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Ultrasound-guided paravertebral nerve block anesthesia for percutaneous endoscopic laser unroofing treatment of symptomatic simple renal cysts—An innovative ambulatory surgery mode

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Asian Journal of Urology 2024年第1期11卷 65-71页

作者： Jia Hu yuan zhang Yong Liu xiao Yu Shaogang Wang Department of Urology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Anesthesiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

Objective:This study was designed to evaluate the feasibility,efficacy,and safety of percutaneous ureteroscopy laser unroofing as an ambulatory surgery for symptomatic simple renal cysts under multilevel paravertebral nerve block anesthesia.Methods:From December 2015 to September 2017,33 simple renal cyst patients who had surgical indications were enrolled.Under ultrasound guidance,the T10/T11,T11/T12,and T12/L1 paravertebral spaces were identified,and 7-10 mL 0.5%ropivacaine was injected at each segment.Then a puncture needle was placed inside the cyst cavity under ultrasonic monitoring.A guidewire was introduced followed by sequential dilation up to 28/30 Fr.The extra parenchymal portion of the cyst wall was dissociated and incised using a thulium laser,and a pathological examination was performed.Results:Sensory loss to pinprick from T8 to L1 and sensory loss to ice from T6 to L2 were observed in all patients.None of the patients complained of pain during surgery.No serious complications occurred perioperatively.After the surgery,all patients recovered their lower limb muscle strength quickly,got out of bed,resumed oral feeding,and left the hospital within 24 h of admission.The pathologic diagnosis of all cyst walls was a simple renal cyst.The mean follow-up was 35.8 months.At the end of follow-up,the cyst units were reduced in size by more than 50%compared to the preoperative size,and no patient experienced a recurrence.Conclusion:Multi-level paravertebral nerve block for percutaneous ureteroscopy laser unroofing as an ambulatory surgery mode is feasible,safe,and effective for the treatment of simple renal cysts in selected patients.

关键词： Paravertebralnerve blockanesthesia Percutaneous puncture Simplerenalcyst Unroofing Ambulatorysurgery

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A novel AMH variant at the prehelix loop impairs the binding to AMHR2 and causes persistent Mullerian duct syndrome

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Asian Journal of Andrology 2024年第2期26卷 222-224页

作者： Qiang Du Chuang Qiu yuan-yuan zhang Xue-Jun Shang xiao-Liang Liu Center of Reproductive Medicine Shengjing Hospital of China Medical UniversityShenyang 110004China Department of Orthopedics Shengjing Hospital of China Medical UniversityShenyang 110004China Department of Clinical Genetics Shengjing Hospital of China Medical UniversityShenyang 110004China Department of Urology Jinling HospitalSchool of MedicineNanjing UniversityNanjing 210012China

Dear Editor,Persistent Mullerian duct syndrome(PMDS;Online Mendelian Inheritance in Man[OMIM]:#261550)is a rare autosomal recessive inherent difference in sex development in males with Mullerian duct derivatives,including the uterus,fallopian tubes,and upper part of the vagina.'Approximately 88%of PMDS patients were found to have biallelic variants in the anti-Mullerian hormone(AMH;OMIM:*600957)or AMH type 2 receptor(AMHR2;OMIM:*600956)genes,and the rest were referred as idiopathic.I The serum AMH levels are usually very low or undetectable in PMDS patients with AMH gene mutations but normal or elevated in those with AMHR2 gene mutations.Here,an adult Chinese patient with PMDS carrying biallelic variants of the AMH gene was reported to have unexpectedly normal serum AMH level.Please refer to Supplementary Information of Patient and Methods for methodologies.

关键词： elevated AMH Muller

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Study on the Effect of Ginaton on Reducing Cerebral Vasospasm and Early Brain Injury after Hemorrhagic Stroke by Inhibiting Inflammatory Response

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World Journal of Traditional Chinese Medicine 2024年第1期10卷 33-39页

作者： Xue-Bo Pang xiao-Lin zhang Mei-Rong Wang Ying yuan xiao zhang Department of Neurology Xingtai Third HospitalXingtaiChina

Objective:The objective of this study was to investigate the effects and possible mechanisms of action of ginseng on cerebral vasospasm and early brain injury(EBI)following hemorrhagic stroke.Materials and Methods:Sprague-Dawley(SD)rats(n=48)were randomly divided into sham operation(sham group),subarachnoid hemorrhage(SAH)model(SAH group),normal saline(NS group),and Ginaton(Extract of Ginkgo Biloba Leaves Drops)intervention(gin group)groups.MCP-1 m RNA and tumor necrosis factor levels were detected using reverse transcription-polymerase chain reaction.The relative expression of m RNA was detected by Western blotting.Results:(1)Compared with the sham group,the SAH,NS,and gin groups had different degrees of neurological dysfunction.Compared with the SAH and NS groups,the neurological deficits in the gin group were significantly improved(P<0.05).(2)Compared with the sham group,the relative expression levels of MCP-1 m RNA in the SAH,NS,and gin groups were 5.1±0.9,3.4±0.6,and 2.5±0.4,respectively;the relative expression levels of m RNA were 13.3±2.4,11.2±1.8,and 3.8±0.6,respectively.(3)The apoptosis rates of brain tissue in the sham,SAH,NS,and gin groups were 4.8±0.7,54.2±10.3,50.1±7.4,and 28.4±4.5,respectively.(4)Western blot showed that the relative expression levels of toll-like receptor-4(TLR-4)protein in the sham,SAH,NS,and gin groups were 0.29±0.03,0.87±0.15,0.65±0.13,and 0.41±0.17,respectively;the relative expression levels of B protein were 0.21±0.04,0.96±0.14,0.73±0.18,and 0.30±0.05,respectively.Gin treatment could inhibit TLR-4 and nuclear factor-κB(NF-κB)protein expression.Conclusions:Dona tablets may inhibit activation of the NF-κB signaling pathway,and SAH-induced inflammatory response,so as to reduce cerebral vasospasm and EBI.

关键词： Cerebral hemorrhage early brain injury ginaton neurological deficit nuclear factor-κB

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Microneedle patch loaded with ferritin-nanocaged doxorubicin for locally targeted drug delivery and efficient skin cancer treatment

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Particuology 2024年第5期88卷 282-289页

作者： Feng Li yuan Yang Hua Yue Shuang Wang xiao zhang Wei Wei State Key Laboratory of Biochemical Engineering Institute of Process EngineeringChinese Academy of SciencesBeijing100190China Key Laboratory of Biopharmaceutical Preparation and Delivery Chinese Academy of SciencesBeijing100190China School of Chemical Engineering University of Chinese Academy of SciencesBeijing100049China

Ferritin has emerged as a promising nanocarrier for delivering therapeutic agents to tumours.However,the limited drug loading and the off-target impacts after systemic administration remain challenges for cancer treatment with ferritin-based agents.Herein,we develop a microneedle patch loaded with ferritin-nanocaged doxorubicin(DoxFe@Fn/MN)for skin cancer treatment.Briefly,doxorubicin(Dox)is encapsulated in ferritin(Fn)using an iron core-assisted strategy,which results in a 3.4-fold increase in Dox loading compared to the direct loading method.Then,a polyvinyl alcohol-based microneedle(MN)patch is used for the transdermal delivery of DoxFe@Fn,enabling targeted tumour accumulation of DoxFe@Fn and preventing off-target impacts.The released DoxFe@Fn can bind to CD71 highly expressed on skin cancer cells,facilitating its uptake.As a result,the DoxFe@Fn/MN therapy presents a robust antitumour effect in a melanoma tumour model,showing its potential as a promising therapeutic modality for skin cancer treatment.

关键词： Ferritin Microneedle Skin cancer Drug delivery

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Global trends in diabetic eye disease research from 2012 to 2021

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Neural Regeneration Research 2024年第10期19卷 2310-2320页

作者： yuan yuan Shangli Ji Yali Song Zhaodi Che Lu xiao Shibo Tang Jia xiao Aier School of Ophthalmology Central South UniversityChangshaHunan ProvinceChina Changsha Aier Eye Hospital ChangshaHunan ProvinceChina Aier Eye Institute ChangshaHunan ProvinceChina Department of Metabolic and Bariatric Surgery The First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong ProvinceChina

Diabetic eye disease refers to a group of eye complications that occur in diabetic patients and include diabetic retinopathy, diabetic macular edema, diabetic cataracts, and diabetic glaucoma. However, the global epidemiology of these conditions has not been well characterized. In this study, we collected information on diabetic eye disease-related research grants from seven representative countries––the United States, China, Japan, the United Kingdom, Spain, Germany, and France––by searching for all global diabetic eye disease journal articles in the Web of Science and Pub Med databases, all global registered clinical trials in the Clinical Trials database, and new drugs approved by the United States, China, Japan, and EU agencies from 2012 to 2021. During this time period, diabetic retinopathy accounted for the vast majority(89.53%) of the 2288 government research grants that were funded to investigate diabetic eye disease, followed by diabetic macular edema(9.27%). The United States granted the most research funding for diabetic eye disease out of the seven countries assessed. The research objectives of grants focusing on diabetic retinopathy and diabetic macular edema differed by country. Additionally, the United States was dominant in terms of research output, publishing 17.53% of global papers about diabetic eye disease and receiving 22.58% of total citations. The United States and the United Kingdom led international collaborations in research into diabetic eye disease. Of the 415 clinical trials that we identified, diabetic macular edema was the major disease that was targeted for drug development(58.19%). Approximately half of the trials(49.13%) pertained to angiogenesis. However, few drugs were approved for ophthalmic(40 out of 1830;2.19%) and diabetic eye disease(3 out of 1830;0.02%) applications. Our findings show that basic and translational research related to diabetic eye disease in the past decade has not been highly active, and has yielded few new treatment methods and newly approved drugs.

关键词： clinical trials diabetic cataracts diabetic eye disease diabetic glaucoma diabetic macular edema diabetic retinopathy drug development global research publication research grant

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Insights and implications of sexual dimorphism in osteoporosis

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Bone Research 2024年第1期12卷 20-49页

作者： yuan-yuan zhang Na Xie xiao-Dong Sun Edouard C.Nice Yih-Cherng Liou Canhua Huang Huili Zhu Zhisen Shen Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province Sichuan Research Center for Drug Precision Industrial TechnologyWest China School of PharmacySichuan UniversityChengdu 610041China West China School of Basic Medical Sciences&Forensic Medicine Sichuan UniversityChengdu 610041China Department of Biochemistry and Molecular Biology Monash UniversityClaytonVIC 3800Australia Department of Biological Sciences Faculty of ScienceNational University of SingaporeSingapore 117543Republic of Singapore Department of Biotherapy Cancer Center and State Key Laboratory of BiotherapyWest China Hospitaland West China School of Basic Medical Sciences&Forensic MedicineSichuan UniversityChengdu 610041China Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education Department of Reproductive MedicineWest China Second University Hospital of Sichuan UniversityChengduChina Department of Otorhinolaryngology and Head and Neck Surgery The Affiliated Lihuili HospitalNingbo University315040 NingboZhejiangChina

Osteoporosis,a metabolic bone disease characterized by low bone mineral density and deterioration of bone microarchitecture,has led to a high risk of fatal osteoporotic fractures worldwide.Accumulating evidence has revealed that sexual dimorphism is a notable feature of osteoporosis,with sex-specific differences in epidemiology and pathogenesis.Specifically,females are more susceptible than males to osteoporosis,while males are more prone to disability or death from the disease.To date,sex chromosome abnormalities and steroid hormones have been proven to contribute greatly to sexual dimorphism in osteoporosis by regulating the functions of bone cells.Understanding the sex-specific differences in osteoporosis and its related complications is essential for improving treatment strategies tailored to women and men.This literature review focuses on the mechanisms underlying sexual dimorphism in osteoporosis,mainly in a population of aging patients,chronic glucocorticoid administration,and diabetes.Moreover,we highlight the implications of sexual dimorphism for developing therapeutics and preventive strategies and screening approaches tailored to women and men.Additionally,the challenges in translating bench research to bedside treatments and future directions to overcome these obstacles will be discussed.

关键词： osteoporosis epidemiology overcome

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Human umbilical cord mesenchymal stem cells derivedexosomes on VEGF-A in hypoxic-induced mice retinal astrocytes and mice model of retinopathy of prematurity

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International Journal of Ophthalmology(English edition) 2024年第7期17卷 1238-1247页

作者： xiao-Tian zhang Bo-Wen Zhao yuan-Long zhang Song Chen Tianjin Eye Hospital Tianjin 300020China Tianjin Key Lab of Ophthalmology and Visual Science Tianjin 300020China

AIM:To observe the effect of human umbilical cord mesenchymal stem cells(hUCMSCs)secretions on the relevant factors in mouse retinal astrocytes,and to investigate the effect of hUCMSCs on the expression of vascular endothelial growth factor-A(VEGF-A)and to observe the therapeutic effect on the mouse model of retinopathy of prematurity(ROP).METHODS:Cultured hUCMSCs and extracted exosomes from them and then retinal astrocytes were divided into control group and hypoxia group.MTT assay,flow cytometry,reverse transcription-polymerase chain reaction(RT-PCR)and Western blot were used to detect related indicators.Possible mechanisms by which hUCMSCs exosomes affect VEGF-A expression in hypoxia-induced mouse retinal astrocytes were explored.At last,the efficacy of exosomes of UCMSCs in a mouse ROP model was explored.Graphpad6 was used to comprehensively process data information.RESULTS:The secretion was successfully extracted from the culture supernatant of hUCMSCs by gradient ultracentrifugation.Reactive oxygen species(ROS)and hypoxia inducible factor-1α(HIF-1α)of mice retinal astrocytes under different hypoxia time and the expression level of VEGF-A protein and VEGF-A mRNA increased,and the ROP cell model was established after 6h of hypoxia.The secretions of medium and high concentrations of hUCMSCs can reduce ROS and HIF-1α,the expression levels of VEGF-A protein and VEGF-A mRNA are statistically significant and concentration dependent.Compared with the ROP cell model group,the expression of phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)signal pathway related factors in the hUCMSCs exocrine group is significantly decreased.The intravitreal injection of the secretions of medium and high concentrations of hUCMSCs can reduce VEGF-A and HIF-1αin ROP model tissues.HE staining shows that the number of retinal neovascularization in ROP mice decreases with the increase of the dose of hUCMSCs secretion.CONCLUSION:In a hypoxia induced mouse retinal astrocyte model,hUCMSCs exosomes

关键词： human umbilical cord mesenchymal stem cells retinal astrocytes retinopathy of prematurity vascular endothelial growth factor hypoxia inducible factor

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Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 700-709页

作者： Kai Liu Chun-xiao Wu Hui Liang Tao Wang Ji-yuan zhang xiao-Tao Wang Department of Radiation and Oncology Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese MedicineLu’an 237000Anhui ProvinceChina Department of Gastroenterology Ehu branch of Xishan People’s Hospital of Wuxi CityWuxi 214116Jiangsu ProvinceChina Department of Gastrointestinal Surgery The First Affiliated Hospital of Guangzhou University of Traditional Chinese MedicineGuangzhou 510400Guangdong ProvinceChina Department of Gastrointestinal Surgery Hunan Provincial People’s HospitalChangsha 410002Hunan ProvinceChina Department of Traditional Chinese medicine Ehu branch of Xishan People’s Hospital of Wuxi CityWuxi 214116Jiangsu ProvinceChina

BACKGROUND Gastric cancer(GC)is the fifth most common type of cancer and has the fourth highest death rate among all cancers.There is a lack of studies examining the impact of liver metastases on the effectiveness of immunotherapy in individuals diagnosed with GC.AIM To investigate the influence of liver metastases on the effectiveness and safety of immunotherapy in patients with advanced GC.METHODS This retrospective investigation collected clinical data of patients with advanced stomach cancer who had immunotherapy at our hospital from February 2021 to January 2023.The baseline attributes were compared using either the Chi-square test or the Fisher exact probability method.The chi-square test and Kaplan-Meier survival analysis were employed to assess the therapeutic efficacy and survival duration in GC patients with and without liver metastases.RESULTS The analysis comprised 48 patients diagnosed with advanced GC,who were categorized into two groups:A liver metastasis cohort(n=20)and a non-liver metastatic cohort(n=28).Patients with liver metastasis exhibited a more deteriorated physical condition compared to those without liver metastasis.The objective response rates in the cohort with metastasis and the cohort without metastasis were 15.0%and 35.7%(P>0.05),respectively.Similarly,the disease control rates in these two cohorts were 65.0%and 82.1%(P>0.05),respectively.The median progression-free survival was 5.0 months in one group and 11.2 months in the other group,with a hazard ratio of 0.40 and a significance level(P)less than 0.05.The median overall survival was 12.0 months in one group and 19.0 months in the other group,with a significance level(P)greater than 0.05.CONCLUSION Immunotherapy is less effective in GC patients with liver metastases compared to those without liver metastasis.

关键词： Gastric cancer Spread of cancer to the liver Treatment with immunotherapy Effectiveness of treatment

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Application of non-mydriatic fundus photography-assisted telemedicine in diabetic retinopathy screening

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World Journal of Diabetes 2024年第2期15卷 251-259页

作者： Wan Zhou xiao-Jing yuan Jie Li Wei Wang Hao-Qiang zhang yuan-yuan Hu Shan-Dong Ye Department of Endocrinology The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Department of Endocrinology Anhui Provincial HospitalAffiliated to Anhui Medical UniversityHefei 230001Anhui ProvinceChina

BACKGROUND Early screening and accurate staging of diabetic retinopathy(DR)can reduce blindness risk in type 2 diabetes patients.DR’s complex pathogenesis involves many factors,making ophthalmologist screening alone insufficient for prevention and treatment.Often,endocrinologists are the first to see diabetic patients and thus should screen for retinopathy for early intervention.AIM To explore the efficacy of non-mydriatic fundus photography(NMFP)-enhanced telemedicine in assessing DR and its various stages.METHODS This retrospective study incorporated findings from an analysis of 93 diabetic patients,examining both NMFP-assisted telemedicine and fundus fluorescein angiography(FFA).It focused on assessing the concordance in DR detection between these two methodologies.Additionally,receiver operating characteristic(ROC)curves were generated to determine the optimal sensitivity and specificity of NMFP-assisted telemedicine,using FFA outcomes as the standard benchmark.RESULTS In the context of DR diagnosis and staging,the kappa coefficients for NMFPassisted telemedicine and FFA were recorded at 0.775 and 0.689 respectively,indicating substantial intermethod agreement.Moreover,the NMFP-assisted telemedicine’s predictive accuracy for positive FFA outcomes,as denoted by the area under the ROC curve,was remarkably high at 0.955,within a confidence interval of 0.914 to 0.995 and a statistically significant P-value of less than 0.001.This predictive model exhibited a specificity of 100%,a sensitivity of 90.9%,and a Youden index of 0.909.CONCLUSION NMFP-assisted telemedicine represents a pragmatic,objective,and precise modality for fundus examination,particularly applicable in the context of endocrinology inpatient care and primary healthcare settings for diabetic patients.Its implementation in these scenarios is of paramount significance,enhancing the clinical accuracy in the diagnosis and therapeutic management of DR.This methodology not only streamlines patient evaluation but also contributes substantially to the optimi

关键词： Diabetes Diabetic retinopathy Non-mydriatic fundus photography-assisted telemedicine Fundus fluorescein angiography

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Establishment of a cholangiocarcinoma risk evaluation model based on mucin expression levels

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1344-1360页

作者： Chun-yuan Yang Li-Mei Guo Yang Li Guang-Xi Wang xiao-Wei Tang Qiu-Lu zhang Ling-Fu zhang Jian-yuan Luo Department of Pathology Institute of Systems BiomedicineSchool of Basic Medical Sciences Peking UniversityPeking University Third HospitalPeking University Health Science CenterBeijing 100191China Department of General Surgery Peking University Third HospitalBeijing 100191China Department of Medical Genetics Department of Biochemistry and BiophysicsSchool of Basic Medical Sciences Peking UniversityPeking University Health Science CenterBeijing 100191China

BACKGROUND Cholangiocarcinoma(CCA)is a highly malignant cancer,characterized by frequent mucin overexpression.MUC1 has been identified as a critical oncogene in the progression of CCA.However,the comprehensive understanding of how the mucin family influences CCA progression and prognosis is still incomplete.AIM To investigate the functions of mucins on the progression of CCA and to establish a risk evaluation formula for stratifying CCA patients.METHODS Single-cell RNA sequencing data from 14 CCA samples were employed for elucidating the roles of mucins,complemented by bioinformatic analyses.Subse-quent validations were conducted through spatial transcriptomics and immuno-histochemistry.The construction of a risk evaluation model utilized the least absolute shrinkage and selection operator regression algorithm,which was further confirmed by independent cohorts and diverse data types.RESULTS CCA tumor cells with elevated levels of MUC1 and MUC4 showed activated nucleotide metabolic pathways and increased invasiveness.MUC5AC-high cells were found to promote CCA progression through WNT signaling.MUC5B-high cells exhibited robust cellular oxidation activities,leading to resistance against antitumoral treatments.MUC13-high cells were observed to secret chemokines,recruiting and transforming macrophages into the M2-polarized state,thereby suppressing antitumor immunity.MUC16-high cells were found to promote tumor progression through interleukin-1/nuclear factor kappa-light-chain-enhancer of activated B cells signaling upon interaction with neutrophils.Utilizing the expression levels of these mucins,a risk factor evaluation formula for CCA was developed and validated across multiple cohorts.CCA samples with higher risk factors exhibited stronger metastatic potential,chemotherapy resistance,and poorer prognosis.CONCLUSION Our study elucidates the functional mechanisms through which mucins contribute to CCA development,and provides tools for risk stratification in CCA.

关键词： Mucin Cholangiocarcinoma Single-cell RNA sequencing Spatial transcriptomics Prognosis

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