Brain lesions,such as those caused by stroke or traumatic brain injury(TBI),frequently result in persistent motor and cognitive impairments that significantly affect the individual patient's quality of life.Despit...Brain lesions,such as those caused by stroke or traumatic brain injury(TBI),frequently result in persistent motor and cognitive impairments that significantly affect the individual patient's quality of life.Despite differences in the mechanisms of injury,both conditions share a high prevalence of motor and cognitive impairments.These deficits show only limited natural recovery.展开更多
The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published s...The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.展开更多
Retinal ganglion cells are the bridging neurons between the eye and the central nervous system,transmitting visual signals to the brain.The injury and loss of retinal ganglion cells are the primary pathological change...Retinal ganglion cells are the bridging neurons between the eye and the central nervous system,transmitting visual signals to the brain.The injury and loss of retinal ganglion cells are the primary pathological changes in several retinal degenerative diseases,including glaucoma,ischemic optic neuropathy,diabetic neuropathy,and optic neuritis.In mammals,injured retinal ganglion cells lack regenerative capacity and undergo apoptotic cell death within a few days of injury.Additionally,these cells exhibit limited regenerative ability,ultimately contributing to vision impairment and potentially leading to blindness.Currently,the only effective clinical treatment for glaucoma is to prevent vision loss by lowering intraocular pressure through medications or surgery;however,this approach cannot halt the effect of retinal ganglion cell loss on visual function.This review comprehensively investigates the mechanisms underlying retinal ganglion cell degeneration in retinal degenerative diseases and further explores the current status and potential of cell replacement therapy for regenerating retinal ganglion cells.As our understanding of the complex processes involved in retinal ganglion cell degeneration deepens,we can explore new treatment strategies,such as cell transplantation,which may offer more effective ways to mitigate the effect of retinal degenerative diseases on vision.展开更多
Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and...Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.展开更多
Fibroblast activation protein(FAP)is overexpressed in cancer-associated fibroblasts across various cancer types.Numerous radiolabeled FAP inhibitors(FAPIs)(Fig.S1A)currently under clinical investigation have shown rem...Fibroblast activation protein(FAP)is overexpressed in cancer-associated fibroblasts across various cancer types.Numerous radiolabeled FAP inhibitors(FAPIs)(Fig.S1A)currently under clinical investigation have shown remarkable potential in cancer theranostics.展开更多
Any new report on the anticancer properties of natural products always awakens new satisfaction and hope about the role of the international scientific community in its continuous contributions to human health,particu...Any new report on the anticancer properties of natural products always awakens new satisfaction and hope about the role of the international scientific community in its continuous contributions to human health,particularly when those reports contribute to both the understanding and therapeutics of cancer.For many de-cades,natural products have been pivotal in drug discovery programs because they offer a diverse array of anticancer therapeutic possibilities.Recently,two manuscripts published in the World Journal of Gastrointestinal Oncology added new data to the already extensive body of anticancer preclinical evidence for resvera-trol and senegenin,two compounds widely present in herbal preparations used in traditional Chinese medicine.The first one,with comprehensive and recognized anticancer properties,and the second one,shows a compelling body of evidence supporting its neuroprotective effects,but with emerging anticancer activities.Natural products have become key elements in the expanding and dynamic field of anticancer drug discovery.However,urgent and collective efforts are still needed to bridge the gap between preclinical and clinical research and thus bring new anticancer therapeutic breakthroughs.展开更多
Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical cen...Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical center. Every study differs in various aspects, such as phases, study indication, eligibility criteria, etc. In terms of meeting the enrollment deadline, typically, the study indication and availability of the patient’s population at the geographical area of the research site would decide if the trial could be time-consuming. Patient recruitment and retention are critical for the success of every clinical trial;however, worldwide, this area is facing tremendous pressure and challenges. Globally 55% of clinical trials terminated due to low recruitment, with an average enrollment success rate of 40% for Phase III and IV trials. Over 80% of clinical trial attempts fail to enroll, extending the study and adding new study sites. In the United States, more than 80% of clinical trials fail to achieve targeted patient enrollment, and 30% of study participants discontinue participation. This article reviewed various factors hindering clinical trial recruitment and retention and suggested strategies to make the research site successful.展开更多
Objective Traditional Chinese medicine(TCM)incorporates traditional diagnostic methods and several major treatment modalities including Chinese herbal medicine,Chinese patent medicine,and non-pharmacological methods s...Objective Traditional Chinese medicine(TCM)incorporates traditional diagnostic methods and several major treatment modalities including Chinese herbal medicine,Chinese patent medicine,and non-pharmacological methods such as acupuncture and tuina.Even though TCM is used daily by more than 70,000 healthcare facilities and over 700,000 clinical practitioners in China,there is a poor understanding of the extent to which TCM diagnostic methods are used,how different treatment modalities are deployed in general,and what major factors may affect the integration of TCM and Western medicine.This study aimed to fill this void in the literature.Methods In the 2021 National Healthcare Improvement Evaluation Survey,we included three questions gauging the perception and practices of TCM amongst physicians working in TCM-related facilities,investigating the frequency of their deployment of TCM diagnostic methods,and predominant TCM treatment methods.Our empirical analysis included descriptive statistics,intergroup chi-square analysis,and binary logistic regression to examine the association between different types of facilities and individual characteristics and TCM utilization patterns.Results A total of 7618 clinical physicians comprised our study sample.Among them,84.27%have integrated TCM and Western medicine in their clinical practice,and 80.77%of TCM practitioners used the 4 diagnostic methods as a tool in their clinical practice.Chinese herbal medicine was the most widely utilized modality by Chinese TCM physicians(used by 88.49%of respondents),compared with the Chinese patent medicine and non-pharmacological TCM methods,which were used by 73.14%,and 69.39%,respectively.Herbal tea as an out-of-pocket health-maintenance intervention is also a notable practice,recommended by 29.43%of physicians.Significant variations exist across certain institutions,departments,and individual practitioners.Conclusion Given that most of the surveyed physicians integrated TCM with Western medicine in their clinical practices,the practice of“pure TCM”appears to be obsolete in China’s tertiary healthcare institutions.Notably,remarkable variation exists in the use of different TCM modalities across institutions and among individuals,which might be related to and thus limited by the practitioners’experience.Future research focusing on the efficacy and safety of TCM interventions for specific diseases,the development of standardized clinical guidelines,and the enhancement of TCM education and training are called for to optimize TCM-Western medicine integration.展开更多
Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affec...Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.展开更多
BACKGROUND Large number of decompensated liver cirrhosis patients in China have been diagnosed with hepatitis B virus(HBV).Human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)can possibly cure decompensated l...BACKGROUND Large number of decompensated liver cirrhosis patients in China have been diagnosed with hepatitis B virus(HBV).Human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)can possibly cure decompensated liver cirrhosis because of their self-renewal and multidirectional differentiation potential.AIM To explore the safety and effect of treating liver cirrhosis with HBV by hUC-MSCs.METHODS Twenty-four participants were recruited,divided into 3 groups,and injected with different amounts of hUC-MSCs via the peripheral vein.Therapy was administered 3 times.A 24-week follow-up examination of each patient’s liver function,coagulation function,general condition,and immune system was performed.Adverse events were also recorded.A 2-year survival assessment was subsequently performed.RESULTS Infusion therapy rapidly improved liver function.Serum albumin transiently increased on days 57 and 85 but returned to baseline by day 169,while prothrombin time activity demonstrated sustained improvement from day 29 through day 169.Interleukin-8 levels decreased persistently throughout treatment.All dosage groups achieved 100%6-month survival;2-year survival rates were 66.7%(low-dose),100%(medium-dose),and 87.5%(high-dose).The interaction between dosage and efficacy was weak.Notably,the improvement in liver function was statistically significant and sustained for almost 3 months,suggesting clinically meaningful therapeutic durability.CONCLUSION hUC-MSCs can be considered a safe treatment for patients with decompensated liver cirrhosis associated with HBV.However,larger-scale randomized controlled trials are needed to prove its therapeutic effect.展开更多
Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock...Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock for the inheritance and development of TM.To meet the growing demand for high-quality healthcare,it is imperative to integrate TM with modern technology to address the issue of insufficient evidence for the efficacy of TM.展开更多
Malaria is considered one of the major causes of travel-related morbidity and mortality,especially among non-immune travelers from non-endemic countries to the endemic regions.According to a multicenter study from the...Malaria is considered one of the major causes of travel-related morbidity and mortality,especially among non-immune travelers from non-endemic countries to the endemic regions.According to a multicenter study from the GeoSentinel surveillance network,malaria was the most frequent cause of fever in 21%of returning travelers,followed by dengue,typhoid fever,chikungunya and rickettsiosis[1].Individuals traveling from regions without malaria transmission to areas where it is endemic face a heightened risk of contracting the disease due to their lack of immunity.Despite the official malaria-free status of the Russian Federation since 2010,annual cases of severe Plasmodium(P.)falciparum malaria continue to be reported[2].This underscores the necessity for heightened clinical vigilance and improved preventive strategies especially in non-endemic settings.展开更多
Hepatitis B virus(HBV)is a serious global public health concern.Although nucleoside drugs and interferons can significantly inhibit HBV replication,issues such as drug resistance and low clinical cure rates remain.Tra...Hepatitis B virus(HBV)is a serious global public health concern.Although nucleoside drugs and interferons can significantly inhibit HBV replication,issues such as drug resistance and low clinical cure rates remain.Traditional Chinese medicine(TCM)is widely used in the treatment of chronic hepatitis B(CHB)in China,with anti-inflammatory,anti-fibrotic,and liver-protective effects;however,reports on its antiviral effects are still inconsistent.We retrieved multicenter clinical studies and meta-analyses of TCM treatment for CHB over the past two decades.The results revealed that TCM has a certain anti-HBV effect,and when combined with antiviral drugs,it can significantly improve antiviral efficacy.It was demonstrated that TCM most effectively promotes serum HBV e antigen conversion to negative,followed by the ability to reduce HBV DNA levels,facilitating HBV surface antigen loss,and improving the treatment of CHB.展开更多
BACKGROUND As the global population ages,the number of elderly patients with acute coronary syndrome(ACS)rises.However,prognostic assessment tools for elderly patients with ACS remain lacking,particularly in the Chine...BACKGROUND As the global population ages,the number of elderly patients with acute coronary syndrome(ACS)rises.However,prognostic assessment tools for elderly patients with ACS remain lacking,particularly in the Chinese population.This study aimed to develop and validate a nomogram to predict 2-year major adverse cardiovascular and cerebrovascular events(MACCE)in elderly Chinese patients with ACS.METHODS A retrospective analysis was conducted using two independent cohorts of ACS patients aged≥65 years who underwent percutaneous coronary intervention:the derivation cohort(n=1674)and the validation cohort(n=2333).Candidate predictors were selected using multivariable Cox proportional hazards regression and the Akaike information criterion.A final nomogram incorporating ten variables was constructed.Model performance was evaluated in terms of discrimination[concordance index(C-index)and area under the receiver operating characteristic curve(AUC)]and calibration(calibration plots).RESULTS The 2-year incidence of MACCE was 12.5%(n=210)in the derivation cohort and 15.6%(n=364)in the validation cohort.The nomogram demonstrated good discrimination,with C-index values of 0.727 and 0.661 and AUCs of 0.723 and 0.699 in the derivation cohort and the validation cohort,respectively;significantly outperforming the GRACE risk score(P<0.001).Calibration plots showed good agreement between the predicted and observed outcomes.Patients classified as the high-risk group by the nomogram had a significantly higher MACCE incidence compared to that of the low-risk group(log-rank P<0.001).CONCLUSIONS This newly developed nomogram provides a reliable tool for individualized prediction of the 2-year MACCE risk in elderly Chinese patients with ACS who underwent percutaneous coronary intervention.It outperformed the GRACE score in both discrimmination and calibration and may help improve clinical decision-making and personalized risk stratification in this vulnerable population.展开更多
BACKGROUND Hepatitis B-associated cirrhosis is an important disease burden in China.However,there is a lack of effective predictors in clinical practice to drive delivery and enable early treatment to delay disease pr...BACKGROUND Hepatitis B-associated cirrhosis is an important disease burden in China.However,there is a lack of effective predictors in clinical practice to drive delivery and enable early treatment to delay disease progression.AIM To analyzing the clinical characteristics of patients with hepatitis and cirrhosis,the nomogram model was established and validated.METHODS The clinical data of 1070 patients with hepatitis B who were treated in our hospital from October 2015 to July 2022 were collected.In a 7:3 ratio,749 cases were divided into training cohorts and 321 cases were divided into validation cohorts.In addition,the training cohort and validation cohort were further divided into hepatitis group and hepatitis B-related cirrhosis group based on whether the patient progressed to cirrhosis.Binary logistic regression was used to analyze the influencing factors of hepatitis progression to cirrhosis.A roadmap prediction model was established,and the predictive effect of the model was evaluated by patientsubject receiver operating characteristic curve(ROC),and the effectiveness of the model was evaluated by decision curve analysis.RESULTS Binary logistic regression analysis was performed using hepatitis B-related cirrhosis=1 and hepatitis=0 as dependent variables,and univariate analysis of serological indicators was used as covariates.The results showed that glutamic oxaloacetate aminotransferase/glutamate acetone aminotransferase levels,prothrombin time activity,and hepatitis B e antigen levels were all contributing factors to the progression of hepatitis to cirrhosis.The area under the ROC curve was 0.693[95%confidence interval(CI):0.631 to 0.756]for the training cohort and 0.675(95%CI:0.561 to 0.790)for the validation cohort.In addition,the decision analysis curves of the prediction models of both the training cohort and the validation cohort confirmed the effectiveness of the nomogram prediction model.CONCLUSION Three independent factors influencing the progression to cirrhosis in patients with hepatitis B were identified.The construction of a nomogram prediction model from hepatitis to cirrhosis has high application value as a tool for predicting the occurrence of liver cirrhosis in hepatitis B patients.展开更多
To the editor:Schizophrenia is a chronic and severe mental disorder characterised by profound disruptions in thinking,affecting language,perception and the sense of self. These disruptions can significantly impair an ...To the editor:Schizophrenia is a chronic and severe mental disorder characterised by profound disruptions in thinking,affecting language,perception and the sense of self. These disruptions can significantly impair an individual’s ability to function socially and occupationally, leading to a high burden on both the individuals affected and society as a whole.展开更多
Colorectal cancer(CRC)is a common and deadly malignancy worldwide,causing high morbidity and mortality rates.Chemoresistance continues to be the major barrier to the effective treatment of CRC.Circular RNA(circRNA),a ...Colorectal cancer(CRC)is a common and deadly malignancy worldwide,causing high morbidity and mortality rates.Chemoresistance continues to be the major barrier to the effective treatment of CRC.Circular RNA(circRNA),a recently identified class of non-coding RNA,has become an emerging focus in CRC research due to its abundant presence and stability in extracellular vesicles(EVs).The circRNA of EVs(EVs-circRNA)is closely associated with CRC progression and plays a pivotal role in chemoresistance mechanisms.This paper investigates the circRNA mechanism underlying different chemoresistance scenarios in CRC and explores the dual role of EVs-circRNA in mediating chemotherapy resistance.Furthermore,EVs-circRNA,a non-invasive biomarker for liquid biopsies,holds significant promise in clinical applications,ranging from early CRC diagnosis to monitoring disease progression and assessing prognosis.These studies provide a new perspective for uncovering CRC pathogenesis and lay the foundation for precision therapy and personalized treatment strategies for CRC.In the future,therapeutic strategies targeting EVs-circRNAs are anticipated to revolutionize CRC treatment,leading to improved therapeutic outcomes and enhanced quality of life for patients.展开更多
The vonoprazan(VPZ)triple therapy regimen for Helicobacter pylori(H.pylori)eradication developed by Han et al employs a scientifically rigorous clinical trial design.This multicenter randomized controlled trial establ...The vonoprazan(VPZ)triple therapy regimen for Helicobacter pylori(H.pylori)eradication developed by Han et al employs a scientifically rigorous clinical trial design.This multicenter randomized controlled trial establishes a standardized treatment framework aimed at improving H.pylori eradication rates,focusing on simplifying treatment regimens,shortening therapy duration,and optimizing therapeutic outcomes.The core of clinical translation lies in improving drug accessibility,establishing multidimensional safety evaluation systems,and optimizing cost-effectiveness.Conducting regional adaptability studies and comprehensive safety assessments is crucial for enhancing VPZ regimen effectiveness in China’s diverse healthcare environments.This study provides important evidence-based support for optimizing H.pylori treatment strategies in China,though further validation of universal applicability for nationwide implementation remains necessary.展开更多
This study aimed to systematically evaluate the clinical efficacy of combining wax therapy with conventional drug therapy for rheumatoid arthritis(RA)and to provide evidence supporting its clinical application.A compr...This study aimed to systematically evaluate the clinical efficacy of combining wax therapy with conventional drug therapy for rheumatoid arthritis(RA)and to provide evidence supporting its clinical application.A comprehensive search was conducted across PubMed,Cochrane Library,China Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),Wanfang,and VIP databases from their inception to May 2024.Randomized controlled trials(RCTs)investigating the combination of wax therapy and conventional drug therapy for RA were included in the analysis.Statistical analysis was performed using Review Manager 5.3 software.Nine studies,encompassing a total of 843 patients,were included.The results demonstrated that the combination therapy significantly improved clinical efficacy compared to conventional drug therapy alone[RR=1.22,95%CI(1.11,1.34)].Moreover,the combination therapy led to notable improvements in DAS 28 scores[MD=-0.90,95%CI(-1.23,-0.57),P<0.00001],VAS scores[MD=-0.90,95%CI(-1.13,-0.66),P<0.00001],reduction in joint tenderness[MD=-1.27,95%CI(-1.81,-0.72),P<0.00001],decreased duration of morning stiffness[MD=-25.47,95%CI(-34.33,-16.61),P<0.00001],and lowered C-reactive protein levels[MD=-6.29,95%CI(-12.02,-0.57),P<0.05].In conclusion,wax therapy combined with conventional anti-rheumatic drugs significantly enhanced the clinical outcomes for RA patients by alleviating symptoms,reducing joint pain and morning stiffness,and decreasing inflammatory markers more effectively than conventional drug therapy alone.展开更多
OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicent...OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.展开更多
基金supported by the Defitech Foundation(Morges,CH)to FCHthe Bertarelli Foundation-Catalyst program(Gstaad,CH)to FCH+2 种基金the Wyss Center for Bio and Neuroengineering the Lighthouse Partnership for AI-guided Neuromodulation to FCHthe Fonds de recherche du Quebec-Sante(FRQS#342969)to CEPthe Neuro X Postdoctoral Fellowship Program to CEP。
文摘Brain lesions,such as those caused by stroke or traumatic brain injury(TBI),frequently result in persistent motor and cognitive impairments that significantly affect the individual patient's quality of life.Despite differences in the mechanisms of injury,both conditions share a high prevalence of motor and cognitive impairments.These deficits show only limited natural recovery.
文摘The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.
基金supported by the National Key Research and Development Program of China,No.2019YFA0111200the National Natural Science Foundation of China,Nos.U23A20436,82371047+3 种基金Key Research Project in Shanxi Province,No.202302130501008Shanxi Provincial Science Fund for Distinguished Young Scholars,No.202103021221008Key Research and Development Program in Shanxi Province,No.202204051001023Shanxi Medical University Doctor’s Startup Fund Project,No.SD22028(all to YG)。
文摘Retinal ganglion cells are the bridging neurons between the eye and the central nervous system,transmitting visual signals to the brain.The injury and loss of retinal ganglion cells are the primary pathological changes in several retinal degenerative diseases,including glaucoma,ischemic optic neuropathy,diabetic neuropathy,and optic neuritis.In mammals,injured retinal ganglion cells lack regenerative capacity and undergo apoptotic cell death within a few days of injury.Additionally,these cells exhibit limited regenerative ability,ultimately contributing to vision impairment and potentially leading to blindness.Currently,the only effective clinical treatment for glaucoma is to prevent vision loss by lowering intraocular pressure through medications or surgery;however,this approach cannot halt the effect of retinal ganglion cell loss on visual function.This review comprehensively investigates the mechanisms underlying retinal ganglion cell degeneration in retinal degenerative diseases and further explores the current status and potential of cell replacement therapy for regenerating retinal ganglion cells.As our understanding of the complex processes involved in retinal ganglion cell degeneration deepens,we can explore new treatment strategies,such as cell transplantation,which may offer more effective ways to mitigate the effect of retinal degenerative diseases on vision.
文摘Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.
基金supported by the grants provided by Zhuhai People's Hospital,China(Grant No.:2021KYQD-03)the National Natural Science Foundation of China(Grant No.:22176016).
文摘Fibroblast activation protein(FAP)is overexpressed in cancer-associated fibroblasts across various cancer types.Numerous radiolabeled FAP inhibitors(FAPIs)(Fig.S1A)currently under clinical investigation have shown remarkable potential in cancer theranostics.
文摘Any new report on the anticancer properties of natural products always awakens new satisfaction and hope about the role of the international scientific community in its continuous contributions to human health,particularly when those reports contribute to both the understanding and therapeutics of cancer.For many de-cades,natural products have been pivotal in drug discovery programs because they offer a diverse array of anticancer therapeutic possibilities.Recently,two manuscripts published in the World Journal of Gastrointestinal Oncology added new data to the already extensive body of anticancer preclinical evidence for resvera-trol and senegenin,two compounds widely present in herbal preparations used in traditional Chinese medicine.The first one,with comprehensive and recognized anticancer properties,and the second one,shows a compelling body of evidence supporting its neuroprotective effects,but with emerging anticancer activities.Natural products have become key elements in the expanding and dynamic field of anticancer drug discovery.However,urgent and collective efforts are still needed to bridge the gap between preclinical and clinical research and thus bring new anticancer therapeutic breakthroughs.
文摘Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical center. Every study differs in various aspects, such as phases, study indication, eligibility criteria, etc. In terms of meeting the enrollment deadline, typically, the study indication and availability of the patient’s population at the geographical area of the research site would decide if the trial could be time-consuming. Patient recruitment and retention are critical for the success of every clinical trial;however, worldwide, this area is facing tremendous pressure and challenges. Globally 55% of clinical trials terminated due to low recruitment, with an average enrollment success rate of 40% for Phase III and IV trials. Over 80% of clinical trial attempts fail to enroll, extending the study and adding new study sites. In the United States, more than 80% of clinical trials fail to achieve targeted patient enrollment, and 30% of study participants discontinue participation. This article reviewed various factors hindering clinical trial recruitment and retention and suggested strategies to make the research site successful.
基金The Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences——A Strategic Study on Healthy China Development and Health System Reform(2021-I2M-1-046).
文摘Objective Traditional Chinese medicine(TCM)incorporates traditional diagnostic methods and several major treatment modalities including Chinese herbal medicine,Chinese patent medicine,and non-pharmacological methods such as acupuncture and tuina.Even though TCM is used daily by more than 70,000 healthcare facilities and over 700,000 clinical practitioners in China,there is a poor understanding of the extent to which TCM diagnostic methods are used,how different treatment modalities are deployed in general,and what major factors may affect the integration of TCM and Western medicine.This study aimed to fill this void in the literature.Methods In the 2021 National Healthcare Improvement Evaluation Survey,we included three questions gauging the perception and practices of TCM amongst physicians working in TCM-related facilities,investigating the frequency of their deployment of TCM diagnostic methods,and predominant TCM treatment methods.Our empirical analysis included descriptive statistics,intergroup chi-square analysis,and binary logistic regression to examine the association between different types of facilities and individual characteristics and TCM utilization patterns.Results A total of 7618 clinical physicians comprised our study sample.Among them,84.27%have integrated TCM and Western medicine in their clinical practice,and 80.77%of TCM practitioners used the 4 diagnostic methods as a tool in their clinical practice.Chinese herbal medicine was the most widely utilized modality by Chinese TCM physicians(used by 88.49%of respondents),compared with the Chinese patent medicine and non-pharmacological TCM methods,which were used by 73.14%,and 69.39%,respectively.Herbal tea as an out-of-pocket health-maintenance intervention is also a notable practice,recommended by 29.43%of physicians.Significant variations exist across certain institutions,departments,and individual practitioners.Conclusion Given that most of the surveyed physicians integrated TCM with Western medicine in their clinical practices,the practice of“pure TCM”appears to be obsolete in China’s tertiary healthcare institutions.Notably,remarkable variation exists in the use of different TCM modalities across institutions and among individuals,which might be related to and thus limited by the practitioners’experience.Future research focusing on the efficacy and safety of TCM interventions for specific diseases,the development of standardized clinical guidelines,and the enhancement of TCM education and training are called for to optimize TCM-Western medicine integration.
基金Supported by National Science and Technology Major Project,No.2024ZD0521002The Innovation Team Project of Traditional Chinese Medicine of Liaoning Province,No.LNZYYCXTD-CCCX-003+1 种基金General Program of the National Natural Science Foundation of China,No.82074296Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China,No.[2022]No.75.
文摘Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.
基金Supported by the Foundation of Health Commission of Hubei Province,No.WJ2019H053Natural Science Foundation of Hubei Province,No.2023AFB169+1 种基金Foundation of Health Commission of Hubei Province,No.ZY2021Q019Open Fund Hubei Provincial Clinical Research Center for Umbilical Cord Blood Hematopoietic Stem Cells,Taihe Hospital,No.2024SCOF008.
文摘BACKGROUND Large number of decompensated liver cirrhosis patients in China have been diagnosed with hepatitis B virus(HBV).Human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)can possibly cure decompensated liver cirrhosis because of their self-renewal and multidirectional differentiation potential.AIM To explore the safety and effect of treating liver cirrhosis with HBV by hUC-MSCs.METHODS Twenty-four participants were recruited,divided into 3 groups,and injected with different amounts of hUC-MSCs via the peripheral vein.Therapy was administered 3 times.A 24-week follow-up examination of each patient’s liver function,coagulation function,general condition,and immune system was performed.Adverse events were also recorded.A 2-year survival assessment was subsequently performed.RESULTS Infusion therapy rapidly improved liver function.Serum albumin transiently increased on days 57 and 85 but returned to baseline by day 169,while prothrombin time activity demonstrated sustained improvement from day 29 through day 169.Interleukin-8 levels decreased persistently throughout treatment.All dosage groups achieved 100%6-month survival;2-year survival rates were 66.7%(low-dose),100%(medium-dose),and 87.5%(high-dose).The interaction between dosage and efficacy was weak.Notably,the improvement in liver function was statistically significant and sustained for almost 3 months,suggesting clinically meaningful therapeutic durability.CONCLUSION hUC-MSCs can be considered a safe treatment for patients with decompensated liver cirrhosis associated with HBV.However,larger-scale randomized controlled trials are needed to prove its therapeutic effect.
文摘Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock for the inheritance and development of TM.To meet the growing demand for high-quality healthcare,it is imperative to integrate TM with modern technology to address the issue of insufficient evidence for the efficacy of TM.
文摘Malaria is considered one of the major causes of travel-related morbidity and mortality,especially among non-immune travelers from non-endemic countries to the endemic regions.According to a multicenter study from the GeoSentinel surveillance network,malaria was the most frequent cause of fever in 21%of returning travelers,followed by dengue,typhoid fever,chikungunya and rickettsiosis[1].Individuals traveling from regions without malaria transmission to areas where it is endemic face a heightened risk of contracting the disease due to their lack of immunity.Despite the official malaria-free status of the Russian Federation since 2010,annual cases of severe Plasmodium(P.)falciparum malaria continue to be reported[2].This underscores the necessity for heightened clinical vigilance and improved preventive strategies especially in non-endemic settings.
基金Supported by The Funding of Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A00810The Escort Project of Guang’anmen Hosital,China Academy of Chinese Medical Science-Backbone Talent Cultivation Project,No.9323013。
文摘Hepatitis B virus(HBV)is a serious global public health concern.Although nucleoside drugs and interferons can significantly inhibit HBV replication,issues such as drug resistance and low clinical cure rates remain.Traditional Chinese medicine(TCM)is widely used in the treatment of chronic hepatitis B(CHB)in China,with anti-inflammatory,anti-fibrotic,and liver-protective effects;however,reports on its antiviral effects are still inconsistent.We retrieved multicenter clinical studies and meta-analyses of TCM treatment for CHB over the past two decades.The results revealed that TCM has a certain anti-HBV effect,and when combined with antiviral drugs,it can significantly improve antiviral efficacy.It was demonstrated that TCM most effectively promotes serum HBV e antigen conversion to negative,followed by the ability to reduce HBV DNA levels,facilitating HBV surface antigen loss,and improving the treatment of CHB.
基金supported by the National High Level Hospital Clinical Research Funding(2025-GSP-QN-31&2022-GSP-QN-1)the Young Talent Program of the Academician Fund(YS-2022-002)the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)(2023-I2M-1-002)。
文摘BACKGROUND As the global population ages,the number of elderly patients with acute coronary syndrome(ACS)rises.However,prognostic assessment tools for elderly patients with ACS remain lacking,particularly in the Chinese population.This study aimed to develop and validate a nomogram to predict 2-year major adverse cardiovascular and cerebrovascular events(MACCE)in elderly Chinese patients with ACS.METHODS A retrospective analysis was conducted using two independent cohorts of ACS patients aged≥65 years who underwent percutaneous coronary intervention:the derivation cohort(n=1674)and the validation cohort(n=2333).Candidate predictors were selected using multivariable Cox proportional hazards regression and the Akaike information criterion.A final nomogram incorporating ten variables was constructed.Model performance was evaluated in terms of discrimination[concordance index(C-index)and area under the receiver operating characteristic curve(AUC)]and calibration(calibration plots).RESULTS The 2-year incidence of MACCE was 12.5%(n=210)in the derivation cohort and 15.6%(n=364)in the validation cohort.The nomogram demonstrated good discrimination,with C-index values of 0.727 and 0.661 and AUCs of 0.723 and 0.699 in the derivation cohort and the validation cohort,respectively;significantly outperforming the GRACE risk score(P<0.001).Calibration plots showed good agreement between the predicted and observed outcomes.Patients classified as the high-risk group by the nomogram had a significantly higher MACCE incidence compared to that of the low-risk group(log-rank P<0.001).CONCLUSIONS This newly developed nomogram provides a reliable tool for individualized prediction of the 2-year MACCE risk in elderly Chinese patients with ACS who underwent percutaneous coronary intervention.It outperformed the GRACE score in both discrimmination and calibration and may help improve clinical decision-making and personalized risk stratification in this vulnerable population.
基金Supported by the“Climbing Program”Construction Project“High Peak Project”Department of Major Infectious Disease Prevention and Control.
文摘BACKGROUND Hepatitis B-associated cirrhosis is an important disease burden in China.However,there is a lack of effective predictors in clinical practice to drive delivery and enable early treatment to delay disease progression.AIM To analyzing the clinical characteristics of patients with hepatitis and cirrhosis,the nomogram model was established and validated.METHODS The clinical data of 1070 patients with hepatitis B who were treated in our hospital from October 2015 to July 2022 were collected.In a 7:3 ratio,749 cases were divided into training cohorts and 321 cases were divided into validation cohorts.In addition,the training cohort and validation cohort were further divided into hepatitis group and hepatitis B-related cirrhosis group based on whether the patient progressed to cirrhosis.Binary logistic regression was used to analyze the influencing factors of hepatitis progression to cirrhosis.A roadmap prediction model was established,and the predictive effect of the model was evaluated by patientsubject receiver operating characteristic curve(ROC),and the effectiveness of the model was evaluated by decision curve analysis.RESULTS Binary logistic regression analysis was performed using hepatitis B-related cirrhosis=1 and hepatitis=0 as dependent variables,and univariate analysis of serological indicators was used as covariates.The results showed that glutamic oxaloacetate aminotransferase/glutamate acetone aminotransferase levels,prothrombin time activity,and hepatitis B e antigen levels were all contributing factors to the progression of hepatitis to cirrhosis.The area under the ROC curve was 0.693[95%confidence interval(CI):0.631 to 0.756]for the training cohort and 0.675(95%CI:0.561 to 0.790)for the validation cohort.In addition,the decision analysis curves of the prediction models of both the training cohort and the validation cohort confirmed the effectiveness of the nomogram prediction model.CONCLUSION Three independent factors influencing the progression to cirrhosis in patients with hepatitis B were identified.The construction of a nomogram prediction model from hepatitis to cirrhosis has high application value as a tool for predicting the occurrence of liver cirrhosis in hepatitis B patients.
基金funded by Peking University Sixth Hospital(BDLYYLZL2024-01)the Capital Health Development Research Project Program of China(2014-4-4112).
文摘To the editor:Schizophrenia is a chronic and severe mental disorder characterised by profound disruptions in thinking,affecting language,perception and the sense of self. These disruptions can significantly impair an individual’s ability to function socially and occupationally, leading to a high burden on both the individuals affected and society as a whole.
基金Supported by Open Project of National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,No.NCRCOP2023007.
文摘Colorectal cancer(CRC)is a common and deadly malignancy worldwide,causing high morbidity and mortality rates.Chemoresistance continues to be the major barrier to the effective treatment of CRC.Circular RNA(circRNA),a recently identified class of non-coding RNA,has become an emerging focus in CRC research due to its abundant presence and stability in extracellular vesicles(EVs).The circRNA of EVs(EVs-circRNA)is closely associated with CRC progression and plays a pivotal role in chemoresistance mechanisms.This paper investigates the circRNA mechanism underlying different chemoresistance scenarios in CRC and explores the dual role of EVs-circRNA in mediating chemotherapy resistance.Furthermore,EVs-circRNA,a non-invasive biomarker for liquid biopsies,holds significant promise in clinical applications,ranging from early CRC diagnosis to monitoring disease progression and assessing prognosis.These studies provide a new perspective for uncovering CRC pathogenesis and lay the foundation for precision therapy and personalized treatment strategies for CRC.In the future,therapeutic strategies targeting EVs-circRNAs are anticipated to revolutionize CRC treatment,leading to improved therapeutic outcomes and enhanced quality of life for patients.
文摘The vonoprazan(VPZ)triple therapy regimen for Helicobacter pylori(H.pylori)eradication developed by Han et al employs a scientifically rigorous clinical trial design.This multicenter randomized controlled trial establishes a standardized treatment framework aimed at improving H.pylori eradication rates,focusing on simplifying treatment regimens,shortening therapy duration,and optimizing therapeutic outcomes.The core of clinical translation lies in improving drug accessibility,establishing multidimensional safety evaluation systems,and optimizing cost-effectiveness.Conducting regional adaptability studies and comprehensive safety assessments is crucial for enhancing VPZ regimen effectiveness in China’s diverse healthcare environments.This study provides important evidence-based support for optimizing H.pylori treatment strategies in China,though further validation of universal applicability for nationwide implementation remains necessary.
基金supported by the Key Research and Development Program of Yunnan Science and Technology Department(Grant No.202303AC100326)the National Natural Science Foundation of China(Grant No.81960863)the Education Department of Yunnan Province(Grant No.2023Y0463 and 2024Y380).
文摘This study aimed to systematically evaluate the clinical efficacy of combining wax therapy with conventional drug therapy for rheumatoid arthritis(RA)and to provide evidence supporting its clinical application.A comprehensive search was conducted across PubMed,Cochrane Library,China Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),Wanfang,and VIP databases from their inception to May 2024.Randomized controlled trials(RCTs)investigating the combination of wax therapy and conventional drug therapy for RA were included in the analysis.Statistical analysis was performed using Review Manager 5.3 software.Nine studies,encompassing a total of 843 patients,were included.The results demonstrated that the combination therapy significantly improved clinical efficacy compared to conventional drug therapy alone[RR=1.22,95%CI(1.11,1.34)].Moreover,the combination therapy led to notable improvements in DAS 28 scores[MD=-0.90,95%CI(-1.23,-0.57),P<0.00001],VAS scores[MD=-0.90,95%CI(-1.13,-0.66),P<0.00001],reduction in joint tenderness[MD=-1.27,95%CI(-1.81,-0.72),P<0.00001],decreased duration of morning stiffness[MD=-25.47,95%CI(-34.33,-16.61),P<0.00001],and lowered C-reactive protein levels[MD=-6.29,95%CI(-12.02,-0.57),P<0.05].In conclusion,wax therapy combined with conventional anti-rheumatic drugs significantly enhanced the clinical outcomes for RA patients by alleviating symptoms,reducing joint pain and morning stiffness,and decreasing inflammatory markers more effectively than conventional drug therapy alone.
基金supported by the National Key Research and Development Program of China(No.2022YFC3602500)Beijing High-level Public Health Technical Talents Construction Project(Discipline Leader-03-24)Beijing Hospitals Authority’s Ascent Plan(DFL20240601).
文摘OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.
