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Cyclin-dependent kinase (CDK)4/6 inhibitors combined with traditional endocrine therapy can significantly improve the progression-free survival and overall survival of hormone receptor-positive and human epithelial growth factor receptor 2-negative breast cancer patients. But different drugs, dosage and medication cycle will also bring different efficacy and safety incidents to patients. At the same time, confirming whether CDK4/6 inhibitors are equally applicable to Chinese breast cancer patients is not only an academic hotspot concerned by domestic clinicians, but also a practical need in actual diagnosis and treatment. This article reviews the classic clinical trials of drugs and the latest research progress.
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Objective:To investigate the risk factors and predictive value of early neurological deterioration (END) in patients with minor stroke caused by middle cerebral artery occlusion.Methods:Consecutive patients with minor stroke caused by middle cerebral artery occlusion admitted to Zhangjiagang Hospital Affiliated to Soochow University from October 2021 to May 2023 were retrospectively included. Minor stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5 at admission, and END was defined as an increase of ≥4 from baseline in the NIHSS score within 24 h of admission (excluding intracranial hemorrhage). Multivariate logistic regression analysis was used to determine independent risk factors for END. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of various risk factors on END. Results:A total of 130 patients with minor stroke caused by middle cerebral artery occlusion were included, of which 33 (25.4%) had END and 97 (74.6%) did not. Univariate analysis showed that there were statistically significant differences in NIHSS scores, volume with cerebral blood flow <30%, CT perfusion mismatch volume, baseline blood glucose, and baseline white blood cell count between the END and non-END groups (all P<0.05). Multivariate logistic regression analysis showed that CT perfusion mismatch volume (odds ratio [ OR] 1.010, 95% confidence interval [ CI] 1.003-1.017; P=0.007) and baseline white blood cell count ( OR 1.582, 95% CI 1.200-2.085; P=0.001) were the independent risk factors for END. ROC curve analysis showed that the area under the curves of CT perfusion mismatch volume and baseline white blood cell count for predicting END were 0.748 (95% CI 0.660-0.835; P<0.001) and 0.757 (95% CI 0.659-0.854; P<0.001), respectively. The area under the curve of combined predicting END was 0.821 (95% CI 0.738-0.905; P<0.001). Conclusions:CT perfusion mismatch volume and baseline white blood cell count are independent risk factors for the occurrence of END patients with minor stroke caused by middle cerebral artery occlusion, and the combination of the two has good predictive value for END.
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Traditional microtubule inhibitors fail to significantly enhance the effect of colorectal cancer;hence,new and efficient strategies are necessary.In this study,a supramolecular nanoreactor(DOC@TA-Fe3+)based on tannic acid(TA),iron ion(Fe3+),and docetaxel(DOC)with microtubule inhibition,reactive oxygen species(ROS)generation,and glutathione peroxidase 4(GPX4)inhibition,is prepared for ferroptosis/apoptosis treatment.After internalization by CT26 cells,the DOC@TA-Fe3+nanoreactor escapes from the lysosomes to release payloads.The subsequent Fe3+/Fe2+conversion mediated by TA reducibility can trigger the Fenton reaction to enhance the ROS concentration.Additionally,Fe3+can consume gluta-thione to repress the activity of GPX4 to induce ferroptosis.Meanwhile,the released DOC controls microtubule dynamics to activate the apoptosis pathway.The superior in vivo antitumor efficacy of DOC@TA-Fe3+nanoreactor in terms of tumor growth inhibition and improved survival is verified in CT26 tumor-bearing mouse model.Therefore,the nanoreactor can act as an effective apoptosis and ferroptosis inducer for application in colorectal cancer therapy.
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Fumarate hydratasedeficient renal cell carcinoma(FH-RCC)is s a rare and highly aggressive and metastatic form of renal cell carcinoma. Clinical diagnosis is relatively challenging, and there is a lack of recognized systemic treatment options. Therefore, in clinical practice, it is necessary to have a deeper understanding of this disease and fully integrate family history, imaging findings, and pathological manifestations for clinical identification, and genetic testing shoule be conducted when necessary. Improved patient prognosis can be achieved through the selection of appropriate curative surgery or systemic treatment strategies.
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【Objective】 To introduce the key techniques of "one-cut" circumcision, and to compare its clinical efficacy with traditional circumcision. 【Methods】 A retrospective analysis was conducted on 120 cases of circumcision in our center during Jul.2020 and Jul.2022, including 60 cases in the "one-cut" group and 60 cases in the traditional circumcision group. The operation time, postoperative edema time, satisfaction with cosmetics and improvement of sexual life were compared between the two groups. 【Results】 Compared with the tradition group, the "one-cut" group had shorter operation time [(19.2±7.4) min vs. (23.1±1.7) min, P<0.001] , shorter postoperative edema time [(5.5±3.2) d vs. (9.6±5.5) d, P<0.001] , and higher satisfaction with cosmetics [(3.6±0.5) vs. (3.1±0.8), P<0.001)] , but there was no difference in improvement of sexual life between the two groups (P=0.08). 【Conclusion】 "One-cut" circumcision is easy to operate, with short operation time, fast postoperative recovery, neat incision and satisfactory appearance, which is worth popularizing.
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On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.
Subject(s)
Humans , China/epidemiology , Disease Eradication , Public Health , Schistosomiasis/prevention & control , World Health OrganizationABSTRACT
Preventive chemotherapy is one of the pivotal interventions for the control and elimination of schistosomiasis, which is effective to reduce the morbidity and prevalence of schistosomiasis. In order to promote the United Nations' sustainable development goals and the targets set for schistosomiasis control in the Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030, WHO released the guideline on control and elimination of human schistosomiasis in 2022, with major evidence-based updates of the current preventive chemotherapy strategy for schistosomiasis. In China where great success has been achieved in schistosomiasis control, the preventive chemotherapy strategy for schistosomiasis has been updated several times during the past seven decades. This article reviews the evolution of the WHO guidelines on preventive chemotherapy and Chinese national preventive chemotherapy schemes, compares the current Chinese national preventive chemotherapy scheme and the recommendations for preventive chemotherapy proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, and proposes recommendations for preventive chemotherapy during the future implementation of the 2022 WHO guideline, so as to provide insights into schistosomiasis control among public health professionals engaging in healthcare foreign aid.
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Humans , China/epidemiology , Prevalence , Public Health , Schistosomiasis/prevention & control , World Health OrganizationABSTRACT
Schistosomiasis is a parasitic disease that seriously hinders socioeconomic developments and threatens public health security. To achieve the global elimination of schistosomiasis as a public health problem by 2030, WHO released the guideline on control and elimination of human schistosomiasis on February, 2022, with aims to provide evidence-based recommendations for schistosomiasis morbidity control, elimination of schistosomiasis as a public health problem, and ultimate interruption of schistosomiasis transmission in disease-endemic countries. Following concerted efforts for decades, great achievements have been obtained for schistosomiasis control in China where the disease was historically highly prevalent, and the country is moving towards schistosomiasis elimination. This article reviews the successful experiences from the national schistosmiasis control program in China, and summarizes their contributions to the formulation and implementation of the WHO guideline on control and elimination of human schistosomiasis. With the progress of the "Belt and Road" initiative, the world is looking forward to more China's solutions on schistosomiasis control.
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Humans , China/epidemiology , Disease Eradication , Public Health , Schistosomiasis/prevention & control , World Health OrganizationABSTRACT
Currently, the national schistosomiasis control program of China is moving from transmission interruption to elimination, and there are multiple challenges during the stage moving towards the progression of schistosomiasis elimination, including a high difficulty in shrinking snail-infested areas, unstable achievements for infectious source control, imperfect surveillance system and a reduction in schistosomiasis control and administration. Based on the core suggestions proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, recommendations on schistosomiasis surveillance system building, development of novel diagnostics, adjustment of the schistosomiasis control strategy and maintaining and improvements of the schistosomiasis control capability are proposed for the national schistosomiasis control program of China in the new era according to the actual status of schistosomiasis control in China. Formulation of the national schistosomiasis control strategy and goal from One Health perspective, verification of transmission interruption and elimination of schistosomiasis, precision implementation of schistosomiasis control interventions with adaptations to local circumstances, development and application of highly sensitive and specific diagnostics are recommended for elimination of schistosomiasis in China. In addition, the implementation of the 2022 WHO guideline on control and elimination of human schistosomiasis may guide the elimination of schistosomiasis in China.
Subject(s)
Animals , Humans , China/epidemiology , Goals , Schistosomiasis/prevention & control , Snails , World Health OrganizationABSTRACT
Hereditary breast cancer refers to malignant tumors caused by pathogenic germline mutations of breast cancer susceptibility genes (BRCA). At present, it is believed that BRCA1/2 genes are most closely related to the development of hereditary breast cancer. Mutation will lead to loss of normal function, instability of genome, and then lead to tumorigenesis. Especially for those with germline mutations, not only the risk of breast cancer will be greatly increased, but also the probability of ovarian cancer and other cancers will be increased. With the emergence and clinical application of poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors, BRCA1/2 genes have been regarded as new targets for the treatment of breast cancer. This article reviews the latest research of breast cancer with BRCA1/2 gene mutations.
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Breast cancer is the malignant tumor with the highest incidence among women in the worldwide. The triple-negative breast cancer (TNBC) has the strongest immunogenicity. Because of the lack of clear molecular targets, TNBC is a subtype of breast cancer with more difficulties in the treatment and poorer prognosis compared to other breast cancer subtypes. Blocking the programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) signaling pathway has been a hot spot of research and treatment of tumors. PD-1/PD-L1 inhibitors provide new treatment options for TNBC. This article reviews the research progress of PD-1/PD-L1 inhibitors alone or in combination with other drugs in treatment of TNBC, intending to provide the theoretical basis for basic or clinical studies.
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OBJECTIVE: To carry out HPTLC and HPLC fingerprint analysis of 18 batches of Ganoderma samples using two kinds of reference substance of Ganoderma extract, G. lucidum Extract Reference Substance(CZERS) and G. sinense Extract Reference Substance(ZZERS). METHODS: HPTLC Fingerprint was used to analyze triterpene acids and sterols in Ganoderma with chloroform-acetonitrile-methanol-formic acid (13∶2∶0.5∶0.5, develop 3 times) and cyclohexane-ethyl acetate-methanol-formic acid (15∶5∶0.5∶0.5, develop 2 times) respectively. HPLC Fingerprint analysis was conducted using Kromasil 100-5 C18 column (4.6 mm×250 mm, 5 μm) kept at 25 ℃. Mobile phase A was acetonitrile and B was 0.02% phosphoric acid; gradient elution procedure was as follows: 0-40 min, 29%→33% A; 40-70 min, 33%→65%A; 70-105 min, 65%→100%A; 105-120 min, 100% A; flow rate was 1.0 mL•min-1. DAD detector was adopted with detection wavelength set at 244 nm. The injection volume was 10 μL. RESULTS: By using ERS and fingerprint analysis, G. lucidum, G. sessile and G. lucidum could be distinguished. The components of G. lucidum in different species and growth patterns were different. CONCLUSION: There are many varieties of G. lucidum, which can be divided into wild and artificial cultures, and the culture media of artificial culture are different, which leads to the difference of individual components of different G. lucidum. Fingerprint analysis based on ERS of specific varieties are more suitable for the overall quality control of G. lucidum.
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We present an unusual case of a patient with bilateral-lung transplantation due to severe coronavirus disease 2019 (COVID-19), who subsequently suffered complications with acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI).
Subject(s)
Aged , Humans , Male , Betacoronavirus , China , Coronavirus Infections , Lung Diseases , General Surgery , Virology , Lung Transplantation , Pandemics , Percutaneous Coronary Intervention , Pneumonia, Viral , ST Elevation Myocardial Infarction , General Surgery , VirologyABSTRACT
Based on the latest clinical finding in recent years, the European Association of Urology (EAU) updated the 2019 guideline for renal cell carcinoma, mainly related to surgical treatment of renal tumors, immunotherapy and molecular targeted treatment of metastatic renal cell carcinoma. The updates in the surgical treatment of renal tumor included surgical indication of renal angiomyolipoma and renal medullary carcinoma, the risk of active surveillance and non-surgical treatment of early renal cell carcinoma. This article introduces and interprets the updated content and clinical signification of surgical treatment of renal tumor in EAU guideline 2020.
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Echinococcus granulosus is an important zoonotic parasite globally causing cystic echinococcosis (CE) in humans and animals. In this study, prevalence of CE and variation of cox1 gene sequence were analyzed with isolates E. granulosus collected from different areas in northern Xinjiang, China. The survey showed that 3.5% of sheep and 4.1% of cattle were infected with CE. Fragment of cox1 was amplified from all the positive sheep and cattle samples by PCR. In addition, 26 positive samples across the 4 areas were included. The isolates were all E. granulosus sensu stricto (s.s.) containing 15 haplotypes (Hap1-15), and clustered into 2 genotypes, G1 (90.1%, 91/101) and G3 (9.9%, 10/101). Hap1 was the most common haplotype (48.5%, 49/101). Hap9 were found in humans samples, indicating that sheep and cattle reservoir human CE. It is indicate that E. granulosus may impact on control of CE in livestock and humans in the region.
Subject(s)
Animals , Cattle , Humans , China , Cross-Sectional Studies , Echinococcosis , Echinococcus granulosus , Echinococcus , Genotype , Haplotypes , Livestock , Parasites , Polymerase Chain Reaction , Prevalence , SheepABSTRACT
Objective Both triptolide and pulsed radiofrequency can effectively alleviate neuropathic pain (NP). This study aims to investigate the effects of combined treatment with triptolide and pulsed radiofrequency on Wnt/β-catenin signaling pathway and inflammatory factors by establishing a spinal nerve ligation (SNL) rat NP model, thus providing a new idea for NP therapy. Methods A rat NP model of SNL was established, and sham surgery group, model group, triptolide group, pulsed radio frequency group and combined treatment group were set up. The mechanical withdrawal threshold (MWT) of rats in each group was measured at preoperative (Day 1) and postoperative (Days 1, 3, 5, 7 and 14) time points. Spinal dorsal root ganglion was collected 3, 7 and 14 days after the surgery, and mRNA expression levels of Wnt-3α and β-catenin were detected by RT-PCR, protein expression levels of iNOS and COX-2 by Western blot, and relative expression levels of GAP-43 by immunohistochemical staining. Results The MWT of the model group, triptolide group and pulsed radiofrequency group (7.38±0.08, 9.31±0.23, 8.46±0.30) were lower than that of the combined treatment group (11.65±0.19), with a statistically significant difference (P<0.05). The relative expression levels of Wnt-3α, β-catenin, iNOS mRNA and COX-2 mRNA after the combined treatment were significantly lower than those of the model group, triptolide group and pulsed radiofrequency group (P<0.05). The relative expression levels of GAP-43 after the combined treatment (1.23±0.02) was significantly higher than that of the model group, triptolide group and pulsed radiofrequency group (1.01±0.02, 0.94±0.03, 0.79±0.01), with a statistically significant difference (P<0.05). Conclusion The effects of the combined treatment is significantly better than that of triptolide and pulsed radiofrequency alone, as the combination has a stronger relieving effect on nerve inflammation and promotes the regeneration of nerve cells.
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For many years, studies on cholesteryl ester transfer protein inhibitors(CETP) have not been interrupted, intending to achieve further cardiovascular protection through increasing the level of HDL-C on the basis of statin-lowering LDL-C. However, the failure of large clinical studies of CETP inhibitors represented by torcetrapib has caused continuous controversy in this area of research. The 2017 European Society of Cardiology Annual Conference published the results of Phase 3 clinical trials on Anacetrapib, which regained significant attention to CETP inhibitors. Based on these, this article reviewed the development of the four major CETP inhibitors, and briefly discusses their clinical effects and differences.
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Objective@#To analyze the prevalence and influencing factors of suicidal behaviors among middle school students in minority areas of Guizhou Province, and to provide the reference for targetedly preventing suicidal behavior among middle school students.@*Methods@#Questionnaire survey including adolescent health information, Depression Self-rating Scale for Children(DSR-SC), Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the Pittsburgh Sleep Quality Index survey were conducted among 6 139 middle school students in minority areas of Guizhou Province, Logistic regression was used to analyze the influencing factors of suicidal behavior of middle school students.@*Results@#A total of 1 241(20.2%) had suicidal ideation in the past 12 months, and 250 (4.1%) of middle school students had committed suicide in the past 12 months. Suicidal ideation among middle school students was positively associated with: female, non-residence, being only child, smoking, having poor relationship with teachers, poor relationship with classmates, school violence victimization, physical abused, sexual abuse, emotionally neglected, having depression, having sleeping disorders(OR=1.67, 1.64, 0.84, 0.72, 0.67, 0.58, 2.06, 2.45, 2.12, 1.68, 2.82, 1.62). While being women(OR=1.52), non-residence(OR=2.25), smoking(OR=0.52), poor relationship with teachers(OR=0.49), poor relationship with classmates(OR=0.47), school violence victimization (OR=1.79) and physically abused(OR=2.17), sexual abused(OR=1.97), physically neglected(OR=1.94), depressive symptoms(OR=3.14), sleep disorders (OR=1.66) were associated positively with the risk of suicide attempt.@*Conclusion@#Suicide-related behaviors are more common in minority areas of Guizhou Province. Teachers and parents should attach great importance to it, and their suicidal risk should be early recognized to reduce suicide-related behaviors.
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OBJECTIVE@#Mutations in LIM domain binding 3 (LDB3) gene cause idiopathic dilated cardiomyopathy (IDCM), a structural heart disease with a complicated genetic background. However, the association of polymorphisms in the LDB3 gene with susceptibility to IDCM in Chinese populations remains unexplored as dose the impact on clinical presentation.@*METHODS@#We sequenced all exons and the adjacent part of introns of the LDB3 gene in 159 Chinese Han IDCM patients and 247 healthy controls. Then we detected the distribution of polymorphisms in the LDB3 gene in all participants and assessed their associations with risk of IDCM. Additionally, we conducted a stratified genotype-phenotype correlation analysis.@*RESULTS@#The A allele of rs4468255 was significantly associated with IDCM (P<0.01). The rs4468255, rs11812601, rs56165849, and rs3740346 were also associated with diastolic blood pressure (DBP) and left ventricular ejection fraction (LVEF) (P<0.05). Notably, a higher frequency of rs4468255 polymorphism was observed in implantable cardioverter defibrillator (ICD) recipients under a recessive model (P<0.01), whereas the significant association disappeared after adjusting for potential confounders. However, in the dominant model, notable correlations could only be observed after adjusting for multi parameters.@*CONCLUSIONS@#The rs4468255 was significantly correlated with IDCM of Chinese Han population. A allele of rs4468255 is higher in IDCM patients with ICD implantation, suggesting the influence of genetic background in the generation of this response. In addition, rs11812601, rs56165849, and rs3740346 in LDB3 show association with brain natriuretic peptide, DBP, and LVEF levels in patients with IDCM but did not show any association with IDCM susceptibility.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adaptor Proteins, Signal Transducing/genetics , Alleles , Asian People , Cardiomyopathy, Dilated/surgery , China/epidemiology , Defibrillators, Implantable , Exons , Genetic Association Studies , Genetic Predisposition to Disease , Genotype , LIM Domain Proteins/genetics , Linkage Disequilibrium , Mutation , Polymorphism, Genetic , Sequence Analysis, DNAABSTRACT
Objective To set up and apply the evaluation standards for photography of schistosomiasis control theme,so as to offer the scientific advice for enriching the health information carrier of schistosomiasis control.Methods Through the litera-ture review and expert consultation,the evaluation standard for photography of schistosomiasis control theme was formulated. The themes were divided into 4 projects,such as new construction,natural scenery,working scene,and control achievements. Results The evaluation criteria of the theme photography were divided into the theme(60%),photographic composition (15%),focus exposure(15%),and color saturation(10%).A total of 495 pictures(sets)from 59 units with 77 authors were collected from schistosomiasis epidemic areas national wide.After the first-step screening and second-step evaluation,the prizes of 3 themes of control achievements and new construction,working scene,and natural scenery were selected,such as 6 pictures of first prize,12 pictures of second prize,18 pictures of third prize,and 20 pictures of honorable prize.Conclusions The eval-uation standards of theme photography should be taken into the consideration of the technical elements of photography and the work specification of schistosomiasis prevention and control.In order to improve the ability of records for propaganda purpose of schistosomiasis control and better play a role of guiding correct propaganda,the training and guidance of photography of profes-sionals should be carried out.