Background Hospitalized elderly patients are at high risk of venous thromboembolism(VTE),and the appropriate use of thromboprophylaxis can significantly reduce the incidence of VTE in high-risk patients.We investigate...Background Hospitalized elderly patients are at high risk of venous thromboembolism(VTE),and the appropriate use of thromboprophylaxis can significantly reduce the incidence of VTE in high-risk patients.We investigated the pattern of VTE prophylaxis administration among elderly medical patients and assessed its appropriateness based on the American College of Chest Physicians(ACCP)recommendations.Methods A cross-sectional single-center study was conducted between October 2019 and March 2020,including hospitalized(>48 h),elderly(≥60 years),medical patients,and excluding patients receiving anticoagulant for other reason,having contraindication to thromboprophylaxis,or had VTE diagnosed within 48 h.The Padua prediction score was used to determine the patients’risk for VTE,and thromboprophylaxis use was assessed against the ACCP recommendations.Results The study included 396 patients with an average age of 75.0±9.01 years,and most patients(71.7%)were classified as high risk for VTE development(Padua score≥4 points).Thromboprophylaxis use was inappropriate in 27.3%of patients,of whom 85.2%were ineligible but still received thromboprophylaxis.Patients who were classified as low risk of VTE were more likely to receive inappropriate thromboprophylaxis(AOR=76.5,95%CI:16.1-363.2),whereas patients with acute infection or rheumatologic disorder were less likely to receive inappropriate thromboprophylaxis(AOR=0.46,95%CI:0.22-0.96).Conclusions Although the use of thromboprophylaxis among high-risk elderly patients was reasonably adequate,a large proportion of low-risk patients were exposed to unnecessary risk through inappropriate overutilization of thromboprophylaxis.Thus,healthcare providers should accurately assess patients’risk before prescribing thromboprophylaxis to ensure patient safety.展开更多
The tree shrew(Tupaia belangeri)has long been proposed as a suitable alternative to non-human primates(NHPs)in biomedical and laboratory research due to its close evolutionary relationship with primates.In recent year...The tree shrew(Tupaia belangeri)has long been proposed as a suitable alternative to non-human primates(NHPs)in biomedical and laboratory research due to its close evolutionary relationship with primates.In recent years,significant advances have facilitated tree shrew studies,including the determination of the tree shrew genome,genetic manipulation using spermatogonial stem cells,viral vector-mediated gene delivery,and mapping of the tree shrew brain atlas.However,the limited availability of tree shrews globally remains a substantial challenge in the field.Additionally,determining the key questions best answered using tree shrews constitutes another difficulty.Tree shrew models have historically been used to study hepatitis B virus(HBV)and hepatitis C virus(HCV)infection,myopia,and psychosocial stress-induced depression,with more recent studies focusing on developing animal models for infectious and neurodegenerative diseases.Despite these efforts,the impact of tree shrew models has not yet matched that of rodent or NHP models in biomedical research.This review summarizes the prominent advancements in tree shrew research and reflects on the key biological questions addressed using this model.We emphasize that intensive dedication and robust international collaboration are essential for achieving breakthroughs in tree shrew studies.The use of tree shrews as a unique resource is expected to gain considerable attention with the application of advanced techniques and the development of viable animal models,meeting the increasing demands of life science and biomedical research.展开更多
BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the ...BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the infection.AIM To examine whether COVID-19 infection is associated with exacerbation,recurrence,or progression of pre-existing neurological or psychiatric disorders-a highrisk population that is underrepresented in COVID-19 outcome research in National Guard Health Affair patients in 4-years following a COVID-19 diagnosis.METHODS For this multicenter retrospective cohort study,we used data from the National Guard hospitals electronic health records network(BestCare)with over 10 million patients.Our cohort comprised patients who had a COVID-19 diagnosis;a matched control cohort included patient did not expose to COVID-19 in same period.Age and sex were matching factors.We estimated the incidence of 14 neurological and psychiatric outcomes in nearly 4 years after a confirmed diagnosis of COVID-19.Using a multiple logistic regression,we compared incidences with those in propensity score-matched cohorts of patients with no exposure to COVID-19.Ramadan M et al.Neurological and psychiatric risks post-COVID-19 RESULTS Our primary cohort comprised 4437 patients diagnosed with COVID-19,and our propensity-score 1:1 matched control cohort comprised 4437 individuals.Nearly two-third of the COVID-19 cohort(71%)were diagnosed in 2020,and 2021.The most prevalent diagnoses for both cohorts were epilepsy 30.68%,mood disorder 23.92%,and nerve plexus disorder 22.13%.Dementia was nearly 4 times higher among COVID-19 cohort(8.27%)compared to the control cohort(2.57%).Five neurological and psychiatric outcomes had odds ratios(OR)that were significantly higher than 1 for people who had COVID-19 compared to people who had never been infected.These outcomes were cognitive deficit OR=1.54,95%confidence interval(CI):1.23-1.91,P=0.0001;nerve plexus disorder OR=1.13,95%CI:1.01-1.25,P=0.02;substance use disorder OR=1.95,95%CI:1.12-3.38,P=0.01;mood disorder OR=1.16,95%CI:1.05-1.29,P=0.003;and anxiety disorder OR=1.39,95%CI:1.07-1.79,P=0.01.CONCLUSION The study highlights the persistent risk of neurological and psychiatric conditions in COVID-19 survivors up to four years post-infection.Although the incidence was lower than in previous large studies,long-term consequences remain significant,emphasizing the need for ongoing monitoring and support in mental health and neurological care.展开更多
Background:Anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA)is a rare congenital anomalous coronary artery origin disorder.Objective:We sought to summarize the clinical experience and prog...Background:Anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA)is a rare congenital anomalous coronary artery origin disorder.Objective:We sought to summarize the clinical experience and prognostic characteristics of surgical treatment of ALCAPA.Methods:We retrospectively analyzed clinical information on patients who had ALCAPA and underwent surgery at our center from February 2016 to October 2023.Results:This comparative study of 23 ALCAPA patients(9 infants<1 year;14 children>1 year)demonstrated significant age-dependent outcomes.Infant patients exhibited markedly prolonged mechanical ventilation(183±105.6 vs.48.5±62.2 min,p=0.001)and hospitalization(30.8±8.2 vs.19.5±6.2 days,p=0.001),despite comparable operative times(p>0.05).The perioperative mortality rate was 8.7%(2/23).Early postoperative mortality showed a non-significant trend in infants(22.2%vs.0%,p=0.11).Serial follow-up revealed substantial functional improvement,with abnormal left ventricular ejection fractions decreasing from 56.5%preoperatively to 14.3%at 1-month(p<0.01),and severe mitral regurgitation declining from 34.7%to 14.3%.However,persistent left ventricular enlargement(81%at follow-up)and moderate mitral regurgitation(52.4%)were frequently observed.Conclusion:Surgical correction of ALCPA effectively restores coronary perfusion and reduces severe mitral regurgitation,though residual ventricular dilation and moderate valvular dysfunction persist in the short-term postoperative period.Nevertheless,the overall prognosis remains favorable when timely intervention is performed.展开更多
Cancer remains a major global health concern,with escalating incidence and mortality rates underscoring the urgent need for novel diagnostic and therapeutic strategies.Increasing evidence has identified the oral micro...Cancer remains a major global health concern,with escalating incidence and mortality rates underscoring the urgent need for novel diagnostic and therapeutic strategies.Increasing evidence has identified the oral microbiota as a critical contributor to tumorigenesis,thereby expanding the understanding of cancer pathogenesis beyond conventional risk factors such as tobacco use and genetic predisposition.This review summarizes recent progress in elucidating the complex relationship between the oral microbiota and various malignancies,particularly oral squamous cell carcinoma,esophageal adenocarcinoma,and pancreatic ductal adenocarcinoma.Pathogenic bacteria,including Porphyromonas gingivalis and Fusobacterium nucleatum,have been implicated in promoting tumor progression through mechanisms involving chronic inflammation,the production of metabolic toxins,and immune evasion.The dysbiosis of the oral microbiota,often driven by lifestyle factors such as poor diet,tobacco use,and alcohol consumption,further exacerbates these carcinogenic processes.Emerging therapeutic approaches including probiotics,oral microbiota transplantation,and CRISPR-based bacterial editing are under investigation for their potential to restore microbial homeostasis and suppress pathogenic species.Additionally,saliva-based microbial biomarkers have shown promise for non-invasive cancer screening.The integration of multi-omics technologies and artificial intelligence-driven platforms is further advancing the development of precision oncology.This review aims to consolidate fragmented findings concerning the oral microbiota-cancer axis and address existing gaps in mechanistic understanding.The review’s significance lies in the translational potential of microbial research to clinical applications,offering opportunities to reduce the global cancer burden through early detection and microbiota-targeted therapies.展开更多
Background:Three-dimensional(3D)printing has revolutionized craniofacial and craniomaxillofacial applications,leading to substantial advancements in patient-specific treatments.In this study,a bibliometric analysis wa...Background:Three-dimensional(3D)printing has revolutionized craniofacial and craniomaxillofacial applications,leading to substantial advancements in patient-specific treatments.In this study,a bibliometric analysis was performed to identify the key contributors,research trends,thematic developments,and collaboration networks in this evolving field.Methods:Two search strategies were employed to ensure a comprehensive analysis:(1)a broad search,in which selected keywords were searched in the title,abstract,and keyword fields to capture all relevant publications,and(2)a title-specific search,in which keywords were restricted to the title field to identify publications with a strong focus on 3D printing in craniofacial and craniomaxillofacial applications.The retrieved dataset was analyzed using VOSviewer and RStudio(bibliometrix package).Results:The broad search retrieved 3534 publications,whereas the title-specific search yielded 280 publications.The analysis of these 280 papers focused on identifying the top authors,universities,and countries,as well as their research dynamics and collaboration networks.A more detailed approach was adopted by examining the titles of these 280 papers.VOSviewer segmented the titles into approximately 800 words,which were then categorized into 18 distinct thematic groups to represent research trends.The focus areas of the ten most cited papers were also analyzed.Conclusion:This bibliometric study provides valuable insights into the progress in 3D printing for craniofacial and craniomaxillofacial applications.By highlighting the key contributors,thematic developments,and collaborative networks,this study offers a foundation for future research in this rapidly advancing field.展开更多
Background: Peripheral nerve regeneration is a critical research area with significant implications for neurology,neurosurgery,and regenerative medicine.A bibliometric analysis was conducted to provide a structured ov...Background: Peripheral nerve regeneration is a critical research area with significant implications for neurology,neurosurgery,and regenerative medicine.A bibliometric analysis was conducted to provide a structured overview of research trends,intellectual impact,and evolving themes in peripheral nerve regeneration.This study aimed to identify the most influential research articles on peripheral nerve regeneration;analyze keyword trends,thematic evolution,and co-word structures;assess the contributions of top authors,universities,and countries;and examine collaboration networks and research dynamics.Methods: A systematic bibliometric approach was employed using two search strategies.The first strategy involved searching within the title,abstract,and keyword fields,yielding 15 317 papers,whereas the second strategy was restricted to searching titles only,retrieving 3 531 papers.From these,the 100 most cited papers were selected for analysis.A thematic analysis was conducted using co-word clustering.The leading contributors were ranked according to the number of publications,citations,h-index,g-index,and m-index.Results: The bibliometric analysis provided several key insights.Keyword analysis using bi-and tri-gram techniques revealed the dominant research themes within the field.The top contributors,including authors,universities,and countries,were ranked based on their productivity and citation impact.Collaboration networks were mapped at the author,institutional,and country levels,highlighting key partnerships and global research interactions.Thematic analysis classified research into seven major domains: neural regeneration and repair;cellular and molecular biology;biomaterials and tissue engineering;experimental studies and statistical analyses;functional and therapeutic aspects;neuropathic pain and peripheral nerve disorders;and Schwann cell and cellular responses.Additionally,the ten most influential papers were reviewed in detail to understand their contributions to the field.Conclusion: This study provides a comprehensive and structured overview of peripheral nerve regeneration research.These findings offer valuable insights into the intellectual foundation of the field by identifying key contributors,research trends,and collaboration patterns.The results serve as a guide for future research,helping researchers to navigate the evolving landscape of peripheral nerve regeneration.展开更多
Background:The Cre/loxP system is most popular in mice,but its application in rats has largely lagged far behind.The rat is vital laboratory animal,especially in toxicological and neurological studies.Generating genet...Background:The Cre/loxP system is most popular in mice,but its application in rats has largely lagged far behind.The rat is vital laboratory animal,especially in toxicological and neurological studies.Generating genetic tools to manipulate neurons in rats could benefit neurological research.Methods:Using the CRISPR/Cas9 system,we inserted a Cre cassette into endogenous Thy1 and NeuN loci.Thy1-Cre rats featured a downstream P2A-linked insertion,while NeuN-Cre was inserted at the transcriptional start site.The Cre activity was assessed by crossing with a Cre reporter(Rosa26 imCherry)rat and through analyzing mCherry expression patterns.The specificity of cell type was further confirmed by immunofluorescence with NeuN antibody.Phenotypic consequences were assessed by crossing with ND1^(LSL) rats to deplete ND1,followed by monitoring weight/survival and conducting motor function tests.Results:We generated two neuron-specific rats(Thy1-Cre and NeuN-Cre),which exhibited high neuron-specific Cre expression in brain and spinal cord with minor leakage in other tissues.Thy1-Cre showed minor leakage in spleen,lung and kidney while NeuN-Cre showed minor leakage in spleen and kidney.ND1^(Thy1-Cre) and ND1^(NeuN-Cre) rats both showed decreased body weights and survival times.The ND1^(NeuN-Cre) rats died within two weeks,while ND1^(Thy1-Cre) rats lived longer with impaired motor function.Conclusions:We successfully generated two neuron-specific NeuN-Cre and Thy1-Cre rats,and systemically analyzed their expression pattern.展开更多
Objective To assess the effect of upper urinary tract(UUT)urolithiasis on urology services in a region with a high prevalence of the condition,and analyze the trends in endourological procedures for treating UUT uroli...Objective To assess the effect of upper urinary tract(UUT)urolithiasis on urology services in a region with a high prevalence of the condition,and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.Methods Using the hospital surgery statistics database,data were gathered from the urology departments of 11 hospitals in Saudi Arabia.The analysis focused on the trends,distribution,and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.Results Out of the total surgery performed(54711),over half(31039,57%)were related to UUT urolithiasis.Extracorporeal shock wave lithotripsy(ESWL)was the most performed procedure among stone-related procedures,accounting for 38%of all procedures.Double-J stent insertion,flexible ureteroscopy(URS),semi-rigid URS,percutaneous nephrolithotomy,and pyelo-and uretero-lithotomy accounted for 25%,19%,14%,3.8%,and 0.35%,respectively.Notably,the number of stone-related UUT procedures in 2022 increased by 35%(from 4671 to 6283)compared to 2017.In the year 2022 compared to 2017,there was a statistically significant increase in the rate of all stone-related UUT procedures(p<0.001),except for ESWL and pyelo-and uretero-lithotomy.The rates of ESWL procedures reduced from 21%in 2017 to 13%in 2022(p<0.001).Overall,the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107%(47.7 million SAR in 2022 vs.23.0 million SAR in 2017).Conclusion Our research findings suggest that urolithiasis poses a significant burden,accounting for over half of all urological surgery performed at the participating centers.Furthermore,there has been a 35%rise in stone-related UUT procedures over the past 6 years.Percutaneous nephrolithotomy,flexible URS,and semi-rigid URS have experienced significant increase in usage.Furthermore,in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.展开更多
BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges f...BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.展开更多
We read with great interest the investigation of Kang et al related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer pa...We read with great interest the investigation of Kang et al related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients with gene mutations.The authors focused on decision-making based on the integration of tumor differentiation,signal intensity ratio,margin distance,and magnetic resonance imaging-detected lymph node metastasis.Indeed,these multiparameter predictive models could also be used for diagnosis as an alternative to invasive tissue examination methods.However,progress in this field enables us to shift the paradigm to radiology biopsies,particularly given the nonlinear effects of various radiation sources.展开更多
We read with the great interest the study by Ababneh et al in which inducedmesenchymal stem cell-derived exosomes were shown to exhibit a stronger andmore sustained anti-proliferative effect by inducing a senescence-l...We read with the great interest the study by Ababneh et al in which inducedmesenchymal stem cell-derived exosomes were shown to exhibit a stronger andmore sustained anti-proliferative effect by inducing a senescence-like state withoutapoptosis.The results obtained by the authors highlight the features of theeffects of senescent drift induction in surrounding tissues.In the light of thesefindings,the role of the properties of extracellular matrix and cellular glycocalyxin responses of human tumors to therapy remain uninvestigated.These extracellularbarriers appear to be significant obstacles to effective cancer therapy,especiallyin relation to the use of unique properties of tumor microenvironment forthe immunotherapy-resistant cancer treatment.展开更多
Acute pancreatitis(AP)is sudden inflammation of the pancreas,which can lead to multiple organ dysfunction in severe cases.Hypertriglyceridemia(HTG)is the third most common cause.In recent years,HTG-induced AP(HTG-AP)h...Acute pancreatitis(AP)is sudden inflammation of the pancreas,which can lead to multiple organ dysfunction in severe cases.Hypertriglyceridemia(HTG)is the third most common cause.In recent years,HTG-induced AP(HTG-AP)has garnered increasing attention.Compared to AP caused by other causes,HTG-AP often has a more subtle onset but is more likely to progress to a severe,critical illness that poses a serious threat to a patient’s life and health.Research suggests a potential connection between the gut microbiota and AP,which could be mediated by bacterial metabolites,immune cells,and inflammatory factors.This is supported by observations of microbial imbalance and higher intestinal permeability in patients with AP.In addition,studies have shown that HTG-induced changes in gut microbiota can worsen AP by negatively impacting the host metabolism,immune response,and function of the intestinal barrier.In this review,we summarize recent clinical and animal studies on the role and mechanism of gut microbiota in the severity of AP aggravated by HTG.The application prospects of the newly proposed microbial-host-isozyme concept are summarized,focusing on its potential for the precision diagnosis and treatment of HTG-AP through gut microbiota regulation.展开更多
AIM: To investigate and compare frequencies of serum positive cagA in patients from two separate regions of Turkey who were grouped according to the presence of peptic ulcer disease or non-ulcer dyspepsia.METHODS: One...AIM: To investigate and compare frequencies of serum positive cagA in patients from two separate regions of Turkey who were grouped according to the presence of peptic ulcer disease or non-ulcer dyspepsia.METHODS: One hundred and eighty Helicobacter pyloripositive patients with peptic ulcer disease or non-ulcer dyspepsia were included in the study. One hundred and fourteen patients had non-ulcer dyspepsia and 66 had peptic ulcer disease (32 with gastric ulcers and/or erosions and 34with duodenal ulcers). Each patient was tested for serum antibody to H. pylori cagA protein by enzyme immunoassay.RESULTS: The total frequency of serum positive cagA in the study group was 97.2 %. The rates in the patients with peptic ulcers and in those with non-ulcer dyspepsia were 100% and 95.6%, respectively. These results were similar to those reported in Asian studies, but higher than those that have been noted in other studies from Turkey and Western countries.CONCLUSION: The high rates of serum positive cagA in these patients with peptic ulcer disease and non-ulcer dyspepsia were similar to results reported in Asia. The fact that there was high seroum prevalence regardless of ulcer status suggests that factors other than cagA might be responsible for ulceration or other types of severe pathology in H. pylori-positive individuals.展开更多
The Ilizarov method is one of the current methods used in bone reconstruction.It originated in the middle of the past century and comprises a number of bone reconstruction techniques executed with a ring external fixa...The Ilizarov method is one of the current methods used in bone reconstruction.It originated in the middle of the past century and comprises a number of bone reconstruction techniques executed with a ring external fixator developed by Ilizarov GA.Its main merits are viable new bone formation through distraction osteogenesis,high union rates and functional use of the limb throughout the course of treatment.The study of the phenomenon of distraction osteogenesis induced by tension stress with the Ilizarov apparatus was the impetus for advancement in bone reconstruction surgery.Since then,the original method has been used along with a number of its modifications developed due to emergence of new fixation devices and techniques of their application such as hexapod external fixators and motorized intramedullary lengthening nails.They gave rise to a relatively new orthopedic subspecialty termed“limb lengthening and reconstruction surgery”.Based on a comprehensive literature search,we summarized the recent clinical practice and research in bone reconstruction by the Ilizarov method with a special focus on its modification and recognition by the world orthopedic community.The international influence of the Ilizarov method was reviewed in regard to the origin country of the authors and journal’s rating.The Ilizarov method and other techniques based on distraction osteogenesis have been used in many countries and on all populated continents.It proves its international significance and confirms the greatest contribution of Ilizarov GA to bone reconstruction surgery.展开更多
AIM: To determine whether the positive status of human epidermal growth receptor 2(HER2) can be regarded as an effective prognostic factor for patients with gastric cancer(GC) undergoing R0 resection.METHODS: A total ...AIM: To determine whether the positive status of human epidermal growth receptor 2(HER2) can be regarded as an effective prognostic factor for patients with gastric cancer(GC) undergoing R0 resection.METHODS: A total of 1562 GC patients treated by R0 resection were recruited. HER2 status was evaluated in surgically resected samples of all the patients using immunohistochemical(IHC) staining. Correlations between HER2 status and clinicopathological characteristics were retrospective analyzed. Hazard ratios(HRs) and 95% confidence intervals(CIs) were estimated using Cox proportional hazard model, stratified by age, gender, tumor location and tumor-nodemetastasis(TNM) stage, with additional adjustment for potential prognostic factors.RESULTS: Among 1562 patients, 548(positive rate = 35.08%, 95%CI: 32.72%-37.45%) were HER2 positive. Positive status of HER2 was significantly correlated with gender(P = 0.004), minority(P < 0.001), tumor location(P = 0.001), pathological grade(P < 0.001), TNM stage(P < 0.001) and adjuvant radiotherapy(74.67% vs 23.53%, P = 0.011). No significant associations were observed between HER2 status and disease free survival(HR = 0.19, 95%CI: 0.96-1.46, P = 0.105) or overall survival(HR = 1.19, 95%CI: 0.96-1.48, P = 0.118) using multivariate analysis, although stratified analyses showed marginally statistically significant associations both in disease free survival and overall survival, especially among patients aged < 60 years or with early TNM stages(Ⅰ and Ⅱ). Categorical age, TNM stage, neural invasion, and adjuvant chemotherapy were, as expected, independent prognostic factors for both disease free survival and overall survival. CONCLUSION: The positive status of HER2 based on IHC staining was not related to the survival in patients with GC among the Chinese population.展开更多
Diabetes mellitus can damage the eyes,kidneys,nerves and heart.Microvascular and macrovascular disorders are the leading causes of morbidity and mortality in diabetic patients.Hyperglycemia can increase the indicators...Diabetes mellitus can damage the eyes,kidneys,nerves and heart.Microvascular and macrovascular disorders are the leading causes of morbidity and mortality in diabetic patients.Hyperglycemia can increase the indicators of lipid peroxidation and oxidative stress in which free radicals have the main role in the pathogenesis of these complications.Therefore,antioxidants which combat oxidative stress should be able to prevent and repair free radicals induced damages.Although free radicals contribute to kidney damage,atherosclerosis,diabetes,heart disease,nephrotoxicity and hepatotoxicity; however,clinical trials do not uniquely confirm a substantial impact on diabetic damage.It seems that antioxidants in vegetables,fruits and grains help preventing diabetes complications; however,there is little evidence that taking single antioxidants such as vitamin E or vitamin C protect these complications.The findings about combination antioxidants are also complicated and not entirely clear.In this review paper we tried to present the role of oxidative stress on microvascular complications of type2 diabetes mellitus.Other objective of this paper is to review the new findings about the role of various antioxidants on prevention and treatment of diabetes mellitus as well as its complications including retinopathy,nephropathy and neuropathy.展开更多
AIM： To identify the clinical features and outcomes of infrequently reported leptomeningeal carcinomatosis （LMC） of gastric cancer.METHODS： We analyzed 54 cases of cytologically confirmed gastric LMC at four insti...AIM： To identify the clinical features and outcomes of infrequently reported leptomeningeal carcinomatosis （LMC） of gastric cancer.METHODS： We analyzed 54 cases of cytologically confirmed gastric LMC at four institutions from 1994 to 2007.RESULTS： The male-to-female ratio was 32：22, and the patients ranged in age from 28 to 78 years （median,48.5 years）. The majority of patients had advanced disease at initial diagnosis of gastric cancer. The clini-cal or pathologic tumor, node and metastasis stage ofthe primary gastric cancer wasin 38 patients （70%）.The median interval from diagnosis of the primarymalignancy to the diagnosis of LMC was 6.3 mo, rang-ing between 0 and 73.1 mo. Of the initial endoscopic f indings for the 45 available patients, 23 （51%） of the patients were Bormann typeand 15 （33%） patientswere Bormann type. Pathologically, 94% of cases proved to be poorly differentiated adenocarcinomas. Signet ring cell component was also observed in 40% of patients. Headache （85%） and nausea/vomiting （58%） were the most common presenting symptoms of LMC. A gadolinium-enhanced magnetic resonance imaging was conducted in 51 patients. Leptomeningeal enhancement was noted in 45 cases （82%）. Intrathecal （IT） chemotherapy was administered to 36 patients-primarily methotrexate alone （61%）, but also in combi-nation with hydrocortisone/± Ara-C （39%）. The median number of IT treatments was 7 （range, 1-18）. Concomitant radiotherapy was administered to 18 patients, and concomitant chemotherapy to seven patients. Sev-enteen patients （46%） achieved cytological negative conversion. Median overall survival duration from the diagnosis of LMC was 6.7 wk （95% CI： 4.3-9.1 wk）. In the univariate analysis of survival duration, hemoglobin, IT chemotherapy, and cytological negative conversion showed superior survival duration （P = 0.038, P = 0.010, and P = 0.002, respectively）. However, in our multivariate analysis, only cytological negative conversion was predictive of relatively longer survival duration （3.6, 6.7 and 14.6 wk, P = 0.03, RR： 0.415, 95% CI：0.188-0.918）.CONCLUSION： Although these patients had a fatal clinical course, cytologic negative conversion by IT chemotherapy may improve survival.展开更多
On April 14,2010,an earthquake reaching Richter scale 7.1 struck Jiegu Town of Yushu,a mountain rescue operation promptly launched. All injurers had a direct assess to take medical care,and were immediately rescued an...On April 14,2010,an earthquake reaching Richter scale 7.1 struck Jiegu Town of Yushu,a mountain rescue operation promptly launched. All injurers had a direct assess to take medical care,and were immediately rescued and rapidly evacuated by air to Xining and Golmud at lower altitudes and admitted to advanced hospitals. Almost all of the injurers have been completely recovered. Yushu Earthquake was one of the highest earthquakes in the world,with a high incidence of acute altitude illness,which was observed in about 80 % of the lowland rescuers at an altitude of 4 000 m."Rescue the rescuers"became the major task of Qinghai-Tibetan rescue teams,all the severe patients were rapidly descended to Xining and treated promptly and effectively. The outcome was excellent,all patients survived. After the earthquake,it is a long and arduous task to reconstruct what has been destroyed. Medical teams continue to work in the Yushu Earthquake area because about 30 000 workers and carders are now here for rebuilding the earthquake center. Thus the prevention and treatment of altitude illness are still critical tasks for medical teams. Although all the fights are successful,there are more experiences and lessons we have learned from the medical mountain rescue during the earthquake and the reconstruction,and reports here are to sum up our experiences from the medical mountain rescue operation in Yushu Earthquake and draw the lessons that we should learn. With the increasing of earthquake probability occurring in the Qinghai-Tibetan Plateau,we also should prepare against earthquake disasters and for further rescue training in the high mountains.展开更多
Filamin B （FLNB） is a large dimeric actin-binding protein which crosslinks actin cytoskeleton filaments into a dynamic structure. Lip to present, pathogenic mutations in FLNB are solely found to cause skeletal defor...Filamin B （FLNB） is a large dimeric actin-binding protein which crosslinks actin cytoskeleton filaments into a dynamic structure. Lip to present, pathogenic mutations in FLNB are solely found to cause skeletal deformities, indicating the important role of FLNB in skeletal development. FLNB-related disorders are classified as spondylocarpotarsal synostosis （SCT）, Larsen syndrome （LS）, atelosteogenesis （AO）, boomerang dysplasia （BD）, and isolated congenital talipes equinovarus, presenting with scoliosis, short- limbed dwarfism, clubfoot, joint dislocation and other unique skeletal abnormalities. Several mecha- nisms of FLNB mutations causing skeletal malformations have been proposed, including delay of ossi- fication in long bone growth plate, reduction of bone mineral density （BMD）, dysregulation of muscle differentiation, ossification of intervertebral disc （IVD）, disturbance of proliferation, differentiation and apoptosis in chondrocytes, impairment of angiogenesis, and hypomotility of osteoblast, chondrocyte and fibroblast. Interventions on FLNB-related diseases require prenatal surveillance by sonography, gene testing in high-risk carriers, and proper orthosis or orthopedic surgeries to correct malformations including scoliosis, cervical spine instability, large joint dislocation, and clubfoot. Gene and cell therapies for FLNB-related diseases are also promising but require further studies.展开更多
基金the Researcher Supporting Project(RSP-2020/77),King Saud University,Riyadh,Saudi Arabia.
文摘Background Hospitalized elderly patients are at high risk of venous thromboembolism(VTE),and the appropriate use of thromboprophylaxis can significantly reduce the incidence of VTE in high-risk patients.We investigated the pattern of VTE prophylaxis administration among elderly medical patients and assessed its appropriateness based on the American College of Chest Physicians(ACCP)recommendations.Methods A cross-sectional single-center study was conducted between October 2019 and March 2020,including hospitalized(>48 h),elderly(≥60 years),medical patients,and excluding patients receiving anticoagulant for other reason,having contraindication to thromboprophylaxis,or had VTE diagnosed within 48 h.The Padua prediction score was used to determine the patients’risk for VTE,and thromboprophylaxis use was assessed against the ACCP recommendations.Results The study included 396 patients with an average age of 75.0±9.01 years,and most patients(71.7%)were classified as high risk for VTE development(Padua score≥4 points).Thromboprophylaxis use was inappropriate in 27.3%of patients,of whom 85.2%were ineligible but still received thromboprophylaxis.Patients who were classified as low risk of VTE were more likely to receive inappropriate thromboprophylaxis(AOR=76.5,95%CI:16.1-363.2),whereas patients with acute infection or rheumatologic disorder were less likely to receive inappropriate thromboprophylaxis(AOR=0.46,95%CI:0.22-0.96).Conclusions Although the use of thromboprophylaxis among high-risk elderly patients was reasonably adequate,a large proportion of low-risk patients were exposed to unnecessary risk through inappropriate overutilization of thromboprophylaxis.Thus,healthcare providers should accurately assess patients’risk before prescribing thromboprophylaxis to ensure patient safety.
基金supported by the STI2030-Major Projects(2021ZD0200900 to Y.G.Y.)"Light of West China" Program of the Chinese Academy of Sciences(xbzg-zdsys-202302 to Y.G.Y.)
文摘The tree shrew(Tupaia belangeri)has long been proposed as a suitable alternative to non-human primates(NHPs)in biomedical and laboratory research due to its close evolutionary relationship with primates.In recent years,significant advances have facilitated tree shrew studies,including the determination of the tree shrew genome,genetic manipulation using spermatogonial stem cells,viral vector-mediated gene delivery,and mapping of the tree shrew brain atlas.However,the limited availability of tree shrews globally remains a substantial challenge in the field.Additionally,determining the key questions best answered using tree shrews constitutes another difficulty.Tree shrew models have historically been used to study hepatitis B virus(HBV)and hepatitis C virus(HCV)infection,myopia,and psychosocial stress-induced depression,with more recent studies focusing on developing animal models for infectious and neurodegenerative diseases.Despite these efforts,the impact of tree shrew models has not yet matched that of rodent or NHP models in biomedical research.This review summarizes the prominent advancements in tree shrew research and reflects on the key biological questions addressed using this model.We emphasize that intensive dedication and robust international collaboration are essential for achieving breakthroughs in tree shrew studies.The use of tree shrews as a unique resource is expected to gain considerable attention with the application of advanced techniques and the development of viable animal models,meeting the increasing demands of life science and biomedical research.
文摘BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the infection.AIM To examine whether COVID-19 infection is associated with exacerbation,recurrence,or progression of pre-existing neurological or psychiatric disorders-a highrisk population that is underrepresented in COVID-19 outcome research in National Guard Health Affair patients in 4-years following a COVID-19 diagnosis.METHODS For this multicenter retrospective cohort study,we used data from the National Guard hospitals electronic health records network(BestCare)with over 10 million patients.Our cohort comprised patients who had a COVID-19 diagnosis;a matched control cohort included patient did not expose to COVID-19 in same period.Age and sex were matching factors.We estimated the incidence of 14 neurological and psychiatric outcomes in nearly 4 years after a confirmed diagnosis of COVID-19.Using a multiple logistic regression,we compared incidences with those in propensity score-matched cohorts of patients with no exposure to COVID-19.Ramadan M et al.Neurological and psychiatric risks post-COVID-19 RESULTS Our primary cohort comprised 4437 patients diagnosed with COVID-19,and our propensity-score 1:1 matched control cohort comprised 4437 individuals.Nearly two-third of the COVID-19 cohort(71%)were diagnosed in 2020,and 2021.The most prevalent diagnoses for both cohorts were epilepsy 30.68%,mood disorder 23.92%,and nerve plexus disorder 22.13%.Dementia was nearly 4 times higher among COVID-19 cohort(8.27%)compared to the control cohort(2.57%).Five neurological and psychiatric outcomes had odds ratios(OR)that were significantly higher than 1 for people who had COVID-19 compared to people who had never been infected.These outcomes were cognitive deficit OR=1.54,95%confidence interval(CI):1.23-1.91,P=0.0001;nerve plexus disorder OR=1.13,95%CI:1.01-1.25,P=0.02;substance use disorder OR=1.95,95%CI:1.12-3.38,P=0.01;mood disorder OR=1.16,95%CI:1.05-1.29,P=0.003;and anxiety disorder OR=1.39,95%CI:1.07-1.79,P=0.01.CONCLUSION The study highlights the persistent risk of neurological and psychiatric conditions in COVID-19 survivors up to four years post-infection.Although the incidence was lower than in previous large studies,long-term consequences remain significant,emphasizing the need for ongoing monitoring and support in mental health and neurological care.
文摘Background:Anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA)is a rare congenital anomalous coronary artery origin disorder.Objective:We sought to summarize the clinical experience and prognostic characteristics of surgical treatment of ALCAPA.Methods:We retrospectively analyzed clinical information on patients who had ALCAPA and underwent surgery at our center from February 2016 to October 2023.Results:This comparative study of 23 ALCAPA patients(9 infants<1 year;14 children>1 year)demonstrated significant age-dependent outcomes.Infant patients exhibited markedly prolonged mechanical ventilation(183±105.6 vs.48.5±62.2 min,p=0.001)and hospitalization(30.8±8.2 vs.19.5±6.2 days,p=0.001),despite comparable operative times(p>0.05).The perioperative mortality rate was 8.7%(2/23).Early postoperative mortality showed a non-significant trend in infants(22.2%vs.0%,p=0.11).Serial follow-up revealed substantial functional improvement,with abnormal left ventricular ejection fractions decreasing from 56.5%preoperatively to 14.3%at 1-month(p<0.01),and severe mitral regurgitation declining from 34.7%to 14.3%.However,persistent left ventricular enlargement(81%at follow-up)and moderate mitral regurgitation(52.4%)were frequently observed.Conclusion:Surgical correction of ALCPA effectively restores coronary perfusion and reduces severe mitral regurgitation,though residual ventricular dilation and moderate valvular dysfunction persist in the short-term postoperative period.Nevertheless,the overall prognosis remains favorable when timely intervention is performed.
基金Supported by Key Science and Technology Research and Development Program Project of Guangxi,No.GuikeAB22035017,and No.GuikeAB25069071.
文摘Cancer remains a major global health concern,with escalating incidence and mortality rates underscoring the urgent need for novel diagnostic and therapeutic strategies.Increasing evidence has identified the oral microbiota as a critical contributor to tumorigenesis,thereby expanding the understanding of cancer pathogenesis beyond conventional risk factors such as tobacco use and genetic predisposition.This review summarizes recent progress in elucidating the complex relationship between the oral microbiota and various malignancies,particularly oral squamous cell carcinoma,esophageal adenocarcinoma,and pancreatic ductal adenocarcinoma.Pathogenic bacteria,including Porphyromonas gingivalis and Fusobacterium nucleatum,have been implicated in promoting tumor progression through mechanisms involving chronic inflammation,the production of metabolic toxins,and immune evasion.The dysbiosis of the oral microbiota,often driven by lifestyle factors such as poor diet,tobacco use,and alcohol consumption,further exacerbates these carcinogenic processes.Emerging therapeutic approaches including probiotics,oral microbiota transplantation,and CRISPR-based bacterial editing are under investigation for their potential to restore microbial homeostasis and suppress pathogenic species.Additionally,saliva-based microbial biomarkers have shown promise for non-invasive cancer screening.The integration of multi-omics technologies and artificial intelligence-driven platforms is further advancing the development of precision oncology.This review aims to consolidate fragmented findings concerning the oral microbiota-cancer axis and address existing gaps in mechanistic understanding.The review’s significance lies in the translational potential of microbial research to clinical applications,offering opportunities to reduce the global cancer burden through early detection and microbiota-targeted therapies.
文摘Background:Three-dimensional(3D)printing has revolutionized craniofacial and craniomaxillofacial applications,leading to substantial advancements in patient-specific treatments.In this study,a bibliometric analysis was performed to identify the key contributors,research trends,thematic developments,and collaboration networks in this evolving field.Methods:Two search strategies were employed to ensure a comprehensive analysis:(1)a broad search,in which selected keywords were searched in the title,abstract,and keyword fields to capture all relevant publications,and(2)a title-specific search,in which keywords were restricted to the title field to identify publications with a strong focus on 3D printing in craniofacial and craniomaxillofacial applications.The retrieved dataset was analyzed using VOSviewer and RStudio(bibliometrix package).Results:The broad search retrieved 3534 publications,whereas the title-specific search yielded 280 publications.The analysis of these 280 papers focused on identifying the top authors,universities,and countries,as well as their research dynamics and collaboration networks.A more detailed approach was adopted by examining the titles of these 280 papers.VOSviewer segmented the titles into approximately 800 words,which were then categorized into 18 distinct thematic groups to represent research trends.The focus areas of the ten most cited papers were also analyzed.Conclusion:This bibliometric study provides valuable insights into the progress in 3D printing for craniofacial and craniomaxillofacial applications.By highlighting the key contributors,thematic developments,and collaborative networks,this study offers a foundation for future research in this rapidly advancing field.
文摘Background: Peripheral nerve regeneration is a critical research area with significant implications for neurology,neurosurgery,and regenerative medicine.A bibliometric analysis was conducted to provide a structured overview of research trends,intellectual impact,and evolving themes in peripheral nerve regeneration.This study aimed to identify the most influential research articles on peripheral nerve regeneration;analyze keyword trends,thematic evolution,and co-word structures;assess the contributions of top authors,universities,and countries;and examine collaboration networks and research dynamics.Methods: A systematic bibliometric approach was employed using two search strategies.The first strategy involved searching within the title,abstract,and keyword fields,yielding 15 317 papers,whereas the second strategy was restricted to searching titles only,retrieving 3 531 papers.From these,the 100 most cited papers were selected for analysis.A thematic analysis was conducted using co-word clustering.The leading contributors were ranked according to the number of publications,citations,h-index,g-index,and m-index.Results: The bibliometric analysis provided several key insights.Keyword analysis using bi-and tri-gram techniques revealed the dominant research themes within the field.The top contributors,including authors,universities,and countries,were ranked based on their productivity and citation impact.Collaboration networks were mapped at the author,institutional,and country levels,highlighting key partnerships and global research interactions.Thematic analysis classified research into seven major domains: neural regeneration and repair;cellular and molecular biology;biomaterials and tissue engineering;experimental studies and statistical analyses;functional and therapeutic aspects;neuropathic pain and peripheral nerve disorders;and Schwann cell and cellular responses.Additionally,the ten most influential papers were reviewed in detail to understand their contributions to the field.Conclusion: This study provides a comprehensive and structured overview of peripheral nerve regeneration research.These findings offer valuable insights into the intellectual foundation of the field by identifying key contributors,research trends,and collaboration patterns.The results serve as a guide for future research,helping researchers to navigate the evolving landscape of peripheral nerve regeneration.
基金Research Project of China Baoyuan Investment Co.,Ltd,Grant/Award Number:Program CBYI202102Haihe Laboratory of Cell Ecosystem Innovation Fund,Grant/Award Number:HH24KYZX0007+4 种基金CAMS Innovation Fund for Medical Sciences,Grant/Award Number:2021-I2M-1-024,2021-I2M-1-034 and 2023-I2M-2-001Fundamental Research Funds for the Central Universities,Grant/Award Number:3332022040 and 3332023164Open Research Project in State Key Laboratory of Vascular Homeostasis and Remodeling,Peking University,Grant/Award Number:202411State Key Laboratory Special Fund,Grant/Award Number:2060204the Non-profit Central Research Institute Fund of the Chinese Academy of Medical Sciences,Grant/Award Number:2023-PT180-01.
文摘Background:The Cre/loxP system is most popular in mice,but its application in rats has largely lagged far behind.The rat is vital laboratory animal,especially in toxicological and neurological studies.Generating genetic tools to manipulate neurons in rats could benefit neurological research.Methods:Using the CRISPR/Cas9 system,we inserted a Cre cassette into endogenous Thy1 and NeuN loci.Thy1-Cre rats featured a downstream P2A-linked insertion,while NeuN-Cre was inserted at the transcriptional start site.The Cre activity was assessed by crossing with a Cre reporter(Rosa26 imCherry)rat and through analyzing mCherry expression patterns.The specificity of cell type was further confirmed by immunofluorescence with NeuN antibody.Phenotypic consequences were assessed by crossing with ND1^(LSL) rats to deplete ND1,followed by monitoring weight/survival and conducting motor function tests.Results:We generated two neuron-specific rats(Thy1-Cre and NeuN-Cre),which exhibited high neuron-specific Cre expression in brain and spinal cord with minor leakage in other tissues.Thy1-Cre showed minor leakage in spleen,lung and kidney while NeuN-Cre showed minor leakage in spleen and kidney.ND1^(Thy1-Cre) and ND1^(NeuN-Cre) rats both showed decreased body weights and survival times.The ND1^(NeuN-Cre) rats died within two weeks,while ND1^(Thy1-Cre) rats lived longer with impaired motor function.Conclusions:We successfully generated two neuron-specific NeuN-Cre and Thy1-Cre rats,and systemically analyzed their expression pattern.
文摘Objective To assess the effect of upper urinary tract(UUT)urolithiasis on urology services in a region with a high prevalence of the condition,and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.Methods Using the hospital surgery statistics database,data were gathered from the urology departments of 11 hospitals in Saudi Arabia.The analysis focused on the trends,distribution,and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.Results Out of the total surgery performed(54711),over half(31039,57%)were related to UUT urolithiasis.Extracorporeal shock wave lithotripsy(ESWL)was the most performed procedure among stone-related procedures,accounting for 38%of all procedures.Double-J stent insertion,flexible ureteroscopy(URS),semi-rigid URS,percutaneous nephrolithotomy,and pyelo-and uretero-lithotomy accounted for 25%,19%,14%,3.8%,and 0.35%,respectively.Notably,the number of stone-related UUT procedures in 2022 increased by 35%(from 4671 to 6283)compared to 2017.In the year 2022 compared to 2017,there was a statistically significant increase in the rate of all stone-related UUT procedures(p<0.001),except for ESWL and pyelo-and uretero-lithotomy.The rates of ESWL procedures reduced from 21%in 2017 to 13%in 2022(p<0.001).Overall,the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107%(47.7 million SAR in 2022 vs.23.0 million SAR in 2017).Conclusion Our research findings suggest that urolithiasis poses a significant burden,accounting for over half of all urological surgery performed at the participating centers.Furthermore,there has been a 35%rise in stone-related UUT procedures over the past 6 years.Percutaneous nephrolithotomy,flexible URS,and semi-rigid URS have experienced significant increase in usage.Furthermore,in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.
基金approved by King Abdullah International Medical Research Center Ethics Committee(approval No.0000074524).
文摘BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.
基金Supported by Russian Science Foundation,No.24-64-00028.
文摘We read with great interest the investigation of Kang et al related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients with gene mutations.The authors focused on decision-making based on the integration of tumor differentiation,signal intensity ratio,margin distance,and magnetic resonance imaging-detected lymph node metastasis.Indeed,these multiparameter predictive models could also be used for diagnosis as an alternative to invasive tissue examination methods.However,progress in this field enables us to shift the paradigm to radiology biopsies,particularly given the nonlinear effects of various radiation sources.
文摘We read with the great interest the study by Ababneh et al in which inducedmesenchymal stem cell-derived exosomes were shown to exhibit a stronger andmore sustained anti-proliferative effect by inducing a senescence-like state withoutapoptosis.The results obtained by the authors highlight the features of theeffects of senescent drift induction in surrounding tissues.In the light of thesefindings,the role of the properties of extracellular matrix and cellular glycocalyxin responses of human tumors to therapy remain uninvestigated.These extracellularbarriers appear to be significant obstacles to effective cancer therapy,especiallyin relation to the use of unique properties of tumor microenvironment forthe immunotherapy-resistant cancer treatment.
基金Supported by the Innovation Foundation for Doctor Dissertation of Northwestern Polytechnical University,No.CX2023021.
文摘Acute pancreatitis(AP)is sudden inflammation of the pancreas,which can lead to multiple organ dysfunction in severe cases.Hypertriglyceridemia(HTG)is the third most common cause.In recent years,HTG-induced AP(HTG-AP)has garnered increasing attention.Compared to AP caused by other causes,HTG-AP often has a more subtle onset but is more likely to progress to a severe,critical illness that poses a serious threat to a patient’s life and health.Research suggests a potential connection between the gut microbiota and AP,which could be mediated by bacterial metabolites,immune cells,and inflammatory factors.This is supported by observations of microbial imbalance and higher intestinal permeability in patients with AP.In addition,studies have shown that HTG-induced changes in gut microbiota can worsen AP by negatively impacting the host metabolism,immune response,and function of the intestinal barrier.In this review,we summarize recent clinical and animal studies on the role and mechanism of gut microbiota in the severity of AP aggravated by HTG.The application prospects of the newly proposed microbial-host-isozyme concept are summarized,focusing on its potential for the precision diagnosis and treatment of HTG-AP through gut microbiota regulation.
文摘AIM: To investigate and compare frequencies of serum positive cagA in patients from two separate regions of Turkey who were grouped according to the presence of peptic ulcer disease or non-ulcer dyspepsia.METHODS: One hundred and eighty Helicobacter pyloripositive patients with peptic ulcer disease or non-ulcer dyspepsia were included in the study. One hundred and fourteen patients had non-ulcer dyspepsia and 66 had peptic ulcer disease (32 with gastric ulcers and/or erosions and 34with duodenal ulcers). Each patient was tested for serum antibody to H. pylori cagA protein by enzyme immunoassay.RESULTS: The total frequency of serum positive cagA in the study group was 97.2 %. The rates in the patients with peptic ulcers and in those with non-ulcer dyspepsia were 100% and 95.6%, respectively. These results were similar to those reported in Asian studies, but higher than those that have been noted in other studies from Turkey and Western countries.CONCLUSION: The high rates of serum positive cagA in these patients with peptic ulcer disease and non-ulcer dyspepsia were similar to results reported in Asia. The fact that there was high seroum prevalence regardless of ulcer status suggests that factors other than cagA might be responsible for ulceration or other types of severe pathology in H. pylori-positive individuals.
文摘The Ilizarov method is one of the current methods used in bone reconstruction.It originated in the middle of the past century and comprises a number of bone reconstruction techniques executed with a ring external fixator developed by Ilizarov GA.Its main merits are viable new bone formation through distraction osteogenesis,high union rates and functional use of the limb throughout the course of treatment.The study of the phenomenon of distraction osteogenesis induced by tension stress with the Ilizarov apparatus was the impetus for advancement in bone reconstruction surgery.Since then,the original method has been used along with a number of its modifications developed due to emergence of new fixation devices and techniques of their application such as hexapod external fixators and motorized intramedullary lengthening nails.They gave rise to a relatively new orthopedic subspecialty termed“limb lengthening and reconstruction surgery”.Based on a comprehensive literature search,we summarized the recent clinical practice and research in bone reconstruction by the Ilizarov method with a special focus on its modification and recognition by the world orthopedic community.The international influence of the Ilizarov method was reviewed in regard to the origin country of the authors and journal’s rating.The Ilizarov method and other techniques based on distraction osteogenesis have been used in many countries and on all populated continents.It proves its international significance and confirms the greatest contribution of Ilizarov GA to bone reconstruction surgery.
基金Supported by National Natural Science Foundation of ChinaNo.81360318+1 种基金the Application and Basic Research Program of Qinghai Province of ChinaNo.2014-Z-745
文摘AIM: To determine whether the positive status of human epidermal growth receptor 2(HER2) can be regarded as an effective prognostic factor for patients with gastric cancer(GC) undergoing R0 resection.METHODS: A total of 1562 GC patients treated by R0 resection were recruited. HER2 status was evaluated in surgically resected samples of all the patients using immunohistochemical(IHC) staining. Correlations between HER2 status and clinicopathological characteristics were retrospective analyzed. Hazard ratios(HRs) and 95% confidence intervals(CIs) were estimated using Cox proportional hazard model, stratified by age, gender, tumor location and tumor-nodemetastasis(TNM) stage, with additional adjustment for potential prognostic factors.RESULTS: Among 1562 patients, 548(positive rate = 35.08%, 95%CI: 32.72%-37.45%) were HER2 positive. Positive status of HER2 was significantly correlated with gender(P = 0.004), minority(P < 0.001), tumor location(P = 0.001), pathological grade(P < 0.001), TNM stage(P < 0.001) and adjuvant radiotherapy(74.67% vs 23.53%, P = 0.011). No significant associations were observed between HER2 status and disease free survival(HR = 0.19, 95%CI: 0.96-1.46, P = 0.105) or overall survival(HR = 1.19, 95%CI: 0.96-1.48, P = 0.118) using multivariate analysis, although stratified analyses showed marginally statistically significant associations both in disease free survival and overall survival, especially among patients aged < 60 years or with early TNM stages(Ⅰ and Ⅱ). Categorical age, TNM stage, neural invasion, and adjuvant chemotherapy were, as expected, independent prognostic factors for both disease free survival and overall survival. CONCLUSION: The positive status of HER2 based on IHC staining was not related to the survival in patients with GC among the Chinese population.
文摘Diabetes mellitus can damage the eyes,kidneys,nerves and heart.Microvascular and macrovascular disorders are the leading causes of morbidity and mortality in diabetic patients.Hyperglycemia can increase the indicators of lipid peroxidation and oxidative stress in which free radicals have the main role in the pathogenesis of these complications.Therefore,antioxidants which combat oxidative stress should be able to prevent and repair free radicals induced damages.Although free radicals contribute to kidney damage,atherosclerosis,diabetes,heart disease,nephrotoxicity and hepatotoxicity; however,clinical trials do not uniquely confirm a substantial impact on diabetic damage.It seems that antioxidants in vegetables,fruits and grains help preventing diabetes complications; however,there is little evidence that taking single antioxidants such as vitamin E or vitamin C protect these complications.The findings about combination antioxidants are also complicated and not entirely clear.In this review paper we tried to present the role of oxidative stress on microvascular complications of type2 diabetes mellitus.Other objective of this paper is to review the new findings about the role of various antioxidants on prevention and treatment of diabetes mellitus as well as its complications including retinopathy,nephropathy and neuropathy.
基金Supported by The Dong-A University Research Fund and the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MEST R13-2002-044-05001-0)
文摘AIM： To identify the clinical features and outcomes of infrequently reported leptomeningeal carcinomatosis （LMC） of gastric cancer.METHODS： We analyzed 54 cases of cytologically confirmed gastric LMC at four institutions from 1994 to 2007.RESULTS： The male-to-female ratio was 32：22, and the patients ranged in age from 28 to 78 years （median,48.5 years）. The majority of patients had advanced disease at initial diagnosis of gastric cancer. The clini-cal or pathologic tumor, node and metastasis stage ofthe primary gastric cancer wasin 38 patients （70%）.The median interval from diagnosis of the primarymalignancy to the diagnosis of LMC was 6.3 mo, rang-ing between 0 and 73.1 mo. Of the initial endoscopic f indings for the 45 available patients, 23 （51%） of the patients were Bormann typeand 15 （33%） patientswere Bormann type. Pathologically, 94% of cases proved to be poorly differentiated adenocarcinomas. Signet ring cell component was also observed in 40% of patients. Headache （85%） and nausea/vomiting （58%） were the most common presenting symptoms of LMC. A gadolinium-enhanced magnetic resonance imaging was conducted in 51 patients. Leptomeningeal enhancement was noted in 45 cases （82%）. Intrathecal （IT） chemotherapy was administered to 36 patients-primarily methotrexate alone （61%）, but also in combi-nation with hydrocortisone/± Ara-C （39%）. The median number of IT treatments was 7 （range, 1-18）. Concomitant radiotherapy was administered to 18 patients, and concomitant chemotherapy to seven patients. Sev-enteen patients （46%） achieved cytological negative conversion. Median overall survival duration from the diagnosis of LMC was 6.7 wk （95% CI： 4.3-9.1 wk）. In the univariate analysis of survival duration, hemoglobin, IT chemotherapy, and cytological negative conversion showed superior survival duration （P = 0.038, P = 0.010, and P = 0.002, respectively）. However, in our multivariate analysis, only cytological negative conversion was predictive of relatively longer survival duration （3.6, 6.7 and 14.6 wk, P = 0.03, RR： 0.415, 95% CI：0.188-0.918）.CONCLUSION： Although these patients had a fatal clinical course, cytologic negative conversion by IT chemotherapy may improve survival.
基金"973"National Key Basic Research and Development Program(No.2012CB518202)Project of Qinghai Development of Science and Technology(No.2011-N-150)
文摘On April 14,2010,an earthquake reaching Richter scale 7.1 struck Jiegu Town of Yushu,a mountain rescue operation promptly launched. All injurers had a direct assess to take medical care,and were immediately rescued and rapidly evacuated by air to Xining and Golmud at lower altitudes and admitted to advanced hospitals. Almost all of the injurers have been completely recovered. Yushu Earthquake was one of the highest earthquakes in the world,with a high incidence of acute altitude illness,which was observed in about 80 % of the lowland rescuers at an altitude of 4 000 m."Rescue the rescuers"became the major task of Qinghai-Tibetan rescue teams,all the severe patients were rapidly descended to Xining and treated promptly and effectively. The outcome was excellent,all patients survived. After the earthquake,it is a long and arduous task to reconstruct what has been destroyed. Medical teams continue to work in the Yushu Earthquake area because about 30 000 workers and carders are now here for rebuilding the earthquake center. Thus the prevention and treatment of altitude illness are still critical tasks for medical teams. Although all the fights are successful,there are more experiences and lessons we have learned from the medical mountain rescue during the earthquake and the reconstruction,and reports here are to sum up our experiences from the medical mountain rescue operation in Yushu Earthquake and draw the lessons that we should learn. With the increasing of earthquake probability occurring in the Qinghai-Tibetan Plateau,we also should prepare against earthquake disasters and for further rescue training in the high mountains.
基金supported by the National Natural Science Foundation of China(Nos.81501852,81472046 and 81472045)the Beijing Natural Science Foundation(No.7172175)+6 种基金the Beijing nova program(No.2161100004916123)the Beijing nova program interdisciplinary collaborative project(No.xxjc201717)the 2016 Milstein Medical Asian American Partnership Foundation Fellowship Award in Translational Medicine,the Central Level Public Interest Program for Scientific Research Institute(No.2016ZX310177)the PUMC Youth Fund&the Fundamental Research Funds for the Central Universities(No.3332016006)the CAMS Initiative for Innovative Medicine(No.2016-12M-3-003)the Distinguished Youth foundation of Peking Union Medical College Hospital(No.JQ201506)the National Key Research and Development Program of China(No.2016YFC0901501)
文摘Filamin B （FLNB） is a large dimeric actin-binding protein which crosslinks actin cytoskeleton filaments into a dynamic structure. Lip to present, pathogenic mutations in FLNB are solely found to cause skeletal deformities, indicating the important role of FLNB in skeletal development. FLNB-related disorders are classified as spondylocarpotarsal synostosis （SCT）, Larsen syndrome （LS）, atelosteogenesis （AO）, boomerang dysplasia （BD）, and isolated congenital talipes equinovarus, presenting with scoliosis, short- limbed dwarfism, clubfoot, joint dislocation and other unique skeletal abnormalities. Several mecha- nisms of FLNB mutations causing skeletal malformations have been proposed, including delay of ossi- fication in long bone growth plate, reduction of bone mineral density （BMD）, dysregulation of muscle differentiation, ossification of intervertebral disc （IVD）, disturbance of proliferation, differentiation and apoptosis in chondrocytes, impairment of angiogenesis, and hypomotility of osteoblast, chondrocyte and fibroblast. Interventions on FLNB-related diseases require prenatal surveillance by sonography, gene testing in high-risk carriers, and proper orthosis or orthopedic surgeries to correct malformations including scoliosis, cervical spine instability, large joint dislocation, and clubfoot. Gene and cell therapies for FLNB-related diseases are also promising but require further studies.
