Pancreatic cancer(PC)is a highly lethal disease,and current clinical drugs often have significant side effects.Traditional Chinese medicines,particularly food and medicine homology herbs,present novel opportunities fo...Pancreatic cancer(PC)is a highly lethal disease,and current clinical drugs often have significant side effects.Traditional Chinese medicines,particularly food and medicine homology herbs,present novel opportunities for the development of low-toxicity tumor treatments.It is imperative to further explore the application of these substances in the field of tumor therapy.To investigate the effect of Ci-Gu-Tang(CGT)on PC both in vitro and in vivo and to elucidate its underlying mechanism.In this study,liquid chromatography-mass spectrometry(LC-MS)technology was utilized to validate the constituents of CGT,whereas network pharmacology was employed to further analyze the 37 active ingredients in CGT and their nine targets associated with PC.Protein-protein interaction(PPI)investigations revealed that the three potential key targets are epidermal growth factor receptor(EGFR),AKT serine/threonine kinase 1(AKT1),and signal transducer and activator of transcription 3(STAT3).Molecular docking was used to elucidate the binding mode and energy between four active ingredients(β-sitosterol,stigmasterol,quercetin,and prangenidin)and the above three targets.Subsequent in vitro and in vivo studies further validated its anti-PC efficacy and confirmed the involvement of the EGFR/AKT1/STAT3 signaling pathway.The utilization of patient-derived organoid(PDO)and patient-derived xenograft(PDX)models enhanced the clinical significance of this investigation.The present research utilized network pharmacology,molecular docking,LC-MS,and in vitro and in vivo experiments to examine the effects and mechanism of CGT in the treatment of PC.This study revealed thatβ-sitosterol,stigmasterol,quercetin,and prangenidin could be practical components by inhibiting tumorigenesis through the EGFR/AKT1/STAT3 axis.PDO and PDX models also demonstrated the effectiveness of CGT.This study represents a pioneering effort in the use of patient-derived models to investigate the potential of food and medicine homology species in cancer treatment.展开更多
Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult ...Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases.Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits.This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment.Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment,including cerebrovascular diseases,Alzheimer's disease,aging-related conditions,and issues related to anesthesia and surgery.The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized,and targeting AHN is considered a promising approach for treating cognitive impairment.However,the underlying mechanisms of this role are not yet fully understood,and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited,with a need for further development of treatment methods and detection techniques.By reviewing recent studies,we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories:immunity,energy metabolism,aging,and pathological states.In immunity-related mechanisms,abnormalities in meningeal,brain,and peripheral immunity can disrupt normal adult hippocampal neurogenesis.Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis.During aging,the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients.Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis.Among the current strategies used to enhance this form of neurogenesis,physical therapies such as exercise,transcutaneous electrical nerve stimulation,and enriched environments have proven effective.Dietary interventions,including energy intake restriction and nutrient optimization,have shown efficacy in both basic research and clinical trials.However,drug treatments,such as antidepressants and stem cell therapy,are primarily reported in basic research,with limited clinical application.The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention,and targeting the former may be an important strategy for treating the latter.However,the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear,and treatments are lacking.This highlights the need for greater focus on translating research findings into clinical practice.展开更多
As the central template for protein expression,messenger ribonucleic acid(mRNA)holds immense potential for novel therapeutic strategies.Over the past few decades,mRNA-based therapeutics have demonstrated remarkable ef...As the central template for protein expression,messenger ribonucleic acid(mRNA)holds immense potential for novel therapeutic strategies.Over the past few decades,mRNA-based therapeutics have demonstrated remarkable efficacy in a range of applications,including epidemic vaccine,cancer vaccine,protein replacement therapy,cytokine therapy,cell therapy and gene editing.Due to the inherent instability of mRNA,the rational design of mRNA structure is the prerequisite for therapeutic utility while effective delivery systems are also essential for in vivo applications.This review focuses on the optimization of mRNA structure and highlights key delivery strategies.It also provides a comprehensive overview of the major applications of mRNA-based strategies.In addition,it highlights the persistent challenges in m RNA therapeutics,particularly in terms of stability,immunogenicity,delivery efficiency and safety.By examining recent advances in mRNA design,delivery and application,this review aims to support ongoing research and development in the field of mRNA-based therapeutics.展开更多
Tumor metabolic reprogramming is a core hallmark of cancer,characterized by pathways such as aerobic glycolysis,aberrant lipid metabolism,and glutaminolysis that support rapid proliferation and immunosuppressive micro...Tumor metabolic reprogramming is a core hallmark of cancer,characterized by pathways such as aerobic glycolysis,aberrant lipid metabolism,and glutaminolysis that support rapid proliferation and immunosuppressive microenvironments.Circular RNAs(circRNAs)are highly stable,evolutionarily conserved non-coding RNAs that have emerged as critical modulators of these metabolic shifts.This review aims to systematically elucidate the roles and mechanisms of circRNAs in reprogramming tumor metabolism,and to discuss their clinical potential as biomarkers and therapeutic targets.Through mechanisms including miRNA sponging,protein interactions,regulation of mitochondrial dynamics,and modulation of metabolic enzymes,circRNAs influence key metabolic pathways by targeting glycolytic enzymes,lipid synthesis regulators,and glutaminolysis-related molecules to either facilitate or inhibit their expression.This review systematically summarizes the unique contributions of circRNAs to tumor metabolic reprogramming,highlighting key mechanisms such as regulation of peptide-encoding protein translation,mitochondrial localization function,gene promoter-targeted transcriptional regulation,and cross-pathway metabolic mediation,which underscore their distinct biological advantages and regulatory roles in tumor metabolism.The stability and tissue specificity of circRNAs make them promising diagnostic biomarkers,while their role in drug resistance mediated by metabolic reprogramming highlights their potential as therapeutic targets.Strategies such as circRNA inhibitors,mimics,and nanoparticle-based delivery systems are being explored to modulate tumor metabolism.Despite challenges including complex regulatory networks and limited manipulation tools,advances in high-throughput technologies and clinical trials hold promise for translating circRNA research into novel cancer therapies.展开更多
Objective: This review aims to explore the efficacy of exercise in the treatment of anxiety disorders and its underlying mechanisms, summarizing recent research advances and focusing on the potential biological and ps...Objective: This review aims to explore the efficacy of exercise in the treatment of anxiety disorders and its underlying mechanisms, summarizing recent research advances and focusing on the potential biological and psychological pathways through which exercise exerts its anxiolytic effects.Methods: To ensure comprehensive coverage of relevant studies, we conducted a systematic search in databases such as PubMed, Web of Science, and Embase, combining MeSH terms with free-text terms. Keywords included“exercise,” “physical activity,” and “anxiety disorder.”Results and conclusions: Current research widely supports exercise as a safe and effective intervention for anxiety.Both aerobic exercise and resistance training have shown significant anxiety-reducing effects across various populations. The mechanisms of action can be categorized into three main types: cellular and molecular mechanisms, systemic immune effects, and behavioral and cognitive pathways. Different forms of exercise have distinct advantages: aerobic exercise is suitable for the general population, resistance training is beneficial for individuals with coexisting physical conditions, and low-intensity exercises such as yoga and Tai Chi are suitable for pregnant women, the elderly, or postoperative recovery patients. Given its good safety profile and broad applicability, moderate exercise should be considered a first-line treatment for mild anxiety and an adjunctive intervention for moderate to severe anxiety. Future research should further clarify the mechanistic differences between various exercise modalities and promote the development of individualized exercise prescriptions.展开更多
Cancer continues to pose a formidable challenge in global health,with conventional treatments such as chemotherapy and radiotherapy often resulting in severe toxicities that significantly degrade patients’quality of ...Cancer continues to pose a formidable challenge in global health,with conventional treatments such as chemotherapy and radiotherapy often resulting in severe toxicities that significantly degrade patients’quality of life and restrict therapeutic outcomes.Addressing this pressing issue,this review presents a thorough and systematic analysis of innovative and emerging strategies designed to minimize the toxicity induced by treatment,while maintaining or even enhancing antitumor efficacy.The focus is on six promising therapeutic approaches:combination therapies utilizing natural bioactive products,molecularly targeted therapies,immunotherapies,nanotechnology-mediated drug delivery systems,adjunct traditional Chinese medicine interventions,and low-dose spatiotemporally concerted regimens.Each approach employs unique mechanisms—such as enhanced targeting precision,immune system activation,tumor microenvironment reprogramming,and multi-component synergistic effects—to mitigate damage to normal tissues and reduce systemic adverse reactions.Despite promising preclinical and clinical advancements,several challenges persist,including drug resistance,high economic costs,a lack of reliable predictive biomarkers,and complexities in clinical translation and regulatory approval.Looking ahead,the incorporation of artificial intelligence,multi-omics profiling,and novel biomimetic nanotechnologies offers unprecedented opportunities for developing highly personalized,low-toxicity treatment frameworks.This review highlights a fundamental shift in oncology towards precision medicine that balances efficacy with safety,demonstrating the transformative potential of these strategies in shaping the future of cancer therapy and enhancing patient care globally.展开更多
BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is sparse.AIM To investigate the...BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is sparse.AIM To investigate the prevalence,outcome and risk factors for AILD in cirrhotic patients complicated with AD in China.METHODS We collected data from patients with cirrhosis and AD from two prospective,multicenter cohorts in hepatitis B virus endemic areas.Patients were regularly followed up at the end of 28-d,90-d and 365-d,or until death or liver transplantation(LT).The primary outcome in this study was 90-d LTfree mortality.Acute-on-chronic liver failure(ACLF)was assessed on admission and during 28-d hospitalization,according to the diagnostic criteria of the European Association for the Study of the Liver(EASL).Risk factors for death were analyzed with logistic regression model.RESULTS In patients with cirrhosis and AD,the overall prevalence of AILD was 9.3%(242/2597).Prevalence of ACLF was significantly lower in AILD cases(14%)than those with all etiology groups with cirrhosis and AD(22.8%)(P<0.001).Among 242 enrolled AILD patients,the prevalence rates of primary biliary cirrhosis(PBC),autoimmune hepatitis(AIH)and PBC-AIH overlap syndrome(PBC/AIH)were 50.8%,28.5%and 12.0%,respectively.In ACLF patients,the proportions of PBC,AIH and PBC/AIH were 41.2%,29.4% and 20.6%.28-d and 90-d mortality were 43.8% and 80.0% in AILD-related ACLF.The etiology of AILD had no significant impact on 28-d,90-d or 365-d LTfree mortality in patients with cirrhosis and AD in both univariate and multivariate analysis.Total bilirubin(TB),hepatic encephalopathy(HE)and blood urea nitrogen(BUN)were independent risk factors for 90-d LT-free mortality in multivariate analysis.The development of ACLF during hospitalization only independently correlated to TB and international normalized ratio.CONCLUSION AILD was not rare in hospitalized patients with cirrhosis and AD in China,among which PBC was the most common etiology.90-d LT-free mortality were independently associated with TB,HE and BUN.展开更多
In recent years, due to frequent occurrence of public health emergencies, outbreaks of major infectious diseases represented by COVID-19have brought great harm to the lives and health of people. General hospitals are ...In recent years, due to frequent occurrence of public health emergencies, outbreaks of major infectious diseases represented by COVID-19have brought great harm to the lives and health of people. General hospitals are indispensable in disease prevention and control. The studyanalyzed a comprehensive evaluation method of epidemic prewarning and treatment for COVID‑19 in general hospitals through literature reviewand provided a reference for constructing urban public health prewarning and treatment system.展开更多
BACKGROUND Whether regional lymphadenectomy(RL)should be routinely performed in patients with T1b gallbladder cancer(GBC)remains a subject of debate.AIM To investigate whether RL can improve the prognosis of patients ...BACKGROUND Whether regional lymphadenectomy(RL)should be routinely performed in patients with T1b gallbladder cancer(GBC)remains a subject of debate.AIM To investigate whether RL can improve the prognosis of patients with T1b GBC.METHODS We studied a multicenter cohort of patients with T1b GBC who underwent surgery between 2008 and 2016 at 24 hospitals in 13 provinces in China.The logrank test and Cox proportional hazards model were used to compare the overall survival(OS)of patients who underwent cholecystectomy(Ch)+RL and those who underwent Ch only.To investigate whether combined hepatectomy(Hep)improved OS in T1b patients,we studied patients who underwent Ch+RL to compare the OS of patients who underwent combined Hep and patients who did not.RESULTS Of the 121 patients(aged 61.9±10.1 years),77(63.6%)underwent Ch+RL,and 44(36.4%)underwent Ch only.Seven(9.1%)patients in the Ch+RL group had lymph node metastasis.The 5-year OS rate was significantly higher in the Ch+RL group than in the Ch group(76.3%vs 56.8%,P=0.036).Multivariate analysis showed that Ch+RL was significantly associated with improved OS(hazard ratio:0.51;95%confidence interval:0.26-0.99).Among the 77 patients who underwent Ch+RL,no survival improvement was found in patients who underwent combined Hep(5-year OS rate:79.5%for combined Hep and 76.1%for no Hep;P=0.50).CONCLUSION T1b GBC patients who underwent Ch+RL had a better prognosis than those who underwent Ch.Hep+Ch showed no improvement in prognosis in T1b GBC patients.Although recommended by both the National Comprehensive Cancer Network and Chinese Medical Association guidelines,RL was only performed in 63.6%of T1b GBC patients.Routine Ch+RL should be advised in T1b GBC.展开更多
In China pediatric liver transplantation(PLT)has become a safe and standardized procedure.Innovations and measures to further improve long-term survival and quality of life for children should be the next focus.In par...In China pediatric liver transplantation(PLT)has become a safe and standardized procedure.Innovations and measures to further improve long-term survival and quality of life for children should be the next focus.In particular better strategies related to the surgical treatment of high-risk recipients as well as the long-term follow-up of pediatric liver recipients have to be addressed.A particular attention should be given to children presenting significant co-morbidities and those needing retransplantation.A tight mul-tidisciplinary follow-up system addressing both short-and long-term issues of pediatric liver recipients is still a challenge for the Chinese pediatric transplant community.展开更多
Gallstone ileus is an uncommon but life-threatening form of mechanical small bowel obstruction,[1]especially in elderly female patients.[2]It is caused by large gallstone impaction that enters the bowel via a cholecys...Gallstone ileus is an uncommon but life-threatening form of mechanical small bowel obstruction,[1]especially in elderly female patients.[2]It is caused by large gallstone impaction that enters the bowel via a cholecystoduodenal fistula.Since the rarity of gallstone ileus is associated with relatively high rates of morbidity and mortality in elderly patients with multiple comorbidities,making an early and accurate diagnosis in emergency settings crucial.展开更多
BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double c...BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.展开更多
Itaconate,a macrophage-specific anti-inflammatory metabolite,has recently emerged as a critical regulator in rheumatoid arthritis pathogenesis.We found that itaconate is a TNF-αresponsive metabolite significantly ele...Itaconate,a macrophage-specific anti-inflammatory metabolite,has recently emerged as a critical regulator in rheumatoid arthritis pathogenesis.We found that itaconate is a TNF-αresponsive metabolite significantly elevated in the serum and synovial fluid of rheumatoid arthritis patients and we demonstrated that itaconate is primarily produced by inflammatory macrophages rather than osteoclasts or osteoblasts.In TNF-transgenic and Irg1−/−hybrid mice,a more severe bone destruction phenotype was observed.展开更多
With the sustained growth of the economy and significant changes in social demographics,the issue of elderly-related diseases has increasingly drawn attention,particularly.Alzheimer’s disease(AD),as a representative ...With the sustained growth of the economy and significant changes in social demographics,the issue of elderly-related diseases has increasingly drawn attention,particularly.Alzheimer’s disease(AD),as a representative disease of neurodegenerative diseases,has become a major challenge,affecting the health and quality of life of the elderly population severely.In recent years,the incidence,prevalence and mortality rates of AD have increased in China,imposing substantial economic burdens on families,society and the entire healthcare system.To proactively address this challenge and respond to the national‘Healthy China Action’initiative,leading experts from authoritative institutions jointly authored the China Alzheimer Report 2025.Building on previous editions,this report updates epidemiological data on AD in China,thoroughly analyses the latest economic burdens of the disease and comprehensively evaluates the current status of AD diagnosis and treatment services,as well as the allocation of public health resources in our country.Its release reflects China’s progress in AD research and prevention,underscores societal concern for elderly health and aims to provide scientific guidance and data support for AD prevention,diagnosis and treatment.It also facilitates academic exchanges and cooperation,enhancing public awareness and promoting active participation in elderly healthcare,towards achieving‘healthy ageing’in China.展开更多
Background:Diagnostic panels based on multiple biomarkers and clinical characteristics are considered more favorable than individual biomarker to diagnose hepatocellular carcinoma(HCC).Based on age,sex,alpha-fetoprote...Background:Diagnostic panels based on multiple biomarkers and clinical characteristics are considered more favorable than individual biomarker to diagnose hepatocellular carcinoma(HCC).Based on age,sex,alpha-fetoprotein(AFP),and protein induced by vitamin K absence II(PIVKA-II)with/without AFP-L3,ASAP and GALAD models are potential diagnostic panels.The diagnostic performances of these two panels were compared relative to HCC detection among patients with various etiologies of chronic liver diseases(CLDs).Methods:A multicenter case-control study recruited CLDs patients with and without HCC from 14 Chi-nese hospitals.The etiologies of CLDs included hepatitis B virus(HBV),hepatitis C virus(HCV),alcoholic liver disease(ALD),and nonalcoholic fatty liver disease(NAFLD).Using area under the receiver operating characteristic curve(AUC)values,the diagnostic performances of ASAP and GALAD models were com-pared to detect HCC among patients with various etiologies of CLDs.Results:Among 248 HCC patients and 722 CLD controls,the ASAP model demonstrated the highest AUC(0.886)to detect HCC at any stage,outperforming the GALAD model(0.853,P=0.001),as well as any individual biomarker(0.687-0.799,all P<0.001).In the subgroup analysis of various CLDs etiologies,the ASAP model outperformed the GALAD model to HCC independent of CLDs etiology.In addition,the ASAP model performed better in detecting early-stage(BCLC stage 0/A)HCC versus the GALAD model.Conclusions:Despite using one less laboratory variable(AFP-L3),the ASAP model demonstrated better diagnostic performance than the GALAD model to detect all-stage HCC among patients with various eti-ologies of CLDs-related HCC.展开更多
BACKGROUND Liposarcoma is the most common soft tissue tumor in adults.Liposarcoma commonly occurs in the lower extremities and retroperitoneum but rarely in the mediastinum.To the best of our knowledge,this is the fir...BACKGROUND Liposarcoma is the most common soft tissue tumor in adults.Liposarcoma commonly occurs in the lower extremities and retroperitoneum but rarely in the mediastinum.To the best of our knowledge,this is the first report of bilateral single-port video-assisted thoracoscopic surgery(VATS)for giant mediastinal liposarcoma and the first report of esophageal fistula after this surgery.CASE SUMMARY We present the case of a 71-year-old male patient with a giant posterior mediastinal tumor.Chest computed tomography and magnetic resonance imaging showed that the tumor completely involved the esophagus.The patient underwent bilateral single-port VATS and the tumor was completely removed.An esophageal fistula was detected 9 days after surgery and 2 days after eating.Emergency debridement surgery was performed,and a drainage tube was placed.The fistula healed gradually after the second surgery.CONCLUSION VATS is safer than thoracotomy for treating giant mediastinal liposarcoma.For tumors extensively involving the esophagus,preventive measures against esophageal fistula are necessary.展开更多
BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recom...BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients.展开更多
Lymphatic-venous anastomosis(LVA)surgery has recently emerged as a potential treatment for Alzheimer’s disease(AD)in China.This minimally invasive microsurgical procedure has been used for decades to treat lymphoedem...Lymphatic-venous anastomosis(LVA)surgery has recently emerged as a potential treatment for Alzheimer’s disease(AD)in China.This minimally invasive microsurgical procedure has been used for decades to treat lymphoedema,typically in the limbs,to decompress blocked lymphatic drainage pathways.展开更多
BACKGROUND Epstein-Barr virus(EBV)infection of the intestinal mucosa is associated with surgical risk in ulcerative colitis(UC);however,the exact effect remains unclear.AIM To determine whether EBV infection can predi...BACKGROUND Epstein-Barr virus(EBV)infection of the intestinal mucosa is associated with surgical risk in ulcerative colitis(UC);however,the exact effect remains unclear.AIM To determine whether EBV infection can predict the need for colectomy and to develop a surgical risk predictive model.METHODS This was a single-center retrospective study of 153 patients with moderate-tosevere UC between September 2012 and May 2023.EBV-encoded small RNA(EBER)in situ hybridization and immunohistochemistry(IHC)were used for EBV testing and assessment.Cytomegalovirus(CMV)was detected by IHC.Logistic regression analysis was conducted to identify risk factors for colectomy and develop a predictive risk model.RESULTS EBER-positivity in the intestinal mucosa was present in 40.4%(19/47)and 4.7%(5/106)of patients in the surgery and non-surgery groups,respectively,with significant differences between the groups(P<0.01,odds ratio=13.707).The result of multivariate logistic regression revealed that age,EBV infection in the colonic mucosa,CMV infection in the colonic mucosa,and treatment with three or more immunosuppressive agents before admission were significant independent predictors of colectomy.A nomogram incorporating these variables demonstrated good discriminative ability,and exhibited good calibration and clinical utility.IHC showed that EBV-infected cells mainly included B and T lymphocytes in patients with high EBER concentrations.CONCLUSION EBV infection of the intestinal mucosa is a significant independent risk factor for colectomy in patients with moderate-to-severe UC.The nomogram model,which includes EBV infection,effectively predicts colectomy risk.展开更多
Background:Organ transplantation recipients encounter significant risks from acute or chronic infections that threaten graft survival.BK virus(BKV)and JC virus(JCV)are 2 prominent opportunistic infection viruses,and t...Background:Organ transplantation recipients encounter significant risks from acute or chronic infections that threaten graft survival.BK virus(BKV)and JC virus(JCV)are 2 prominent opportunistic infection viruses,and they may cause polyomavirus-associated nephropathy and graft kidney loss in patients who are in an immunosuppressed state after kidney transplantation.Hence,timely detection and sustained monitoring of the viral load are indispensable.However,the current diagnostic methods remain limited,and the development of new molecular detection technology is extremely urgent.Methods:The sequences and concentrations of clustered regularly interspaced short palindromic repeats(CRISPR)RNA(crRNA),the concentration of Cas13a,and the primers for recombinase polymerase amplification(RPA)were optimized for BKV and JCV detection.Next,a novel microfluidic dual-droplet chip was designed and fabricated,and it was integrated with CRISPR(ddCRISPR)to simultaneously qualitatively detect BKV and JCV.Subsequently,the ddCRISPR assay was verified using clinical samples.Then,a lateral flow strip combined with CRISPR(LFCRISPR)was developed for the detection of BKV and JCV in resource-limited settings.Results:A one-pot RPA-CRISPR reaction system was established and optimized for BKV and JCV detection.ddCRISPR can simultaneously and rapidly detect BKV and JCV with high sensitivity(10 copies/ml for BKV and 1 copy/ml for JCV),and provide absolute quantification,which is suitable for viral load detection and conducive to personalized and precise treatment for organ transplant recipients.LFCRISPR simplified the operational process through a simple visual readout,facilitating virus screening after organ transplantation.Conclusion:These platforms incorporate molecular testing into the transplantation treatment model,thereby reducing costs,prolonging the survival time of the graft,improving the clinical outcomes of postoperative management in kidney transplantation,and enhancing the patients’quality of life.展开更多
基金supported by the National Natural Science Foundation of China(91940305)。
文摘Pancreatic cancer(PC)is a highly lethal disease,and current clinical drugs often have significant side effects.Traditional Chinese medicines,particularly food and medicine homology herbs,present novel opportunities for the development of low-toxicity tumor treatments.It is imperative to further explore the application of these substances in the field of tumor therapy.To investigate the effect of Ci-Gu-Tang(CGT)on PC both in vitro and in vivo and to elucidate its underlying mechanism.In this study,liquid chromatography-mass spectrometry(LC-MS)technology was utilized to validate the constituents of CGT,whereas network pharmacology was employed to further analyze the 37 active ingredients in CGT and their nine targets associated with PC.Protein-protein interaction(PPI)investigations revealed that the three potential key targets are epidermal growth factor receptor(EGFR),AKT serine/threonine kinase 1(AKT1),and signal transducer and activator of transcription 3(STAT3).Molecular docking was used to elucidate the binding mode and energy between four active ingredients(β-sitosterol,stigmasterol,quercetin,and prangenidin)and the above three targets.Subsequent in vitro and in vivo studies further validated its anti-PC efficacy and confirmed the involvement of the EGFR/AKT1/STAT3 signaling pathway.The utilization of patient-derived organoid(PDO)and patient-derived xenograft(PDX)models enhanced the clinical significance of this investigation.The present research utilized network pharmacology,molecular docking,LC-MS,and in vitro and in vivo experiments to examine the effects and mechanism of CGT in the treatment of PC.This study revealed thatβ-sitosterol,stigmasterol,quercetin,and prangenidin could be practical components by inhibiting tumorigenesis through the EGFR/AKT1/STAT3 axis.PDO and PDX models also demonstrated the effectiveness of CGT.This study represents a pioneering effort in the use of patient-derived models to investigate the potential of food and medicine homology species in cancer treatment.
基金supported by Technological Innovation 2030-Major Projects of“Brain Science and Brain-like Research,”No.2022ZD0206200(to XG)the National Natural Science Foundation of China,No.82371245(to SJ),82102246(to XD),81701092(to XG)+2 种基金the Natural Science Foundation of Shandong Province,No.ZR2020MH129(to SJ)Shanghai Municipal Key Clinical Specialty,No.shslczdzk03601Shanghai Engineering Research Center of Peri-operative Organ Support and Function Preservation,No.20DZ2254200。
文摘Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases.Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits.This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment.Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment,including cerebrovascular diseases,Alzheimer's disease,aging-related conditions,and issues related to anesthesia and surgery.The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized,and targeting AHN is considered a promising approach for treating cognitive impairment.However,the underlying mechanisms of this role are not yet fully understood,and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited,with a need for further development of treatment methods and detection techniques.By reviewing recent studies,we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories:immunity,energy metabolism,aging,and pathological states.In immunity-related mechanisms,abnormalities in meningeal,brain,and peripheral immunity can disrupt normal adult hippocampal neurogenesis.Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis.During aging,the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients.Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis.Among the current strategies used to enhance this form of neurogenesis,physical therapies such as exercise,transcutaneous electrical nerve stimulation,and enriched environments have proven effective.Dietary interventions,including energy intake restriction and nutrient optimization,have shown efficacy in both basic research and clinical trials.However,drug treatments,such as antidepressants and stem cell therapy,are primarily reported in basic research,with limited clinical application.The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention,and targeting the former may be an important strategy for treating the latter.However,the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear,and treatments are lacking.This highlights the need for greater focus on translating research findings into clinical practice.
基金supported by the National Key Research and Development Program of China(No.2023YFA0915400)the National Natural Science Foundation of China(No.22277072,22407099 and 32401161)+3 种基金Shanghai Oriental Talents(QNWS2024055)Shanghai Municipal Science and Technology Commission(No.24ZR1462700)the Science and Technology Development Fund of Pudong Health Bureau of Shanghai(No.PKJ2024-Y40)“Clinic Plus”Outstanding Project(No.2021ZYB009 and No.2021ZYB003)from Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine,and Innovative research team of high-level local universities in Shanghai。
文摘As the central template for protein expression,messenger ribonucleic acid(mRNA)holds immense potential for novel therapeutic strategies.Over the past few decades,mRNA-based therapeutics have demonstrated remarkable efficacy in a range of applications,including epidemic vaccine,cancer vaccine,protein replacement therapy,cytokine therapy,cell therapy and gene editing.Due to the inherent instability of mRNA,the rational design of mRNA structure is the prerequisite for therapeutic utility while effective delivery systems are also essential for in vivo applications.This review focuses on the optimization of mRNA structure and highlights key delivery strategies.It also provides a comprehensive overview of the major applications of mRNA-based strategies.In addition,it highlights the persistent challenges in m RNA therapeutics,particularly in terms of stability,immunogenicity,delivery efficiency and safety.By examining recent advances in mRNA design,delivery and application,this review aims to support ongoing research and development in the field of mRNA-based therapeutics.
基金funded by National Natural Science Foundation of China(82360801).
文摘Tumor metabolic reprogramming is a core hallmark of cancer,characterized by pathways such as aerobic glycolysis,aberrant lipid metabolism,and glutaminolysis that support rapid proliferation and immunosuppressive microenvironments.Circular RNAs(circRNAs)are highly stable,evolutionarily conserved non-coding RNAs that have emerged as critical modulators of these metabolic shifts.This review aims to systematically elucidate the roles and mechanisms of circRNAs in reprogramming tumor metabolism,and to discuss their clinical potential as biomarkers and therapeutic targets.Through mechanisms including miRNA sponging,protein interactions,regulation of mitochondrial dynamics,and modulation of metabolic enzymes,circRNAs influence key metabolic pathways by targeting glycolytic enzymes,lipid synthesis regulators,and glutaminolysis-related molecules to either facilitate or inhibit their expression.This review systematically summarizes the unique contributions of circRNAs to tumor metabolic reprogramming,highlighting key mechanisms such as regulation of peptide-encoding protein translation,mitochondrial localization function,gene promoter-targeted transcriptional regulation,and cross-pathway metabolic mediation,which underscore their distinct biological advantages and regulatory roles in tumor metabolism.The stability and tissue specificity of circRNAs make them promising diagnostic biomarkers,while their role in drug resistance mediated by metabolic reprogramming highlights their potential as therapeutic targets.Strategies such as circRNA inhibitors,mimics,and nanoparticle-based delivery systems are being explored to modulate tumor metabolism.Despite challenges including complex regulatory networks and limited manipulation tools,advances in high-throughput technologies and clinical trials hold promise for translating circRNA research into novel cancer therapies.
基金Suppored by Nanjing Municipal Bureau of Physical Education and Sports Research Bureau Management Subjects (NJTY2023-104)Nanjing "Sports and Health Integration" New Model (JSYGY-3-2023-505)。
文摘Objective: This review aims to explore the efficacy of exercise in the treatment of anxiety disorders and its underlying mechanisms, summarizing recent research advances and focusing on the potential biological and psychological pathways through which exercise exerts its anxiolytic effects.Methods: To ensure comprehensive coverage of relevant studies, we conducted a systematic search in databases such as PubMed, Web of Science, and Embase, combining MeSH terms with free-text terms. Keywords included“exercise,” “physical activity,” and “anxiety disorder.”Results and conclusions: Current research widely supports exercise as a safe and effective intervention for anxiety.Both aerobic exercise and resistance training have shown significant anxiety-reducing effects across various populations. The mechanisms of action can be categorized into three main types: cellular and molecular mechanisms, systemic immune effects, and behavioral and cognitive pathways. Different forms of exercise have distinct advantages: aerobic exercise is suitable for the general population, resistance training is beneficial for individuals with coexisting physical conditions, and low-intensity exercises such as yoga and Tai Chi are suitable for pregnant women, the elderly, or postoperative recovery patients. Given its good safety profile and broad applicability, moderate exercise should be considered a first-line treatment for mild anxiety and an adjunctive intervention for moderate to severe anxiety. Future research should further clarify the mechanistic differences between various exercise modalities and promote the development of individualized exercise prescriptions.
文摘Cancer continues to pose a formidable challenge in global health,with conventional treatments such as chemotherapy and radiotherapy often resulting in severe toxicities that significantly degrade patients’quality of life and restrict therapeutic outcomes.Addressing this pressing issue,this review presents a thorough and systematic analysis of innovative and emerging strategies designed to minimize the toxicity induced by treatment,while maintaining or even enhancing antitumor efficacy.The focus is on six promising therapeutic approaches:combination therapies utilizing natural bioactive products,molecularly targeted therapies,immunotherapies,nanotechnology-mediated drug delivery systems,adjunct traditional Chinese medicine interventions,and low-dose spatiotemporally concerted regimens.Each approach employs unique mechanisms—such as enhanced targeting precision,immune system activation,tumor microenvironment reprogramming,and multi-component synergistic effects—to mitigate damage to normal tissues and reduce systemic adverse reactions.Despite promising preclinical and clinical advancements,several challenges persist,including drug resistance,high economic costs,a lack of reliable predictive biomarkers,and complexities in clinical translation and regulatory approval.Looking ahead,the incorporation of artificial intelligence,multi-omics profiling,and novel biomimetic nanotechnologies offers unprecedented opportunities for developing highly personalized,low-toxicity treatment frameworks.This review highlights a fundamental shift in oncology towards precision medicine that balances efficacy with safety,demonstrating the transformative potential of these strategies in shaping the future of cancer therapy and enhancing patient care globally.
基金Supported by Shanghai Hospital Development Commission,No.SHDC2020CR1037Bthe National Key R&D Program of China,No.2017YFC0908100+7 种基金the National Science and Technology Major Project,No.2018ZX10302206,2018ZX10723203 and 2017ZX10202202Shanghai Municipal Education Commission-Guofeng Clinical Medicine Grant,No.20152213the National Natural Science Foundation of China,No.82170629,81930061,81900579,81970550,82070613,82070650,and 81972265Chongqing Natural Science Foundation,No.CSTC2019jcyj-zdxmX0004Beijing Municipal Science&Technology Commission,No.Z191100006619033Local Innovative and Research Teams Project of Guangdong Pearl River Talents Program,No.2017BT01S131the Foundation for Innovative Research Groups of Hubei Provincial Natural Science Foundation,No.2018CFA031Guangdong Basic and Applied Basic Research Foundation,No.2020A1515010052.
文摘BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is sparse.AIM To investigate the prevalence,outcome and risk factors for AILD in cirrhotic patients complicated with AD in China.METHODS We collected data from patients with cirrhosis and AD from two prospective,multicenter cohorts in hepatitis B virus endemic areas.Patients were regularly followed up at the end of 28-d,90-d and 365-d,or until death or liver transplantation(LT).The primary outcome in this study was 90-d LTfree mortality.Acute-on-chronic liver failure(ACLF)was assessed on admission and during 28-d hospitalization,according to the diagnostic criteria of the European Association for the Study of the Liver(EASL).Risk factors for death were analyzed with logistic regression model.RESULTS In patients with cirrhosis and AD,the overall prevalence of AILD was 9.3%(242/2597).Prevalence of ACLF was significantly lower in AILD cases(14%)than those with all etiology groups with cirrhosis and AD(22.8%)(P<0.001).Among 242 enrolled AILD patients,the prevalence rates of primary biliary cirrhosis(PBC),autoimmune hepatitis(AIH)and PBC-AIH overlap syndrome(PBC/AIH)were 50.8%,28.5%and 12.0%,respectively.In ACLF patients,the proportions of PBC,AIH and PBC/AIH were 41.2%,29.4% and 20.6%.28-d and 90-d mortality were 43.8% and 80.0% in AILD-related ACLF.The etiology of AILD had no significant impact on 28-d,90-d or 365-d LTfree mortality in patients with cirrhosis and AD in both univariate and multivariate analysis.Total bilirubin(TB),hepatic encephalopathy(HE)and blood urea nitrogen(BUN)were independent risk factors for 90-d LT-free mortality in multivariate analysis.The development of ACLF during hospitalization only independently correlated to TB and international normalized ratio.CONCLUSION AILD was not rare in hospitalized patients with cirrhosis and AD in China,among which PBC was the most common etiology.90-d LT-free mortality were independently associated with TB,HE and BUN.
文摘In recent years, due to frequent occurrence of public health emergencies, outbreaks of major infectious diseases represented by COVID-19have brought great harm to the lives and health of people. General hospitals are indispensable in disease prevention and control. The studyanalyzed a comprehensive evaluation method of epidemic prewarning and treatment for COVID‑19 in general hospitals through literature reviewand provided a reference for constructing urban public health prewarning and treatment system.
基金National Natural Science Foundation of China(General Program),No.31620103910National Natural Science Foundation of China(Key Program),No.81874181+3 种基金National Health Commission of China,No.2019ZX09301158Shanghai Municipal Commission of Economy and Informatization,No.2019RGZN01096Shanghai Shenkang Hospital Development Center,No.12018107and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,No.19XHCR13D.
文摘BACKGROUND Whether regional lymphadenectomy(RL)should be routinely performed in patients with T1b gallbladder cancer(GBC)remains a subject of debate.AIM To investigate whether RL can improve the prognosis of patients with T1b GBC.METHODS We studied a multicenter cohort of patients with T1b GBC who underwent surgery between 2008 and 2016 at 24 hospitals in 13 provinces in China.The logrank test and Cox proportional hazards model were used to compare the overall survival(OS)of patients who underwent cholecystectomy(Ch)+RL and those who underwent Ch only.To investigate whether combined hepatectomy(Hep)improved OS in T1b patients,we studied patients who underwent Ch+RL to compare the OS of patients who underwent combined Hep and patients who did not.RESULTS Of the 121 patients(aged 61.9±10.1 years),77(63.6%)underwent Ch+RL,and 44(36.4%)underwent Ch only.Seven(9.1%)patients in the Ch+RL group had lymph node metastasis.The 5-year OS rate was significantly higher in the Ch+RL group than in the Ch group(76.3%vs 56.8%,P=0.036).Multivariate analysis showed that Ch+RL was significantly associated with improved OS(hazard ratio:0.51;95%confidence interval:0.26-0.99).Among the 77 patients who underwent Ch+RL,no survival improvement was found in patients who underwent combined Hep(5-year OS rate:79.5%for combined Hep and 76.1%for no Hep;P=0.50).CONCLUSION T1b GBC patients who underwent Ch+RL had a better prognosis than those who underwent Ch.Hep+Ch showed no improvement in prognosis in T1b GBC patients.Although recommended by both the National Comprehensive Cancer Network and Chinese Medical Association guidelines,RL was only performed in 63.6%of T1b GBC patients.Routine Ch+RL should be advised in T1b GBC.
文摘In China pediatric liver transplantation(PLT)has become a safe and standardized procedure.Innovations and measures to further improve long-term survival and quality of life for children should be the next focus.In particular better strategies related to the surgical treatment of high-risk recipients as well as the long-term follow-up of pediatric liver recipients have to be addressed.A particular attention should be given to children presenting significant co-morbidities and those needing retransplantation.A tight mul-tidisciplinary follow-up system addressing both short-and long-term issues of pediatric liver recipients is still a challenge for the Chinese pediatric transplant community.
基金National Natural Science Foundation of China(81902379)Chenguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission(21CGA20)Cultivation Foundation of Renji Hospital(RJPY-LX-011).
文摘Gallstone ileus is an uncommon but life-threatening form of mechanical small bowel obstruction,[1]especially in elderly female patients.[2]It is caused by large gallstone impaction that enters the bowel via a cholecystoduodenal fistula.Since the rarity of gallstone ileus is associated with relatively high rates of morbidity and mortality in elderly patients with multiple comorbidities,making an early and accurate diagnosis in emergency settings crucial.
基金Supported by the Health Technology Project of Pudong New District Health Commission,No.PW2020D-12.
文摘BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
基金supported by the National Natural Science Foundation of China(NSFC)(No.82130073,No.82372430,No.31871431,No.31821002,No.32101011,No.22177073)Shanghai Frontiers Science Center of Degeneration and Regeneration in Skeletal System+3 种基金Shanghai Science and Technology Committee(No.23ZR1437600,No.24410710600,No.24141901302)Shenzhen Medical Research Fund(No.B2302005)The Open Project Funding of Shanghai Key Laboratory of Orthopedics(No.KFKT202201)Biomaterials and Regenerative Medicine Institute Cooperative,Research Project,Shanghai Jiao Tong University School of Medicine(No.2022LHA01).
文摘Itaconate,a macrophage-specific anti-inflammatory metabolite,has recently emerged as a critical regulator in rheumatoid arthritis pathogenesis.We found that itaconate is a TNF-αresponsive metabolite significantly elevated in the serum and synovial fluid of rheumatoid arthritis patients and we demonstrated that itaconate is primarily produced by inflammatory macrophages rather than osteoclasts or osteoblasts.In TNF-transgenic and Irg1−/−hybrid mice,a more severe bone destruction phenotype was observed.
基金supported by a grant from Brain Science and BrainLike Intelligence Technology of the Ministry of Science and Technology of China(2021ZD0201804).
文摘With the sustained growth of the economy and significant changes in social demographics,the issue of elderly-related diseases has increasingly drawn attention,particularly.Alzheimer’s disease(AD),as a representative disease of neurodegenerative diseases,has become a major challenge,affecting the health and quality of life of the elderly population severely.In recent years,the incidence,prevalence and mortality rates of AD have increased in China,imposing substantial economic burdens on families,society and the entire healthcare system.To proactively address this challenge and respond to the national‘Healthy China Action’initiative,leading experts from authoritative institutions jointly authored the China Alzheimer Report 2025.Building on previous editions,this report updates epidemiological data on AD in China,thoroughly analyses the latest economic burdens of the disease and comprehensively evaluates the current status of AD diagnosis and treatment services,as well as the allocation of public health resources in our country.Its release reflects China’s progress in AD research and prevention,underscores societal concern for elderly health and aims to provide scientific guidance and data support for AD prevention,diagnosis and treatment.It also facilitates academic exchanges and cooperation,enhancing public awareness and promoting active participation in elderly healthcare,towards achieving‘healthy ageing’in China.
基金supported by grants from the National Natural Science Foundation of China(81972726 and 82273074)Abbott Diagnostics(ADD-China-2016).
文摘Background:Diagnostic panels based on multiple biomarkers and clinical characteristics are considered more favorable than individual biomarker to diagnose hepatocellular carcinoma(HCC).Based on age,sex,alpha-fetoprotein(AFP),and protein induced by vitamin K absence II(PIVKA-II)with/without AFP-L3,ASAP and GALAD models are potential diagnostic panels.The diagnostic performances of these two panels were compared relative to HCC detection among patients with various etiologies of chronic liver diseases(CLDs).Methods:A multicenter case-control study recruited CLDs patients with and without HCC from 14 Chi-nese hospitals.The etiologies of CLDs included hepatitis B virus(HBV),hepatitis C virus(HCV),alcoholic liver disease(ALD),and nonalcoholic fatty liver disease(NAFLD).Using area under the receiver operating characteristic curve(AUC)values,the diagnostic performances of ASAP and GALAD models were com-pared to detect HCC among patients with various etiologies of CLDs.Results:Among 248 HCC patients and 722 CLD controls,the ASAP model demonstrated the highest AUC(0.886)to detect HCC at any stage,outperforming the GALAD model(0.853,P=0.001),as well as any individual biomarker(0.687-0.799,all P<0.001).In the subgroup analysis of various CLDs etiologies,the ASAP model outperformed the GALAD model to HCC independent of CLDs etiology.In addition,the ASAP model performed better in detecting early-stage(BCLC stage 0/A)HCC versus the GALAD model.Conclusions:Despite using one less laboratory variable(AFP-L3),the ASAP model demonstrated better diagnostic performance than the GALAD model to detect all-stage HCC among patients with various eti-ologies of CLDs-related HCC.
文摘BACKGROUND Liposarcoma is the most common soft tissue tumor in adults.Liposarcoma commonly occurs in the lower extremities and retroperitoneum but rarely in the mediastinum.To the best of our knowledge,this is the first report of bilateral single-port video-assisted thoracoscopic surgery(VATS)for giant mediastinal liposarcoma and the first report of esophageal fistula after this surgery.CASE SUMMARY We present the case of a 71-year-old male patient with a giant posterior mediastinal tumor.Chest computed tomography and magnetic resonance imaging showed that the tumor completely involved the esophagus.The patient underwent bilateral single-port VATS and the tumor was completely removed.An esophageal fistula was detected 9 days after surgery and 2 days after eating.Emergency debridement surgery was performed,and a drainage tube was placed.The fistula healed gradually after the second surgery.CONCLUSION VATS is safer than thoracotomy for treating giant mediastinal liposarcoma.For tumors extensively involving the esophagus,preventive measures against esophageal fistula are necessary.
基金Supported by the National Natural Science Foundation of China,No.82471804.
文摘BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients.
基金the Ministry of Science and Technology of the People's Republic of China(2021ZD0201804,GW)the National Natural Science Foundation of China(82371416,HW).
文摘Lymphatic-venous anastomosis(LVA)surgery has recently emerged as a potential treatment for Alzheimer’s disease(AD)in China.This minimally invasive microsurgical procedure has been used for decades to treat lymphoedema,typically in the limbs,to decompress blocked lymphatic drainage pathways.
基金Supported by General Hospital Integrated Guidance Project of Shanghai Municipal Health Commission and Municipal Administration of Traditional Chinese Medicine(Phase I),No.ZXXT-202210"Science and Technology Innovation Action Plan"Medical Innovation Research Project of Shanghai Municipal Science and Technology Commission,No.22Y11907900.
文摘BACKGROUND Epstein-Barr virus(EBV)infection of the intestinal mucosa is associated with surgical risk in ulcerative colitis(UC);however,the exact effect remains unclear.AIM To determine whether EBV infection can predict the need for colectomy and to develop a surgical risk predictive model.METHODS This was a single-center retrospective study of 153 patients with moderate-tosevere UC between September 2012 and May 2023.EBV-encoded small RNA(EBER)in situ hybridization and immunohistochemistry(IHC)were used for EBV testing and assessment.Cytomegalovirus(CMV)was detected by IHC.Logistic regression analysis was conducted to identify risk factors for colectomy and develop a predictive risk model.RESULTS EBER-positivity in the intestinal mucosa was present in 40.4%(19/47)and 4.7%(5/106)of patients in the surgery and non-surgery groups,respectively,with significant differences between the groups(P<0.01,odds ratio=13.707).The result of multivariate logistic regression revealed that age,EBV infection in the colonic mucosa,CMV infection in the colonic mucosa,and treatment with three or more immunosuppressive agents before admission were significant independent predictors of colectomy.A nomogram incorporating these variables demonstrated good discriminative ability,and exhibited good calibration and clinical utility.IHC showed that EBV-infected cells mainly included B and T lymphocytes in patients with high EBER concentrations.CONCLUSION EBV infection of the intestinal mucosa is a significant independent risk factor for colectomy in patients with moderate-to-severe UC.The nomogram model,which includes EBV infection,effectively predicts colectomy risk.
基金supported by the National Key Research and Development Program(2023YFC2306200)the National Natural Science Foundation of China(82472374)+1 种基金the Cross-Research Fund of Biomedical Engineering of Shanghai Jiaotong University(YG2024LC02)the Clinical Excellence project of Shanghai Key Laboratory of Nucleic Acid Chemistry and Nanomedicine(2024ZY008).
文摘Background:Organ transplantation recipients encounter significant risks from acute or chronic infections that threaten graft survival.BK virus(BKV)and JC virus(JCV)are 2 prominent opportunistic infection viruses,and they may cause polyomavirus-associated nephropathy and graft kidney loss in patients who are in an immunosuppressed state after kidney transplantation.Hence,timely detection and sustained monitoring of the viral load are indispensable.However,the current diagnostic methods remain limited,and the development of new molecular detection technology is extremely urgent.Methods:The sequences and concentrations of clustered regularly interspaced short palindromic repeats(CRISPR)RNA(crRNA),the concentration of Cas13a,and the primers for recombinase polymerase amplification(RPA)were optimized for BKV and JCV detection.Next,a novel microfluidic dual-droplet chip was designed and fabricated,and it was integrated with CRISPR(ddCRISPR)to simultaneously qualitatively detect BKV and JCV.Subsequently,the ddCRISPR assay was verified using clinical samples.Then,a lateral flow strip combined with CRISPR(LFCRISPR)was developed for the detection of BKV and JCV in resource-limited settings.Results:A one-pot RPA-CRISPR reaction system was established and optimized for BKV and JCV detection.ddCRISPR can simultaneously and rapidly detect BKV and JCV with high sensitivity(10 copies/ml for BKV and 1 copy/ml for JCV),and provide absolute quantification,which is suitable for viral load detection and conducive to personalized and precise treatment for organ transplant recipients.LFCRISPR simplified the operational process through a simple visual readout,facilitating virus screening after organ transplantation.Conclusion:These platforms incorporate molecular testing into the transplantation treatment model,thereby reducing costs,prolonging the survival time of the graft,improving the clinical outcomes of postoperative management in kidney transplantation,and enhancing the patients’quality of life.
