Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain...Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.展开更多
Acute kidney injury(AKI)and chronic kidney disease(CKD)are significant public health issues associated with a long-term increase in mortality risk,resulting from various etiologies including renal ischemia,sepsis,drug...Acute kidney injury(AKI)and chronic kidney disease(CKD)are significant public health issues associated with a long-term increase in mortality risk,resulting from various etiologies including renal ischemia,sepsis,drug toxicity,and diabetes mellitus.Numerous preclinical models have been developed to deepen our understanding of the pathophysiological mechanisms and therapeutic approaches for kidney diseases.Among these,rodent models have proven to be powerful tools in the discovery of novel therapeutics,while the development of kidney organoids has emerged as a promising advancement in the field.This review provides a comprehensive analysis of the construction methodologies,underlying biological mechanisms,and recent therapeutic developments across different AKI and CKD models.Additionally,this review summarizes the advantages,limitations,and challenges inherent in these preclinical models,thereby contributing robust evidence to support the development of effective therapeutic strategies.展开更多
Acupuncture originated in China and is an important component of traditional Chinese medicine.The elucidation of its anesthetic mechanisms,the medical needs of Western societies,as well as the proven therapeutic effec...Acupuncture originated in China and is an important component of traditional Chinese medicine.The elucidation of its anesthetic mechanisms,the medical needs of Western societies,as well as the proven therapeutic effects of this technique have made it the most widely used medical practice in the world.The concept of evidence-based medicine has been introduced in acupuncture research for technical improvement and the production of high-quality clinical evidence.Upon reviewing the acupuncture clinical research over the past 10years,we found the gradually increasing range of diseases that it benefits,from pain management to neoplasms and genitourinary,digestive,and mental disorders.Acupuncture is included in a number of international guidelines for clinical practice.However,high-quality clinical evidence to support the efficacy and effectiveness of acupuncture is lacking as a result of multiple exceptional clinical trials conducted by Western researchers that have yielded antagonistic results.Future clinical research should focus on exploring objective evaluation methods for studying the therapeutic effects of acupuncture.展开更多
Dry eye is a common and frequently occurring ophthalmology disease with complex etiology and easy recurrence.Oral administration of traditional Chinese medicine has the characteristicsof high curative effect and littl...Dry eye is a common and frequently occurring ophthalmology disease with complex etiology and easy recurrence.Oral administration of traditional Chinese medicine has the characteristicsof high curative effect and little toxic and side effect in the treatment of dry eye.This paper collates the domestic reported clinical studies on the oral administration of traditional Chinese medicine in the treatment of dry eye,which are discussed from four aspects:special prescription for specific disease,addition and subtraction of main prescription,treatment based on syndrome differentiation and proprietary Chinese medicine.The curative effect and advantages of traditional Chinese medicine in the treatment of dry eye are demonstrated,providing a reference for the treatment of dry eye in the future.展开更多
Surgeons need to understand the effects of the nasal cartilage on facial morphology,the function of both soft tissues and hard tissues and nasal function when performing nasal surgery.In nasal cartilage-related surger...Surgeons need to understand the effects of the nasal cartilage on facial morphology,the function of both soft tissues and hard tissues and nasal function when performing nasal surgery.In nasal cartilage-related surgery,the main goals for clinical research should include clarification of surgical goals,rationalization of surgical methods,precision and personalization of surgical design and preparation and improved convenience of doctor–patient communication.Computational technology has become an effective way to achieve these goals.Advances in three-dimensional(3D)imaging technology will promote nasal cartilage-related applications,including research on computational modelling technology,computational simulation technology,virtual surgery planning and 3D printing technology.These technologies are destined to revolutionize nasal surgery further.In this review,we summarize the advantages,latest findings and application progress of various computational technologies used in clinical nasal cartilage-related work and research.The application prospects of each technique are also discussed.展开更多
Thank you for your introduction,thank DIA inviting me to come to this conference.After knowing so many data,I am very happy to learn some details about traditional Chinese medicine (TCM),including China's efforts ...Thank you for your introduction,thank DIA inviting me to come to this conference.After knowing so many data,I am very happy to learn some details about traditional Chinese medicine (TCM),including China's efforts in TCM,and what has been done in Europe.I would like to tell you about some of the challenges of TCM from the perspective of the European Union (EU).Many of them are mentioned by previous speakers.In fact,there are ways to allow herbs to enter the European market.Traditional herbal products have been established.And there is a full market authorization.Traditionally,it is necessary to ensure their medicinal efficacy and safety.Clinical trials are not necessary for every circumstance,but 10 years of use history within the EU is necessary.This is the process of full marketing.The USA and Europe have a similar situation: 3 of the 4 phases are required before the marketing authorization.These are 3 examples: a newly developed drug in Europe,it is from gentian roots,primrose,sorrel and other drugs,mainly for rhinitis;this is from Switzerland,which is from an extract of coltsfoot flowers;Schwabe's is from lavender,used for anxiety,and this is its name in Australia.展开更多
Small cell lung cancer(SCLC)has a high degree of malignancy and rapid progression,and most of the patients are in the extensive stage when they are diagnosed.The traditional treatment of SCLC is mainly systematic chem...Small cell lung cancer(SCLC)has a high degree of malignancy and rapid progression,and most of the patients are in the extensive stage when they are diagnosed.The traditional treatment of SCLC is mainly systematic chemotherapy combined with radiotherapy,but there has been no significant progress for many years.The emergence of immunotherapy represented by immune checkpoint inhibitors(ICIs)has changed the treatment pattern of SCLC.Some studies have confirmed the effect of ICIs monotherapy.However,the disadvantages of ICIs monotherapy such as low responsiveness,drug resistance,and adverse reactions limited the clinical application.The combined treatment of immune checkpoint inhibitors was newly developing treatment models.Clinical studies have found that ICIs combined with standard chemotherapy can significantly improve the survival of patients with extensive small cell lung cancer without increasing adverse reactions.Based on the synergistic effect of immunotherapy combined with chemotherapy,this paper reviews the current progress,deficiency and future exploration direction of first-line immunotherapy for extensive small cell lung cancer.展开更多
Aortic dissection is a life-threatening condition for which diagnosis mainly relies on imaging examinations,while reliable biomarkers to detect or monitor are still under investigation.Recent advances in technologies ...Aortic dissection is a life-threatening condition for which diagnosis mainly relies on imaging examinations,while reliable biomarkers to detect or monitor are still under investigation.Recent advances in technologies provide an unprecedented opportunity to yield the identification of clinically valuable biomarkers,including proteins,ribonucleic acids(RNAs),and deoxyribonucleic acids(DNAs),for early detection of pathological changes in susceptible patients,rapid diagnosis at the bedside after onset,and a superior therapeutic regimen primarily within the concept of personalized and tailored endovascular therapy for aortic dissection.展开更多
The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,rob...The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.展开更多
Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical cen...Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical center. Every study differs in various aspects, such as phases, study indication, eligibility criteria, etc. In terms of meeting the enrollment deadline, typically, the study indication and availability of the patient’s population at the geographical area of the research site would decide if the trial could be time-consuming. Patient recruitment and retention are critical for the success of every clinical trial;however, worldwide, this area is facing tremendous pressure and challenges. Globally 55% of clinical trials terminated due to low recruitment, with an average enrollment success rate of 40% for Phase III and IV trials. Over 80% of clinical trial attempts fail to enroll, extending the study and adding new study sites. In the United States, more than 80% of clinical trials fail to achieve targeted patient enrollment, and 30% of study participants discontinue participation. This article reviewed various factors hindering clinical trial recruitment and retention and suggested strategies to make the research site successful.展开更多
BACKGROUND Several bibliometric analyses have been carried out to identify research hotspots and trends in nonalcoholic fatty liver disease(NAFLD)research.Nonetheless,there are still significant knowledge gaps that mu...BACKGROUND Several bibliometric analyses have been carried out to identify research hotspots and trends in nonalcoholic fatty liver disease(NAFLD)research.Nonetheless,there are still significant knowledge gaps that must be filled to advance our understanding of and ability to treat NAFLD.AIM To evaluate,through bibliometric and visual analysis,the current status of related research,related research frontiers,and the developmental trends in the field of diet and NAFLD.METHODS We retrieved publications about diet and NAFLD published between 1987 and 2022 from Scopus.Next,we used VOSviewer 1.6.20 to perform bibliometric analysis and visualization.RESULTS We found a total of 1905 studies,including 1637(85.93%)original articles and 195(10.24%)reviews,focused on the examination of NAFLD and its correlation with diet that were published between 1987 and 2022.Among the remaining five types of documents,38 were letters,notes,editorials,meeting minutes,or brief surveys,representing 1.99%of the total documents.The countries with the most publications on this topic were China(n=539;28.29%),followed by the United States(n=379;19.90%),Japan(n=133;6.98%),and South Korea(n=127;6.6%).According to the citation analysis,the retrieved papers were cited an average of 32.3 times and had an h-index of 106,with 61014 total citations.The two main clusters on the map included those related to:(1)Inflammation and oxidative stress;and(2)Dietary interventions for NAFLD.CONCLUSION This was the first study to use data taken from Scopus to visualize network mapping in a novel bibliometric analysis of studies focused on diet and NAFLD.After 2017,the two domains that received the most attention were“dietary interventions for NAFL”’and“‘inflammation and oxidative stress implicated in NAFLD and its correlation with diet.”We believe that this study provides important information for academics,dietitians,and doctors,and that additional research on dietary interventions and NAFLD is warranted.展开更多
This research aimed to examine the diagnostic accuracy and clinical significance of endoscopic ultrasonography(EUS)in the context of small rectal neuroendocrine neoplasms(NENs).A total of 108 patients with rectal sube...This research aimed to examine the diagnostic accuracy and clinical significance of endoscopic ultrasonography(EUS)in the context of small rectal neuroendocrine neoplasms(NENs).A total of 108 patients with rectal subepithelial lesions(SELs)with a diameter of<20 mm were included in the analysis.The diagnosis and depth assessment of EUS was compared to the histology findings.The prevalence of NENs in rectal SELs was 78.7%(85/108).The sensitivity of EUS in detecting rectal NENs was 98.9%(84/85),while the specificity was 52.2%(12/23).Overall,the diagnostic accuracy of EUS in identifying rectal NENs was 88.9%(96/108).The overall accuracy rate for EUS in assessing the depth of invasion in rectal NENs was 92.9%(78/84).Therefore,EUS demonstrates reasonable diagnostic accuracy in detecting small rectal NENs,with good sensitivity but inferior specificity.EUS may also assist physicians in assessing the depth of invasion in small rectal NENs before endoscopic excision.展开更多
The activation and development of primordial follicles is the key to the maturation of female gametes.Premature ovarian insufficiency(POI)patients are unable to complete the primordial follicle activation and developm...The activation and development of primordial follicles is the key to the maturation of female gametes.Premature ovarian insufficiency(POI)patients are unable to complete the primordial follicle activation and development due to follicular dormancy and unbalanced developmental regulation in the body,leading to female infertility.Ovarian tissue in vitro activation(IVA)technology has become a new way to solve the problem of patients who cannot auto-activate primordial follicles to obtain their own mature oocytes.In IVA research,signaling pathways such as PI3K/PTEN/Akt and Hippo have become the focus of current research.This review will describe the relevant research progress and clinical application of the IVA mechanism,and provide a reference for clinical research on ovarian tissue culture and activation in vitro.展开更多
Colorectal cancer(CRC)is the third most common cancer and the second leading cause of cancer death worldwide.Clinical research results have provided more treatment opportunities for CRC patients,showing that an optima...Colorectal cancer(CRC)is the third most common cancer and the second leading cause of cancer death worldwide.Clinical research results have provided more treatment opportunities for CRC patients,showing that an optimal combination of existing drugs and new drugs is needed to mitigate the burden of this disease.In this review,we have summarized recent advances in drug clinical research for CRC in 2022,including chemotherapy,targeted therapy,and immunotherapy,to find opportunities for substantial improvements in drug discovery and clinical development methods.展开更多
Objective:Little progress has been made in recent years using first-line chemotherapy,including gemcitabine combined with nab-paclitaxel,FOLFIRINOX,and NALIRIFOX,for advanced pancreatic adenocarcinoma(APC).In addition...Objective:Little progress has been made in recent years using first-line chemotherapy,including gemcitabine combined with nab-paclitaxel,FOLFIRINOX,and NALIRIFOX,for advanced pancreatic adenocarcinoma(APC).In addition,the optimal second-line chemotherapy regimen has not been determined.This study aimed to compare the effectiveness of different types of second-line chemotherapy for APC.Methods:Patients with APC who received first-line treatment from January 2008 to January 2021 were considered eligible for this retrospective analysis.The primary and secondary endpoints were overall survival(OS)and progression-free survival(PFS),respectively.Results:Four hundred and thirty-seven and 617 patients were treated with 5-fluorouracil-and gemcitabine-based chemotherapy as first-line treatment,respectively.Demographic and clinical features,except age and liver metastasis,were comparable between the two groups(P<0.05).The median OS was 8.8 and 7.8 months in patients who received a 5-fluorouracil-and gemcitabine-based combined regimen for first-line therapy,respectively(HR=1.244,95%CI=1.090–1.419;P<0.001).The median OS was 5.6 and 1.9 months in patients who received second-line chemotherapy and supportive care,respectively(HR=0.766,95%CI=0.677–0.867;P<0.001).The median PFS was not significantly differently between gemcitabine or 5-fluorouracil monotherapy and combination therapy.Conclusions:A 5-fluorouracil-or gemcitabine-based combined regimen was shown to be as effective as a single 5-fluorouracil or gemcitabine regimen as second-line therapy for patients with APC.展开更多
AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants ...AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants underwent ICL surgery and were divided into the low(<250μm)and normal(250-1000μm)vault groups based on the postoperative vault at 3mo.The preoperative biometric parameters and clinical outcomes were compared between the two groups.The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations.RESULTS:Sixteen(23 eyes)and 36 patients(63 eyes)were in the low and normal vault groups,respectively.All implantation procedures were uneventful with no cataract formation in the early postoperative period.The sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after surgery.Every 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in vault.CONCLUSION:Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these patients.Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.展开更多
Objective:CDK4/6 inhibitors(CDK4/6is)in combination with endocrine therapy have secured a central role in the treatment of hormone receptor(HR)-positive advanced breast cancer(ABC)and have transformed the therapeutic ...Objective:CDK4/6 inhibitors(CDK4/6is)in combination with endocrine therapy have secured a central role in the treatment of hormone receptor(HR)-positive advanced breast cancer(ABC)and have transformed the therapeutic landscape.Cross-line CDK4/6i therapy in which another CDK4/6i is continued after progression on a prior CDK4/6i may still offer advantageous therapeutic effects.Cross-line CDK4/6i therapy is an area of active investigation in the ongoing pursuit to improve outcomes for patients with HR+/human epidermal growth factor receptor 2(HER2)–ABC.Methods:This retrospective study enrolled 82 patients with HR+/HER2–ABC who were treated with cross-line CDK4/6is(abemaciclib,palbociclib,ribociclib,and dalpiciclib)after progression with another CDK4/6i.The primary endpoint was progression-free survival(PFS)according to version 1.1 of the Response Evaluation Criteria in Solid Tumors.Secondary endpoints included toxicity,objective response rate,disease control rate,and overall survival.Adverse events(AEs)were graded according to version 5.0 of the Common Terminology Criteria for Adverse Events,as promulgated by the U.S.Department of Health and Human Services.Results:Eighty-two HR+/HER2–ABC patients who received cross-line CDK4/6i therapy from January 2022 to February 2024 were enrolled.The median age of the patients was 60 years.The median PFS of all patients was 7.6 months(95%CI,5.9-9.2).Cox regression analysis identified lung metastasis and a switch to endocrine therapy following prior CDK4/6i therapy as independent predictive factors for PFS.Notably,patients who previously received abemaciclib and switched to palbociclib upon disease progression had a median PFS of 10.7 months.The strategy of transitioning to chemotherapy after progression on a prior CDK4/6i,then to a subsequent CDK4/6i merits further investigation.Hematologic toxicity was the most common grade≥3 AEs.No instances of fatal safety events were observed.Conclusions:Cross-line CDK4/6i therapy is associated with significant clinical benefits and manageable safety profiles in patients with HR+/HER2–ABC,which underscores cross-line CDK4/6i therapy potential as an effective treatment strategy.展开更多
AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conduc...AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conducted using a standardized recognition acuity chart(Snellen visual chart:at 3 m)and the baby vision model assessment.The baby vision device includes a screen,a near infrared camera and a computer.Children were seated at a measured distance of 33-40 cm from a display for testing.VA was estimated according to the highest resolution the children could follow.Decimal VA data were converted to logarithm of the minimum angle of resolution(logMAR)for statistical analysis.The VA results for each child were recorded and analyzed for consistency.RESULTS:The mean VA measured using the Snellen visual chart was 0.62±0.32,and that assessed using the baby vision test was 0.66±0.27.The 95%limit of agreement was-0.609 to 0.695,with 95.2%(100/105)plots within the 95%limits of agreement.VA values of the baby vision test were significantly correlated with those of the Snellen chart(R=0.274,P=0.005).CONCLUSION:The baby vision test can be used as a relatively reliable method for estimating VA in young children.This new acuity assessment might be a valid predictor of optotype-measured acuity later in preverbal children.展开更多
3,3′,5-Triiodo-L-thyronine(T3)is a key endocrine hormone in the human body that plays crucial roles in growth,development,metabolism,and immune function.Macrophages,the key regulatory cells within the immune system,e...3,3′,5-Triiodo-L-thyronine(T3)is a key endocrine hormone in the human body that plays crucial roles in growth,development,metabolism,and immune function.Macrophages,the key regulatory cells within the immune system,exhibit marked“heterogeneity”and“plasticity”,with their phenotype and function subject to modulation by local environmental signals.The interplay between the endocrine and immune systems is well documented.Numerous studies have shown that T3 significantly target macrophages,highlighting them as key cellular components in this interaction.Through the regulation of macrophage function and phenotype,T3 influences immune function and tissue repair in the body.This review comprehensively summarizes the regulatory actions and mechanisms of T3 on macrophages,offering valuable insights into further research of the immunoregulatory effects of T3.展开更多
Targeted therapy is crucial for advanced colorectal cancer(CRC) positive for genetic drivers. With advances in deep sequencing technology and new targeted drugs, existing standard molecular pathological detection syst...Targeted therapy is crucial for advanced colorectal cancer(CRC) positive for genetic drivers. With advances in deep sequencing technology and new targeted drugs, existing standard molecular pathological detection systems and therapeutic strategies can no longer meet the requirements for careful management of patients with advanced CRC. Thus, rare genetic variations require diagnosis and targeted therapy in clinical practice. Rare gene mutations, amplifications, and rearrangements are usually associated with poor prognosis and poor response to conventional therapy. This review summarizes the clinical diagnosis and treatment of rare genetic variations, in genes including erb-b2 receptor tyrosine kinase 2(ERBB2), B-Raf proto-oncogene, serine/threonine kinase(BRAF), ALK receptor tyrosine kinase/ROS proto-oncogene 1, receptor tyrosine kinase(ALK/ROS1), neurotrophic receptor tyrosine kinases(NTRKs), ret proto-oncogene(RET), fibroblast growth factor receptor 2(FGFR2), and epidermal growth factor receptor(EGFR), to enhance understanding and identify more accurate personalized treatments for patients with rare genetic variations.展开更多
基金supported by the Ministry of Science and Tech-nology of the People's Republic of China(2021ZD0201900),Project 5(2021ZD0201905).
文摘Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.
基金supported by the Zhejiang Provincial Natural Science Foundation of China(LZ22H050001)National Natural Science Foundation of China(82270704,81970573)+1 种基金“Lingyan”R&D Research and Development Project(2024C03165)Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents。
文摘Acute kidney injury(AKI)and chronic kidney disease(CKD)are significant public health issues associated with a long-term increase in mortality risk,resulting from various etiologies including renal ischemia,sepsis,drug toxicity,and diabetes mellitus.Numerous preclinical models have been developed to deepen our understanding of the pathophysiological mechanisms and therapeutic approaches for kidney diseases.Among these,rodent models have proven to be powerful tools in the discovery of novel therapeutics,while the development of kidney organoids has emerged as a promising advancement in the field.This review provides a comprehensive analysis of the construction methodologies,underlying biological mechanisms,and recent therapeutic developments across different AKI and CKD models.Additionally,this review summarizes the advantages,limitations,and challenges inherent in these preclinical models,thereby contributing robust evidence to support the development of effective therapeutic strategies.
文摘Acupuncture originated in China and is an important component of traditional Chinese medicine.The elucidation of its anesthetic mechanisms,the medical needs of Western societies,as well as the proven therapeutic effects of this technique have made it the most widely used medical practice in the world.The concept of evidence-based medicine has been introduced in acupuncture research for technical improvement and the production of high-quality clinical evidence.Upon reviewing the acupuncture clinical research over the past 10years,we found the gradually increasing range of diseases that it benefits,from pain management to neoplasms and genitourinary,digestive,and mental disorders.Acupuncture is included in a number of international guidelines for clinical practice.However,high-quality clinical evidence to support the efficacy and effectiveness of acupuncture is lacking as a result of multiple exceptional clinical trials conducted by Western researchers that have yielded antagonistic results.Future clinical research should focus on exploring objective evaluation methods for studying the therapeutic effects of acupuncture.
基金The study was supported by the Tianjin municipal health and Health Committee and Tianjin Administration of traditional Chinese Medicine(Scientific research project of integrated traditional Chinese and Western Medicine NO.2019027).
文摘Dry eye is a common and frequently occurring ophthalmology disease with complex etiology and easy recurrence.Oral administration of traditional Chinese medicine has the characteristicsof high curative effect and little toxic and side effect in the treatment of dry eye.This paper collates the domestic reported clinical studies on the oral administration of traditional Chinese medicine in the treatment of dry eye,which are discussed from four aspects:special prescription for specific disease,addition and subtraction of main prescription,treatment based on syndrome differentiation and proprietary Chinese medicine.The curative effect and advantages of traditional Chinese medicine in the treatment of dry eye are demonstrated,providing a reference for the treatment of dry eye in the future.
文摘Surgeons need to understand the effects of the nasal cartilage on facial morphology,the function of both soft tissues and hard tissues and nasal function when performing nasal surgery.In nasal cartilage-related surgery,the main goals for clinical research should include clarification of surgical goals,rationalization of surgical methods,precision and personalization of surgical design and preparation and improved convenience of doctor–patient communication.Computational technology has become an effective way to achieve these goals.Advances in three-dimensional(3D)imaging technology will promote nasal cartilage-related applications,including research on computational modelling technology,computational simulation technology,virtual surgery planning and 3D printing technology.These technologies are destined to revolutionize nasal surgery further.In this review,we summarize the advantages,latest findings and application progress of various computational technologies used in clinical nasal cartilage-related work and research.The application prospects of each technique are also discussed.
文摘Thank you for your introduction,thank DIA inviting me to come to this conference.After knowing so many data,I am very happy to learn some details about traditional Chinese medicine (TCM),including China's efforts in TCM,and what has been done in Europe.I would like to tell you about some of the challenges of TCM from the perspective of the European Union (EU).Many of them are mentioned by previous speakers.In fact,there are ways to allow herbs to enter the European market.Traditional herbal products have been established.And there is a full market authorization.Traditionally,it is necessary to ensure their medicinal efficacy and safety.Clinical trials are not necessary for every circumstance,but 10 years of use history within the EU is necessary.This is the process of full marketing.The USA and Europe have a similar situation: 3 of the 4 phases are required before the marketing authorization.These are 3 examples: a newly developed drug in Europe,it is from gentian roots,primrose,sorrel and other drugs,mainly for rhinitis;this is from Switzerland,which is from an extract of coltsfoot flowers;Schwabe's is from lavender,used for anxiety,and this is its name in Australia.
基金supported by the National Natural Science Foundation of China(No.81403220)Tianjin Health and family planning-high level talent selection and training project+1 种基金Tianjin Science and Technology Plan Projects(No.17ZXMFSY00190)Tianjin Traditional Chinese Medicine Research Project,Tianjin health and family planning commission(No.2017003).
文摘Small cell lung cancer(SCLC)has a high degree of malignancy and rapid progression,and most of the patients are in the extensive stage when they are diagnosed.The traditional treatment of SCLC is mainly systematic chemotherapy combined with radiotherapy,but there has been no significant progress for many years.The emergence of immunotherapy represented by immune checkpoint inhibitors(ICIs)has changed the treatment pattern of SCLC.Some studies have confirmed the effect of ICIs monotherapy.However,the disadvantages of ICIs monotherapy such as low responsiveness,drug resistance,and adverse reactions limited the clinical application.The combined treatment of immune checkpoint inhibitors was newly developing treatment models.Clinical studies have found that ICIs combined with standard chemotherapy can significantly improve the survival of patients with extensive small cell lung cancer without increasing adverse reactions.Based on the synergistic effect of immunotherapy combined with chemotherapy,this paper reviews the current progress,deficiency and future exploration direction of first-line immunotherapy for extensive small cell lung cancer.
基金supported by grants from the National Natural Science Foundation of China(No.81970412)the Science and Technology Innovation Plan of the Shanghai Science and Technology Commission(No.18441902400)
文摘Aortic dissection is a life-threatening condition for which diagnosis mainly relies on imaging examinations,while reliable biomarkers to detect or monitor are still under investigation.Recent advances in technologies provide an unprecedented opportunity to yield the identification of clinically valuable biomarkers,including proteins,ribonucleic acids(RNAs),and deoxyribonucleic acids(DNAs),for early detection of pathological changes in susceptible patients,rapid diagnosis at the bedside after onset,and a superior therapeutic regimen primarily within the concept of personalized and tailored endovascular therapy for aortic dissection.
基金supported by the National Natural Science Foundation of China[grant number 81970987].
文摘The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.
文摘Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical center. Every study differs in various aspects, such as phases, study indication, eligibility criteria, etc. In terms of meeting the enrollment deadline, typically, the study indication and availability of the patient’s population at the geographical area of the research site would decide if the trial could be time-consuming. Patient recruitment and retention are critical for the success of every clinical trial;however, worldwide, this area is facing tremendous pressure and challenges. Globally 55% of clinical trials terminated due to low recruitment, with an average enrollment success rate of 40% for Phase III and IV trials. Over 80% of clinical trial attempts fail to enroll, extending the study and adding new study sites. In the United States, more than 80% of clinical trials fail to achieve targeted patient enrollment, and 30% of study participants discontinue participation. This article reviewed various factors hindering clinical trial recruitment and retention and suggested strategies to make the research site successful.
文摘BACKGROUND Several bibliometric analyses have been carried out to identify research hotspots and trends in nonalcoholic fatty liver disease(NAFLD)research.Nonetheless,there are still significant knowledge gaps that must be filled to advance our understanding of and ability to treat NAFLD.AIM To evaluate,through bibliometric and visual analysis,the current status of related research,related research frontiers,and the developmental trends in the field of diet and NAFLD.METHODS We retrieved publications about diet and NAFLD published between 1987 and 2022 from Scopus.Next,we used VOSviewer 1.6.20 to perform bibliometric analysis and visualization.RESULTS We found a total of 1905 studies,including 1637(85.93%)original articles and 195(10.24%)reviews,focused on the examination of NAFLD and its correlation with diet that were published between 1987 and 2022.Among the remaining five types of documents,38 were letters,notes,editorials,meeting minutes,or brief surveys,representing 1.99%of the total documents.The countries with the most publications on this topic were China(n=539;28.29%),followed by the United States(n=379;19.90%),Japan(n=133;6.98%),and South Korea(n=127;6.6%).According to the citation analysis,the retrieved papers were cited an average of 32.3 times and had an h-index of 106,with 61014 total citations.The two main clusters on the map included those related to:(1)Inflammation and oxidative stress;and(2)Dietary interventions for NAFLD.CONCLUSION This was the first study to use data taken from Scopus to visualize network mapping in a novel bibliometric analysis of studies focused on diet and NAFLD.After 2017,the two domains that received the most attention were“dietary interventions for NAFL”’and“‘inflammation and oxidative stress implicated in NAFLD and its correlation with diet.”We believe that this study provides important information for academics,dietitians,and doctors,and that additional research on dietary interventions and NAFLD is warranted.
基金Supported by Basic and Applied Basic Research Foundation of Guangzhou,No.202201011331National Natural Science Foundation of China,No.82373118Natural Science Foundation of Guangdong Province,No.2023A1515010828.
文摘This research aimed to examine the diagnostic accuracy and clinical significance of endoscopic ultrasonography(EUS)in the context of small rectal neuroendocrine neoplasms(NENs).A total of 108 patients with rectal subepithelial lesions(SELs)with a diameter of<20 mm were included in the analysis.The diagnosis and depth assessment of EUS was compared to the histology findings.The prevalence of NENs in rectal SELs was 78.7%(85/108).The sensitivity of EUS in detecting rectal NENs was 98.9%(84/85),while the specificity was 52.2%(12/23).Overall,the diagnostic accuracy of EUS in identifying rectal NENs was 88.9%(96/108).The overall accuracy rate for EUS in assessing the depth of invasion in rectal NENs was 92.9%(78/84).Therefore,EUS demonstrates reasonable diagnostic accuracy in detecting small rectal NENs,with good sensitivity but inferior specificity.EUS may also assist physicians in assessing the depth of invasion in small rectal NENs before endoscopic excision.
基金Major Science and Technology Projects in Hainan Province(ZDKJ2017007)Hainan Natural Science Foundation(2019CXTD408)。
文摘The activation and development of primordial follicles is the key to the maturation of female gametes.Premature ovarian insufficiency(POI)patients are unable to complete the primordial follicle activation and development due to follicular dormancy and unbalanced developmental regulation in the body,leading to female infertility.Ovarian tissue in vitro activation(IVA)technology has become a new way to solve the problem of patients who cannot auto-activate primordial follicles to obtain their own mature oocytes.In IVA research,signaling pathways such as PI3K/PTEN/Akt and Hippo have become the focus of current research.This review will describe the relevant research progress and clinical application of the IVA mechanism,and provide a reference for clinical research on ovarian tissue culture and activation in vitro.
基金National Natural Science Foundation of China,Grant/Award Numbers:82102858,82173233,U22A20330。
文摘Colorectal cancer(CRC)is the third most common cancer and the second leading cause of cancer death worldwide.Clinical research results have provided more treatment opportunities for CRC patients,showing that an optimal combination of existing drugs and new drugs is needed to mitigate the burden of this disease.In this review,we have summarized recent advances in drug clinical research for CRC in 2022,including chemotherapy,targeted therapy,and immunotherapy,to find opportunities for substantial improvements in drug discovery and clinical development methods.
基金This work was supported by the National Key Research and Development Program of China(Grant No.2021YFA1201100)the National Natural Science Foundation of China(Grant No.82072657).
文摘Objective:Little progress has been made in recent years using first-line chemotherapy,including gemcitabine combined with nab-paclitaxel,FOLFIRINOX,and NALIRIFOX,for advanced pancreatic adenocarcinoma(APC).In addition,the optimal second-line chemotherapy regimen has not been determined.This study aimed to compare the effectiveness of different types of second-line chemotherapy for APC.Methods:Patients with APC who received first-line treatment from January 2008 to January 2021 were considered eligible for this retrospective analysis.The primary and secondary endpoints were overall survival(OS)and progression-free survival(PFS),respectively.Results:Four hundred and thirty-seven and 617 patients were treated with 5-fluorouracil-and gemcitabine-based chemotherapy as first-line treatment,respectively.Demographic and clinical features,except age and liver metastasis,were comparable between the two groups(P<0.05).The median OS was 8.8 and 7.8 months in patients who received a 5-fluorouracil-and gemcitabine-based combined regimen for first-line therapy,respectively(HR=1.244,95%CI=1.090–1.419;P<0.001).The median OS was 5.6 and 1.9 months in patients who received second-line chemotherapy and supportive care,respectively(HR=0.766,95%CI=0.677–0.867;P<0.001).The median PFS was not significantly differently between gemcitabine or 5-fluorouracil monotherapy and combination therapy.Conclusions:A 5-fluorouracil-or gemcitabine-based combined regimen was shown to be as effective as a single 5-fluorouracil or gemcitabine regimen as second-line therapy for patients with APC.
基金Supported by National Natural Science Foundation of China(No.81900910)Natural Science Foundation of Zhejiang Province(No.LQ19H120003)Basic Scientific Research Project of Wenzhou(No.Y2023809).
文摘AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants underwent ICL surgery and were divided into the low(<250μm)and normal(250-1000μm)vault groups based on the postoperative vault at 3mo.The preoperative biometric parameters and clinical outcomes were compared between the two groups.The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations.RESULTS:Sixteen(23 eyes)and 36 patients(63 eyes)were in the low and normal vault groups,respectively.All implantation procedures were uneventful with no cataract formation in the early postoperative period.The sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after surgery.Every 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in vault.CONCLUSION:Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these patients.Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.
基金supported by grants from the CAMS Innovation Fund for Medical Sciences[CIFMS](Grant Nos.2021-I2M-1-014 and 2022-I2M-2-002).
文摘Objective:CDK4/6 inhibitors(CDK4/6is)in combination with endocrine therapy have secured a central role in the treatment of hormone receptor(HR)-positive advanced breast cancer(ABC)and have transformed the therapeutic landscape.Cross-line CDK4/6i therapy in which another CDK4/6i is continued after progression on a prior CDK4/6i may still offer advantageous therapeutic effects.Cross-line CDK4/6i therapy is an area of active investigation in the ongoing pursuit to improve outcomes for patients with HR+/human epidermal growth factor receptor 2(HER2)–ABC.Methods:This retrospective study enrolled 82 patients with HR+/HER2–ABC who were treated with cross-line CDK4/6is(abemaciclib,palbociclib,ribociclib,and dalpiciclib)after progression with another CDK4/6i.The primary endpoint was progression-free survival(PFS)according to version 1.1 of the Response Evaluation Criteria in Solid Tumors.Secondary endpoints included toxicity,objective response rate,disease control rate,and overall survival.Adverse events(AEs)were graded according to version 5.0 of the Common Terminology Criteria for Adverse Events,as promulgated by the U.S.Department of Health and Human Services.Results:Eighty-two HR+/HER2–ABC patients who received cross-line CDK4/6i therapy from January 2022 to February 2024 were enrolled.The median age of the patients was 60 years.The median PFS of all patients was 7.6 months(95%CI,5.9-9.2).Cox regression analysis identified lung metastasis and a switch to endocrine therapy following prior CDK4/6i therapy as independent predictive factors for PFS.Notably,patients who previously received abemaciclib and switched to palbociclib upon disease progression had a median PFS of 10.7 months.The strategy of transitioning to chemotherapy after progression on a prior CDK4/6i,then to a subsequent CDK4/6i merits further investigation.Hematologic toxicity was the most common grade≥3 AEs.No instances of fatal safety events were observed.Conclusions:Cross-line CDK4/6i therapy is associated with significant clinical benefits and manageable safety profiles in patients with HR+/HER2–ABC,which underscores cross-line CDK4/6i therapy potential as an effective treatment strategy.
文摘AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conducted using a standardized recognition acuity chart(Snellen visual chart:at 3 m)and the baby vision model assessment.The baby vision device includes a screen,a near infrared camera and a computer.Children were seated at a measured distance of 33-40 cm from a display for testing.VA was estimated according to the highest resolution the children could follow.Decimal VA data were converted to logarithm of the minimum angle of resolution(logMAR)for statistical analysis.The VA results for each child were recorded and analyzed for consistency.RESULTS:The mean VA measured using the Snellen visual chart was 0.62±0.32,and that assessed using the baby vision test was 0.66±0.27.The 95%limit of agreement was-0.609 to 0.695,with 95.2%(100/105)plots within the 95%limits of agreement.VA values of the baby vision test were significantly correlated with those of the Snellen chart(R=0.274,P=0.005).CONCLUSION:The baby vision test can be used as a relatively reliable method for estimating VA in young children.This new acuity assessment might be a valid predictor of optotype-measured acuity later in preverbal children.
文摘3,3′,5-Triiodo-L-thyronine(T3)is a key endocrine hormone in the human body that plays crucial roles in growth,development,metabolism,and immune function.Macrophages,the key regulatory cells within the immune system,exhibit marked“heterogeneity”and“plasticity”,with their phenotype and function subject to modulation by local environmental signals.The interplay between the endocrine and immune systems is well documented.Numerous studies have shown that T3 significantly target macrophages,highlighting them as key cellular components in this interaction.Through the regulation of macrophage function and phenotype,T3 influences immune function and tissue repair in the body.This review comprehensively summarizes the regulatory actions and mechanisms of T3 on macrophages,offering valuable insights into further research of the immunoregulatory effects of T3.
基金supported by the National Natural Science Foundation of China (Grant Nos. 82073197, 82273142, and 82222058)。
文摘Targeted therapy is crucial for advanced colorectal cancer(CRC) positive for genetic drivers. With advances in deep sequencing technology and new targeted drugs, existing standard molecular pathological detection systems and therapeutic strategies can no longer meet the requirements for careful management of patients with advanced CRC. Thus, rare genetic variations require diagnosis and targeted therapy in clinical practice. Rare gene mutations, amplifications, and rearrangements are usually associated with poor prognosis and poor response to conventional therapy. This review summarizes the clinical diagnosis and treatment of rare genetic variations, in genes including erb-b2 receptor tyrosine kinase 2(ERBB2), B-Raf proto-oncogene, serine/threonine kinase(BRAF), ALK receptor tyrosine kinase/ROS proto-oncogene 1, receptor tyrosine kinase(ALK/ROS1), neurotrophic receptor tyrosine kinases(NTRKs), ret proto-oncogene(RET), fibroblast growth factor receptor 2(FGFR2), and epidermal growth factor receptor(EGFR), to enhance understanding and identify more accurate personalized treatments for patients with rare genetic variations.
