BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehe...BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.展开更多
The cerebellum is receiving increasing attention for its cognitive,emotional,and social functions,as well as its unique metabolic profiles.Cerebellar microglia exhibit specialized and highly immunogenic phenotypes und...The cerebellum is receiving increasing attention for its cognitive,emotional,and social functions,as well as its unique metabolic profiles.Cerebellar microglia exhibit specialized and highly immunogenic phenotypes under both physiological and pathological conditions.These immune cells communicate with intrinsic and systemic factors and contribute to the structural and functional compartmentalization of the cerebellum.In this review,we discuss the roles of microglia in the cerebellar microenvironment,neuroinflammation,cerebellar adaptation,and neuronal activity,the associated molecular and cellular mechanisms,and potential therapeutic strategies targeting cerebellar microglia in the context of neuroinflammation.Future directions and unresolved questions in this field are further highlighted,particularly regarding therapeutic interventions targeting cerebellar microglia,functional mechanisms and activities of microglia in the cerebellar circuitry,neuronal connectivity,and neurofunctional outcomes of their activity.Cerebellar morphology and neuronal performance are influenced by both intrinsic and systemic factors that are actively monitored by microglia in both healthy and diseased states.Under pathological conditions,local subsets of microglia exhibit diverse responses to the altered microenvironment that contribute to the structural and functional compartmentalization of the cerebellum.Microglia in the cerebellum undergo early maturation during the embryonic stage and display specialized,highly immunogenic phenotypes.In summary,cerebellar microglia have the capacity to serve as regulatory tools that influence outcomes across a wide range of neurological and systemic conditions,including neurodevelopmental,neurodegenerative,metabolic,and stress-related disorders.展开更多
Population aging is one of the common challenges in the current world.As people age,the body’s tissues including cells,and molecules inevitably degrade,and their functions gradually decline,causing various age-relate...Population aging is one of the common challenges in the current world.As people age,the body’s tissues including cells,and molecules inevitably degrade,and their functions gradually decline,causing various age-related diseases like Alzheimer’s disease,osteoporosis,low immunity,glucose and lipid metabolism disorders,and cardiovascular diseases.With the continuous increase of the elderly population,the pressure on the medical industry is increasing.To lower the burden on the medical industry and increase the average age of the elderly,it is vital to explore effective anti-aging materials.Ginseng Radix et Rhizoma(Renshen),as a traditional and precious Chinese medicinal herb,is known as the“king of all herbs”.It is famous for its effects of“tonifying Qi,restoring pulse”(helping with the generation of Qi(the fundamental,vital energy that continuously flows within the body)and the circulation of blood)and strengthening the body,nourishing the spleen and lungs,generating fluids and nourishing blood,calming the mind and improving intelligence.Recently,its anti-aging effect has received increasing attention from modern scientific research.This study summarizes the pharmacological effects of the main active ingredients of Renshen(ginsenosides,polysaccharides,etc.)on resisting aging,including preventing neuroaging,suppressing skin aging,mitigating ovarian aging,inhibiting osteoporosis and arthritis,enhancing the immune system of the elderly,protecting the cardiovascular system,resisting aging-induced fatigue and exerting the anti-tumor effects.Through network pharmacology and molecular docking,the anti-aging active ingredients of Renshen were screened,and the key targets and pathways of anti-aging active ingredients in Renshen were determined.Using network pharmacology,totally 106 drug targets and 3,479 disease targets were screened,and 79 common targets between aging and Renshen were identified.Three core targets were identified in the PPI network,including TNF,AKT1,and IL-1β.Molecular docking was used to obtain further verification.This study emphasizes the potential of Renshen as a source of anti-aging activity,which can be developed into a novel drug for the treatment of age-related diseases.展开更多
Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expen...Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan(CNY)using 2011 values.Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stageI cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval(95%CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011(P for trend <0.001), with a cumulative increase of 2.4 times(from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages Ⅰ, Ⅱ, Ⅲ and Ⅳ were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively(P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion(52.6%).Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.展开更多
Objective The Nutritional Risk Screening 2002(NRS 2002)was used to assess the nutritional risk of hospitalized oncology patients in China.This study explored the factors affecting the risk of nutrition to provide a sc...Objective The Nutritional Risk Screening 2002(NRS 2002)was used to assess the nutritional risk of hospitalized oncology patients in China.This study explored the factors affecting the risk of nutrition to provide a scientific basis for the assessment and treatment of malnutrition in oncology patients.Methods We used the NRS 2002 to evaluate the nutritional risk in 48,831 hospitalized cancer patients.Descriptive statistical methods were used to describe the general patient information.A Chi-squared test was applied to analyze the relationship between NRS 2002 scores and different demographic characteristics,and the NRS 2002 scores of cancer patients with different characteristics were compared by one-way ANOVA.Results Among 48,831 patients,43.3%were women and 57.7%were men,and 36.5%(17,802)of patients were at risk of nutrition(score≥3).The NRS 2002 score was the highest in leukemia patients(2.93±1.28).A one-way ANOVA revealed that the differences in NRS 2002 scores among patients of different gender,ages,TNM stages,education levels,occupations and areas of residence were statistically significant(P<0.001).Male patients had slightly higher NRS 2002 scores than females(2.33 vs.2.17).The lowest NRS 2002 scores were in patients aged 45-59(2.00±1.26)years and the highest scores were in patients aged≥70(2.76±1.43)years.The NRS 2002 score of patients receiving surgery was the highest(2.45±1.41),and patients receiving surgery plus radiotherapy/chemotherapy was the lowest(2.00±1.26).The risk of nutrition was highest in patients who were farmers(2.34±1.37 scores)and lowest in office staff(2.15±1.32 scores).Patients living in rural areas had the highest risk of nutrition(2.32±1.37 scores).There were significant differences in the NRS 2002 scores for different cancer sub-types for different ethnic groups(P<0.05),except for Zhuang individuals(P=0.124).The risk of nutrition was highest in Uyghur patients(3.35±1.33 scores)and lowest in Mongolians(2.04±1.37 scores).Conclusion More attention should be paid to people at high risk of nutrition,such as elderly patients,patients with a high TNM stage,patients receiving surgical treatment,and patients living in rural areas.Active nutritional interventions should be carried out to improve the nutritional status of malnourished patients.展开更多
Background: The purpose of this study is to evaluate the quality of life(QoL) of hospitalized patients in China suffering from digestive system malignancies and to identify potential risk factors for a decrease in QoL...Background: The purpose of this study is to evaluate the quality of life(QoL) of hospitalized patients in China suffering from digestive system malignancies and to identify potential risk factors for a decrease in QoL.Methods: The European Organization for Research and Treatment Core Quality of Life questionnaire(EORTC QLQ-C30) was applied to evaluate the QoL of 23,519 patients with six digestive malignancies(esophageal cancer, gastric cancer, colorectal cancer, liver cancer, biliary tract cancer, and pancreatic cancer). A t test or analysis of variance was employed to analyze the total EORTC QLQ-C30 scale scores and domain scores of the EORTC QLQ-C30 scale among patients in different subgroups.Results: The average QoL score was 50.4 ± 10.8. The tumor type, age, sex, and TNM stage al had an impact on QoL ratings. Colorectal cancer patients had a better total QoL score(49.3 ± 10.3) and scores in the domains of functioning, with milder symptoms, except for diarrhea. Patients with biliary tract cancer(54.2 ± 12.3) and pancreatic cancer(54.2 ± 12.3) reported a poorer QoL, significant functional impairment, and more pronounced symptoms. Patients with esophageal cancer experienced the most severe financial difficulties(35.2 ± 27.5). Patients aged ≥65 years, women, and those with TNM stage Ⅲ/Ⅳ reported lower QoL. In addition, the disparities in total QoL scores and scores in specific domains were significant among patients with some types of tumors, and based on ethnicity, educational level, occupation, treatment(s) received, and place of residence.Conclusions: There is a need to focus on elderly individuals, those with low educational levels, and patients with progressive malignant tumors and to improve routine disease monitoring and symptom management to enhance the quality of life for patients with malignancies of the digestive system.展开更多
Triple-negative breast cancer(TNBC)is currently the most heterogeneous and aggressive breast cancer type.It has a high recurrence rate,poor clinical prospects,and lack of predictive markers and potential treatment opt...Triple-negative breast cancer(TNBC)is currently the most heterogeneous and aggressive breast cancer type.It has a high recurrence rate,poor clinical prospects,and lack of predictive markers and potential treatment options.Dysregulated microRNAs(miRNAs)are involved in various cellular processes in TNBC.Moreover,variations in the miRNA levels in TNBC may act as a dependable indicator for predicting the effectiveness and specificity of treatments.Currently,the application of miRNAs for breast cancer therapy is primarily in the preclinical stage,with a focus on identifying highly specific and sensitive miRNAs that could offer new possibilities for early diagnosis,clinical treat-ment,and prognostic monitoring of TNBC.展开更多
AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This...AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.展开更多
Cardiovascular disease(CVD)is a major global health challenge,which causes significant illness and death worldwide.These include a range of conditions that affect the heart and blood vessels,including coro-nary artery...Cardiovascular disease(CVD)is a major global health challenge,which causes significant illness and death worldwide.These include a range of conditions that affect the heart and blood vessels,including coro-nary artery disease,stroke,peripheral artery disease,and heart failure.Despite advances in medicine and healthcare delivery,CVD continues to have a serious impact on individuals,families,and the healthcare system.This review begins by delineating the merits and demerits of commonly employed synthetic and natural materials for artificial blood vessels.It delves into various techniques commonly employed in the fabrication of artificial blood vessels,encompassing advanced textile technologies,electrospinning,ther-mally induced phase separation,and 3D printing.The review critically analyzes the attributes of different preparation methodologies alongside the latest advancements in research.The review also outlines the requisite performance requirements for artificial blood vessels,which encompass robust mechanical prop-erties,appropriate porosity,exceptional compatibility,and antibacterial attributes.It provides a succinct overview of ongoing effort s in vascular functionalization,particularly emphasizing thrombus mitigation,promotion of endothelialization,and enhancement of nitric oxide production.The review finally encap-sulates the primary challenges confronting vascular grafts and prospective avenues for future research.展开更多
DNA2,a multifunctional enzyme with structure-specific nuclease,5'-to-3'helicase,and DNA-dependent ATPase activities,plays a pivotal role in the cellular response to DNA damage.However,its involvement in cerebr...DNA2,a multifunctional enzyme with structure-specific nuclease,5'-to-3'helicase,and DNA-dependent ATPase activities,plays a pivotal role in the cellular response to DNA damage.However,its involvement in cerebral ischemia/reperfusion(I/R)injury remains to be elucidated.This study investigated the involvement of DNA2 in cerebral I/R injury using conditional knockout(cKO)mice(Nestin-Cre)subjected to middle cerebral artery occlusion(MCAO),an established model of cerebral I/R.Results demonstrated a gradual up-regulation of DNA2 expression,peaking at 72 h post-MCAO.Notably,DNA2 cKO mice exhibited more pronounced brain injury,neurological deficits,and neuronal apoptosis within the penumbra following MCAO.Additionally,DNA2 expression was elevated in an oxygen-glucose deprivation/reoxygenation(OGD/R)cell culture model,and DNA2 knockdown(KD)exacerbated neuronal apoptosis and oxidative stress.Transcriptome analysis of ischemic penumbra tissues via RNA sequencing revealed significant down-regulation of Homer1 in DNA2 cKO mice.Furthermore,in vitro experiments demonstrated that overexpression of Homer1a ameliorated DNA2 KD-induced neuronal apoptosis.Collectively,these findings demonstrate that DNA2 deficiency exacerbates cerebral I/R injury through the down-regulation of Homer1a,highlighting a novel regulatory axis in ischemic neuroprotection.展开更多
BACKGROUND Primary renal synovial sarcoma(PRSS)is extremely rare in clinical practice,and most cases are associated with SYT-SSX gene fusion.The PRSS with specific MDM2 gene amplification has not been reported so far....BACKGROUND Primary renal synovial sarcoma(PRSS)is extremely rare in clinical practice,and most cases are associated with SYT-SSX gene fusion.The PRSS with specific MDM2 gene amplification has not been reported so far.Therefore,there is no practical experience regarding the clinical,pathological features and diagnosis and treatment plans for patients of this type.This article reports a case of PRSS with specific MDM2 gene amplification.CASE SUMMARY The patient was preoperatively diagnosed with a malignant tumor of the left kidney(with a high probability of clear cell carcinoma).During the operation,a radical left nephrectomy was performed.The postoperative pathological examination report confirmed synovial sarcoma,and the gene test suggested PRSS with specific MDM2 gene amplification.Forty-eight days after the operation,the patient presented with"abdominal distension and diarrhea"and was found to have a huge metastatic tumor in the original left renal area.The patient died clinically 17 hours after admission due to"multiple organ failure".CONCLUSION PRSS with MDM2 gene amplification has a poorer prognosis,a higher degree of malignancy,and a faster progression,and clinicians need to be highly vigilant.展开更多
BACKGROUND Diabetic retinopathy(DR)is one of the major eye diseases contributing to blindness worldwide.Endoplasmic reticulum(ER)stress in retinal cells is a key factor leading to retinal inflammation and vascular lea...BACKGROUND Diabetic retinopathy(DR)is one of the major eye diseases contributing to blindness worldwide.Endoplasmic reticulum(ER)stress in retinal cells is a key factor leading to retinal inflammation and vascular leakage in DR,but its mechanism is still unclear.AIM To investigate the potential mechanism of LEF1 and related RNAs in DR.METHODS ARPE-19 cells were exposed to high levels of glucose for 24 hours to simulate a diabetic environment.Intraperitoneally injected streptozotocin was used to induce the rat model of DR.The expression levels of genes and related proteins were measured by RT-qPCR and Western blotting;lnc-MGC and miR-495-3p were detected by fluorescent in situ hybridization;CCK-8 and TUNEL assays were used to detect cell viability and apoptosis;enzyme-linked immunosorbent assay was used to detect inflammatory factors;dual-luciferase gene assays were used to verify the targeting relationship;and the retina was observed by HE staining.RESULTS LEF1 and lnc-MGC have binding sites,and lnc-MGC can regulate the miR-495-3p/GRP78 molecular axis.In high glucose-treated cells,inflammation was aggravated,the intracellular reactive oxygen species concentration was increased,cell viability was reduced,apoptosis was increased,the ER response was intensified,and ferroptosis was increased.As an ER molecular chaperone,GRP78 regulates the ER and ferroptosis under the targeting of miR-495-3p,whereas inhibiting LEF1 can further downregulate the expression of lnc-MGC,increase the level of miR-495-3p,and sequentially regulate the level of GRP78 to alleviate the occurrence and development of DR.Animal experiments indicated that the knockdown of LEF1 can affect the lnc-MGC/miR-495-3p/GRP78 signaling axis to restrain the progression of DR.CONCLUSION LEF1 knockdown can regulate the miR-495-3p/GRP78 molecular axis through lnc-MGC,which affects ER stress and restrains the progression of DR and ferroptosis in retinal pigment epithelial cells.展开更多
BACKGROUND The role of cerebral microvascular dysfunction in early cognitive impairment and dementia has become increasingly recognized.Furthermore,pathological changes in both Alzheimer’s disease and vascular dement...BACKGROUND The role of cerebral microvascular dysfunction in early cognitive impairment and dementia has become increasingly recognized.Furthermore,pathological changes in both Alzheimer’s disease and vascular dementia are almost always associated with cerebral hemodynamic deficits.AIM To investigate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)assessment of the blood-brain barrier(BBB)in combination with relevant plasma biomarkers for mild cognitive impairment(MCI).METHODS This study selected 50 patients with non-amnestic MCI(na-MCI group),52 patients with amnestic MCI(a-MCI group),and 55 healthy elderly controls(control group).The Chinese version of the Montreal cognitive assessment(MoCA),auditory verbal learning test(AVLT),Hamilton anxiety/depression scale(HAMA/HAMD),and activity of daily living(ADL)scales were used to analyze the characteristics of mental and behavioral symptoms of patients with MCI.The DCE-MRI technique was used to assess the contrast enhancement kinetics.The Patlak model was utilized to analyze the BBB permeability(volume transfer constants).Further,fasting blood was was used to quantify plasma homocysteine(Hcy),β-amyloid protein(Aβ)40,Aβ42,human phosphorylated tau-181 protein(p-tau181),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),and plasminogen activator inhibitor-1(PAI-1)levels,as well as serum neurofilament light chain(NFL)and glial fibrillary acidic protein(GFAP)concentrations.RESULTS The na-MCI and a-MCI groups demonstrated significantly lower MoCA and AVLT-Huashan version scores,and statistically higher HAMA,HAMD,and ADL scores compared to the control group.Moreover,the a-MCI group showed notably higher HAMA,HAMD,and ADL scores compared to the na-MCI group.Cranial MRI results revealed significant disparities in cerebral blood flow in the left and right frontal lobes,temporal lobes,hippocampi,cuneus,precuneus,parietal lobes,basal ganglia,and occipital lobes between the a-MCI and na-MCI groups.Compared to healthy controls,patients with MCI demonstrated a smaller amplitude of hippocampal contrast enhancement kinetics and a slower decay rate,indicating smaller vascular volume and increased BBB permeability.Further,Hcy,p-tau181,ICAM-1,VCAM-1,PAI-1,and NFL levels were substantially higher in the a-MCI group than in the na-MCI group,whereas the Aβ42 level was significantly lower.We did not observe any significant differences in Aβ40 and GFAP levels.CONCLUSION Patients with MCI may have experienced cerebrovascular system changes in the hippocampal region.Disorders associated with changes in cerebral blood supply may begin before pathophysiological changes are visible by imaging,which provides references for the assessment and treatment of patients with cognitive disorders.Further,DCE-MRI provides a noninvasive approach to diagnose subtle BBB leakage associated with cerebrovascular pathology.展开更多
BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life...BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.展开更多
BACKGROUND Patients with postoperative severe acute pancreatitis(SAP)in the intensive care unit(ICU)face complex challenges arising from physiological and microenvironmental imbalances,psychological stress,and the int...BACKGROUND Patients with postoperative severe acute pancreatitis(SAP)in the intensive care unit(ICU)face complex challenges arising from physiological and microenvironmental imbalances,psychological stress,and the interaction of multiple environmental factors.Traditional nursing models inadequately address this integrated microenvironment,highlighting the need for microenvironment theory-based nursing interventions to optimize outcomes.AIM To evaluate the impact of a microenvironment theory-based nursing intervention model on the prognosis of patients with postoperative SAP in the ICU.METHODS Between January 2022 and December 2024,106 patients with SAP who were admitted to ICU of the Fourth Affiliated Hospital of Soochow University(Suzhou Dushu Lake Hospital)were randomly assigned to two groups:(1)A control group(n=53,routine care);and(2)An observation group(n=53,routine care plus microenvironment theory-based nursing).Postoperative recovery,psychological distress,disease severity,and complication rates were compared between groups.RESULTS The observation group had significantly shorter postoperative flatus,defecation,and hospital stay compared with the control group(P<0.05).The Hamilton Depression Rating Scale(17-item)and Hamilton Anxiety Rating Scale(14-item)scores in the observation group were significantly lower than those in the control group(P<0.05).The observation group had a lower Acute Physiology and Chronic Health Evaluation II score(P<0.05)compared with the control group.The postoperative complication rates were 5.66%(3/53)and 18.87%(10/53)in the observation group and control group,respectively(P<0.05).CONCLUSION In patients with SAP,the microenvironment theory-based nursing intervention model facilitated postoperative recovery,alleviated depression and anxiety,reduced disease severity,and decreased postoperative complications.展开更多
BACKGROUND Gastrointestinal bleeding due to metastasis of an invasive mole to the small intestine is very rare.Most reported cases of metastatic invasive mole are diagnosed after surgery,and lack rich illustrations,wh...BACKGROUND Gastrointestinal bleeding due to metastasis of an invasive mole to the small intestine is very rare.Most reported cases of metastatic invasive mole are diagnosed after surgery,and lack rich illustrations,which leads to insufficient understanding by clinicians,misdiagnosis,and unnecessary surgeries.CASE SUMMARY A 22-year-old female patient presented with bloody stool and elevated human chorionic gonadotropin.The transvaginal gynecological ultrasound ruled out pregnancy.Upper gastrointestinal endoscopy and colonoscopy were performed,but no bleeding focus was detected.The contrast-enhanced computed tomography was unremarkable.The capsule endoscopy suggested jejunal protuberant lesions with dark red blood clots.Therefore,oral single-balloon enteroscopy was performed,and two connected protuberant lesions were detected,with blood clot traces and local ulceration.The enteroscopic biopsy revealed trophoblastic cells with a probable diagnosis of trophoblastic tumor.The patient underwent surgical resection of the diseased jejunum.Intraoperative endoscopy was performed,and the findings were the same as those of the small intestine endoscopy.The postoperative pathology confirmed the preoperative diagnosis of invasive mole.CONCLUSION In non-pregnant women with elevated human chorionic gonadotropin and gastrointestinal bleeding,metastatic trophoblastic neoplasia should be considered.展开更多
Objective:To evaluate the value of real-time two-dimensional shear wave elastography(SWE)in predicting liver parenchymal stiffness in non-alcoholic fatty liver disease(NAFLD).Methods:A total of 200 NAFLD patients(70 i...Objective:To evaluate the value of real-time two-dimensional shear wave elastography(SWE)in predicting liver parenchymal stiffness in non-alcoholic fatty liver disease(NAFLD).Methods:A total of 200 NAFLD patients(70 in the mild group,70 in the moderate group,and 60 in the severe group)and 60 healthy individuals(control group)who visited the hospital from December 2023 to December 2024 underwent real-time two-dimensional SWE examinations.Results:Except for high-density lipoprotein,comparisons of body mass index and biochemical indicators showed that the severe group>moderate group>mild group>control group,with P<0.05.Comparisons of liver stiffness values also showed that the severe group>moderate group>mild group>control group,with P<0.05.Pearson correlation analysis revealed a positive correlation between liver stiffness values and body mass index,triglycerides,total cholesterol,low-density lipoprotein,fasting blood glucose,and glycosylated hemoglobin.Analysis of the ROC curve indicated that the AUC,standard deviation,and P-value for liver stiffness values were 0.901,0.025,and 0.01,respectively,suggesting that liver stiffness values can predict the severity of NAFLD.Conclusion:The real-time two-dimensional shear wave elastography(SWE)technique for diagnosing NAFLD can differentiate between NAFLD patients and healthy individuals,as well as determine liver parenchymal stiffness,thereby assisting physicians in quantifying the degree of fatty liver.展开更多
Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for ...Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for musculoskeletal and connective tissue disorders related to six PPI formulations—omeprazole,pantoprazole,lansoprazole,esomeprazole,rabeprazole,and dexlansoprazole—from Q12004 to Q42023 were collected from the FDA Adverse Event Reporting System(FAERS).Signal detection was performed using the Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayesian Geometric Mean(EBGM).Data processing and statistical analysis were conducted using R Studio 4.40.Results:A total of 6,635,3,853,1,792,15,731,483,and 534 adverse events were identified for the six PPIs,respectively.The four algorithms(ROR,PRR,BCPNN,and EBGM)generated 17,19,8,27,5,and 2 positive signals.Notably,signals for renal osteodystrophy and osteoporosis were more frequent,with stronger signals for lumbar flexion syndrome and renal osteodystrophy.Conclusion:Patients with chronic kidney disease,a high risk of osteoporosis and fractures,or those using statins should select PPIs with a lower risk of adverse musculoskeletal and connective tissue reactions to minimize these adverse effects and ensure standardized clinical use of PPIs.展开更多
BACKGROUND Thymic epithelial neoplasms are rare malignant neoplasms originating in the thymus gland.There have been case reports of patients with advanced thymomas treated with a methylprednisolone pulse or with gluco...BACKGROUND Thymic epithelial neoplasms are rare malignant neoplasms originating in the thymus gland.There have been case reports of patients with advanced thymomas treated with a methylprednisolone pulse or with glucocorticoid(GCs)shock be-fore surgery,followed by surgical treatment,all of whom achieved good results.The effect of GCs on thymomas is related mainly to the action on GC receptors in thymic lymphocytes and epithelial cells.GC receptor expression has been asso-ciated with a better prognosis in patients with thymomas,including those with surgically removed thymomas.CASE SUMMARY We report a case of a patient with thymoma who had a significant response to preoperative low-dose GC therapy.A mediastinal tumor was detected in the patient via computerized tomography upon admission.The tumor was initially suspected to be a thymic tumor,but lymphoma could not be ruled out.The tumor shrank significantly after low-dose(5 mg/day)GC therapy.Thoracoscopic thy-moma resection was performed after puncture pathology was confirmed.The patient recovered well after the operation and is currently performing well with no recurrence of the tumor.CONCLUSION This case highlights that low-dose GCs are effective in the treatment of thymomas,and we believe that GCs should be applied more frequently and studied more thoroughly in the treatment of thymomas.展开更多
Osteosarcoma(OS),chondrosarcoma(CS),and Ewing sarcoma(ES)represent primary malignant bone tumors and pose significant challenges in oncology research and clinical management.Conventional research methods,such as two-d...Osteosarcoma(OS),chondrosarcoma(CS),and Ewing sarcoma(ES)represent primary malignant bone tumors and pose significant challenges in oncology research and clinical management.Conventional research methods,such as two-dimensional(2D)cultured tumor cells and animal models,have limitations in recapitulating the complex tumor microenvironment(TME)and often fail to translate into effective clinical treatments.The advancement of three-dimensional(3D)culture technology has revolutionized the field by enabling the development of in vitro constructed bone tumor models that closely mimic the in vivo TME.These models provide powerful tools for investigating tumor biology,assessing therapeutic responses,and advancing personalized medicine.This comprehensive review summarizes the recent advancements in research on 3D tumor models constructed in vitro for OS,CS,and ES.We discuss the various techniques employed in model construction,their applications,and the challenges and future directions in this field.The integration of advanced technologies and the incorporation of additional cell types hold promise for the development of more sophisticated and physiologically relevant models.As research in this field continues to evolve,we anticipate that these models will play an increasingly crucial role in unraveling the complexities of malignant bone tumors and accelerating the development of novel therapeutic strategies.展开更多
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.
基金supported by grants from STI2030-Major Projects,No.2021ZD0204000(to YS)Key Strategic Science and Technology Cooperation Project of the Ministry of Science and Technology of China,No.SQ2023YFE0201430(to YS)+1 种基金the National Natural Science Foundation of China,Nos.31820103005(to YS),32200620(to LW)the Natural Science Foundation of Zhejiang Province of China,No.LZ24C090003(to YS)。
文摘The cerebellum is receiving increasing attention for its cognitive,emotional,and social functions,as well as its unique metabolic profiles.Cerebellar microglia exhibit specialized and highly immunogenic phenotypes under both physiological and pathological conditions.These immune cells communicate with intrinsic and systemic factors and contribute to the structural and functional compartmentalization of the cerebellum.In this review,we discuss the roles of microglia in the cerebellar microenvironment,neuroinflammation,cerebellar adaptation,and neuronal activity,the associated molecular and cellular mechanisms,and potential therapeutic strategies targeting cerebellar microglia in the context of neuroinflammation.Future directions and unresolved questions in this field are further highlighted,particularly regarding therapeutic interventions targeting cerebellar microglia,functional mechanisms and activities of microglia in the cerebellar circuitry,neuronal connectivity,and neurofunctional outcomes of their activity.Cerebellar morphology and neuronal performance are influenced by both intrinsic and systemic factors that are actively monitored by microglia in both healthy and diseased states.Under pathological conditions,local subsets of microglia exhibit diverse responses to the altered microenvironment that contribute to the structural and functional compartmentalization of the cerebellum.Microglia in the cerebellum undergo early maturation during the embryonic stage and display specialized,highly immunogenic phenotypes.In summary,cerebellar microglia have the capacity to serve as regulatory tools that influence outcomes across a wide range of neurological and systemic conditions,including neurodevelopmental,neurodegenerative,metabolic,and stress-related disorders.
基金supported by the Jilin Science and Technology Development Talent Special Project,Nos.20240601086RC,23JQ08(all to ZH)YDZJ202502CXJD077+1 种基金JLARS-2025-0802-09YDZJ202501ZYTS706.
文摘Population aging is one of the common challenges in the current world.As people age,the body’s tissues including cells,and molecules inevitably degrade,and their functions gradually decline,causing various age-related diseases like Alzheimer’s disease,osteoporosis,low immunity,glucose and lipid metabolism disorders,and cardiovascular diseases.With the continuous increase of the elderly population,the pressure on the medical industry is increasing.To lower the burden on the medical industry and increase the average age of the elderly,it is vital to explore effective anti-aging materials.Ginseng Radix et Rhizoma(Renshen),as a traditional and precious Chinese medicinal herb,is known as the“king of all herbs”.It is famous for its effects of“tonifying Qi,restoring pulse”(helping with the generation of Qi(the fundamental,vital energy that continuously flows within the body)and the circulation of blood)and strengthening the body,nourishing the spleen and lungs,generating fluids and nourishing blood,calming the mind and improving intelligence.Recently,its anti-aging effect has received increasing attention from modern scientific research.This study summarizes the pharmacological effects of the main active ingredients of Renshen(ginsenosides,polysaccharides,etc.)on resisting aging,including preventing neuroaging,suppressing skin aging,mitigating ovarian aging,inhibiting osteoporosis and arthritis,enhancing the immune system of the elderly,protecting the cardiovascular system,resisting aging-induced fatigue and exerting the anti-tumor effects.Through network pharmacology and molecular docking,the anti-aging active ingredients of Renshen were screened,and the key targets and pathways of anti-aging active ingredients in Renshen were determined.Using network pharmacology,totally 106 drug targets and 3,479 disease targets were screened,and 79 common targets between aging and Renshen were identified.Three core targets were identified in the PPI network,including TNF,AKT1,and IL-1β.Molecular docking was used to obtain further verification.This study emphasizes the potential of Renshen as a source of anti-aging activity,which can be developed into a novel drug for the treatment of age-related diseases.
基金co-supported by the National Natural Science Foundation of China (No. 81773521)CAMS Innovation Fund for Medical Sciences (No. 2017-I2M-1006, No. 2016-12M-2-004)+4 种基金the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (No. 2018RC330001)the National Key Projects of Research and Development of China (No. 2018 YFC1315000)China Scholarship Council (No. 201908110180)the Sanming Project of Medicine in Shenzhen (No. SZSM201911015)the Cancer Screening Program in Urban China funded by National Health Commission of People’s Republic of China
文摘Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan(CNY)using 2011 values.Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stageI cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval(95%CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011(P for trend <0.001), with a cumulative increase of 2.4 times(from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages Ⅰ, Ⅱ, Ⅲ and Ⅳ were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively(P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion(52.6%).Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.
基金the National Key Research and Development Program[Grant 2017YFC1309200]Henan University Science and Technology Innovation Talents Support Program[Grant 19HASTIT005].
文摘Objective The Nutritional Risk Screening 2002(NRS 2002)was used to assess the nutritional risk of hospitalized oncology patients in China.This study explored the factors affecting the risk of nutrition to provide a scientific basis for the assessment and treatment of malnutrition in oncology patients.Methods We used the NRS 2002 to evaluate the nutritional risk in 48,831 hospitalized cancer patients.Descriptive statistical methods were used to describe the general patient information.A Chi-squared test was applied to analyze the relationship between NRS 2002 scores and different demographic characteristics,and the NRS 2002 scores of cancer patients with different characteristics were compared by one-way ANOVA.Results Among 48,831 patients,43.3%were women and 57.7%were men,and 36.5%(17,802)of patients were at risk of nutrition(score≥3).The NRS 2002 score was the highest in leukemia patients(2.93±1.28).A one-way ANOVA revealed that the differences in NRS 2002 scores among patients of different gender,ages,TNM stages,education levels,occupations and areas of residence were statistically significant(P<0.001).Male patients had slightly higher NRS 2002 scores than females(2.33 vs.2.17).The lowest NRS 2002 scores were in patients aged 45-59(2.00±1.26)years and the highest scores were in patients aged≥70(2.76±1.43)years.The NRS 2002 score of patients receiving surgery was the highest(2.45±1.41),and patients receiving surgery plus radiotherapy/chemotherapy was the lowest(2.00±1.26).The risk of nutrition was highest in patients who were farmers(2.34±1.37 scores)and lowest in office staff(2.15±1.32 scores).Patients living in rural areas had the highest risk of nutrition(2.32±1.37 scores).There were significant differences in the NRS 2002 scores for different cancer sub-types for different ethnic groups(P<0.05),except for Zhuang individuals(P=0.124).The risk of nutrition was highest in Uyghur patients(3.35±1.33 scores)and lowest in Mongolians(2.04±1.37 scores).Conclusion More attention should be paid to people at high risk of nutrition,such as elderly patients,patients with a high TNM stage,patients receiving surgical treatment,and patients living in rural areas.Active nutritional interventions should be carried out to improve the nutritional status of malnourished patients.
基金supported by the National KeyResearch and Development Program(No.2022YFC2009600 andNo.2022YFC2009601).
文摘Background: The purpose of this study is to evaluate the quality of life(QoL) of hospitalized patients in China suffering from digestive system malignancies and to identify potential risk factors for a decrease in QoL.Methods: The European Organization for Research and Treatment Core Quality of Life questionnaire(EORTC QLQ-C30) was applied to evaluate the QoL of 23,519 patients with six digestive malignancies(esophageal cancer, gastric cancer, colorectal cancer, liver cancer, biliary tract cancer, and pancreatic cancer). A t test or analysis of variance was employed to analyze the total EORTC QLQ-C30 scale scores and domain scores of the EORTC QLQ-C30 scale among patients in different subgroups.Results: The average QoL score was 50.4 ± 10.8. The tumor type, age, sex, and TNM stage al had an impact on QoL ratings. Colorectal cancer patients had a better total QoL score(49.3 ± 10.3) and scores in the domains of functioning, with milder symptoms, except for diarrhea. Patients with biliary tract cancer(54.2 ± 12.3) and pancreatic cancer(54.2 ± 12.3) reported a poorer QoL, significant functional impairment, and more pronounced symptoms. Patients with esophageal cancer experienced the most severe financial difficulties(35.2 ± 27.5). Patients aged ≥65 years, women, and those with TNM stage Ⅲ/Ⅳ reported lower QoL. In addition, the disparities in total QoL scores and scores in specific domains were significant among patients with some types of tumors, and based on ethnicity, educational level, occupation, treatment(s) received, and place of residence.Conclusions: There is a need to focus on elderly individuals, those with low educational levels, and patients with progressive malignant tumors and to improve routine disease monitoring and symptom management to enhance the quality of life for patients with malignancies of the digestive system.
基金supported by Shandong Provincial Natural Science Foundation(no.ZR2020MH319).
文摘Triple-negative breast cancer(TNBC)is currently the most heterogeneous and aggressive breast cancer type.It has a high recurrence rate,poor clinical prospects,and lack of predictive markers and potential treatment options.Dysregulated microRNAs(miRNAs)are involved in various cellular processes in TNBC.Moreover,variations in the miRNA levels in TNBC may act as a dependable indicator for predicting the effectiveness and specificity of treatments.Currently,the application of miRNAs for breast cancer therapy is primarily in the preclinical stage,with a focus on identifying highly specific and sensitive miRNAs that could offer new possibilities for early diagnosis,clinical treat-ment,and prognostic monitoring of TNBC.
基金Supported by the Suzhou Medical Innovation Application Research Project(SZM2023027).
文摘AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.
基金the National Natural Science Foundation of China(No.82374295)the National Key R&D Program of China(No.2021YFE0111100)+1 种基金the Science and Technol-ogy Partnership Program by the Ministry of Science and Technol-ogy of China(No.KY202201002)the Jiangsu Provincial De-partment of Science and Technology(No.BZ2022017).
文摘Cardiovascular disease(CVD)is a major global health challenge,which causes significant illness and death worldwide.These include a range of conditions that affect the heart and blood vessels,including coro-nary artery disease,stroke,peripheral artery disease,and heart failure.Despite advances in medicine and healthcare delivery,CVD continues to have a serious impact on individuals,families,and the healthcare system.This review begins by delineating the merits and demerits of commonly employed synthetic and natural materials for artificial blood vessels.It delves into various techniques commonly employed in the fabrication of artificial blood vessels,encompassing advanced textile technologies,electrospinning,ther-mally induced phase separation,and 3D printing.The review critically analyzes the attributes of different preparation methodologies alongside the latest advancements in research.The review also outlines the requisite performance requirements for artificial blood vessels,which encompass robust mechanical prop-erties,appropriate porosity,exceptional compatibility,and antibacterial attributes.It provides a succinct overview of ongoing effort s in vascular functionalization,particularly emphasizing thrombus mitigation,promotion of endothelialization,and enhancement of nitric oxide production.The review finally encap-sulates the primary challenges confronting vascular grafts and prospective avenues for future research.
基金supported by the National Natural Science Foundation of China (32070979)Shenzhen Science and Technology Program (JCYJ20220530161604009,JCYJ20240813150734043)+3 种基金Key Research and Development Program of Shaanxi (2024SF,YBXM,050)Fundamental Research Funds for the Central Universities (31020190QD004,3102019YX01001)Double First-Class Project of China Pharmaceutical University (CPUQNJC22_02)Global Pharmaceutical Development Alliance Plan of China Pharmaceutical University (1302090024-05)。
文摘DNA2,a multifunctional enzyme with structure-specific nuclease,5'-to-3'helicase,and DNA-dependent ATPase activities,plays a pivotal role in the cellular response to DNA damage.However,its involvement in cerebral ischemia/reperfusion(I/R)injury remains to be elucidated.This study investigated the involvement of DNA2 in cerebral I/R injury using conditional knockout(cKO)mice(Nestin-Cre)subjected to middle cerebral artery occlusion(MCAO),an established model of cerebral I/R.Results demonstrated a gradual up-regulation of DNA2 expression,peaking at 72 h post-MCAO.Notably,DNA2 cKO mice exhibited more pronounced brain injury,neurological deficits,and neuronal apoptosis within the penumbra following MCAO.Additionally,DNA2 expression was elevated in an oxygen-glucose deprivation/reoxygenation(OGD/R)cell culture model,and DNA2 knockdown(KD)exacerbated neuronal apoptosis and oxidative stress.Transcriptome analysis of ischemic penumbra tissues via RNA sequencing revealed significant down-regulation of Homer1 in DNA2 cKO mice.Furthermore,in vitro experiments demonstrated that overexpression of Homer1a ameliorated DNA2 KD-induced neuronal apoptosis.Collectively,these findings demonstrate that DNA2 deficiency exacerbates cerebral I/R injury through the down-regulation of Homer1a,highlighting a novel regulatory axis in ischemic neuroprotection.
基金Supported by The Joint Special Project of Universities in Yunnan Province in 2022,No.2022-ES-530101-207The Hospital-level Scientific Research Project of The Fourth Affiliated Hospital of Dali University,No.2024YJ14.
文摘BACKGROUND Primary renal synovial sarcoma(PRSS)is extremely rare in clinical practice,and most cases are associated with SYT-SSX gene fusion.The PRSS with specific MDM2 gene amplification has not been reported so far.Therefore,there is no practical experience regarding the clinical,pathological features and diagnosis and treatment plans for patients of this type.This article reports a case of PRSS with specific MDM2 gene amplification.CASE SUMMARY The patient was preoperatively diagnosed with a malignant tumor of the left kidney(with a high probability of clear cell carcinoma).During the operation,a radical left nephrectomy was performed.The postoperative pathological examination report confirmed synovial sarcoma,and the gene test suggested PRSS with specific MDM2 gene amplification.Forty-eight days after the operation,the patient presented with"abdominal distension and diarrhea"and was found to have a huge metastatic tumor in the original left renal area.The patient died clinically 17 hours after admission due to"multiple organ failure".CONCLUSION PRSS with MDM2 gene amplification has a poorer prognosis,a higher degree of malignancy,and a faster progression,and clinicians need to be highly vigilant.
基金Supported by Science and Technology Program of Yunnan Provincial Department of Science and Technology-Basic Research Program,No.202301BA070001-025.
文摘BACKGROUND Diabetic retinopathy(DR)is one of the major eye diseases contributing to blindness worldwide.Endoplasmic reticulum(ER)stress in retinal cells is a key factor leading to retinal inflammation and vascular leakage in DR,but its mechanism is still unclear.AIM To investigate the potential mechanism of LEF1 and related RNAs in DR.METHODS ARPE-19 cells were exposed to high levels of glucose for 24 hours to simulate a diabetic environment.Intraperitoneally injected streptozotocin was used to induce the rat model of DR.The expression levels of genes and related proteins were measured by RT-qPCR and Western blotting;lnc-MGC and miR-495-3p were detected by fluorescent in situ hybridization;CCK-8 and TUNEL assays were used to detect cell viability and apoptosis;enzyme-linked immunosorbent assay was used to detect inflammatory factors;dual-luciferase gene assays were used to verify the targeting relationship;and the retina was observed by HE staining.RESULTS LEF1 and lnc-MGC have binding sites,and lnc-MGC can regulate the miR-495-3p/GRP78 molecular axis.In high glucose-treated cells,inflammation was aggravated,the intracellular reactive oxygen species concentration was increased,cell viability was reduced,apoptosis was increased,the ER response was intensified,and ferroptosis was increased.As an ER molecular chaperone,GRP78 regulates the ER and ferroptosis under the targeting of miR-495-3p,whereas inhibiting LEF1 can further downregulate the expression of lnc-MGC,increase the level of miR-495-3p,and sequentially regulate the level of GRP78 to alleviate the occurrence and development of DR.Animal experiments indicated that the knockdown of LEF1 can affect the lnc-MGC/miR-495-3p/GRP78 signaling axis to restrain the progression of DR.CONCLUSION LEF1 knockdown can regulate the miR-495-3p/GRP78 molecular axis through lnc-MGC,which affects ER stress and restrains the progression of DR and ferroptosis in retinal pigment epithelial cells.
文摘BACKGROUND The role of cerebral microvascular dysfunction in early cognitive impairment and dementia has become increasingly recognized.Furthermore,pathological changes in both Alzheimer’s disease and vascular dementia are almost always associated with cerebral hemodynamic deficits.AIM To investigate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)assessment of the blood-brain barrier(BBB)in combination with relevant plasma biomarkers for mild cognitive impairment(MCI).METHODS This study selected 50 patients with non-amnestic MCI(na-MCI group),52 patients with amnestic MCI(a-MCI group),and 55 healthy elderly controls(control group).The Chinese version of the Montreal cognitive assessment(MoCA),auditory verbal learning test(AVLT),Hamilton anxiety/depression scale(HAMA/HAMD),and activity of daily living(ADL)scales were used to analyze the characteristics of mental and behavioral symptoms of patients with MCI.The DCE-MRI technique was used to assess the contrast enhancement kinetics.The Patlak model was utilized to analyze the BBB permeability(volume transfer constants).Further,fasting blood was was used to quantify plasma homocysteine(Hcy),β-amyloid protein(Aβ)40,Aβ42,human phosphorylated tau-181 protein(p-tau181),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),and plasminogen activator inhibitor-1(PAI-1)levels,as well as serum neurofilament light chain(NFL)and glial fibrillary acidic protein(GFAP)concentrations.RESULTS The na-MCI and a-MCI groups demonstrated significantly lower MoCA and AVLT-Huashan version scores,and statistically higher HAMA,HAMD,and ADL scores compared to the control group.Moreover,the a-MCI group showed notably higher HAMA,HAMD,and ADL scores compared to the na-MCI group.Cranial MRI results revealed significant disparities in cerebral blood flow in the left and right frontal lobes,temporal lobes,hippocampi,cuneus,precuneus,parietal lobes,basal ganglia,and occipital lobes between the a-MCI and na-MCI groups.Compared to healthy controls,patients with MCI demonstrated a smaller amplitude of hippocampal contrast enhancement kinetics and a slower decay rate,indicating smaller vascular volume and increased BBB permeability.Further,Hcy,p-tau181,ICAM-1,VCAM-1,PAI-1,and NFL levels were substantially higher in the a-MCI group than in the na-MCI group,whereas the Aβ42 level was significantly lower.We did not observe any significant differences in Aβ40 and GFAP levels.CONCLUSION Patients with MCI may have experienced cerebrovascular system changes in the hippocampal region.Disorders associated with changes in cerebral blood supply may begin before pathophysiological changes are visible by imaging,which provides references for the assessment and treatment of patients with cognitive disorders.Further,DCE-MRI provides a noninvasive approach to diagnose subtle BBB leakage associated with cerebrovascular pathology.
文摘BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.
文摘BACKGROUND Patients with postoperative severe acute pancreatitis(SAP)in the intensive care unit(ICU)face complex challenges arising from physiological and microenvironmental imbalances,psychological stress,and the interaction of multiple environmental factors.Traditional nursing models inadequately address this integrated microenvironment,highlighting the need for microenvironment theory-based nursing interventions to optimize outcomes.AIM To evaluate the impact of a microenvironment theory-based nursing intervention model on the prognosis of patients with postoperative SAP in the ICU.METHODS Between January 2022 and December 2024,106 patients with SAP who were admitted to ICU of the Fourth Affiliated Hospital of Soochow University(Suzhou Dushu Lake Hospital)were randomly assigned to two groups:(1)A control group(n=53,routine care);and(2)An observation group(n=53,routine care plus microenvironment theory-based nursing).Postoperative recovery,psychological distress,disease severity,and complication rates were compared between groups.RESULTS The observation group had significantly shorter postoperative flatus,defecation,and hospital stay compared with the control group(P<0.05).The Hamilton Depression Rating Scale(17-item)and Hamilton Anxiety Rating Scale(14-item)scores in the observation group were significantly lower than those in the control group(P<0.05).The observation group had a lower Acute Physiology and Chronic Health Evaluation II score(P<0.05)compared with the control group.The postoperative complication rates were 5.66%(3/53)and 18.87%(10/53)in the observation group and control group,respectively(P<0.05).CONCLUSION In patients with SAP,the microenvironment theory-based nursing intervention model facilitated postoperative recovery,alleviated depression and anxiety,reduced disease severity,and decreased postoperative complications.
文摘BACKGROUND Gastrointestinal bleeding due to metastasis of an invasive mole to the small intestine is very rare.Most reported cases of metastatic invasive mole are diagnosed after surgery,and lack rich illustrations,which leads to insufficient understanding by clinicians,misdiagnosis,and unnecessary surgeries.CASE SUMMARY A 22-year-old female patient presented with bloody stool and elevated human chorionic gonadotropin.The transvaginal gynecological ultrasound ruled out pregnancy.Upper gastrointestinal endoscopy and colonoscopy were performed,but no bleeding focus was detected.The contrast-enhanced computed tomography was unremarkable.The capsule endoscopy suggested jejunal protuberant lesions with dark red blood clots.Therefore,oral single-balloon enteroscopy was performed,and two connected protuberant lesions were detected,with blood clot traces and local ulceration.The enteroscopic biopsy revealed trophoblastic cells with a probable diagnosis of trophoblastic tumor.The patient underwent surgical resection of the diseased jejunum.Intraoperative endoscopy was performed,and the findings were the same as those of the small intestine endoscopy.The postoperative pathology confirmed the preoperative diagnosis of invasive mole.CONCLUSION In non-pregnant women with elevated human chorionic gonadotropin and gastrointestinal bleeding,metastatic trophoblastic neoplasia should be considered.
文摘Objective:To evaluate the value of real-time two-dimensional shear wave elastography(SWE)in predicting liver parenchymal stiffness in non-alcoholic fatty liver disease(NAFLD).Methods:A total of 200 NAFLD patients(70 in the mild group,70 in the moderate group,and 60 in the severe group)and 60 healthy individuals(control group)who visited the hospital from December 2023 to December 2024 underwent real-time two-dimensional SWE examinations.Results:Except for high-density lipoprotein,comparisons of body mass index and biochemical indicators showed that the severe group>moderate group>mild group>control group,with P<0.05.Comparisons of liver stiffness values also showed that the severe group>moderate group>mild group>control group,with P<0.05.Pearson correlation analysis revealed a positive correlation between liver stiffness values and body mass index,triglycerides,total cholesterol,low-density lipoprotein,fasting blood glucose,and glycosylated hemoglobin.Analysis of the ROC curve indicated that the AUC,standard deviation,and P-value for liver stiffness values were 0.901,0.025,and 0.01,respectively,suggesting that liver stiffness values can predict the severity of NAFLD.Conclusion:The real-time two-dimensional shear wave elastography(SWE)technique for diagnosing NAFLD can differentiate between NAFLD patients and healthy individuals,as well as determine liver parenchymal stiffness,thereby assisting physicians in quantifying the degree of fatty liver.
文摘Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for musculoskeletal and connective tissue disorders related to six PPI formulations—omeprazole,pantoprazole,lansoprazole,esomeprazole,rabeprazole,and dexlansoprazole—from Q12004 to Q42023 were collected from the FDA Adverse Event Reporting System(FAERS).Signal detection was performed using the Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayesian Geometric Mean(EBGM).Data processing and statistical analysis were conducted using R Studio 4.40.Results:A total of 6,635,3,853,1,792,15,731,483,and 534 adverse events were identified for the six PPIs,respectively.The four algorithms(ROR,PRR,BCPNN,and EBGM)generated 17,19,8,27,5,and 2 positive signals.Notably,signals for renal osteodystrophy and osteoporosis were more frequent,with stronger signals for lumbar flexion syndrome and renal osteodystrophy.Conclusion:Patients with chronic kidney disease,a high risk of osteoporosis and fractures,or those using statins should select PPIs with a lower risk of adverse musculoskeletal and connective tissue reactions to minimize these adverse effects and ensure standardized clinical use of PPIs.
文摘BACKGROUND Thymic epithelial neoplasms are rare malignant neoplasms originating in the thymus gland.There have been case reports of patients with advanced thymomas treated with a methylprednisolone pulse or with glucocorticoid(GCs)shock be-fore surgery,followed by surgical treatment,all of whom achieved good results.The effect of GCs on thymomas is related mainly to the action on GC receptors in thymic lymphocytes and epithelial cells.GC receptor expression has been asso-ciated with a better prognosis in patients with thymomas,including those with surgically removed thymomas.CASE SUMMARY We report a case of a patient with thymoma who had a significant response to preoperative low-dose GC therapy.A mediastinal tumor was detected in the patient via computerized tomography upon admission.The tumor was initially suspected to be a thymic tumor,but lymphoma could not be ruled out.The tumor shrank significantly after low-dose(5 mg/day)GC therapy.Thoracoscopic thy-moma resection was performed after puncture pathology was confirmed.The patient recovered well after the operation and is currently performing well with no recurrence of the tumor.CONCLUSION This case highlights that low-dose GCs are effective in the treatment of thymomas,and we believe that GCs should be applied more frequently and studied more thoroughly in the treatment of thymomas.
基金supported by the Zhejiang Province Basic Public Welfare Research Program(No.TGD24H160005),China。
文摘Osteosarcoma(OS),chondrosarcoma(CS),and Ewing sarcoma(ES)represent primary malignant bone tumors and pose significant challenges in oncology research and clinical management.Conventional research methods,such as two-dimensional(2D)cultured tumor cells and animal models,have limitations in recapitulating the complex tumor microenvironment(TME)and often fail to translate into effective clinical treatments.The advancement of three-dimensional(3D)culture technology has revolutionized the field by enabling the development of in vitro constructed bone tumor models that closely mimic the in vivo TME.These models provide powerful tools for investigating tumor biology,assessing therapeutic responses,and advancing personalized medicine.This comprehensive review summarizes the recent advancements in research on 3D tumor models constructed in vitro for OS,CS,and ES.We discuss the various techniques employed in model construction,their applications,and the challenges and future directions in this field.The integration of advanced technologies and the incorporation of additional cell types hold promise for the development of more sophisticated and physiologically relevant models.As research in this field continues to evolve,we anticipate that these models will play an increasingly crucial role in unraveling the complexities of malignant bone tumors and accelerating the development of novel therapeutic strategies.
