Early intervention for sensorineural hearing loss(SNHL)in childhood is crucial for auditory and language development.In recent years,innovative auditory stimulation techniques and speech therapy strategies,such as mid...Early intervention for sensorineural hearing loss(SNHL)in childhood is crucial for auditory and language development.In recent years,innovative auditory stimulation techniques and speech therapy strategies,such as middle ear implants,cochlear implants,auditory brainstem implants,and midbrain implants,have provided new avenues for improving patient outcomes.Additionally,basic research advancements in cell reprogramming and regeneration,stem cell therapy,and targeted drug delivery offer promising approaches to meet the individualized needs of children with SNHL.However,many challenges and unresolved issues remain in the treatment of SNHL.This article comments on the case report,which describes a female pediatric patient with SNHL who underwent foot reflexology which led to the normalization of hearing thresholds.Reflexology is considered to have potential benefits in physical rehabilitation,but its efficacy in hearing restoration requires further scientific validation through rigorous clinical trials and large-scale prospective studies.展开更多
Primary liver cancer is the sixth most prevalent malignancy worldwide and the third leading cause of cancer-related death.According to the latest data from the National Cancer Center of China,its mortality rate has ri...Primary liver cancer is the sixth most prevalent malignancy worldwide and the third leading cause of cancer-related death.According to the latest data from the National Cancer Center of China,its mortality rate has risen,making it the country’s second-deadliest tumor.Hepatocellular carcinoma(HCC),the predo-minant histological subtype,remains a substantial therapeutic challenge.Hepa-tectomy is the treatment of choice for HCC;however,because of its insidious onset and aggressive progression,the global 5-year survival rate is only 14.1%,and up to 70%of patients experience recurrence within five years after surgery.Consequently,reducing postoperative recurrence and prolonging survival have become critical research priorities.Currently,no consensus or guidelines exist regarding the clinical efficacy or potential synergistic effects of diagnostic and therapeutic strategies to prevent postoperative recurrence.In recent years,interest has grown in systemic therapies and combined local modalities-particularly targeted agents and immune checkpoint inhibitors,as adjuvant treatments.This review synthesizes recent advances in targeted and immunotherapeutic adjuvant therapies for postoperative HCC to inform clinical practice and improve patient outcomes.展开更多
BACKGROUND According to the literature,significant disorders of gut microbiota are consistently observed in patients with colorectal cancer(CRC).Disorders of gut microbiota composition are manifesting clinically as ab...BACKGROUND According to the literature,significant disorders of gut microbiota are consistently observed in patients with colorectal cancer(CRC).Disorders of gut microbiota composition are manifesting clinically as abdominal pain,dyspeptic symptoms(such as rumbling,bloating,and altered bowel habits,including both constipation and diarrhea),and overall reduced quality of life.Also,negative changes in the microbiota may be associated with a more frequent development of postoperative complications and complications during chemotherapy.CASE SUMMARY Two patients with CRC underwent surgery(laparoscopic left hemicolectomy)and were prescribed chemotherapy regimen consisted of cisplatin,leucovorin,and fluorouracil.Along with prescribed chemotherapy patients took autoprobiotic enterococci.A fecal sample was collected for autoprobiotic preparation,ensuring that the patient had not taken antibiotics,probiotic supplements,or probiotic-containing foods for at least 10 days.An autoprobiotic contained an indigenous strain of Enterococcus faecium(E.faecium)was formulated.The patients received the autoprobiotic strain E.faecium(liquid form with a concentration of 8 Lg CFU/mL)orally at a dose of 50 mL twice daily during 10 days,regardless of meal times,from the first day of cytostatic treatment,throughout the first course of chemotherapy.As a result,autoprobiotic intake improved patient well-being and prevent side effects associated with the use of cytostatics.CONCLUSION The use of autoprobiotics in the treatment of CRC is a promising area to reduce the risks of postoperative complications,increase the tolerability of the basic chemotherapeutic regimen,as well as improve the quality of life.展开更多
BACKGROUND Low back pain is a major cause of disability worldwide,with intervertebral disc degeneration contributing to nearly 40%of cases.Conventional treatments focus on symptom relief without addressing the underly...BACKGROUND Low back pain is a major cause of disability worldwide,with intervertebral disc degeneration contributing to nearly 40%of cases.Conventional treatments focus on symptom relief without addressing the underlying degeneration.Platelet-rich plasma(PRP),a regenerative therapy rich in growth factors,offers potential therapeutic benefits through growth factor-mediated mechanisms,though clinical evidence is limited.AIM To evaluate the efficacy of intradiscal autologous PRP injection in reducing pain and improving function in patients with chronic lumbar disc prolapse.METHODS This pilot quasi-experimental study was conducted in tertiary care centre between July 2022 and June 2024.The study involved comparing the outcomes between group A(n=17)who failed to respond to conservative treatment measures and received intradiscal PRP injection with group B(n=22)who responded to conservative treatment.Visual Analogue Scale(VAS)and Functional Rating Index(FRI)scores were recorded at baseline,3 weeks,and 6 weeks for both the groups.RESULTS Forty patients were enrolled in the study.The PRP group demonstrated significant improvement in VAS and FRI scores compared to baseline.While both groups improved from their respective baselines,direct between-group comparisons are limited by baseline differences in symptom severity.Patients who failed conservative trial showed significant improvement following PRP intervention,with outcomes approaching those observed in physiotherapy responders.CONCLUSION Intradiscal PRP injection significantly improved pain and function in patients with lumbar disc disease,with clinical improvements that approached the level observed in physiotherapy responders,despite baseline differences in symptom severity.PRP shows promise as an effective treatment for lumbar disc pathology;however,these preliminary findings are limited by the small sample size and short follow-up,warranting larger trials with long-term evaluation.展开更多
Objective:Pediatric patients undergoing day surgery often experience significant anxiety,which can negatively impact both the child and their parents.Addressing this anxiety is crucial to ensure a smooth surgical expe...Objective:Pediatric patients undergoing day surgery often experience significant anxiety,which can negatively impact both the child and their parents.Addressing this anxiety is crucial to ensure a smooth surgical experience and recovery.This mini review aims to evaluate the impact of preoperative anxiety in children,identify contributing factors,and explore effective strategies to manage this anxiety during day surgery.Methods:A literature review was conducted,focusing on studies that assess anxiety levels in pediatric patients before day surgery and the interventions designed to alleviate this anxiety.The review included both psychological and procedural strategies.Results:Preoperative anxiety in children can be influenced by a variety of factors,including age,previous medical experiences,parental anxiety,and the hospital environment.Untreated anxiety may lead to increased postoperative pain,behavioral changes,and extended recovery times.Several strategies,including psychological preparation,family centered approaches,and the involvement of child life specialists,have been shown to effectively reduce anxiety.Conclusions:Managing anxiety in pediatric day surgery is vital to improving both surgical outcomes and the overall experience for children and their families.Healthcare professionals can play a key role in reducing anxiety through targeted interventions and supportive care.展开更多
BACKGROUND Mucopolysaccharidosis typeⅥ(MPSⅥ)is a chronic,progressive,inherited disease with multiorgan involvement and a restricted life expectancy.AIM To investigate the epidemiological,clinical,and genetic charact...BACKGROUND Mucopolysaccharidosis typeⅥ(MPSⅥ)is a chronic,progressive,inherited disease with multiorgan involvement and a restricted life expectancy.AIM To investigate the epidemiological,clinical,and genetic characteristics of patients with mucopolysaccharidosis type 6 and their outcomes using the Russian Federation's national registry,as per the Russian registry,and compare them with previously published data.METHODS In a retrospective cohort study,clinical,laboratory data,molecular genetic analysis results,and enzyme replacement therapy(ERT)data were extracted and analyzed from the Russian MPSⅥregistry for 53 patients,comprising 26 males(49.1%)and 27 females(50.9%).RESULTS The median age of first symptoms was 2 years,ranging from the first months of life to 20 years.A positive family history of MPSⅥwas reported in 19/53(35.8%)patients,a negative family history in 24(45.3%),and missing information in 10(18.9%).The main features of the disease were hepatomegaly(n=23;60.5%),splenomegaly(n=15,39.5%),involvement of otolaryngological organs(n=24/33;72.7%),umbilical and inguinal hernia(n=19/36;52.8%),heart involvement(n=26/32;81.3%)with valve involvement(n=25/26;96.2%)and linear growth delay(n=30/39,76.9%).Two patients(3.8%)died.The most common variants identified in the ARSB gene were c.454C>T and c.194C>T.At the time of data collection,ERT had ever received 48/53(90.5%)patients.CONCLUSION No correlation was observed between the age of onset of the first symptoms,the severity of clinical manifestations,enzyme activity,or nucleotide variants in the ARSB gene.展开更多
Liver metastases are a leading contributor to cancer-related illness and death,occurring far more frequently than primary liver tumors.Their management remains highly challenging due to the complexity of disease behav...Liver metastases are a leading contributor to cancer-related illness and death,occurring far more frequently than primary liver tumors.Their management remains highly challenging due to the complexity of disease behavior and the need for an individualized,multidisciplinary approach.Effective care increasingly relies on integrating sophisticated diagnostic techniques,advanced systemic and locoregional therapies,and molecularly tailored treatment strategies.This review provides an in-depth analysis of the current clinicopathological perspectives on liver metastases.It explores their epidemiology,mechanisms of spread,histological growth patterns,diagnostic imaging advancements,molecular characteristics,and therapeutic interventions.Additionally,it examines the broader implications for patient quality of life(QoL),healthcare costs,and the particular difficulties associated with managing liver metastases in pediatric patients and individuals with rare malignancies.The article outlines the diverse histopathological features and tumor–liver interface growth patterns,emphasizing their prognostic and therapeutic significance.It evaluates contemporary imaging modalities–including magnetic resonance imaging and computed tomography(CT)with hepatocyte-specific agents,positron emission tomography/CT,and contrast-enhanced ultrasound–and highlights the emerging importance of liquid biopsy and molecular profiling in shaping treatment decisions.The review discusses available treatment options such as chemotherapy,targeted agents,immunotherapies,surgical resection,liver transplantation,and various locoregional therapies.Furthermore,it addresses evolving fields like prognostic scoring systems,radiomics,artificial intelligence(AI)applications,and patient–derived organoid and xenograft models.A summary of current clinical trials and translational research initiatives reflects the fast-paced evolution of this field.The management of liver metastases is rapidly advancing,driven by precision oncology principles and collaborative,multidisciplinary care.The integration of molecular diagnostics,novel therapeutic approaches,and cutting–edge technologies–including AI and organoid-based personalized drug testing-is poised to enhance treatment selection,improve clinical outcomes,and support better QoL.These innovations hold the potential to transform the outlook for patients with liver metastases,moving toward more durable disease control in appropriately selected cases.展开更多
Nuclear receptors(NRs)function as crucial transcription factors in orchestrating essential functions within the realms of development,host defense,and homeostasis of body.NRs have garnered increased attention due to t...Nuclear receptors(NRs)function as crucial transcription factors in orchestrating essential functions within the realms of development,host defense,and homeostasis of body.NRs have garnered increased attention due to their potential as therapeutic targets,with drugs directed at NRs demonstrating significant efficacy in impeding chronic disease progression.Consequently,these pharmacological agents hold promise for the treatment and management of various diseases.Accumulating evidence emphasizes the regulatory role of exosome-derived microRNAs(miRNAs)in chronic inflammation,disease progression,and therapy resistance,primarily by modulating transcription factors,particularly NRs.By exploiting inflammatory pathways such as protein kinase B(Akt)/mammalian target of rapamycin(mTOR),nuclear factor kappa-B(NF-κB),signal transducer and activator of transcription 3(STAT3),and Wnt/β-catenin signaling,exosomes and NRs play a pivotal role in the panorama of development,physiology,and pathology.The internalization of exosomes modulates NRs and initiates diverse autocrine or paracrine signaling cascades,influencing various processes in recipient cells such as survival,proliferation,differentiation,metabolism,and cellular defense mechanisms.This comprehensive review meticulously examines the involvement of exosome-mediated NRs regulation in the pathogenesis of chronic ailments,including atherosclerosis,cancer,diabetes,liver diseases,and respiratory conditions.Additionally,it elucidates the molecular intricacies of exosome-mediated communication between host and recipient cells via NRs,leading to immunomodulation.Furthermore,it outlines the implications of exosome-modulated NR pathways in the prophylaxis of chronic inflammation,delineates current limitations,and provides insights into future perspectives.This review also presents existing evidence on the role of exosomes and their components in the emergence of therapeutic resistance.展开更多
Objective:To investigate the potential of ascorbic acid in mitigating reproductive toxicity induced by di-(2-ethyl hexyl)phthalate(DEHP)in female Wistar rats,focusing on oxidative stress,hormone levels,and gonadotropi...Objective:To investigate the potential of ascorbic acid in mitigating reproductive toxicity induced by di-(2-ethyl hexyl)phthalate(DEHP)in female Wistar rats,focusing on oxidative stress,hormone levels,and gonadotropin receptors expression.Methods:Forty female Wistar rats[30 days old,weighing(60±10)g]were randomly divided into five groups(n=8 per group).Group 1 received corn oil(control).Groups 2 and 3 were administered DEHP at 10 and 100 mg/kg body weight(b.wt.),respectively.Groups 4 and 5 received DEHP at 10 and 100 mg/kg b.wt.,respectively,plus ascorbic acid 100 mg/kg b.wt..All treatments were given orally for 30 days.Blood and ovarian tissues were collected to assess serum reproductive hormones,gonadotropin receptor gene expression,oxidative stress markers,and apoptosis.Results:DEHP,particularly at the higher dose,significantly decreased hormone levels(follicle-stimulating hormone,luteinizing hormone,estradiol)and gonadotropin receptor gene expression(FSHR,LHR),while increasing oxidative stress and apoptosis.Co-treatment with ascorbic acid significantly improved these parameters,reducing oxidative stress and apoptosis,and restoring hormone levels and gonadotropin receptor expression.Histopathology revealed fewer atretic follicles and less disruption in ovarian structure in DEHP and ascorbic acid-treated groups compared to those treated with DEHP alone.Conclusions:Ascorbic acid demonstrates protective effects against DEHP-induced reproductive toxicity in female rats,likely through mitigating oxidative stress and normalizing hormone levels and ovarian function.展开更多
Objective To evaluate the in vitro anti-diabetic effects of Bryonia dioica roots extracts,in-cluding water-acetone extracts and their ethyl acetate and butanol fractions,and chloroform-methanol extracts.Methods The to...Objective To evaluate the in vitro anti-diabetic effects of Bryonia dioica roots extracts,in-cluding water-acetone extracts and their ethyl acetate and butanol fractions,and chloroform-methanol extracts.Methods The total phenolic,flavonoid,flavonol,and saponin contents in the Bryonia dioica root extracts(chloroform-methanol extracts,water-acetone extracts and their ethyl acetate and butanol fractions)were determined using colorimetric methods with Folin-Ciocalteu,aluminum trichloride,and vanillin reagents,respectively.The in vitro anti-diabetic activity was evaluated by measuring the half-maximal inhibitory concentration(IC_(50))values of these root extracts againstα-amylase andα-glucosidase activities,evaluating their effects onα-amy-lase kinetics,quantifying the inhibition of bovine serum albumin(BSA)glycation using fluo-rometry to assess advanced glycation end products(AGE)production,and determining glu-cose uptake by isolated rat hemidiaphragm.Additionally,molecular docking analysis was conducted to investigate the binding affinity and interaction types between Bryonia dioica lig-ands(cucurbitacin B,bryogénin,vitexin,and isovitexin)and target enzymes,and a phyto-chemical-targets interaction network was constructed.Results Forα-amylase inhibition,ethyl acetate fraction demonstrated the most potent activi-ty(IC_(50)=145.95μg/mL),followed by chloroform-methanol extract(IC_(50)=300.86μg/mL).Water-acetone root extracts and their ethyl acetate and butanol fractions inhibited theα-glucosidase activity with IC50 values ranging from 562.88 to 583.90μg/mL.Both ethyl acetate and butanol fractions strongly inhibited non-enzymatic BSA glycation(IC_(50)=318.26 and 323.12μg/mL,respectively).The incubation of isolated rat hemidiaphragms with the ethyl acetate fraction(5 mg/mL)significantly increased glucose uptake(35.16%;P<0.0001),exceeding the effects of insulin(29.27%),chloroform-methanol extract(24.07%),and catechin(15.27%).Molecular docking revealed that cucurbitacin B exhibited the strongest docking scores againstα-amylase(-16.4 kcal/mol),andα-glucosidase(-14.2 kcal/mol).Compared with other ligands,isovitexin formed the maximum number of hydrogen bonds with theα-amylase active site residues(Asp300,Asp197,and Glu233),α-glucosidase residues(Ser13,Arg44,Met86,Gly10,Asp39,and Tyr131)and other residues(Arg195,Trp59,His299,and Tyr62).Network analysis identified 36 overlapping targets between Bryonia dioica phyto-chemicals and type 2 diabetes mellitus-associated genes,with cucurbitacins and polyphenols interacting withα-amylase,α-glucosidase,and Glut4 translocation pathway targets.Conclusion Bryonia dioica root extracts demonstrated promising in vitro anti-diabetic activi-ty through multiple mechanisms,including the inhibitory effect on digestive enzymes,pro-tein antiglycation potential,and enhancement of glucose uptake,suggesting their potential as a source for anti-diabetic drugs development.展开更多
Hexaferrites'magnetic and structural properties are highly sensitive to changes in sintering temperature and cationic replacements.We fabricated Ca_(0.5)Cu_(0.5)Fe_(12-x)DyxO_(19)hexaferrites using the sol-gel tec...Hexaferrites'magnetic and structural properties are highly sensitive to changes in sintering temperature and cationic replacements.We fabricated Ca_(0.5)Cu_(0.5)Fe_(12-x)DyxO_(19)hexaferrites using the sol-gel technique.We examined the phase,microstructure and magnetic aspects of the samples with respect to varying doping of rare earth dysprosium.The results show the expansion in the lattice upon incorporation of dysprosium against iron.Morphological studies confirm the uniform distribution of particles with slightly longitudinal nanoflakes in one direction.Magnetic investigations show an increase in magnetic saturation(Ms)with increasing dysprosium incorporation till optimum level is achieved for 15%doping concentration,with negligible change for maximum doping level.Furthermore,coercivity(Hc)and magnetic moment(mB)in terms of Bohr's magneton(μB)also show an increasing trend with dysprosium substitution levels.The maximum saturation magnetization of 33.355 emu/g is achieved with magnetic remanence of 18.290 emu/g,along with optimum magnetic moment of 6.249μB.In addition to the traditional magnetic parameters,magnetic anisotropy parameters were explored for the deep insights into magnetic parameters.These outcomes suggest that improved magnetic properties of Ca_(0.5)Cu_(0.5)Fe_(12-x)DyxO_(19)ferrites make it good substitute for storage devices,magnetic filters,and other magnetic applications.展开更多
Objectives:Bladder Cancer(BC)is one of the most commonly diagnosed malignancies worldwide,with high rates of mortality and morbidity.It can be classified as non-muscle invasive bladder cancer(NMIBC)or muscle-invasive ...Objectives:Bladder Cancer(BC)is one of the most commonly diagnosed malignancies worldwide,with high rates of mortality and morbidity.It can be classified as non-muscle invasive bladder cancer(NMIBC)or muscle-invasive bladder cancer(MIBC),with radical cystectomy being the treatment for MIBC,which significantly reduces quality of life.MicroRNAs(miRs)act as critical genetic regulators,with both oncogenic and tumor-suppressive roles.MiR-10a is described as a tumor suppressor in various neoplasms,but its role in BC is controversial.This study aims to assess the activity of miR-10a in cellular invasion and proliferation in two distinct BC cell lines.Methods:The study used high-grade T24 and low-grade RT4 bladder cell lines.Cells were transfected with miR-10a mimic or a non-targeting control.Transfection efficiency was validated by qPCR.Cell proliferation was cultured for 10–14 days.Cell migration and invasion were evaluated using Matrigel.All assays were conducted in triplicate.Results:The T24 cells transfected with miR-10a presented decreased cellular proliferation and invasion compared to the Scramble(p=0.0481 and p<0.0001,respectively).In the RT4 cell line,there was only a significant reduction in cellular proliferation after miR-10a transfection(p=0.0029).Conclusions:Our findings suggest that miR-10a has a tumoral suppressor role in BC,demonstrating higher efficacy in high-grade cells.展开更多
BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS ...BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS Prospective single-center cohort study evaluating the impact of a novel interactive patient EVM in promoting AUD treatment among hospitalized patients with alcohol-associated liver disease.Treatment was defined as receiving medication or participating in psychosocial treatment within 30 days of discharge.Primary outcome was change in treatment rates after viewing the EVM compared to a retrospective control cohort.Secondary outcomes were predictors of receiving treatment,EVM feedback,30-day hospital readmission,outpatient follow-up,return to alcohol use,and mortality.RESULTS Forty-two patients were included.Mean age was 45 years,50%were female,and mean model for end-stage liver disease score 15.5.After viewing the EVM,treatment rates increased for pharmacologic(50%vs 22%,P=0.0008)and psychosocial treatment(73.8%vs 44%,P=0.01).Return to alcohol use was significantly lower(7.9%vs 35.6%,P=0.003).All 100%of patients would recommend the EVM.CONCLUSION EVM allows hospitalized patients to receive standardized education about AUD treatment.This may address patient and provider knowledge gaps and reduce the growing burden of alcohol-associated liver disease.Future studies should evaluate EVM in larger patient populations using a multi-center study design.展开更多
BACKGROUND Atrial fibrillation(AF)associated with chronic kidney disease(CKD)is a prevalent condition in the United States,significantly impacting global morbidity and mortality.Understanding temporal patterns in AF-r...BACKGROUND Atrial fibrillation(AF)associated with chronic kidney disease(CKD)is a prevalent condition in the United States,significantly impacting global morbidity and mortality.Understanding temporal patterns in AF-related mortality among CKD patients is crucial for effective clinical and public health strategies.AIM To investigate AF-CKD comorbidity and mortality on the national level.METHODS Death certificates from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database spanning 2011-2020 were analyzed to investigate AF-related CKD mortality in adults aged 35 to 85 or more years.Age-adjusted mortality rates(AAMRs)per 100000 persons and annual percent change(APC)were calculated,stratified by year,sex,race/ethnicity,and geographic region.RESULTS A total of 110733 deaths occurred among adults(aged 35-85 or more years)related to AF associated with CKD in the United States.Overall AAMR declined from 8.1 in 2011 to 5.5 in 2014(APC:-14.89;95%confidence interval(CI):-30.44 to-4.06),followed by an increase to 10.3 in 2020(APC:9.91;95%CI:6.1-19.62).Men had higher AAMRs than women(men:7.6,95%CI:7.6-7.7).Non-Hispanic White adults had the highest AAMR(7.8),followed by non-Hispanic Black(5).States in the top 90th percentile had approximately four times higher AAMRs than those in the lower 10th percentile.AAMR also varied by region(Midwest:7.6,West:6.7,Northeast:6.3,South:5.6),with nonmetropolitan areas exhibiting higher AF-associated CKD mortality.CONCLUSION Temporal trends in AF-related mortality among CKD patients showed fluctuations over the study period,with notable disparities across demographic and geographic factors.Targeted interventions are warranted to mitigate the burden of AF associated with CKD and reduce mortality rates in the United States.展开更多
文摘Early intervention for sensorineural hearing loss(SNHL)in childhood is crucial for auditory and language development.In recent years,innovative auditory stimulation techniques and speech therapy strategies,such as middle ear implants,cochlear implants,auditory brainstem implants,and midbrain implants,have provided new avenues for improving patient outcomes.Additionally,basic research advancements in cell reprogramming and regeneration,stem cell therapy,and targeted drug delivery offer promising approaches to meet the individualized needs of children with SNHL.However,many challenges and unresolved issues remain in the treatment of SNHL.This article comments on the case report,which describes a female pediatric patient with SNHL who underwent foot reflexology which led to the normalization of hearing thresholds.Reflexology is considered to have potential benefits in physical rehabilitation,but its efficacy in hearing restoration requires further scientific validation through rigorous clinical trials and large-scale prospective studies.
基金Supported by the Lianyungang Comprehensive Cancer Management and Technology Advancement Project,No.QN202302the First People’s Hospital of Lianyungang Young Talent Development Initiative,No.QN2212Jiangsu Society of Research Hospital Translational Medicine Research Grant,No.2024-GDZXKT-01-07.
文摘Primary liver cancer is the sixth most prevalent malignancy worldwide and the third leading cause of cancer-related death.According to the latest data from the National Cancer Center of China,its mortality rate has risen,making it the country’s second-deadliest tumor.Hepatocellular carcinoma(HCC),the predo-minant histological subtype,remains a substantial therapeutic challenge.Hepa-tectomy is the treatment of choice for HCC;however,because of its insidious onset and aggressive progression,the global 5-year survival rate is only 14.1%,and up to 70%of patients experience recurrence within five years after surgery.Consequently,reducing postoperative recurrence and prolonging survival have become critical research priorities.Currently,no consensus or guidelines exist regarding the clinical efficacy or potential synergistic effects of diagnostic and therapeutic strategies to prevent postoperative recurrence.In recent years,interest has grown in systemic therapies and combined local modalities-particularly targeted agents and immune checkpoint inhibitors,as adjuvant treatments.This review synthesizes recent advances in targeted and immunotherapeutic adjuvant therapies for postoperative HCC to inform clinical practice and improve patient outcomes.
文摘BACKGROUND According to the literature,significant disorders of gut microbiota are consistently observed in patients with colorectal cancer(CRC).Disorders of gut microbiota composition are manifesting clinically as abdominal pain,dyspeptic symptoms(such as rumbling,bloating,and altered bowel habits,including both constipation and diarrhea),and overall reduced quality of life.Also,negative changes in the microbiota may be associated with a more frequent development of postoperative complications and complications during chemotherapy.CASE SUMMARY Two patients with CRC underwent surgery(laparoscopic left hemicolectomy)and were prescribed chemotherapy regimen consisted of cisplatin,leucovorin,and fluorouracil.Along with prescribed chemotherapy patients took autoprobiotic enterococci.A fecal sample was collected for autoprobiotic preparation,ensuring that the patient had not taken antibiotics,probiotic supplements,or probiotic-containing foods for at least 10 days.An autoprobiotic contained an indigenous strain of Enterococcus faecium(E.faecium)was formulated.The patients received the autoprobiotic strain E.faecium(liquid form with a concentration of 8 Lg CFU/mL)orally at a dose of 50 mL twice daily during 10 days,regardless of meal times,from the first day of cytostatic treatment,throughout the first course of chemotherapy.As a result,autoprobiotic intake improved patient well-being and prevent side effects associated with the use of cytostatics.CONCLUSION The use of autoprobiotics in the treatment of CRC is a promising area to reduce the risks of postoperative complications,increase the tolerability of the basic chemotherapeutic regimen,as well as improve the quality of life.
文摘BACKGROUND Low back pain is a major cause of disability worldwide,with intervertebral disc degeneration contributing to nearly 40%of cases.Conventional treatments focus on symptom relief without addressing the underlying degeneration.Platelet-rich plasma(PRP),a regenerative therapy rich in growth factors,offers potential therapeutic benefits through growth factor-mediated mechanisms,though clinical evidence is limited.AIM To evaluate the efficacy of intradiscal autologous PRP injection in reducing pain and improving function in patients with chronic lumbar disc prolapse.METHODS This pilot quasi-experimental study was conducted in tertiary care centre between July 2022 and June 2024.The study involved comparing the outcomes between group A(n=17)who failed to respond to conservative treatment measures and received intradiscal PRP injection with group B(n=22)who responded to conservative treatment.Visual Analogue Scale(VAS)and Functional Rating Index(FRI)scores were recorded at baseline,3 weeks,and 6 weeks for both the groups.RESULTS Forty patients were enrolled in the study.The PRP group demonstrated significant improvement in VAS and FRI scores compared to baseline.While both groups improved from their respective baselines,direct between-group comparisons are limited by baseline differences in symptom severity.Patients who failed conservative trial showed significant improvement following PRP intervention,with outcomes approaching those observed in physiotherapy responders.CONCLUSION Intradiscal PRP injection significantly improved pain and function in patients with lumbar disc disease,with clinical improvements that approached the level observed in physiotherapy responders,despite baseline differences in symptom severity.PRP shows promise as an effective treatment for lumbar disc pathology;however,these preliminary findings are limited by the small sample size and short follow-up,warranting larger trials with long-term evaluation.
文摘Objective:Pediatric patients undergoing day surgery often experience significant anxiety,which can negatively impact both the child and their parents.Addressing this anxiety is crucial to ensure a smooth surgical experience and recovery.This mini review aims to evaluate the impact of preoperative anxiety in children,identify contributing factors,and explore effective strategies to manage this anxiety during day surgery.Methods:A literature review was conducted,focusing on studies that assess anxiety levels in pediatric patients before day surgery and the interventions designed to alleviate this anxiety.The review included both psychological and procedural strategies.Results:Preoperative anxiety in children can be influenced by a variety of factors,including age,previous medical experiences,parental anxiety,and the hospital environment.Untreated anxiety may lead to increased postoperative pain,behavioral changes,and extended recovery times.Several strategies,including psychological preparation,family centered approaches,and the involvement of child life specialists,have been shown to effectively reduce anxiety.Conclusions:Managing anxiety in pediatric day surgery is vital to improving both surgical outcomes and the overall experience for children and their families.Healthcare professionals can play a key role in reducing anxiety through targeted interventions and supportive care.
文摘BACKGROUND Mucopolysaccharidosis typeⅥ(MPSⅥ)is a chronic,progressive,inherited disease with multiorgan involvement and a restricted life expectancy.AIM To investigate the epidemiological,clinical,and genetic characteristics of patients with mucopolysaccharidosis type 6 and their outcomes using the Russian Federation's national registry,as per the Russian registry,and compare them with previously published data.METHODS In a retrospective cohort study,clinical,laboratory data,molecular genetic analysis results,and enzyme replacement therapy(ERT)data were extracted and analyzed from the Russian MPSⅥregistry for 53 patients,comprising 26 males(49.1%)and 27 females(50.9%).RESULTS The median age of first symptoms was 2 years,ranging from the first months of life to 20 years.A positive family history of MPSⅥwas reported in 19/53(35.8%)patients,a negative family history in 24(45.3%),and missing information in 10(18.9%).The main features of the disease were hepatomegaly(n=23;60.5%),splenomegaly(n=15,39.5%),involvement of otolaryngological organs(n=24/33;72.7%),umbilical and inguinal hernia(n=19/36;52.8%),heart involvement(n=26/32;81.3%)with valve involvement(n=25/26;96.2%)and linear growth delay(n=30/39,76.9%).Two patients(3.8%)died.The most common variants identified in the ARSB gene were c.454C>T and c.194C>T.At the time of data collection,ERT had ever received 48/53(90.5%)patients.CONCLUSION No correlation was observed between the age of onset of the first symptoms,the severity of clinical manifestations,enzyme activity,or nucleotide variants in the ARSB gene.
基金Supported by UMM Al-Qura University,Saudi Arabia,No.25UQU4350477GSSR05.
文摘Liver metastases are a leading contributor to cancer-related illness and death,occurring far more frequently than primary liver tumors.Their management remains highly challenging due to the complexity of disease behavior and the need for an individualized,multidisciplinary approach.Effective care increasingly relies on integrating sophisticated diagnostic techniques,advanced systemic and locoregional therapies,and molecularly tailored treatment strategies.This review provides an in-depth analysis of the current clinicopathological perspectives on liver metastases.It explores their epidemiology,mechanisms of spread,histological growth patterns,diagnostic imaging advancements,molecular characteristics,and therapeutic interventions.Additionally,it examines the broader implications for patient quality of life(QoL),healthcare costs,and the particular difficulties associated with managing liver metastases in pediatric patients and individuals with rare malignancies.The article outlines the diverse histopathological features and tumor–liver interface growth patterns,emphasizing their prognostic and therapeutic significance.It evaluates contemporary imaging modalities–including magnetic resonance imaging and computed tomography(CT)with hepatocyte-specific agents,positron emission tomography/CT,and contrast-enhanced ultrasound–and highlights the emerging importance of liquid biopsy and molecular profiling in shaping treatment decisions.The review discusses available treatment options such as chemotherapy,targeted agents,immunotherapies,surgical resection,liver transplantation,and various locoregional therapies.Furthermore,it addresses evolving fields like prognostic scoring systems,radiomics,artificial intelligence(AI)applications,and patient–derived organoid and xenograft models.A summary of current clinical trials and translational research initiatives reflects the fast-paced evolution of this field.The management of liver metastases is rapidly advancing,driven by precision oncology principles and collaborative,multidisciplinary care.The integration of molecular diagnostics,novel therapeutic approaches,and cutting–edge technologies–including AI and organoid-based personalized drug testing-is poised to enhance treatment selection,improve clinical outcomes,and support better QoL.These innovations hold the potential to transform the outlook for patients with liver metastases,moving toward more durable disease control in appropriately selected cases.
基金supported by BT/556/NE/U-Excel/2016 grant awarded to ABKThe authors extend their appreciation to the Deanship of Research and Graduate Studies at King Khalid University for funding this work through Large Research Project under grant number RGP2/485/45.
文摘Nuclear receptors(NRs)function as crucial transcription factors in orchestrating essential functions within the realms of development,host defense,and homeostasis of body.NRs have garnered increased attention due to their potential as therapeutic targets,with drugs directed at NRs demonstrating significant efficacy in impeding chronic disease progression.Consequently,these pharmacological agents hold promise for the treatment and management of various diseases.Accumulating evidence emphasizes the regulatory role of exosome-derived microRNAs(miRNAs)in chronic inflammation,disease progression,and therapy resistance,primarily by modulating transcription factors,particularly NRs.By exploiting inflammatory pathways such as protein kinase B(Akt)/mammalian target of rapamycin(mTOR),nuclear factor kappa-B(NF-κB),signal transducer and activator of transcription 3(STAT3),and Wnt/β-catenin signaling,exosomes and NRs play a pivotal role in the panorama of development,physiology,and pathology.The internalization of exosomes modulates NRs and initiates diverse autocrine or paracrine signaling cascades,influencing various processes in recipient cells such as survival,proliferation,differentiation,metabolism,and cellular defense mechanisms.This comprehensive review meticulously examines the involvement of exosome-mediated NRs regulation in the pathogenesis of chronic ailments,including atherosclerosis,cancer,diabetes,liver diseases,and respiratory conditions.Additionally,it elucidates the molecular intricacies of exosome-mediated communication between host and recipient cells via NRs,leading to immunomodulation.Furthermore,it outlines the implications of exosome-modulated NR pathways in the prophylaxis of chronic inflammation,delineates current limitations,and provides insights into future perspectives.This review also presents existing evidence on the role of exosomes and their components in the emergence of therapeutic resistance.
文摘Objective:To investigate the potential of ascorbic acid in mitigating reproductive toxicity induced by di-(2-ethyl hexyl)phthalate(DEHP)in female Wistar rats,focusing on oxidative stress,hormone levels,and gonadotropin receptors expression.Methods:Forty female Wistar rats[30 days old,weighing(60±10)g]were randomly divided into five groups(n=8 per group).Group 1 received corn oil(control).Groups 2 and 3 were administered DEHP at 10 and 100 mg/kg body weight(b.wt.),respectively.Groups 4 and 5 received DEHP at 10 and 100 mg/kg b.wt.,respectively,plus ascorbic acid 100 mg/kg b.wt..All treatments were given orally for 30 days.Blood and ovarian tissues were collected to assess serum reproductive hormones,gonadotropin receptor gene expression,oxidative stress markers,and apoptosis.Results:DEHP,particularly at the higher dose,significantly decreased hormone levels(follicle-stimulating hormone,luteinizing hormone,estradiol)and gonadotropin receptor gene expression(FSHR,LHR),while increasing oxidative stress and apoptosis.Co-treatment with ascorbic acid significantly improved these parameters,reducing oxidative stress and apoptosis,and restoring hormone levels and gonadotropin receptor expression.Histopathology revealed fewer atretic follicles and less disruption in ovarian structure in DEHP and ascorbic acid-treated groups compared to those treated with DEHP alone.Conclusions:Ascorbic acid demonstrates protective effects against DEHP-induced reproductive toxicity in female rats,likely through mitigating oxidative stress and normalizing hormone levels and ovarian function.
文摘Objective To evaluate the in vitro anti-diabetic effects of Bryonia dioica roots extracts,in-cluding water-acetone extracts and their ethyl acetate and butanol fractions,and chloroform-methanol extracts.Methods The total phenolic,flavonoid,flavonol,and saponin contents in the Bryonia dioica root extracts(chloroform-methanol extracts,water-acetone extracts and their ethyl acetate and butanol fractions)were determined using colorimetric methods with Folin-Ciocalteu,aluminum trichloride,and vanillin reagents,respectively.The in vitro anti-diabetic activity was evaluated by measuring the half-maximal inhibitory concentration(IC_(50))values of these root extracts againstα-amylase andα-glucosidase activities,evaluating their effects onα-amy-lase kinetics,quantifying the inhibition of bovine serum albumin(BSA)glycation using fluo-rometry to assess advanced glycation end products(AGE)production,and determining glu-cose uptake by isolated rat hemidiaphragm.Additionally,molecular docking analysis was conducted to investigate the binding affinity and interaction types between Bryonia dioica lig-ands(cucurbitacin B,bryogénin,vitexin,and isovitexin)and target enzymes,and a phyto-chemical-targets interaction network was constructed.Results Forα-amylase inhibition,ethyl acetate fraction demonstrated the most potent activi-ty(IC_(50)=145.95μg/mL),followed by chloroform-methanol extract(IC_(50)=300.86μg/mL).Water-acetone root extracts and their ethyl acetate and butanol fractions inhibited theα-glucosidase activity with IC50 values ranging from 562.88 to 583.90μg/mL.Both ethyl acetate and butanol fractions strongly inhibited non-enzymatic BSA glycation(IC_(50)=318.26 and 323.12μg/mL,respectively).The incubation of isolated rat hemidiaphragms with the ethyl acetate fraction(5 mg/mL)significantly increased glucose uptake(35.16%;P<0.0001),exceeding the effects of insulin(29.27%),chloroform-methanol extract(24.07%),and catechin(15.27%).Molecular docking revealed that cucurbitacin B exhibited the strongest docking scores againstα-amylase(-16.4 kcal/mol),andα-glucosidase(-14.2 kcal/mol).Compared with other ligands,isovitexin formed the maximum number of hydrogen bonds with theα-amylase active site residues(Asp300,Asp197,and Glu233),α-glucosidase residues(Ser13,Arg44,Met86,Gly10,Asp39,and Tyr131)and other residues(Arg195,Trp59,His299,and Tyr62).Network analysis identified 36 overlapping targets between Bryonia dioica phyto-chemicals and type 2 diabetes mellitus-associated genes,with cucurbitacins and polyphenols interacting withα-amylase,α-glucosidase,and Glut4 translocation pathway targets.Conclusion Bryonia dioica root extracts demonstrated promising in vitro anti-diabetic activi-ty through multiple mechanisms,including the inhibitory effect on digestive enzymes,pro-tein antiglycation potential,and enhancement of glucose uptake,suggesting their potential as a source for anti-diabetic drugs development.
基金the Deanship of Scientific Research at King Khalid University for funding this work through a large group Research Project under grant(RGP2/111/45)。
文摘Hexaferrites'magnetic and structural properties are highly sensitive to changes in sintering temperature and cationic replacements.We fabricated Ca_(0.5)Cu_(0.5)Fe_(12-x)DyxO_(19)hexaferrites using the sol-gel technique.We examined the phase,microstructure and magnetic aspects of the samples with respect to varying doping of rare earth dysprosium.The results show the expansion in the lattice upon incorporation of dysprosium against iron.Morphological studies confirm the uniform distribution of particles with slightly longitudinal nanoflakes in one direction.Magnetic investigations show an increase in magnetic saturation(Ms)with increasing dysprosium incorporation till optimum level is achieved for 15%doping concentration,with negligible change for maximum doping level.Furthermore,coercivity(Hc)and magnetic moment(mB)in terms of Bohr's magneton(μB)also show an increasing trend with dysprosium substitution levels.The maximum saturation magnetization of 33.355 emu/g is achieved with magnetic remanence of 18.290 emu/g,along with optimum magnetic moment of 6.249μB.In addition to the traditional magnetic parameters,magnetic anisotropy parameters were explored for the deep insights into magnetic parameters.These outcomes suggest that improved magnetic properties of Ca_(0.5)Cu_(0.5)Fe_(12-x)DyxO_(19)ferrites make it good substitute for storage devices,magnetic filters,and other magnetic applications.
基金supported by grants from the São Paulo Research Foundation(FAPESP)to ThaináRodrigues(2021/04603-8).
文摘Objectives:Bladder Cancer(BC)is one of the most commonly diagnosed malignancies worldwide,with high rates of mortality and morbidity.It can be classified as non-muscle invasive bladder cancer(NMIBC)or muscle-invasive bladder cancer(MIBC),with radical cystectomy being the treatment for MIBC,which significantly reduces quality of life.MicroRNAs(miRs)act as critical genetic regulators,with both oncogenic and tumor-suppressive roles.MiR-10a is described as a tumor suppressor in various neoplasms,but its role in BC is controversial.This study aims to assess the activity of miR-10a in cellular invasion and proliferation in two distinct BC cell lines.Methods:The study used high-grade T24 and low-grade RT4 bladder cell lines.Cells were transfected with miR-10a mimic or a non-targeting control.Transfection efficiency was validated by qPCR.Cell proliferation was cultured for 10–14 days.Cell migration and invasion were evaluated using Matrigel.All assays were conducted in triplicate.Results:The T24 cells transfected with miR-10a presented decreased cellular proliferation and invasion compared to the Scramble(p=0.0481 and p<0.0001,respectively).In the RT4 cell line,there was only a significant reduction in cellular proliferation after miR-10a transfection(p=0.0029).Conclusions:Our findings suggest that miR-10a has a tumoral suppressor role in BC,demonstrating higher efficacy in high-grade cells.
文摘BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS Prospective single-center cohort study evaluating the impact of a novel interactive patient EVM in promoting AUD treatment among hospitalized patients with alcohol-associated liver disease.Treatment was defined as receiving medication or participating in psychosocial treatment within 30 days of discharge.Primary outcome was change in treatment rates after viewing the EVM compared to a retrospective control cohort.Secondary outcomes were predictors of receiving treatment,EVM feedback,30-day hospital readmission,outpatient follow-up,return to alcohol use,and mortality.RESULTS Forty-two patients were included.Mean age was 45 years,50%were female,and mean model for end-stage liver disease score 15.5.After viewing the EVM,treatment rates increased for pharmacologic(50%vs 22%,P=0.0008)and psychosocial treatment(73.8%vs 44%,P=0.01).Return to alcohol use was significantly lower(7.9%vs 35.6%,P=0.003).All 100%of patients would recommend the EVM.CONCLUSION EVM allows hospitalized patients to receive standardized education about AUD treatment.This may address patient and provider knowledge gaps and reduce the growing burden of alcohol-associated liver disease.Future studies should evaluate EVM in larger patient populations using a multi-center study design.
文摘BACKGROUND Atrial fibrillation(AF)associated with chronic kidney disease(CKD)is a prevalent condition in the United States,significantly impacting global morbidity and mortality.Understanding temporal patterns in AF-related mortality among CKD patients is crucial for effective clinical and public health strategies.AIM To investigate AF-CKD comorbidity and mortality on the national level.METHODS Death certificates from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database spanning 2011-2020 were analyzed to investigate AF-related CKD mortality in adults aged 35 to 85 or more years.Age-adjusted mortality rates(AAMRs)per 100000 persons and annual percent change(APC)were calculated,stratified by year,sex,race/ethnicity,and geographic region.RESULTS A total of 110733 deaths occurred among adults(aged 35-85 or more years)related to AF associated with CKD in the United States.Overall AAMR declined from 8.1 in 2011 to 5.5 in 2014(APC:-14.89;95%confidence interval(CI):-30.44 to-4.06),followed by an increase to 10.3 in 2020(APC:9.91;95%CI:6.1-19.62).Men had higher AAMRs than women(men:7.6,95%CI:7.6-7.7).Non-Hispanic White adults had the highest AAMR(7.8),followed by non-Hispanic Black(5).States in the top 90th percentile had approximately four times higher AAMRs than those in the lower 10th percentile.AAMR also varied by region(Midwest:7.6,West:6.7,Northeast:6.3,South:5.6),with nonmetropolitan areas exhibiting higher AF-associated CKD mortality.CONCLUSION Temporal trends in AF-related mortality among CKD patients showed fluctuations over the study period,with notable disparities across demographic and geographic factors.Targeted interventions are warranted to mitigate the burden of AF associated with CKD and reduce mortality rates in the United States.
