Emerging ferroptosis-immunotherapy strategies,integrating functionalized nanoplatforms with ferroptosis-inducing agents and immunomodulatory therapeutics,demonstrate significant potential in managing primary,recurrent...Emerging ferroptosis-immunotherapy strategies,integrating functionalized nanoplatforms with ferroptosis-inducing agents and immunomodulatory therapeutics,demonstrate significant potential in managing primary,recurrent,and metastatic malignancies.Mechanistically,ferroptosis induction not only directly eliminates tumor cells but also promotes immunogenic cell death(ICD),eliciting damage-associated molecular patterns(DAMPs)release to activate partial antitumor immunity.However,standalone ferroptosis therapy fails to initiate robust systemic antitumor immune responses due to inherent limitations:low tumor immunogenicity,immunosuppressive microenvironment constraints,and tumor microenvironment(TME)-associated physiological barriers(e.g.,hypoxia,dense extracellular matrix).To address these challenges,synergistic approaches have been developed to enhance immune cell infiltration and reestablish immunosurveillance,encompassing(1)direct amplification of antitumor immunity,(2)disruption of immunosuppressive tumor niches,and(3)biophysical hallmark remodeling in TME.Rational nanocarrier design has emerged as a critical enabler for overcoming biological delivery barriers and optimizing therapeutic efficacy.Unlike prior studies solely addressing ferroptosis or nanotechnology in tumor therapy,this work first systematically outlines the synergistic potential of nanoparticles in combined ferroptosis-immunotherapy strategies.It advances multidimensional nanoplatform design principles for material selection,structural configuration,physicochemical modulation,multifunctional integration,and artificial intelligence-enabled design,providing a scientific basis for efficacy optimization.Moreover,it examines translational challenges of ferroptosis-immunotherapy nanoplatforms across preclinical and clinical stages,proposing actionable solutions while envisioning future onco-immunotherapy directions.Collectively,it provides systematic insights into advanced nanomaterial design principles and therapeutic optimization strategies,offering a roadmap for accelerating clinical translation in onco-immunotherapy research.展开更多
Noninvasive brain stimulation techniques offer promising therapeutic and regenerative prospects in neurological diseases by modulating brain activity and improving cognitive and motor functions.Given the paucity of kn...Noninvasive brain stimulation techniques offer promising therapeutic and regenerative prospects in neurological diseases by modulating brain activity and improving cognitive and motor functions.Given the paucity of knowledge about the underlying modes of action and optimal treatment modalities,a thorough translational investigation of noninvasive brain stimulation in preclinical animal models is urgently needed.Thus,we reviewed the current literature on the mechanistic underpinnings of noninvasive brain stimulation in models of central nervous system impairment,with a particular emphasis on traumatic brain injury and stroke.Due to the lack of translational models in most noninvasive brain stimulation techniques proposed,we found this review to the most relevant techniques used in humans,i.e.,transcranial magnetic stimulation and transcranial direct current stimulation.We searched the literature in Pub Med,encompassing the MEDLINE and PMC databases,for studies published between January 1,2020 and September 30,2024.Thirty-five studies were eligible.Transcranial magnetic stimulation and transcranial direct current stimulation demonstrated distinct strengths in augmenting rehabilitation post-stroke and traumatic brain injury,with emerging mechanistic evidence.Overall,we identified neuronal,inflammatory,microvascular,and apoptotic pathways highlighted in the literature.This review also highlights a lack of translational surrogate parameters to bridge the gap between preclinical findings and their clinical translation.展开更多
N umerous neurological disorders negatively impact the nervous system,either through loss of neurons or by disrupting the normal functioning of neural networks.These impairments manifest as cognitive defects,memory lo...N umerous neurological disorders negatively impact the nervous system,either through loss of neurons or by disrupting the normal functioning of neural networks.These impairments manifest as cognitive defects,memory loss,behavioral abnormalities,and motor dysfunctions.Decades of research have significantly advanced our understanding of the pathophysiology underlying neurodegene rative diseases,including Alzheimer's disease(AD),Parkinson's disease,amyotrophic lateral sclerosis,and others.展开更多
Nowadays,hepatocellular carcinoma(HCC) is frequently diagnosed at an early stage,opening good perspectives to radical treatment by means of liver transplantation,surgical resection,or percutaneous ablation.Liver trans...Nowadays,hepatocellular carcinoma(HCC) is frequently diagnosed at an early stage,opening good perspectives to radical treatment by means of liver transplantation,surgical resection,or percutaneous ablation.Liver transplantation is considered the best option,but the lack of liver donors represents a major limitation.Therefore,surgical resection,offering a 5-year-survival rate of over 50%,is considered the first-choice treatment for patients with early stage HCC,whereas percutaneous ablation is usually reserved to patients who are not candidate to surgery.However,in the recent years some trials showed that percutaneous radiofrequency ablation(RFA) can be as effective as surgical resection in terms of overall survival and recurrencefree survival rates in patients with small HCC,and a retrospective comparative study reported 1-,3-,and 5-year overall survival rates and recurrence-free survival rates significantly better in patients with central HCC measuring 2 cm or smaller treated with RFA than in those treated with surgical resection.RFA is less expensive,less invasive,with lower complication rate and shorter hospital stay than surgical resection,and on the basis of the results of these studies it should be considered the first option in the treatment of very early HCC.However,RFA is size-dependent,so at present the need to achieve an adequate safety margin around the tumor limits to about 2 cm the diameter of the nodules that can be ablated with long-term outcomes comparable to or better than surgical resection.The main goal of the next technical developments of the thermal ablation systems should be the achievement of larger ablation areas with a single needle insertion.In this regard,the recent improvements in microwave energy delivery systems seem to open interesting perspectives to percutaneous microwave ablation,which could become the ablation technique of choice in the next future.展开更多
To analyze the importance of para-aortic node status in a series of patients who underwent pancreaticoduodenectomy (PD) in a single Institution. METHODSBetween January 2000 and December 2012, 151 patients underwent PD...To analyze the importance of para-aortic node status in a series of patients who underwent pancreaticoduodenectomy (PD) in a single Institution. METHODSBetween January 2000 and December 2012, 151 patients underwent PD with para-aortic node dissection for pancreatic adenocarcinoma in our Institution. Patients were divided into two groups: patients with negative PALNs (PALNs-), and patients with metastatic PALNs (PALNs+). Pathologic factors, including stage, nodal status, number of positive nodes and lymph node ratio, invasion of para-aortic nodes, tumor’s grading, and radicality of resection were studied by univariate and multivariate analysis. Survival curves were constructed with Kaplan-Meier method and compared with Log-rank test: significance was considered as P < 0.05. RESULTSA total of 107 patients (74%) had nodal metastases. Median number of pathologically assessed lymph nodes was 26 (range 14-63). Twenty-five patients (16.5%) had para-aortic lymph node involvement. Thirty-three patients (23%) underwent R1 pancreatic resection. One-hundred forty-one patients recurred and died for tumor recurrence, one is alive with recurrence, and 9 are alive and free of disease. Overall survival was significantly influenced by grading (P = 0.0001), radicality of resection (P = 0.001), stage (P = 0.03), lymph node status (P = 0.04), para-aortic nodes metastases (P = 0.02). Multivariate analysis showed that grading was an independent prognostic factor for overall survival (P = 0.0001), while grading (P = 0.0001) and radicality of resection (P = 0.01) were prognostic parameters for disease-free survival. Number of metastatic nodes, node ratio, and para-aortic nodes involvement were not independent predictors of disease-free and overall survival. CONCLUSIONIn this experience, lymph node status and para-aortic node metastases were associated with poor survival at univariate analysis, but they were not independent prognostic factors.展开更多
BACKGROUND Recurrent acute pancreatitis(RAP)may be a presenting feature of and an indication for resection of pancreatic cysts,including intra-ductal papillary mucinous neoplasm(IPMN).Few data are available regarding ...BACKGROUND Recurrent acute pancreatitis(RAP)may be a presenting feature of and an indication for resection of pancreatic cysts,including intra-ductal papillary mucinous neoplasm(IPMN).Few data are available regarding the prevalence of malignancy and post-operative RAP in this population.AIM To study the role of resection to help prevent RAP and analyze if presentation as RAP would be a predictor for malignancy.METHODS This retrospective study assessed 172 patients who underwent surgical resection of pancreatic cystic neoplasms at a university hospital between 2002 and 2016.The prevalence of preoperative high-risk cyst features,and of neoplasia was compared between patients with and without RAP.To identify the cause of pancreatitis,all the patients had a detailed history of alcohol,smoking,medications obtained,and had cross-sectional imaging(contrast-enhanced computed tomography/magnetic resonance imaging)and endoscopic ultrasound to look for gallstone etiology and other structural causes for pancreatitis.The incidence of RAP post-resection was the primary outcome.RESULTS IPMN accounted for 101 cases(58.7%){[branch duct(BD)59(34.3%),main duct(MD)42](24.4%)}.Twenty-nine(16.9%)presented with RAP(mean 2.2 episodes):15 had BD-IPMN,8 MD-IPMN,5 mucinous cystic neoplasm and 1 serous cystic neoplasm.Malignancy was similar among those with vs without RAP for all patients[6/29(20.7%)vs 24/143(16.8%)]and IPMN patients[6/23(26.1%)vs 23/78(29.5%)],although tended to be higher with RAP in BD-IPMN,[5/15(33.3%)vs 3/44(6.8%),P=0.04].At mean follow-up of 7.2 years,1(3.4%)RAP patient had post-resection RAP.The mean episodes of acute pancreatitis before vs after surgery were 3.4 vs 0.02(P<0.0001).CONCLUSION Malignancy was not increased in patients with pancreatic cystic neoplasms who have RAP compared to those without RAP.In addition,specific cyst characteristics were not clearly associated with RAP.The incidence of RAP was markedly decreased in almost all patients following cyst resection.展开更多
AIM To evaluate disparities in the treatment of hepatocellular carcinoma(HCC) based on gender.METHODS A retrospective database analysis using the Nationwide Inpatient Sample(NIS) was performed between 2010 and 2013. A...AIM To evaluate disparities in the treatment of hepatocellular carcinoma(HCC) based on gender.METHODS A retrospective database analysis using the Nationwide Inpatient Sample(NIS) was performed between 2010 and 2013. Adult patients with a primary diagnosis of hepatocellular carcinoma determined by International Classification of Disease 9(ICD-9) codes were included. Univariate analysis and multivariate logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient's gender.RESULTS The analysis included 62582 patients with 45908 men and 16674 women. Women were less likely to present with decompensated liver disease(OR = 0.84, P < 0.001) and had less risk of inpatient mortality when compared to men(OR = 0.75, P < 0.001). Women were more likely to receive inpatient resection(OR = 1.31, P < 0.001) or an ablation(OR = 1.22, P = 0.028) than men. There was no significant difference between men and women in regard to liver transplantation and transcatheter arterial chemoembolization(TACE).CONCLUSION Gender impacts treatment for hepatocellular carcinoma. Women are more likely to undergo an ablation or resection then men. Gender disparities in transplantation have resolved.展开更多
In recent years,the increase of psychopathological disorders in the population has become a health emergency,leading to a great effort to understand psychological vulnerability mechanisms.In this scenario,the role of ...In recent years,the increase of psychopathological disorders in the population has become a health emergency,leading to a great effort to understand psychological vulnerability mechanisms.In this scenario,the role of the autonomic nervous system(ANS)has become increasingly important.This study investigated the association between ANS,social skills,and psychopathological functioning in children.As an ANS status proxy,we measured heart rate variability(HRV).Infants admitted to the neonatal intensive care unit of the University Hospital of Padova because of preterm birth or neonatal hypoxic-ischemic encephalopathy were sequentially recruited from January 2011 to June 2013 and followed long-term up to school age in this cross-sectional observational study.We recorded 5 minutes of HRV immediately before measuring performance in social abilities tasks(affect recognition and theory of mind,NEPSY-II)in 50 children(mean age 7.4±1.4 years)with and without risk factors for developing neuropsychiatric disorders due to pre-/perinatal insults without major sequelae.Children also completed extensive cognitive,neuropsychological,and psychosocial assessment.Parents were assessed with psychopathological interviews and a questionnaire(CBCL 6-18).Analysis in a robust Bayesian framework was used to unearth dependencies between HRV,social skills,and psychopathological functioning.Social task scores were associated with HRV components,with high frequency the most consistent.HRV bands were also associated with the psychopathological questionnaire.Only normalized HRV high frequency was able to distinguish impaired children in the affect recognition task.Our data suggest that ANS may be implicated in social cognition both in typical and atypical developmental conditions and that HRV has cross-disease sensitivity.We suggest that HRV parameters may reflect a neurobiological vulnerability to psychopathology.The study was approved by the Ethics Committee of the University Hospital of Padova(Comitato Etico per la Sperimentazione,Azienda Opedaliera di Padova,approval No.1693 P).展开更多
Blockchain technology is increasingly popular and has been widely applied in many industrial fields,due to its unique properties of decentralization,immutability,and traceability.Blockchain systems in different fields...Blockchain technology is increasingly popular and has been widely applied in many industrial fields,due to its unique properties of decentralization,immutability,and traceability.Blockchain systems in different fields vary,with different block structures,consensus mechanisms and access permission models.These differences make it hard for different blockchain systems to interoperate with each other,which isolates them.Cross-chain technologies have been developed to solve this isolation problem in order to improve the interoperability of blockchains.Although some surveys on cross-chain technologies can be found,they are unable to keep up with the latest research progress due to their extremely fast pace of development.Moreover,the literature misses general criteria to evaluate the quality of cross-chain technologies.In this paper,a comprehensive literature review of cross-chain technologies is conducted by employing a comprehensive set of evaluation criteria.The preliminaries on blockchain interoperability are first presented.Then,a set of evaluation criteria is proposed in terms of security,privacy,performance,and functionality.The latest cutting-edge works are reviewed based on the proposed taxonomy of cross-chain technologies and their performance is evaluated against our proposed criteria.Finally,some open issues and future directions of cross-chain research are pointed out.展开更多
Objective: To determine the histopathological correlation between central and lateral neck metastasis in differentiated thyroid carcinoma, and its potential therapeutic impact. Although the central neck dissection (CN...Objective: To determine the histopathological correlation between central and lateral neck metastasis in differentiated thyroid carcinoma, and its potential therapeutic impact. Although the central neck dissection (CND) is recommended in differentiated thyroid carcinoma, the indication for lateral neck dissection (LND) remains controversial. Design: Retrospective study. Methods and Main Outcome Measures: Pathological analysis of systematic ipsilateral central neck dissection (CND) and LND performed with total thyroidectomy in differentiated thyroid carcinoma was retrospectively reviewed according to “side” and to “patient”. Results: A total of 56 sides (46 patients) were suitable for analysis. Analysis by “side” revealed that CND and LND dissection samples were both negative in 15 cases, both positive in 32, CND was positive and LND was negative for 8 cases and CND was negative and LND was positive in 1 case. The combined presence of positive LND and positive CND was therefore observed in 32/40 “sides” and 26/46 “patients”. Analysis by “side” of the impact of the treatment decision to perform ipsilateral LND only in patients with positive CND and vice versa demonstrated a sensitivity, specificity, and accuracy of 97%, 65%, and 84%, respectively. Conclusions: In most cases, the presence of positive LND was associated with positive ipsilateral CND. The very low prevalence of positive LND in patients with negative CND may justify LND as a second step procedure only in patients with positive CND, except in the case of documented lateral neck metastasis.展开更多
Background:Platinum chemotherapy(CT)remains the backbone of systemic therapy for patients with smallcell lung cancer(SCLC).The nucleotide excision repair(NER)pathway plays a central role in the repair of the DNA damag...Background:Platinum chemotherapy(CT)remains the backbone of systemic therapy for patients with smallcell lung cancer(SCLC).The nucleotide excision repair(NER)pathway plays a central role in the repair of the DNA damage exerted by platinum agents.Alteration in this repair mechanism may affect patients’survival.Materials and Methods:We conducted a retrospective analysis of data from 38 patients with extensive disease(ED)-SCLC who underwent platinum-CT at the Clinical Oncology Unit,Careggi University Hospital,Florence(Italy),from 2015 to 2020.mRNA expression analysis and single nucleotide polymorphism(SNP)characterization of three NER pathway genes—namely ERCC1,ERCC2,and ERCC5—were performed on patient tumor samples.Results:Overall,elevated expression of ERCC genes was observed in SCLC patients compared to healthy controls.Patients with low ERCC1 and ERCC5 expression levels exhibited a better median progression-free survival(mPFS=7.1 vs.4.9 months,p=0.39 for ERCC1 and mPFS=6.9 vs.4.8 months,p=0.093 for ERCC5)and overall survival(mOS=8.7 vs.6.0 months,p=0.4 for ERCC1 and mOS=7.2 vs.6.2 months,p=0.13 for ERCC5).Genotyping analysis of five SNPs of ERCC genes showed a longer survival in patients harboring the wild-type genotype or the heterozygous variant of the ERCC1 rs11615 SNP(p=0.24 for PFS and p=0.14 for OS)and of the rs13181 and rs1799793 ERCC2 SNPs(p=0.43 and p=0.26 for PFS and p=0.21 and p=0.16 for OS,respectively)compared to patients with homozygous mutant genotypes.Conclusions:The comprehensive analysis of ERCC gene expression and SNP variants appears to identify patients who derive greater survival benefits from platinum-CT.展开更多
The Macao Science Satellite-1(known as MSS-1)is the first scientific exploration satellite that was designed to measure the Earth's low latitude magnetic field at high resolution and with high precision by collect...The Macao Science Satellite-1(known as MSS-1)is the first scientific exploration satellite that was designed to measure the Earth's low latitude magnetic field at high resolution and with high precision by collecting data in a near-equatorial orbit.Magnetic field data from MSS-1's onboard Vector Fluxgate Magnetometer(VFM),collected at a sample rate of 50 Hz,allows us to detect and investigate sources of magnetic data contamination,from DC to relevant Nyquist frequency.Here we report two types of artificial disturbances in the VFM data.One is V-shaped events concentrated at night,with frequencies sweeping from the Nyquist frequency down to zero and back up.The other is 5-Hz events(ones that exhibit a distinct 5 Hz spectrum peak);these events are always accompanied by intervals of spiky signals,and are clearly related to the attitude control of the satellite.Our analyses show that VFM noise levels in daytime are systematically lower than in nighttime.The daily average noise levels exhibit a period of about 52 days.The V-shaped events are strongly correlated with higher VFM noise levels.展开更多
Spontaneous coronary artery dissection(SCAD)is a rare non-atherosclerotic cause of acute coronary syndromes defined as non-iatrogenic,non-traumatic separation of the coronary artery wall.The most common profile is a m...Spontaneous coronary artery dissection(SCAD)is a rare non-atherosclerotic cause of acute coronary syndromes defined as non-iatrogenic,non-traumatic separation of the coronary artery wall.The most common profile is a middle-aged woman between 44 and 53 years with few cardiovascular risk factors.SCAD is frequently linked with predisposing factors,such as postpartum,fibromuscular dysplasia or other vasculopathies,connective tissue disease and hormonal therapy,and it is often triggered by intense physical or emotional stress,sympathomimetic drugs,childbirth and activities increasing shear stress of the coronary artery walls.Patients with SCAD usually present at the emergency department with chest discomfort,chest pain,and rapid heartbeat or fluttery.During the last decades,the most common problem of SCAD was the lack of awareness about this condition which has led to significant underdiagnosis and misdiagnosis.However,modern imaging techniques such as optical coherence tomography,intravascular ultrasound,coronary angiography or magnetic resonance imaging have contributed to the early diagnosis of the disease.Treatment of SCAD remains controversial,especially during the last years,where invasive techniques are being used more often and in more emergent cardiac syndromes.Although conservative treatment combining aspirin and betablocker remains the recommended strategy in most cases,revascularization could also be suggested as a method of treatment in specific indications,but with a higher risk of complications.The prognosis of SCAD is usually good and long-term mortality seems to be low in these patients.Follow-up should be performed on a regular basis.展开更多
Taxonomic and faunistic results on three genera in the tribes Margaroniini Swinhoe & Cotes, 1889 and Agroterini Acloque, 1897—Omiodes Guinée, 1854, Patania Moore, 1888 and Notarcha Meyrick, 1884 are presente...Taxonomic and faunistic results on three genera in the tribes Margaroniini Swinhoe & Cotes, 1889 and Agroterini Acloque, 1897—Omiodes Guinée, 1854, Patania Moore, 1888 and Notarcha Meyrick, 1884 are presented, based on material sampled in the Afrotropical part of the Arabian Peninsula, in the south-western province of Jizan, Saudi Arabia. Omiodes undularis sp.n., Patania orbiscularis sp.n. and Patania rhomboidalis sp.n. are newly described. Of Omiodes undularis sp.n., the adults, male genitalia, and tympanal organs are described and figured. The female genitalia are unknown. The Afrotropical and Oriental species of the genus potentially related to the new species by external characters are reviewed. The differential character states distinguishing the new species from the closest related Omiodes indicata (Fabricius, 1775) are listed. The adults and male genitalia of Patania orbiscularis sp.n. are described and figured. The female genitalia are unknown. The species most closely related in the male genitalia is Patania tchadalis (Leraut, 2005). The differential character states are listed. Of Patania rhomboidalis sp.n., the adults, female genitalia, and tympanal organs are described and figured. The new species is externally closely related to Patania tchadalis (Leraut, 2005), Patania harutai (Inoue, 1955), Patania crepuscularia Matsui & Naka, 2023, Patania accipitralis (Walker, 1866) and Patania fraterna (Moore, 1885) externally and in the female genitalia. The external and internal differential character states are listed. A determination key to the newly described Arabian species of the genus Patania Moore, 1888 and their closest relatives is given. The female genitalia of Notarcha viridalis Seizmair, 2021 attributed to the Notarcha quaternalis (Zeller, 1852) species complex, are described for the first time. The species is reported as new to the fauna of Saudi Arabia. A determination key based on the internal morphology of the species of the Notarcha quaternalis (Zeller, 1852) species complex is given.展开更多
BACKGROUND Neuroendocrine tumors(NETs)are rare malignancies arising from the diffuse neuroendocrine system,often in the gastroenteropancreatic(GEP)tract.GEP-NETs,primarily involving the intestines(50%)and pancreas(30%...BACKGROUND Neuroendocrine tumors(NETs)are rare malignancies arising from the diffuse neuroendocrine system,often in the gastroenteropancreatic(GEP)tract.GEP-NETs,primarily involving the intestines(50%)and pancreas(30%),may occa-sionally secrete hormones,causing syndromes.Diagnosis relies on markers like chromogranin A,synaptophysin,and Ki-67,along with imaging modalities.Ri-sing NETs incidence is attributed to advancements in diagnostic modalities,parti-cularly endoscopic ultrasonography(EUS).EUS demonstrates high accuracy in detecting small lesions,assessing tumor depth,and identifying locoregional lymph nodes.Despite its proven diagnostic utility,there is limited data on EUS's role in evaluating GEP-NETs in resource-constrained settings like Pakistan.AIM To evaluate the diagnostic role of EUS in characterizing GEP-NETs based on clinical,histopathological,tumor grading,and site-specific differences.METHODS This single-center retrospective descriptive study was conducted at Aga Khan University Hospital,Karachi,a tertiary care hospital,from January 2021 to December 2023.Fourteen adult patients(≥18 years)with suspected NETs who underwent EUS and were diagnosed via histopathology were included.Data on demographics,clinical features,radiological findings,and histopathological characteristics were collected.Descriptive analysis was performed using SPSS version 23,with descriptive statistics expressed as means±SD for continuous variables and frequencies/percentages for categorical data.RESULTS A total of 14 adult GEP-NETs patients who underwent EUS were included,with a mean age of 52±14 years and the majority being male(71.4%).Common clinical presentations included weight loss(85.7%)and abdominal pain(78.6%).Computed tomography scans were performed in 92.9%of cases,with pancreatic masses detected in 42.9%of patients.EUS-guided fine needle biopsy(FNB)had a 100%diagnostic yield.The pancreas was the most common tumor site(57.1%).Histopathology revealed 78.6%of cases as well-differentiated NETs with 42.9%being grade II.Metastases were seen in 57.1%of patients,with the liver being the most common site.Surgical interventions were performed in 28.6%of patients,and all patients were alive at the time of study analysis.CONCLUSION EUS,with accurate imaging and effective EUS-FNB,is the gold standard for GEP-NET diagnosis,aiding tumor assessment and prognosis.Larger studies are needed to validate its impact on management outcomes.展开更多
Foreign body ingestion is a common gastrointestinal emergency,particularly in children,who account for 80%of cases.While most ingested objects pass spontan-eously,around 20%require medical intervention.In adults,incid...Foreign body ingestion is a common gastrointestinal emergency,particularly in children,who account for 80%of cases.While most ingested objects pass spontan-eously,around 20%require medical intervention.In adults,incidents often occur accidentally during meals,leading to impactions,especially in individuals with underlying esophageal conditions.Endoscopy remains the gold standard for foreign body retrieval,with a success rate exceeding 95%.The type,shape,and location of the foreign body determine the clinical presentation and management approach.Sharp objects,batteries,and large items pose the highest risk of complications,including perforation,obstruction,and chemical injury.Prompt endoscopic removal is guided by established protocols,with emergent inter-vention required for complete esophageal obstruction and high-risk objects.Various retrieval devices,including forceps,snares,baskets,and overtubes,are used based on the nature of the foreign body.Technological advancements,such as artificial intelligence-assisted imaging and endoscopic ultrasound,are impro-ving diagnostic precision and procedural outcomes.Despite these advances,foreign body ingestion can still lead to severe complications if not managed in a timely manner.Public awareness,preventive measures,and rapid medical res-ponse are essential in reducing morbidity and mortality associated with foreign body ingestion.展开更多
Bladder cancer remains a significant global health challenge,requiring repeated treatments and surveillance and potentially morbid therapies,particularly in advanced and recurrent stages.Exosomes,small extracellular v...Bladder cancer remains a significant global health challenge,requiring repeated treatments and surveillance and potentially morbid therapies,particularly in advanced and recurrent stages.Exosomes,small extracellular vesicles central to intercellular communication,have emerged as innovative tools in cancer diagnostics,prognosis,and therapy.Their role in modulating the immune response and the tumor microenvironment makes them particularly attractive for cancer immunotherapy.This review provides a comprehensive overview of exosome biology,with a focus on their role in immune modulation and potential therapeutic applications.We explore the progress and challenges of exosome-based immunotherapy in cancer,followed by a discussion on the current state of bladder cancer immunotherapy.Additionally,we highlight the roles of exosomes in bladder cancer,emphasizing their diagnostic and prognostic applications.Despite promising preclinical studies and a growing number of clinical trials in other cancers,exosome-based therapies remain underexplored in bladder cancer.We discuss the current clinical trials related to exosomes in bladder cancer and propose their potential future role in immunotherapy.Finally,we address the challenges and opportunities in translating exosome-based therapies from bench to bedside,emphasizing the need for further preclinical and clinical investigations.This review emphasized the potential of exosome-based immunotherapy as a transformative approach for bladder cancer diagnosis and treatment.展开更多
Chronic hepatitis delta virus(HDV)represents a rare but important co-infection in approximately 5%of patients with chronic hepatitis B virus(HBV)infection,and is associated with significant morbidity and mortality due...Chronic hepatitis delta virus(HDV)represents a rare but important co-infection in approximately 5%of patients with chronic hepatitis B virus(HBV)infection,and is associated with significant morbidity and mortality due to an increased risk for liver cirrhosis,liver failure,and hepatocellular carcinoma relative to HBV monoinfected individuals.The current treatment of chronic HDV infection includes the off-label use of pegylated interferon(IFN),which is limited by poor safety,tolerability,and efficacy.Guidelines of the major international liver organizations such as the American Association for the Study of Liver Diseases,European Association for the Study of the Liver,and Asian Pacific Association for the Study of the Liver provide recommendations for contemporary diagnosis and management of chronic HDV infection,including the incorporation of bulevirtide,a newly licensed antiviral agent in Europe.Significant unmet medical needs remain in the treatment of HDV,and recent advances in drug development offer hope for meaningful advances in drug therapy which may improve virologic response rates and clinical outcomes.This review summarizes trial design and available efficacy data from key phase 2 and 3 trials for investigational therapies including entry inhibitors(bulevirtide),prenylation inhibitors(lonafarnib),novel IFNs(peginterferon lambda),RNA interference molecules(JNJ-3989,elebsiran),monoclonal antibodies(tobevibart),and nucleic acid polymers(REP2139),and addresses future directions in HDV pharmacotherapy.展开更多
In a recent study by He et al,the nomogram integrates postoperative serum tumor markers such as carbohydrate antigen 19-9 and carcinoembryonic antigen,thereby improving the accuracy of identifying high-risk patients c...In a recent study by He et al,the nomogram integrates postoperative serum tumor markers such as carbohydrate antigen 19-9 and carcinoembryonic antigen,thereby improving the accuracy of identifying high-risk patients compared to relying solely on preoperative markers,which has significant implications for customizing adjuvant therapy and potentially improving outcomes for this aggressive form of cancer.However,the study’s single-center design and short follow-up period may limit the generalizability of its findings and potentially introduce reporting bias.Future studies could consider additional confounding factors,such as adjuvant chemotherapy and variations in surgical techniques,to improve the model’s accuracy.Furthermore,it would be valuable to validate the nomogram in broader,prospective cohorts and explore the inclusion of additional markers like circulating tumor DNA to refine further its predictive power and applicability across diverse patient populations.展开更多
Hypogonadotropic hypogonadism(HH)represents a relatively rare cause of nonobstructive azoospermia(NOA),but its knowledge is crucial for the clinical andrologists,as it represents a condition that can be corrected with...Hypogonadotropic hypogonadism(HH)represents a relatively rare cause of nonobstructive azoospermia(NOA),but its knowledge is crucial for the clinical andrologists,as it represents a condition that can be corrected with medical therapy in 3 quarters of cases.There are forms of congenital HH,whether or not associated with an absent sense of smell(anosmic HH or Kallmann syndrome,and normosmic HH,respectively),and forms of acquired HH.In congenital HH,complete absence of pubertal development is characteristic.On the other hand,if the deficit occurs after the time of pubertal development,as in acquired HH patients,infertility and typical symptoms of late-onset hypogonadism are the main reasons for seeking medical assistance.Gonadotropin-releasing hormone(GnRH)or gonadotropin replacement therapy is the mainstay of drug therapy and offers excellent results,although a small but significant proportion of patients do not achieve sufficient responses.展开更多
基金supported by the National Natural Science Foundation of China(Nos.82302373,81903846)Natural Science Foundation of Sichuan Province(No.2022NSFSC1925)+1 种基金Chengdu Technology Innovation Research and Development Project(No.2022-YF05-01546-SN)the Introduction of Talents Research Project of Chengdu University(No.2081921049)。
文摘Emerging ferroptosis-immunotherapy strategies,integrating functionalized nanoplatforms with ferroptosis-inducing agents and immunomodulatory therapeutics,demonstrate significant potential in managing primary,recurrent,and metastatic malignancies.Mechanistically,ferroptosis induction not only directly eliminates tumor cells but also promotes immunogenic cell death(ICD),eliciting damage-associated molecular patterns(DAMPs)release to activate partial antitumor immunity.However,standalone ferroptosis therapy fails to initiate robust systemic antitumor immune responses due to inherent limitations:low tumor immunogenicity,immunosuppressive microenvironment constraints,and tumor microenvironment(TME)-associated physiological barriers(e.g.,hypoxia,dense extracellular matrix).To address these challenges,synergistic approaches have been developed to enhance immune cell infiltration and reestablish immunosurveillance,encompassing(1)direct amplification of antitumor immunity,(2)disruption of immunosuppressive tumor niches,and(3)biophysical hallmark remodeling in TME.Rational nanocarrier design has emerged as a critical enabler for overcoming biological delivery barriers and optimizing therapeutic efficacy.Unlike prior studies solely addressing ferroptosis or nanotechnology in tumor therapy,this work first systematically outlines the synergistic potential of nanoparticles in combined ferroptosis-immunotherapy strategies.It advances multidimensional nanoplatform design principles for material selection,structural configuration,physicochemical modulation,multifunctional integration,and artificial intelligence-enabled design,providing a scientific basis for efficacy optimization.Moreover,it examines translational challenges of ferroptosis-immunotherapy nanoplatforms across preclinical and clinical stages,proposing actionable solutions while envisioning future onco-immunotherapy directions.Collectively,it provides systematic insights into advanced nanomaterial design principles and therapeutic optimization strategies,offering a roadmap for accelerating clinical translation in onco-immunotherapy research.
基金funded by the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation):project ID 431549029-SFB 1451the Marga-und-Walter-Boll-Stiftung(#210-10-15)(to MAR)a stipend from the'Gerok Program'(Faculty of Medicine,University of Cologne,Germany)。
文摘Noninvasive brain stimulation techniques offer promising therapeutic and regenerative prospects in neurological diseases by modulating brain activity and improving cognitive and motor functions.Given the paucity of knowledge about the underlying modes of action and optimal treatment modalities,a thorough translational investigation of noninvasive brain stimulation in preclinical animal models is urgently needed.Thus,we reviewed the current literature on the mechanistic underpinnings of noninvasive brain stimulation in models of central nervous system impairment,with a particular emphasis on traumatic brain injury and stroke.Due to the lack of translational models in most noninvasive brain stimulation techniques proposed,we found this review to the most relevant techniques used in humans,i.e.,transcranial magnetic stimulation and transcranial direct current stimulation.We searched the literature in Pub Med,encompassing the MEDLINE and PMC databases,for studies published between January 1,2020 and September 30,2024.Thirty-five studies were eligible.Transcranial magnetic stimulation and transcranial direct current stimulation demonstrated distinct strengths in augmenting rehabilitation post-stroke and traumatic brain injury,with emerging mechanistic evidence.Overall,we identified neuronal,inflammatory,microvascular,and apoptotic pathways highlighted in the literature.This review also highlights a lack of translational surrogate parameters to bridge the gap between preclinical findings and their clinical translation.
基金supported by the National Institute on Aging(Nos.AG000723 and AG000578)(to VAB)the Fondation Sante(No.19656),Greece 2.0+1 种基金the National Recovery and Resilience Plan’s flagship program TAEDR-0535850the European Research Council(No.101077374-Synapto Mitophagy)(to KP)。
文摘N umerous neurological disorders negatively impact the nervous system,either through loss of neurons or by disrupting the normal functioning of neural networks.These impairments manifest as cognitive defects,memory loss,behavioral abnormalities,and motor dysfunctions.Decades of research have significantly advanced our understanding of the pathophysiology underlying neurodegene rative diseases,including Alzheimer's disease(AD),Parkinson's disease,amyotrophic lateral sclerosis,and others.
文摘Nowadays,hepatocellular carcinoma(HCC) is frequently diagnosed at an early stage,opening good perspectives to radical treatment by means of liver transplantation,surgical resection,or percutaneous ablation.Liver transplantation is considered the best option,but the lack of liver donors represents a major limitation.Therefore,surgical resection,offering a 5-year-survival rate of over 50%,is considered the first-choice treatment for patients with early stage HCC,whereas percutaneous ablation is usually reserved to patients who are not candidate to surgery.However,in the recent years some trials showed that percutaneous radiofrequency ablation(RFA) can be as effective as surgical resection in terms of overall survival and recurrencefree survival rates in patients with small HCC,and a retrospective comparative study reported 1-,3-,and 5-year overall survival rates and recurrence-free survival rates significantly better in patients with central HCC measuring 2 cm or smaller treated with RFA than in those treated with surgical resection.RFA is less expensive,less invasive,with lower complication rate and shorter hospital stay than surgical resection,and on the basis of the results of these studies it should be considered the first option in the treatment of very early HCC.However,RFA is size-dependent,so at present the need to achieve an adequate safety margin around the tumor limits to about 2 cm the diameter of the nodules that can be ablated with long-term outcomes comparable to or better than surgical resection.The main goal of the next technical developments of the thermal ablation systems should be the achievement of larger ablation areas with a single needle insertion.In this regard,the recent improvements in microwave energy delivery systems seem to open interesting perspectives to percutaneous microwave ablation,which could become the ablation technique of choice in the next future.
文摘To analyze the importance of para-aortic node status in a series of patients who underwent pancreaticoduodenectomy (PD) in a single Institution. METHODSBetween January 2000 and December 2012, 151 patients underwent PD with para-aortic node dissection for pancreatic adenocarcinoma in our Institution. Patients were divided into two groups: patients with negative PALNs (PALNs-), and patients with metastatic PALNs (PALNs+). Pathologic factors, including stage, nodal status, number of positive nodes and lymph node ratio, invasion of para-aortic nodes, tumor’s grading, and radicality of resection were studied by univariate and multivariate analysis. Survival curves were constructed with Kaplan-Meier method and compared with Log-rank test: significance was considered as P < 0.05. RESULTSA total of 107 patients (74%) had nodal metastases. Median number of pathologically assessed lymph nodes was 26 (range 14-63). Twenty-five patients (16.5%) had para-aortic lymph node involvement. Thirty-three patients (23%) underwent R1 pancreatic resection. One-hundred forty-one patients recurred and died for tumor recurrence, one is alive with recurrence, and 9 are alive and free of disease. Overall survival was significantly influenced by grading (P = 0.0001), radicality of resection (P = 0.001), stage (P = 0.03), lymph node status (P = 0.04), para-aortic nodes metastases (P = 0.02). Multivariate analysis showed that grading was an independent prognostic factor for overall survival (P = 0.0001), while grading (P = 0.0001) and radicality of resection (P = 0.01) were prognostic parameters for disease-free survival. Number of metastatic nodes, node ratio, and para-aortic nodes involvement were not independent predictors of disease-free and overall survival. CONCLUSIONIn this experience, lymph node status and para-aortic node metastases were associated with poor survival at univariate analysis, but they were not independent prognostic factors.
文摘BACKGROUND Recurrent acute pancreatitis(RAP)may be a presenting feature of and an indication for resection of pancreatic cysts,including intra-ductal papillary mucinous neoplasm(IPMN).Few data are available regarding the prevalence of malignancy and post-operative RAP in this population.AIM To study the role of resection to help prevent RAP and analyze if presentation as RAP would be a predictor for malignancy.METHODS This retrospective study assessed 172 patients who underwent surgical resection of pancreatic cystic neoplasms at a university hospital between 2002 and 2016.The prevalence of preoperative high-risk cyst features,and of neoplasia was compared between patients with and without RAP.To identify the cause of pancreatitis,all the patients had a detailed history of alcohol,smoking,medications obtained,and had cross-sectional imaging(contrast-enhanced computed tomography/magnetic resonance imaging)and endoscopic ultrasound to look for gallstone etiology and other structural causes for pancreatitis.The incidence of RAP post-resection was the primary outcome.RESULTS IPMN accounted for 101 cases(58.7%){[branch duct(BD)59(34.3%),main duct(MD)42](24.4%)}.Twenty-nine(16.9%)presented with RAP(mean 2.2 episodes):15 had BD-IPMN,8 MD-IPMN,5 mucinous cystic neoplasm and 1 serous cystic neoplasm.Malignancy was similar among those with vs without RAP for all patients[6/29(20.7%)vs 24/143(16.8%)]and IPMN patients[6/23(26.1%)vs 23/78(29.5%)],although tended to be higher with RAP in BD-IPMN,[5/15(33.3%)vs 3/44(6.8%),P=0.04].At mean follow-up of 7.2 years,1(3.4%)RAP patient had post-resection RAP.The mean episodes of acute pancreatitis before vs after surgery were 3.4 vs 0.02(P<0.0001).CONCLUSION Malignancy was not increased in patients with pancreatic cystic neoplasms who have RAP compared to those without RAP.In addition,specific cyst characteristics were not clearly associated with RAP.The incidence of RAP was markedly decreased in almost all patients following cyst resection.
文摘AIM To evaluate disparities in the treatment of hepatocellular carcinoma(HCC) based on gender.METHODS A retrospective database analysis using the Nationwide Inpatient Sample(NIS) was performed between 2010 and 2013. Adult patients with a primary diagnosis of hepatocellular carcinoma determined by International Classification of Disease 9(ICD-9) codes were included. Univariate analysis and multivariate logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient's gender.RESULTS The analysis included 62582 patients with 45908 men and 16674 women. Women were less likely to present with decompensated liver disease(OR = 0.84, P < 0.001) and had less risk of inpatient mortality when compared to men(OR = 0.75, P < 0.001). Women were more likely to receive inpatient resection(OR = 1.31, P < 0.001) or an ablation(OR = 1.22, P = 0.028) than men. There was no significant difference between men and women in regard to liver transplantation and transcatheter arterial chemoembolization(TACE).CONCLUSION Gender impacts treatment for hepatocellular carcinoma. Women are more likely to undergo an ablation or resection then men. Gender disparities in transplantation have resolved.
文摘In recent years,the increase of psychopathological disorders in the population has become a health emergency,leading to a great effort to understand psychological vulnerability mechanisms.In this scenario,the role of the autonomic nervous system(ANS)has become increasingly important.This study investigated the association between ANS,social skills,and psychopathological functioning in children.As an ANS status proxy,we measured heart rate variability(HRV).Infants admitted to the neonatal intensive care unit of the University Hospital of Padova because of preterm birth or neonatal hypoxic-ischemic encephalopathy were sequentially recruited from January 2011 to June 2013 and followed long-term up to school age in this cross-sectional observational study.We recorded 5 minutes of HRV immediately before measuring performance in social abilities tasks(affect recognition and theory of mind,NEPSY-II)in 50 children(mean age 7.4±1.4 years)with and without risk factors for developing neuropsychiatric disorders due to pre-/perinatal insults without major sequelae.Children also completed extensive cognitive,neuropsychological,and psychosocial assessment.Parents were assessed with psychopathological interviews and a questionnaire(CBCL 6-18).Analysis in a robust Bayesian framework was used to unearth dependencies between HRV,social skills,and psychopathological functioning.Social task scores were associated with HRV components,with high frequency the most consistent.HRV bands were also associated with the psychopathological questionnaire.Only normalized HRV high frequency was able to distinguish impaired children in the affect recognition task.Our data suggest that ANS may be implicated in social cognition both in typical and atypical developmental conditions and that HRV has cross-disease sensitivity.We suggest that HRV parameters may reflect a neurobiological vulnerability to psychopathology.The study was approved by the Ethics Committee of the University Hospital of Padova(Comitato Etico per la Sperimentazione,Azienda Opedaliera di Padova,approval No.1693 P).
基金supported in part by the National Natural Science Foundation of China under Grant 62072351in part by the Key Research Project of Shaanxi Natural Science Foundation under Grant 2023-JCZD-35in part by the open research project of ZheJiang Lab under grant 2021PD0AB01。
文摘Blockchain technology is increasingly popular and has been widely applied in many industrial fields,due to its unique properties of decentralization,immutability,and traceability.Blockchain systems in different fields vary,with different block structures,consensus mechanisms and access permission models.These differences make it hard for different blockchain systems to interoperate with each other,which isolates them.Cross-chain technologies have been developed to solve this isolation problem in order to improve the interoperability of blockchains.Although some surveys on cross-chain technologies can be found,they are unable to keep up with the latest research progress due to their extremely fast pace of development.Moreover,the literature misses general criteria to evaluate the quality of cross-chain technologies.In this paper,a comprehensive literature review of cross-chain technologies is conducted by employing a comprehensive set of evaluation criteria.The preliminaries on blockchain interoperability are first presented.Then,a set of evaluation criteria is proposed in terms of security,privacy,performance,and functionality.The latest cutting-edge works are reviewed based on the proposed taxonomy of cross-chain technologies and their performance is evaluated against our proposed criteria.Finally,some open issues and future directions of cross-chain research are pointed out.
文摘Objective: To determine the histopathological correlation between central and lateral neck metastasis in differentiated thyroid carcinoma, and its potential therapeutic impact. Although the central neck dissection (CND) is recommended in differentiated thyroid carcinoma, the indication for lateral neck dissection (LND) remains controversial. Design: Retrospective study. Methods and Main Outcome Measures: Pathological analysis of systematic ipsilateral central neck dissection (CND) and LND performed with total thyroidectomy in differentiated thyroid carcinoma was retrospectively reviewed according to “side” and to “patient”. Results: A total of 56 sides (46 patients) were suitable for analysis. Analysis by “side” revealed that CND and LND dissection samples were both negative in 15 cases, both positive in 32, CND was positive and LND was negative for 8 cases and CND was negative and LND was positive in 1 case. The combined presence of positive LND and positive CND was therefore observed in 32/40 “sides” and 26/46 “patients”. Analysis by “side” of the impact of the treatment decision to perform ipsilateral LND only in patients with positive CND and vice versa demonstrated a sensitivity, specificity, and accuracy of 97%, 65%, and 84%, respectively. Conclusions: In most cases, the presence of positive LND was associated with positive ipsilateral CND. The very low prevalence of positive LND in patients with negative CND may justify LND as a second step procedure only in patients with positive CND, except in the case of documented lateral neck metastasis.
文摘Background:Platinum chemotherapy(CT)remains the backbone of systemic therapy for patients with smallcell lung cancer(SCLC).The nucleotide excision repair(NER)pathway plays a central role in the repair of the DNA damage exerted by platinum agents.Alteration in this repair mechanism may affect patients’survival.Materials and Methods:We conducted a retrospective analysis of data from 38 patients with extensive disease(ED)-SCLC who underwent platinum-CT at the Clinical Oncology Unit,Careggi University Hospital,Florence(Italy),from 2015 to 2020.mRNA expression analysis and single nucleotide polymorphism(SNP)characterization of three NER pathway genes—namely ERCC1,ERCC2,and ERCC5—were performed on patient tumor samples.Results:Overall,elevated expression of ERCC genes was observed in SCLC patients compared to healthy controls.Patients with low ERCC1 and ERCC5 expression levels exhibited a better median progression-free survival(mPFS=7.1 vs.4.9 months,p=0.39 for ERCC1 and mPFS=6.9 vs.4.8 months,p=0.093 for ERCC5)and overall survival(mOS=8.7 vs.6.0 months,p=0.4 for ERCC1 and mOS=7.2 vs.6.2 months,p=0.13 for ERCC5).Genotyping analysis of five SNPs of ERCC genes showed a longer survival in patients harboring the wild-type genotype or the heterozygous variant of the ERCC1 rs11615 SNP(p=0.24 for PFS and p=0.14 for OS)and of the rs13181 and rs1799793 ERCC2 SNPs(p=0.43 and p=0.26 for PFS and p=0.21 and p=0.16 for OS,respectively)compared to patients with homozygous mutant genotypes.Conclusions:The comprehensive analysis of ERCC gene expression and SNP variants appears to identify patients who derive greater survival benefits from platinum-CT.
基金supported by the National Key R&D Program of China(Grant2022YFF0503700)the National Natural Science Foundation of China(42474200 and 42174186)。
文摘The Macao Science Satellite-1(known as MSS-1)is the first scientific exploration satellite that was designed to measure the Earth's low latitude magnetic field at high resolution and with high precision by collecting data in a near-equatorial orbit.Magnetic field data from MSS-1's onboard Vector Fluxgate Magnetometer(VFM),collected at a sample rate of 50 Hz,allows us to detect and investigate sources of magnetic data contamination,from DC to relevant Nyquist frequency.Here we report two types of artificial disturbances in the VFM data.One is V-shaped events concentrated at night,with frequencies sweeping from the Nyquist frequency down to zero and back up.The other is 5-Hz events(ones that exhibit a distinct 5 Hz spectrum peak);these events are always accompanied by intervals of spiky signals,and are clearly related to the attitude control of the satellite.Our analyses show that VFM noise levels in daytime are systematically lower than in nighttime.The daily average noise levels exhibit a period of about 52 days.The V-shaped events are strongly correlated with higher VFM noise levels.
文摘Spontaneous coronary artery dissection(SCAD)is a rare non-atherosclerotic cause of acute coronary syndromes defined as non-iatrogenic,non-traumatic separation of the coronary artery wall.The most common profile is a middle-aged woman between 44 and 53 years with few cardiovascular risk factors.SCAD is frequently linked with predisposing factors,such as postpartum,fibromuscular dysplasia or other vasculopathies,connective tissue disease and hormonal therapy,and it is often triggered by intense physical or emotional stress,sympathomimetic drugs,childbirth and activities increasing shear stress of the coronary artery walls.Patients with SCAD usually present at the emergency department with chest discomfort,chest pain,and rapid heartbeat or fluttery.During the last decades,the most common problem of SCAD was the lack of awareness about this condition which has led to significant underdiagnosis and misdiagnosis.However,modern imaging techniques such as optical coherence tomography,intravascular ultrasound,coronary angiography or magnetic resonance imaging have contributed to the early diagnosis of the disease.Treatment of SCAD remains controversial,especially during the last years,where invasive techniques are being used more often and in more emergent cardiac syndromes.Although conservative treatment combining aspirin and betablocker remains the recommended strategy in most cases,revascularization could also be suggested as a method of treatment in specific indications,but with a higher risk of complications.The prognosis of SCAD is usually good and long-term mortality seems to be low in these patients.Follow-up should be performed on a regular basis.
文摘Taxonomic and faunistic results on three genera in the tribes Margaroniini Swinhoe & Cotes, 1889 and Agroterini Acloque, 1897—Omiodes Guinée, 1854, Patania Moore, 1888 and Notarcha Meyrick, 1884 are presented, based on material sampled in the Afrotropical part of the Arabian Peninsula, in the south-western province of Jizan, Saudi Arabia. Omiodes undularis sp.n., Patania orbiscularis sp.n. and Patania rhomboidalis sp.n. are newly described. Of Omiodes undularis sp.n., the adults, male genitalia, and tympanal organs are described and figured. The female genitalia are unknown. The Afrotropical and Oriental species of the genus potentially related to the new species by external characters are reviewed. The differential character states distinguishing the new species from the closest related Omiodes indicata (Fabricius, 1775) are listed. The adults and male genitalia of Patania orbiscularis sp.n. are described and figured. The female genitalia are unknown. The species most closely related in the male genitalia is Patania tchadalis (Leraut, 2005). The differential character states are listed. Of Patania rhomboidalis sp.n., the adults, female genitalia, and tympanal organs are described and figured. The new species is externally closely related to Patania tchadalis (Leraut, 2005), Patania harutai (Inoue, 1955), Patania crepuscularia Matsui & Naka, 2023, Patania accipitralis (Walker, 1866) and Patania fraterna (Moore, 1885) externally and in the female genitalia. The external and internal differential character states are listed. A determination key to the newly described Arabian species of the genus Patania Moore, 1888 and their closest relatives is given. The female genitalia of Notarcha viridalis Seizmair, 2021 attributed to the Notarcha quaternalis (Zeller, 1852) species complex, are described for the first time. The species is reported as new to the fauna of Saudi Arabia. A determination key based on the internal morphology of the species of the Notarcha quaternalis (Zeller, 1852) species complex is given.
文摘BACKGROUND Neuroendocrine tumors(NETs)are rare malignancies arising from the diffuse neuroendocrine system,often in the gastroenteropancreatic(GEP)tract.GEP-NETs,primarily involving the intestines(50%)and pancreas(30%),may occa-sionally secrete hormones,causing syndromes.Diagnosis relies on markers like chromogranin A,synaptophysin,and Ki-67,along with imaging modalities.Ri-sing NETs incidence is attributed to advancements in diagnostic modalities,parti-cularly endoscopic ultrasonography(EUS).EUS demonstrates high accuracy in detecting small lesions,assessing tumor depth,and identifying locoregional lymph nodes.Despite its proven diagnostic utility,there is limited data on EUS's role in evaluating GEP-NETs in resource-constrained settings like Pakistan.AIM To evaluate the diagnostic role of EUS in characterizing GEP-NETs based on clinical,histopathological,tumor grading,and site-specific differences.METHODS This single-center retrospective descriptive study was conducted at Aga Khan University Hospital,Karachi,a tertiary care hospital,from January 2021 to December 2023.Fourteen adult patients(≥18 years)with suspected NETs who underwent EUS and were diagnosed via histopathology were included.Data on demographics,clinical features,radiological findings,and histopathological characteristics were collected.Descriptive analysis was performed using SPSS version 23,with descriptive statistics expressed as means±SD for continuous variables and frequencies/percentages for categorical data.RESULTS A total of 14 adult GEP-NETs patients who underwent EUS were included,with a mean age of 52±14 years and the majority being male(71.4%).Common clinical presentations included weight loss(85.7%)and abdominal pain(78.6%).Computed tomography scans were performed in 92.9%of cases,with pancreatic masses detected in 42.9%of patients.EUS-guided fine needle biopsy(FNB)had a 100%diagnostic yield.The pancreas was the most common tumor site(57.1%).Histopathology revealed 78.6%of cases as well-differentiated NETs with 42.9%being grade II.Metastases were seen in 57.1%of patients,with the liver being the most common site.Surgical interventions were performed in 28.6%of patients,and all patients were alive at the time of study analysis.CONCLUSION EUS,with accurate imaging and effective EUS-FNB,is the gold standard for GEP-NET diagnosis,aiding tumor assessment and prognosis.Larger studies are needed to validate its impact on management outcomes.
文摘Foreign body ingestion is a common gastrointestinal emergency,particularly in children,who account for 80%of cases.While most ingested objects pass spontan-eously,around 20%require medical intervention.In adults,incidents often occur accidentally during meals,leading to impactions,especially in individuals with underlying esophageal conditions.Endoscopy remains the gold standard for foreign body retrieval,with a success rate exceeding 95%.The type,shape,and location of the foreign body determine the clinical presentation and management approach.Sharp objects,batteries,and large items pose the highest risk of complications,including perforation,obstruction,and chemical injury.Prompt endoscopic removal is guided by established protocols,with emergent inter-vention required for complete esophageal obstruction and high-risk objects.Various retrieval devices,including forceps,snares,baskets,and overtubes,are used based on the nature of the foreign body.Technological advancements,such as artificial intelligence-assisted imaging and endoscopic ultrasound,are impro-ving diagnostic precision and procedural outcomes.Despite these advances,foreign body ingestion can still lead to severe complications if not managed in a timely manner.Public awareness,preventive measures,and rapid medical res-ponse are essential in reducing morbidity and mortality associated with foreign body ingestion.
基金funded by start-up funds from the University of Chicago.
文摘Bladder cancer remains a significant global health challenge,requiring repeated treatments and surveillance and potentially morbid therapies,particularly in advanced and recurrent stages.Exosomes,small extracellular vesicles central to intercellular communication,have emerged as innovative tools in cancer diagnostics,prognosis,and therapy.Their role in modulating the immune response and the tumor microenvironment makes them particularly attractive for cancer immunotherapy.This review provides a comprehensive overview of exosome biology,with a focus on their role in immune modulation and potential therapeutic applications.We explore the progress and challenges of exosome-based immunotherapy in cancer,followed by a discussion on the current state of bladder cancer immunotherapy.Additionally,we highlight the roles of exosomes in bladder cancer,emphasizing their diagnostic and prognostic applications.Despite promising preclinical studies and a growing number of clinical trials in other cancers,exosome-based therapies remain underexplored in bladder cancer.We discuss the current clinical trials related to exosomes in bladder cancer and propose their potential future role in immunotherapy.Finally,we address the challenges and opportunities in translating exosome-based therapies from bench to bedside,emphasizing the need for further preclinical and clinical investigations.This review emphasized the potential of exosome-based immunotherapy as a transformative approach for bladder cancer diagnosis and treatment.
文摘Chronic hepatitis delta virus(HDV)represents a rare but important co-infection in approximately 5%of patients with chronic hepatitis B virus(HBV)infection,and is associated with significant morbidity and mortality due to an increased risk for liver cirrhosis,liver failure,and hepatocellular carcinoma relative to HBV monoinfected individuals.The current treatment of chronic HDV infection includes the off-label use of pegylated interferon(IFN),which is limited by poor safety,tolerability,and efficacy.Guidelines of the major international liver organizations such as the American Association for the Study of Liver Diseases,European Association for the Study of the Liver,and Asian Pacific Association for the Study of the Liver provide recommendations for contemporary diagnosis and management of chronic HDV infection,including the incorporation of bulevirtide,a newly licensed antiviral agent in Europe.Significant unmet medical needs remain in the treatment of HDV,and recent advances in drug development offer hope for meaningful advances in drug therapy which may improve virologic response rates and clinical outcomes.This review summarizes trial design and available efficacy data from key phase 2 and 3 trials for investigational therapies including entry inhibitors(bulevirtide),prenylation inhibitors(lonafarnib),novel IFNs(peginterferon lambda),RNA interference molecules(JNJ-3989,elebsiran),monoclonal antibodies(tobevibart),and nucleic acid polymers(REP2139),and addresses future directions in HDV pharmacotherapy.
文摘In a recent study by He et al,the nomogram integrates postoperative serum tumor markers such as carbohydrate antigen 19-9 and carcinoembryonic antigen,thereby improving the accuracy of identifying high-risk patients compared to relying solely on preoperative markers,which has significant implications for customizing adjuvant therapy and potentially improving outcomes for this aggressive form of cancer.However,the study’s single-center design and short follow-up period may limit the generalizability of its findings and potentially introduce reporting bias.Future studies could consider additional confounding factors,such as adjuvant chemotherapy and variations in surgical techniques,to improve the model’s accuracy.Furthermore,it would be valuable to validate the nomogram in broader,prospective cohorts and explore the inclusion of additional markers like circulating tumor DNA to refine further its predictive power and applicability across diverse patient populations.
文摘Hypogonadotropic hypogonadism(HH)represents a relatively rare cause of nonobstructive azoospermia(NOA),but its knowledge is crucial for the clinical andrologists,as it represents a condition that can be corrected with medical therapy in 3 quarters of cases.There are forms of congenital HH,whether or not associated with an absent sense of smell(anosmic HH or Kallmann syndrome,and normosmic HH,respectively),and forms of acquired HH.In congenital HH,complete absence of pubertal development is characteristic.On the other hand,if the deficit occurs after the time of pubertal development,as in acquired HH patients,infertility and typical symptoms of late-onset hypogonadism are the main reasons for seeking medical assistance.Gonadotropin-releasing hormone(GnRH)or gonadotropin replacement therapy is the mainstay of drug therapy and offers excellent results,although a small but significant proportion of patients do not achieve sufficient responses.
