and significantly lower nonunion rates(63.9%reduction)compared to functional bracing,particularly in complex cases,while conservative treatment remains viable for low-demand patients.Surgical techniques,including open reduction internal fixation,intramedullary nailing,and minimally invasive plate osteosynthesis,offer trade-offs between anatomic precision and complication risks(e.g.,radial nerve injury vs rotator cuff damage),with over 90%of radial nerve injuries resolving spontaneously.Ultrasound-guided diagnosis(89%sensitivity,95%specificity)optimizes decision-making for nerve entrapment.Individualized treatment selection,prioritizing fracture complexity and patient needs,is critical to balance accelerated rehabilitation with minimized complications.
文摘BACKGROUND Gastric adenocarcinoma with enteroblastic differentiation(GAED)is one of the common subtypes of alpha-foetoprotein(AFP)-producing gastric cancer.GAED frequently results in venous invasion and liver metastasis,the latter being particularly linked to a poor prognosis.So far,the evidence for liver metastases from AFP-producing gastric cancer is only focused on those from gastric hepatoid adenocarcinoma,owing to their imaging similarities with hepatocellular carcinoma.This case report describes the characteristic diagnostic imaging findings of liver metastasis from GAED.CASE SUMMARY A 65-year-old man who had undergone a pyloric gastrectomy for GAED two years ago was found to have a liver tumor in the hepatic segment 7,accompanied by elevated serum AFP levels.Dynamic contrast-enhanced computed tomography revealed the tumor showing peripheral-dominant enhancement in the arterial phase with persistent central enhancement in the delayed phase.Gadoliniumethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced magnetic resonance imaging demonstrated a signal drop in the tumor periphery in chemical shift imaging,along with arterial enhancement.Additionally,rim-like hypointensity surrounding the tumor was observed in the hepatobiliary phase.Postresection examination confirmed the tumor to be a metastasis from GAED.Histopathological examination revealed severe invasion of the tumor into the portal vein and hepatic vein surrounding the tumor,which explained the imaging features.CONCLUSION The imaging features of blood flow alternations resulting from vascular invasion may be crucial to diagnosing liver metastases from GAED.
文摘Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosome 11q13.As main etiology of MEN1 is genetic mutations,clinical symptoms may vary.In this editorial,we comment on the article by Yuan et al.This article describes a case of(MEN1)characterized by low incidence and diagnostic complexity.MEN1 co-mmonly presents as parathyroid,pancreatic,and pituitary tumors.Diagnosis requires a combination of serologic tests,magnetic resonance imaging,computed tomography,endoscopic ultrasonography,immunologic and pathology.The diagnosis is unique depending on the site of disease.Surgical resection is the treatment of choice for MEN1.The prognosis depends on the site of origin,but early detection and intervention is the most effective.
文摘BACKGROUND Pancreatic carcinoma is recognized as one of the most prothrombotic malig-nancies,carrying a high risk of thrombotic events,which may even precede the diagnosis of the underlying occult tumor.Acute renal infarction(ARI)as the initial presenting feature in patients with pancreatic cancer is a rare occurrence,and misdiagnosis is common during early evaluation.CASE SUMMARY We report a patient who presented with ARI as the initial manifestation prior to the diagnosis of pancreatic cancer.The 50-year-old male was admitted to our emergency department with sharp,left-sided abdominal pain and was subse-quently transferred to our department following the detection of a pancreatic space-occupying lesion on computed tomography(CT).CT angiography prom-ptly identified the cause of his pain,confirming right renal infarction.Urgent interventional treatment was initiated to alleviate symptoms and restore renal perfusion.Despite aggressive thrombolytic and anticoagulant therapy,the thrombotic event rapidly worsened,leading to multiple cerebral infarctions.The patient’s condition ultimately deteriorated under palliative care.CONCLUSION This case illustrates that arterial thromboembolism,when diagnosed at an ad-vanced stage of pancreatic cancer,appears to be a terminal event that portends a poor prognosis.Establishing an arterial thrombosis prediction model will po-tentially identify the profile of high-risk patients with thrombotic consequences for primary prevention.
基金supported by Dongguan Social Development Science and Technology Program(No.202218009016172)。
文摘Background Diabetic cardiomyopathy(DCM)represents a severe cardiovascular complication of diabetes mellitus,characterized by insidious onset,diagnostic challenges in early stages,and poor prognosis.Current diagnosis of DCM primarily relies on imaging techniques,lacking convenient and effective early biomarkers.Method Using a case-control study design,we enrolled 50 DCM patients(DCM group)and 50 diabetes-only patients(control group)diagnosed at our hospital between January 2023 and January 2025.Demographic data were collected from all participants.Serum levels of hemoglobinA1c(HbAlc),interleukin-1β(IL-1β),and superoxide dismutase(SOD)were measured and compared between groups.Logistic regression analysis was performed to identify DCM risk factors,while receiver operating characteristic(ROC)curve analysis evaluated the diagnostic value of individual and combined biomarkers for DCM screening.Results The levels of HbAlc and IL-1βin the DCM group were higher than those in the control group,and the level of SOD was lower than that in the control group(P<0.05).Multivariate Logistic regression analysis showed that HbAlc,IL-1βand SOD were all independent risk factors for DCM.The results of the ROC curve showed that the areas under curve(AUC)of HbA1c,IL-1β,and SOD levels in diagnosing DCM patients were 0.673,0.783,and 0.728,respectively.The AUC predicted by the combination of the three was 0.836,which was higher than that detected by any above single index(P<0.05).Conclusions DCM patients exhibited significantly higher HbAlc and IL-1βlevels but lower SOD activity compared to the controls.Each biomarker demonstrated significant diagnostic value for DCM,and their combination yielded superior diagnostic performance compared to any single marker.
文摘Early diagnosis of rapidly progressive osteoarthritis of the hip(RPOH)remains clinically challenging due to the lack of unified guidelines and standardized diagnostic criteria.Current diagnostic criteria(chondrolysis>2 mm/year)require follow-up for at least 12 months.This review characterizes two types of earlystage RPOH progression:Chondrolysis with or without subsequent femoral head destruction within 12 months of onset.Based on their association with early disease progression in RPOH,elevated serum matrix metalloproteinase-3 levels and spinopelvic malalignment may serve as predictive factors for subsequent bone destruction when only joint space narrowing is observed.This review also proposes potential mechanisms of pathogenesis and intervention strategies for RPOH at its initial stage.Cartilage matrix fragments generated by stress concentrations on the hip joint,resulting from spinopelvic malalignment,may trigger inflammatory pathways involving proinflammatory cytokines and inflammasome activation,ultimately leading to joint destruction in the initial phase of RPOH.Suppression of these early pathological events may prevent joint destruction caused by RPOH.However,further elucidation of the cellular and molecular pathways involved in rapid joint destruction is necessary to identify specific biomarkers for early diagnosis and to facilitate the development of targeted therapies in the initial phase of RPOH.
