BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,e...BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.展开更多
Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture proto...Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture protocols,this study aimed to assess the publications trends of acupuncture protocols over the past two decades and provided an overview for future research directions.Methods:Publications focusing on acupuncture protocols in clinical settings were retrieved and compiled from the Web of Science Core Collection spanning the period from 2004 to 2023.CiteSpace and Microsoft Excel software were used to analyze the relationship of publication with countries,institutions,authors,co-cited author,journals,references,keywords and other literature aspects.Results:This study analyzed 721 articles encompassing acupuncture protocols.A continuous yet fluctuating growth in publications volume were observed from 2004 to 2023.Notably,China stands at the forefront in contributing to acupuncture protocols,publishing 513 papers and demonstrating a high centrality score of 1.07 in cooperative network.Furthermore,China has fostered close collaborations with the USA and South Korea.Beijing University of Chinese Medicine(89),Zhishun Liu(36)and Trials(306)emerged as the top contributors in terms of institution,author,and journal,respectively.However,inter-institutional and author collaboration was relatively weak.Macpherson H was the most frequently cited author.High-frequency keywords included“randomized controlled trials”,“acupuncture”,“management”,“study protocol”,“quality of life”.Analysis of timeline diagram of keywords indicated that“functional dyspepsia”,“stroke”,“electroacupuncture”,and“colorectal cancer”were the research development trends and focus.Conclusion:Clinical acupuncture protocols have experienced robust development over the past two decades,with current research hotspots focusing on disease management and quality of life,which remain key research concerns.Moreover,we advocate for researchers to publish acupuncture protocols,which remain key research concerns.This approach allows for thorough pre-study planning of methodologies and objectives,enhancing scientific rigor through peer review,thereby laying the foundation for conducting high-quality research.展开更多
BACKGROUND Cholangiocarcinoma(CCA)poses a significant clinical challenge due to its low radical resection rate and a propensity for high postoperative recurrence,resulting in a poor dismal.Although the combination of ...BACKGROUND Cholangiocarcinoma(CCA)poses a significant clinical challenge due to its low radical resection rate and a propensity for high postoperative recurrence,resulting in a poor dismal.Although the combination of targeted therapy and immunotherapy has demonstrated notable efficacy in several solid tumors recently,however,its application in CCA remains underexplored and poorly documented.CASE SUMMARY This case report describes a patient diagnosed with stage IV CCA,accompanied by liver and abdominal wall metastases,who underwent palliative surgery.Subsequently,the patient received two cycles of treatment combining lenvatinib with sintilimab,which resulted in a reduction in abdominal wall metastasis,while intrahepatic metastasis displayed progression.This unexpected observation illustrates different responses of intrahepatic and extrahepatic metastases to the same therapy.CONCLUSION Lenvatinib combined with sintilimab shows promise as a potential treatment strategy for advanced CCA.Genetic testing for related driver and/or passenger mutations,as well as an analysis of tumor immune microenvironment analysis,is crucial for optimizing drug combinations and eventually addressing the issue of non-response in specific metastatic sites.展开更多
BACKGROUND Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasin...BACKGROUND Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CASE SUMMARY We treated three patients with acute cerebral infarction who died following treatment with edaravone.Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CONCLUSION Our cases highlight the importance of educating clinicians regarding the new edaravone-induced clinical syndromes of cerebral infarction as potentially fatal adverse drug reactions.Considering that no laboratory or confirmatory test exists to diagnose edaravone-induced death from cerebral infarction,clinicians’knowledge is the key element in recognizing this phenomenon.展开更多
Background:Temozolomide(TMZ)is an important adjuvant chemotherapy drug after glioma surgery.However,with the progress of treatment,most patients will gradually develop drug resistance.Long non-coding RNA(lncRNA)in the...Background:Temozolomide(TMZ)is an important adjuvant chemotherapy drug after glioma surgery.However,with the progress of treatment,most patients will gradually develop drug resistance.Long non-coding RNA(lncRNA)in the prediction and reversal of chemotherapy drug resistance possesses great potential.Methods:1.The clinical data and RNA expression matrix of glioma patients were downloaded from the Chinese Glioma Genome Atlas(CGGA),and the clinical data and RNA expression profiles of 47 patients who only received TMZ chemotherapy after surgery were selected;2.WGCNA was performed on RNA expression profiles to find modules highly correlated with survival time and lncRNAs with high connectivity in modules.Core lncRNA were further screened from the GEO database(P<0.05);survival analysis,correlation analysis,enrichment analysis and co-expression analysis were performed;and 3.A TMZ concentration gradient induced glioma-resistant cells(U251TR).Cell proliferation toxicity assays and real-time quantitative PCR were used to verify the core lncRNA and identify the biological characteristics of U251TR.Results:1.According to the WGCNA analysis,it was found that the pink module is highly correlated with survival time and that there are 17 core lncRNAs with high connectivity in the pink module.2.The expression of the core lncRNA MOCS2-DT in the U251 resistant strain was significantly lower than that in the sensitive strain(P<0.05).3.U251TR cells had significantly larger cell bodies with irregular shapes.U251TR cells had a stronger tolerance to TMZ than U251 cells,and the resistance index was about four times higher(P<0.05).4.The expression levels of MGMT and ABCG2 in U251TR cells were significantly higher than those in parental U251 cells(P<0.05),and the expression levels of MOCS2-DT in U251TR cells were significantly lower than those in parental U251 cells(P<0.05).5.The survival time and survival rate of patients with low expression of MOCS2-DT were significantly lower than those of patients with high expression of MOCS2-DT in patients who only received TMZ chemotherapy after surgery.6.The enrichment analysis results show that the mRNA co-expressed with MOCS2-DT is enriched in synapse organization,regulation of membrane potential and signal release,indicating that MOCS2-DT is closely related to these functions.Conclusion:Targeted regulation of MOCS2-DT may reverse the drug resistance of glioma,improve the prognosis of patients and prolong the survival time of patients.展开更多
Endoscopic retrograde cholangiopancreatography (ERCP) is efficacious in patients who have undergone Billroth II gastroenterostomies, but the success rate decreases in patients who also have experienced Braun anastomos...Endoscopic retrograde cholangiopancreatography (ERCP) is efficacious in patients who have undergone Billroth II gastroenterostomies, but the success rate decreases in patients who also have experienced Braun anastomoses. There are currently no reports describing the preferred enterography route for cannulation in these patients. We first review the patient’s previous surgery records, which most often indicate that the efferent loop is at the greater curvature of the stomach. We recommend extending the duodenoscope along the greater curvature of the stomach and then advancing it through the “lower entrance” at the site of the gastrojejunal anastomosis, along the efferent loop, and through the “middle entrance” at the site of the Braun anastomosis to reach the papilla of Vater. Ten patients who had each undergone Billroth II gastroenterostomy and Braun anastomosis between January 2009 and December 2011 were included in our study. The overall success rate of enterography was 90% for the patients who had undergone Billroth II gastroenterostomy and Braun anastomosis, and the therapeutic success rate was 80%. We believe that this enterography route for ERCP is optimal for a patient who has had Billroth II gastroenterostomy and Braun anastomosis and helps to increase the success rate of the procedure.展开更多
AIM: To describe an optimal route to the Braun anastomosis including the use of retrieval-balloon-assisted enterography.METHODS: Patients who received a Billroth Ⅱ gastroenterostomy(n = 109) and a Billroth Ⅱ gastroe...AIM: To describe an optimal route to the Braun anastomosis including the use of retrieval-balloon-assisted enterography.METHODS: Patients who received a Billroth Ⅱ gastroenterostomy(n = 109) and a Billroth Ⅱ gastroenterostomy with Braun anastomosis(n = 20) between January 2009 and May 2013 were analyzed in this study. Endoscopic ret-rograde cholangiopancreatography(ERCP) was performed under fluoroscopic control using a total length of 120 cm oblique-viewing duodenoscope with a 3.7-mm diameter working channel. For this procedure, we used a triplelumen retrieval balloon catheter in which a 0.035-inch guidewire could be inserted into the "open-channel" guidewire lumen while the balloon could be simultaneously injected and inflated through the other 2 lumens.RESULTS: For the patients with Billroth Ⅱ gastroenterostomy and Braun anastomosis, successful access to the papilla was gained in 17 patients(85%) and there was therapeutic success in 16 patients(80%). One patient had afferent loop perforation, but postoperative bleeding did not occur. For Billroth Ⅱ gastroenterostomy, there was failure in accessing the papilla in 15 patients(13.8%). ERCP was unsuccessful because of tumor infiltration(6 patients), a long afferent loop(9 patients), and cannulation failure(4 patients). The papilla was successfully accessed in 94 patients(86.2%), and there was therapeutic success in 90 patients(82.6%). Afferent loop perforation did not occur in any of these patients. One patient had hemorrhage 2 h after ERCP, which was successfully managed with conservative treatment.CONCLUSION: Retrieval-balloon-assisted enterography along an optimal route may improve the ERCP success rate after Billroth Ⅱ gastroenterostomy and Braun anastomosis.展开更多
AIM: To explore the effects of liniment levamisole on cellular immune functions of patients with chronic hepatitis B. METHODS: The levels of T lymphocyte subsets and mlL-2R in peripheral blood mononuclear cells (PBMCs...AIM: To explore the effects of liniment levamisole on cellular immune functions of patients with chronic hepatitis B. METHODS: The levels of T lymphocyte subsets and mlL-2R in peripheral blood mononuclear cells (PBMCs) were measured by biotin-streptavidin (BSA) technique in patients with chronic hepatitis B before and after the treatment with liniment levamisole. RESULTS: After one course of treatment with liniment levamisole, the levels of CD3+, CD4+, and the ratio of CD4+/CD8+ increased as compared to those before the treatment but the level of CD8+ decreased. The total expression level of mIL-2R in PBMCs increased before and after the treatment with liniment levamisole. CONCLUSION: Liniment levamisole may reinforce cellular immune functions of patients with chronic hepatitis B.展开更多
AIM:To characterize peripheral refraction and its relationship with myopia development in a selected group of male teenage Chinese students.METHODS:This 2-year prospective cohort study randomly enrolled 85 non-myopic ...AIM:To characterize peripheral refraction and its relationship with myopia development in a selected group of male teenage Chinese students.METHODS:This 2-year prospective cohort study randomly enrolled 85 non-myopic boys(age,14-16 y)from the Experimental Class of Air Force in China.Cycloplegic peripheral refraction was examined at 0°,±10°,and±20°along the horizontal visual field in the right eye at the baseline and 2-year follow-up.RESULTS:The incidence of myopia at the 2-year followup was 15.29%(13/85).The baseline central refraction(CR)and peripheral refraction at±10°were significantly lower in students who developed myopia than in those who did not(P<0.05).Relative peripheral refraction(RPR)did not differ between students with and without myopia(P>0.05).At the 2-year follow-up,the RPR at±10°and 20°nasal was significantly more hyperopic in the myopic group than in the non-myopic group.Multiple linear regression analysis indicated that the change in CR was significantly correlated with the changes in RPR at 20°nasal,10°nasal,and 20°temporal.Multivariate Logistic regression analysis indicated that the baseline CR[odds ratio(OR):0.092,95%confidence interval(CI):0.012-0.688,P=0.020]and the baseline RPR at 10°nasal(OR:0.182,95%CI:0.042-0.799,P=0.024)were significantly correlated with incident myopia(Omnibus test,χ=10.20,P=0.006).CONCLUSION:CR change is significantly correlated with changes in RPR,and students who develop myopia have more relative peripheral hyperopia.More baseline CR and relative peripheral hyperopia at 10°nasal are protective of myopia onset.展开更多
BACKGROUND Bilioenteric Roux-en-Y anastomosis is one of the most complicated approaches for reconstructing the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP) is technically challengi...BACKGROUND Bilioenteric Roux-en-Y anastomosis is one of the most complicated approaches for reconstructing the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients after bilioenteric Roux-en-Y anastomosis. The optimal endoscopic strategies for such cases remain unknown. AIM To explore the feasibility and effectiveness of single balloon enteroscopy-assisted (SBE-assisted) therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis based on multi-disciplinary collaboration between endoscopists and surgeons as well as report the experience from China. METHODS This is a single center retrospective study. All of the SBE-assisted therapeutic ERCP procedures were performed by the collaboration between endoscopists and surgeons. The operation time, success rate, and complication rate were calculated. RESULTS Forty-six patients received a total of 64 SBE-assisted therapeutic ERCP procedures, with successful scope intubation in 60 (93.8%) cases and successful diagnosis in 59 (92.2%). All successfully diagnosed cases received successful therapy. None of the cases had perforation or bleeding during or after operation, and no post-ERCP pancreatitis occurred. CONCLUSION Based on multi-disciplinary collaboration, SBE-assisted therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis is relatively safe and effective and has a high success rate.展开更多
Successful cannulation of the common bile duct may be difficult in patients in whom the papilla is located entirely within a diverticulum.In this study,we report successful biliary cannulation in three patients follow...Successful cannulation of the common bile duct may be difficult in patients in whom the papilla is located entirely within a diverticulum.In this study,we report successful biliary cannulation in three patients following intubation of the distal tip of the duodenoscope into the duodenal diverticulum and locating the major papilla.No complications occurred during the operation or during the postoperative period.This method didn't need second incubation an endoscope and might lower the burden of patients.So this skill is useful to deal with the papilla hidden inside the large diverticulum because of its safety and convenience.展开更多
The retention and release of deuterium in W–2%Y2O3 composite materials and commercially pure tungsten after they have been implanted by deuterium plasma(flux ~ 3.71 × 1021 D/m2·s, energy ~ 25 eV, and fluenc...The retention and release of deuterium in W–2%Y2O3 composite materials and commercially pure tungsten after they have been implanted by deuterium plasma(flux ~ 3.71 × 1021 D/m2·s, energy ~ 25 eV, and fluence up to 1.3 × 1026D/m2)are studied. The results show that the total amount of deuterium released from W–2%Y2O3 is 5.23 × 1020 D/m2(2.5 K/min),about 2.5 times higher than that from the pure tungsten. Thermal desorption spectra(TDS) at different heating rates(2.5 K/min–20 K/min) reveal that both W and W–2%Y2O3 have two main deuterium trapped sites. For the low temperature trap, the deuterium desorption activation energy is 0.85 eV(grain boundary) in W, while for high temperature trap, the desorption activation energy is 1.57 eV(vacancy) in W and 1.73 eV(vacancy) in W–2%Y2O3.展开更多
Reaction of laser ablated zinc and cadmium atoms with SO2 molecules was studied by low temperature matrix isolation infrared spectroscopy. Cyclic M（SO2） and anion M（SO2）-（M=Zn, Cd） were produced in excess argon ...Reaction of laser ablated zinc and cadmium atoms with SO2 molecules was studied by low temperature matrix isolation infrared spectroscopy. Cyclic M（SO2） and anion M（SO2）-（M=Zn, Cd） were produced in excess argon and neon, which were identified by 34SO2 and S18O2 isotopic substitutions. The observed infrared spectra and molecular structures were confirmed by density functional theoretical calculations. Natural charge distributions indicated significant electron transfer from s orbitals of zinc or cadmium metal atom to S02 ligand and cyclic M（SO2） complexes favored ＂ion pair＂ M＋（SO2）-formation, which were trapped in low temperature matrices. In addition Zn-O or Cd-O bond in M（SO2） exhibited strong polarized covalent character. Reaction of Hg atom with SO2 was also investigated, but no reaction product was observed, due to the relativistic effect that resulted in the contraction of 6s valence shell and high ionization potential of Hg atom.展开更多
Forced normalization(FN)is a unique phenomenon that is often seen in the treatment of epilepsy.FN is characterized by abnormal mental behavior and disordered emotions in epilepsy patients despite a significantly impro...Forced normalization(FN)is a unique phenomenon that is often seen in the treatment of epilepsy.FN is characterized by abnormal mental behavior and disordered emotions in epilepsy patients despite a significantly improved electroencephalogram and successful seizure control;the occurrence of FN seriously affects patients’quality of life.The causes of FN include antiseizure medications(ASMs),epilepsy surgery and vagus nerve stimulation,with ASMs being the most common cause.However,with the timely reduction or discontinuation of ASMs and the use of antipsychotic drugs,the overall prognosis is good.Here,we perform an extensive review of the literature pertaining to FN,including its epidemiology,possible mechanisms,clinical features,treatment and prognosis.展开更多
Topological crystalline insulators （TCIs） have attracted worldwide interest since their theoretical predication and have created exciting opportunities for studying topological quantum physics and for exploring spin...Topological crystalline insulators （TCIs） have attracted worldwide interest since their theoretical predication and have created exciting opportunities for studying topological quantum physics and for exploring spintronic appli- cations. In this work, we successfully synthesize PbTe nanowires via the chemical vapor deposition method and demonstrate the existence of topological surface states by their 2D weak anti-localization effect and Shubnikov-de Haas oscillations. More importantly, the surface state contributes ~61% of the total conduction, suggesting dom- inant surface transport in PbTe nanowires at low temperatures. Our work provides an experimental groundwork for researching TCIs and is a step forward for the applications of PbTe nanowires in spintronic devices.展开更多
Diaphorina citri is a global citrus pest.As a vector insect,it can transmit the causative agents of citrus huanglongbing,causing irreversible losses to the citrus industry.The acquisition of genomic information can pr...Diaphorina citri is a global citrus pest.As a vector insect,it can transmit the causative agents of citrus huanglongbing,causing irreversible losses to the citrus industry.The acquisition of genomic information can provide a molecular genetic basis for effective control of D.citri.Here,the DNBSEQ™,Oxford Nanopore Technologies,and Hi-C technologies are applied to generate a high-quality chromosome-level genome of D.citri.The genome size of D.citri was 523.78 Mb with a scaffold N50 of 47.05 Mb distributed on 13 chromosomes.A total of 250.64 Mb(47.85%)repeat sequences and 24048 protein-coding genes were predicted.Genome resequencing of female and male individuals indicated that the sex chromosome system of D.citri is XO.Phylogenetic analysis demonstrated that D.citri and Pachypsylla venusta,which separated from their most recent common ancestor about 336.62 million years ago,were the most closely related.Additionally,we identified genes potentially involved in detoxification metabolism,pathogen transmission,and honeydew secretion for further investigation.The high-quality genome provides an important reference for developing effective management strategies of D.citri.展开更多
Various SARS-CoV-2-related coronaviruses have been increasingly identified in pangolins,showing a potential threat to humans.Here we report the infectivity and pathogenicity of the SARS-CoV-2-related virus,PCoV-GX/P2V...Various SARS-CoV-2-related coronaviruses have been increasingly identified in pangolins,showing a potential threat to humans.Here we report the infectivity and pathogenicity of the SARS-CoV-2-related virus,PCoV-GX/P2V,which was isolated from a Malayan pangolin(Manis javanica).PCoV-GX/P2V could grow in human hepatoma,colorectal adenocarcinoma cells,and human primary nasal epithelial cells.It replicated more efficiently in cells expressing human angiotensin-converting enzyme 2(hACE2)as SARS-CoV-2 did.After intranasal inoculation to the hACE2-transgenic mice,PCoV-GX/P2V not only replicated in nasal turbinate and lungs,but also caused interstitial pneumonia,characterized by infiltration of mixed inflammatory cells and multifocal alveolar hemorrhage.Existing population immunity established by SARS-CoV-2 infection and vaccination may not protect people from PCoV-GX/P2V infection.These findings further verify the hACE2 utility of PCoV-GX/P2V by in vivo experiments using authentic viruses and highlight the importance for intensive surveillance to prevent possible cross-species transmission.展开更多
基金Supported by National Natural Science Foundation of China,No.82293665Anhui Provincial Department of Education University Research Project,No.2023AH051763.
文摘BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.
基金supported by the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-C-202006)the High-level traditional Chinese medicine key subject construction project of National Administration of Traditional Chinese Medicine--Evidence-based Traditional Chinese Medicine(ZYYZDXK-2023249).
文摘Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture protocols,this study aimed to assess the publications trends of acupuncture protocols over the past two decades and provided an overview for future research directions.Methods:Publications focusing on acupuncture protocols in clinical settings were retrieved and compiled from the Web of Science Core Collection spanning the period from 2004 to 2023.CiteSpace and Microsoft Excel software were used to analyze the relationship of publication with countries,institutions,authors,co-cited author,journals,references,keywords and other literature aspects.Results:This study analyzed 721 articles encompassing acupuncture protocols.A continuous yet fluctuating growth in publications volume were observed from 2004 to 2023.Notably,China stands at the forefront in contributing to acupuncture protocols,publishing 513 papers and demonstrating a high centrality score of 1.07 in cooperative network.Furthermore,China has fostered close collaborations with the USA and South Korea.Beijing University of Chinese Medicine(89),Zhishun Liu(36)and Trials(306)emerged as the top contributors in terms of institution,author,and journal,respectively.However,inter-institutional and author collaboration was relatively weak.Macpherson H was the most frequently cited author.High-frequency keywords included“randomized controlled trials”,“acupuncture”,“management”,“study protocol”,“quality of life”.Analysis of timeline diagram of keywords indicated that“functional dyspepsia”,“stroke”,“electroacupuncture”,and“colorectal cancer”were the research development trends and focus.Conclusion:Clinical acupuncture protocols have experienced robust development over the past two decades,with current research hotspots focusing on disease management and quality of life,which remain key research concerns.Moreover,we advocate for researchers to publish acupuncture protocols,which remain key research concerns.This approach allows for thorough pre-study planning of methodologies and objectives,enhancing scientific rigor through peer review,thereby laying the foundation for conducting high-quality research.
文摘BACKGROUND Cholangiocarcinoma(CCA)poses a significant clinical challenge due to its low radical resection rate and a propensity for high postoperative recurrence,resulting in a poor dismal.Although the combination of targeted therapy and immunotherapy has demonstrated notable efficacy in several solid tumors recently,however,its application in CCA remains underexplored and poorly documented.CASE SUMMARY This case report describes a patient diagnosed with stage IV CCA,accompanied by liver and abdominal wall metastases,who underwent palliative surgery.Subsequently,the patient received two cycles of treatment combining lenvatinib with sintilimab,which resulted in a reduction in abdominal wall metastasis,while intrahepatic metastasis displayed progression.This unexpected observation illustrates different responses of intrahepatic and extrahepatic metastases to the same therapy.CONCLUSION Lenvatinib combined with sintilimab shows promise as a potential treatment strategy for advanced CCA.Genetic testing for related driver and/or passenger mutations,as well as an analysis of tumor immune microenvironment analysis,is crucial for optimizing drug combinations and eventually addressing the issue of non-response in specific metastatic sites.
文摘BACKGROUND Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CASE SUMMARY We treated three patients with acute cerebral infarction who died following treatment with edaravone.Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CONCLUSION Our cases highlight the importance of educating clinicians regarding the new edaravone-induced clinical syndromes of cerebral infarction as potentially fatal adverse drug reactions.Considering that no laboratory or confirmatory test exists to diagnose edaravone-induced death from cerebral infarction,clinicians’knowledge is the key element in recognizing this phenomenon.
文摘Background:Temozolomide(TMZ)is an important adjuvant chemotherapy drug after glioma surgery.However,with the progress of treatment,most patients will gradually develop drug resistance.Long non-coding RNA(lncRNA)in the prediction and reversal of chemotherapy drug resistance possesses great potential.Methods:1.The clinical data and RNA expression matrix of glioma patients were downloaded from the Chinese Glioma Genome Atlas(CGGA),and the clinical data and RNA expression profiles of 47 patients who only received TMZ chemotherapy after surgery were selected;2.WGCNA was performed on RNA expression profiles to find modules highly correlated with survival time and lncRNAs with high connectivity in modules.Core lncRNA were further screened from the GEO database(P<0.05);survival analysis,correlation analysis,enrichment analysis and co-expression analysis were performed;and 3.A TMZ concentration gradient induced glioma-resistant cells(U251TR).Cell proliferation toxicity assays and real-time quantitative PCR were used to verify the core lncRNA and identify the biological characteristics of U251TR.Results:1.According to the WGCNA analysis,it was found that the pink module is highly correlated with survival time and that there are 17 core lncRNAs with high connectivity in the pink module.2.The expression of the core lncRNA MOCS2-DT in the U251 resistant strain was significantly lower than that in the sensitive strain(P<0.05).3.U251TR cells had significantly larger cell bodies with irregular shapes.U251TR cells had a stronger tolerance to TMZ than U251 cells,and the resistance index was about four times higher(P<0.05).4.The expression levels of MGMT and ABCG2 in U251TR cells were significantly higher than those in parental U251 cells(P<0.05),and the expression levels of MOCS2-DT in U251TR cells were significantly lower than those in parental U251 cells(P<0.05).5.The survival time and survival rate of patients with low expression of MOCS2-DT were significantly lower than those of patients with high expression of MOCS2-DT in patients who only received TMZ chemotherapy after surgery.6.The enrichment analysis results show that the mRNA co-expressed with MOCS2-DT is enriched in synapse organization,regulation of membrane potential and signal release,indicating that MOCS2-DT is closely related to these functions.Conclusion:Targeted regulation of MOCS2-DT may reverse the drug resistance of glioma,improve the prognosis of patients and prolong the survival time of patients.
基金Supported by Shanghai Education Commission Scientific Research and Innovation ProjectNo.11YZ55
文摘Endoscopic retrograde cholangiopancreatography (ERCP) is efficacious in patients who have undergone Billroth II gastroenterostomies, but the success rate decreases in patients who also have experienced Braun anastomoses. There are currently no reports describing the preferred enterography route for cannulation in these patients. We first review the patient’s previous surgery records, which most often indicate that the efferent loop is at the greater curvature of the stomach. We recommend extending the duodenoscope along the greater curvature of the stomach and then advancing it through the “lower entrance” at the site of the gastrojejunal anastomosis, along the efferent loop, and through the “middle entrance” at the site of the Braun anastomosis to reach the papilla of Vater. Ten patients who had each undergone Billroth II gastroenterostomy and Braun anastomosis between January 2009 and December 2011 were included in our study. The overall success rate of enterography was 90% for the patients who had undergone Billroth II gastroenterostomy and Braun anastomosis, and the therapeutic success rate was 80%. We believe that this enterography route for ERCP is optimal for a patient who has had Billroth II gastroenterostomy and Braun anastomosis and helps to increase the success rate of the procedure.
基金Supported by Leading Talent program of Shanghai,Sailing program of Shanghai science and technology commission NO.14YF1403000
文摘AIM: To describe an optimal route to the Braun anastomosis including the use of retrieval-balloon-assisted enterography.METHODS: Patients who received a Billroth Ⅱ gastroenterostomy(n = 109) and a Billroth Ⅱ gastroenterostomy with Braun anastomosis(n = 20) between January 2009 and May 2013 were analyzed in this study. Endoscopic ret-rograde cholangiopancreatography(ERCP) was performed under fluoroscopic control using a total length of 120 cm oblique-viewing duodenoscope with a 3.7-mm diameter working channel. For this procedure, we used a triplelumen retrieval balloon catheter in which a 0.035-inch guidewire could be inserted into the "open-channel" guidewire lumen while the balloon could be simultaneously injected and inflated through the other 2 lumens.RESULTS: For the patients with Billroth Ⅱ gastroenterostomy and Braun anastomosis, successful access to the papilla was gained in 17 patients(85%) and there was therapeutic success in 16 patients(80%). One patient had afferent loop perforation, but postoperative bleeding did not occur. For Billroth Ⅱ gastroenterostomy, there was failure in accessing the papilla in 15 patients(13.8%). ERCP was unsuccessful because of tumor infiltration(6 patients), a long afferent loop(9 patients), and cannulation failure(4 patients). The papilla was successfully accessed in 94 patients(86.2%), and there was therapeutic success in 90 patients(82.6%). Afferent loop perforation did not occur in any of these patients. One patient had hemorrhage 2 h after ERCP, which was successfully managed with conservative treatment.CONCLUSION: Retrieval-balloon-assisted enterography along an optimal route may improve the ERCP success rate after Billroth Ⅱ gastroenterostomy and Braun anastomosis.
文摘AIM: To explore the effects of liniment levamisole on cellular immune functions of patients with chronic hepatitis B. METHODS: The levels of T lymphocyte subsets and mlL-2R in peripheral blood mononuclear cells (PBMCs) were measured by biotin-streptavidin (BSA) technique in patients with chronic hepatitis B before and after the treatment with liniment levamisole. RESULTS: After one course of treatment with liniment levamisole, the levels of CD3+, CD4+, and the ratio of CD4+/CD8+ increased as compared to those before the treatment but the level of CD8+ decreased. The total expression level of mIL-2R in PBMCs increased before and after the treatment with liniment levamisole. CONCLUSION: Liniment levamisole may reinforce cellular immune functions of patients with chronic hepatitis B.
基金Supported by National Natural Science Foundation of China(No.81800854)Joint Innovation Project of National Defense Technology Innovation Zone(No.20-163-15-ZT-001-001-10)Efficiency Improvement Project of Air Force Medical University(No.2021HKYX24)。
文摘AIM:To characterize peripheral refraction and its relationship with myopia development in a selected group of male teenage Chinese students.METHODS:This 2-year prospective cohort study randomly enrolled 85 non-myopic boys(age,14-16 y)from the Experimental Class of Air Force in China.Cycloplegic peripheral refraction was examined at 0°,±10°,and±20°along the horizontal visual field in the right eye at the baseline and 2-year follow-up.RESULTS:The incidence of myopia at the 2-year followup was 15.29%(13/85).The baseline central refraction(CR)and peripheral refraction at±10°were significantly lower in students who developed myopia than in those who did not(P<0.05).Relative peripheral refraction(RPR)did not differ between students with and without myopia(P>0.05).At the 2-year follow-up,the RPR at±10°and 20°nasal was significantly more hyperopic in the myopic group than in the non-myopic group.Multiple linear regression analysis indicated that the change in CR was significantly correlated with the changes in RPR at 20°nasal,10°nasal,and 20°temporal.Multivariate Logistic regression analysis indicated that the baseline CR[odds ratio(OR):0.092,95%confidence interval(CI):0.012-0.688,P=0.020]and the baseline RPR at 10°nasal(OR:0.182,95%CI:0.042-0.799,P=0.024)were significantly correlated with incident myopia(Omnibus test,χ=10.20,P=0.006).CONCLUSION:CR change is significantly correlated with changes in RPR,and students who develop myopia have more relative peripheral hyperopia.More baseline CR and relative peripheral hyperopia at 10°nasal are protective of myopia onset.
基金Supported by the National Natural Science Foundation of China,No.31600075
文摘BACKGROUND Bilioenteric Roux-en-Y anastomosis is one of the most complicated approaches for reconstructing the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients after bilioenteric Roux-en-Y anastomosis. The optimal endoscopic strategies for such cases remain unknown. AIM To explore the feasibility and effectiveness of single balloon enteroscopy-assisted (SBE-assisted) therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis based on multi-disciplinary collaboration between endoscopists and surgeons as well as report the experience from China. METHODS This is a single center retrospective study. All of the SBE-assisted therapeutic ERCP procedures were performed by the collaboration between endoscopists and surgeons. The operation time, success rate, and complication rate were calculated. RESULTS Forty-six patients received a total of 64 SBE-assisted therapeutic ERCP procedures, with successful scope intubation in 60 (93.8%) cases and successful diagnosis in 59 (92.2%). All successfully diagnosed cases received successful therapy. None of the cases had perforation or bleeding during or after operation, and no post-ERCP pancreatitis occurred. CONCLUSION Based on multi-disciplinary collaboration, SBE-assisted therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis is relatively safe and effective and has a high success rate.
基金Supported by National Natural Science Foundation of China,No. 30900671Shanghai Natural Science Foundation,No. 09ZR1419700
文摘Successful cannulation of the common bile duct may be difficult in patients in whom the papilla is located entirely within a diverticulum.In this study,we report successful biliary cannulation in three patients following intubation of the distal tip of the duodenoscope into the duodenal diverticulum and locating the major papilla.No complications occurred during the operation or during the postoperative period.This method didn't need second incubation an endoscope and might lower the burden of patients.So this skill is useful to deal with the papilla hidden inside the large diverticulum because of its safety and convenience.
基金National Magnetic Confinement Fusion Energy Research Project,Ministry of Science and Technology of China(Grant No.2015GB109002)the Innovation Fund of Postgraduate,Xihua University,China(Grant No.ycjj2018017)the National Natural Science Foundation of China(Grant No.21401173).
文摘The retention and release of deuterium in W–2%Y2O3 composite materials and commercially pure tungsten after they have been implanted by deuterium plasma(flux ~ 3.71 × 1021 D/m2·s, energy ~ 25 eV, and fluence up to 1.3 × 1026D/m2)are studied. The results show that the total amount of deuterium released from W–2%Y2O3 is 5.23 × 1020 D/m2(2.5 K/min),about 2.5 times higher than that from the pure tungsten. Thermal desorption spectra(TDS) at different heating rates(2.5 K/min–20 K/min) reveal that both W and W–2%Y2O3 have two main deuterium trapped sites. For the low temperature trap, the deuterium desorption activation energy is 0.85 eV(grain boundary) in W, while for high temperature trap, the desorption activation energy is 1.57 eV(vacancy) in W and 1.73 eV(vacancy) in W–2%Y2O3.
文摘Reaction of laser ablated zinc and cadmium atoms with SO2 molecules was studied by low temperature matrix isolation infrared spectroscopy. Cyclic M（SO2） and anion M（SO2）-（M=Zn, Cd） were produced in excess argon and neon, which were identified by 34SO2 and S18O2 isotopic substitutions. The observed infrared spectra and molecular structures were confirmed by density functional theoretical calculations. Natural charge distributions indicated significant electron transfer from s orbitals of zinc or cadmium metal atom to S02 ligand and cyclic M（SO2） complexes favored ＂ion pair＂ M＋（SO2）-formation, which were trapped in low temperature matrices. In addition Zn-O or Cd-O bond in M（SO2） exhibited strong polarized covalent character. Reaction of Hg atom with SO2 was also investigated, but no reaction product was observed, due to the relativistic effect that resulted in the contraction of 6s valence shell and high ionization potential of Hg atom.
文摘Forced normalization(FN)is a unique phenomenon that is often seen in the treatment of epilepsy.FN is characterized by abnormal mental behavior and disordered emotions in epilepsy patients despite a significantly improved electroencephalogram and successful seizure control;the occurrence of FN seriously affects patients’quality of life.The causes of FN include antiseizure medications(ASMs),epilepsy surgery and vagus nerve stimulation,with ASMs being the most common cause.However,with the timely reduction or discontinuation of ASMs and the use of antipsychotic drugs,the overall prognosis is good.Here,we perform an extensive review of the literature pertaining to FN,including its epidemiology,possible mechanisms,clinical features,treatment and prognosis.
基金Supported by the National Key Research and Development Program of China under Grant No 2016YFA0300803the National Basic Research Program of China under Grant No 2014CB921101the National Natural Science Foundation of China under Grant Nos 61474061 and 61674079
文摘Topological crystalline insulators （TCIs） have attracted worldwide interest since their theoretical predication and have created exciting opportunities for studying topological quantum physics and for exploring spintronic appli- cations. In this work, we successfully synthesize PbTe nanowires via the chemical vapor deposition method and demonstrate the existence of topological surface states by their 2D weak anti-localization effect and Shubnikov-de Haas oscillations. More importantly, the surface state contributes ~61% of the total conduction, suggesting dom- inant surface transport in PbTe nanowires at low temperatures. Our work provides an experimental groundwork for researching TCIs and is a step forward for the applications of PbTe nanowires in spintronic devices.
文摘Diaphorina citri is a global citrus pest.As a vector insect,it can transmit the causative agents of citrus huanglongbing,causing irreversible losses to the citrus industry.The acquisition of genomic information can provide a molecular genetic basis for effective control of D.citri.Here,the DNBSEQ™,Oxford Nanopore Technologies,and Hi-C technologies are applied to generate a high-quality chromosome-level genome of D.citri.The genome size of D.citri was 523.78 Mb with a scaffold N50 of 47.05 Mb distributed on 13 chromosomes.A total of 250.64 Mb(47.85%)repeat sequences and 24048 protein-coding genes were predicted.Genome resequencing of female and male individuals indicated that the sex chromosome system of D.citri is XO.Phylogenetic analysis demonstrated that D.citri and Pachypsylla venusta,which separated from their most recent common ancestor about 336.62 million years ago,were the most closely related.Additionally,we identified genes potentially involved in detoxification metabolism,pathogen transmission,and honeydew secretion for further investigation.The high-quality genome provides an important reference for developing effective management strategies of D.citri.
基金supported by the National Natural Science Foundation of China(81621005)。
文摘Various SARS-CoV-2-related coronaviruses have been increasingly identified in pangolins,showing a potential threat to humans.Here we report the infectivity and pathogenicity of the SARS-CoV-2-related virus,PCoV-GX/P2V,which was isolated from a Malayan pangolin(Manis javanica).PCoV-GX/P2V could grow in human hepatoma,colorectal adenocarcinoma cells,and human primary nasal epithelial cells.It replicated more efficiently in cells expressing human angiotensin-converting enzyme 2(hACE2)as SARS-CoV-2 did.After intranasal inoculation to the hACE2-transgenic mice,PCoV-GX/P2V not only replicated in nasal turbinate and lungs,but also caused interstitial pneumonia,characterized by infiltration of mixed inflammatory cells and multifocal alveolar hemorrhage.Existing population immunity established by SARS-CoV-2 infection and vaccination may not protect people from PCoV-GX/P2V infection.These findings further verify the hACE2 utility of PCoV-GX/P2V by in vivo experiments using authentic viruses and highlight the importance for intensive surveillance to prevent possible cross-species transmission.
基金financially supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB30000000)the National Natural Science Foundation of China(52192600,11790291,61888102,61999102,52001220,and 51822107)+1 种基金the National Key Research and Development Plan(2018YFA0703603)the Natural Science Foundation of Guangdong Province(2019B030302010)。
