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When to start renal replacement therapy in acute kidney injury: What are we waiting for?

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Journal of Intensive medicine 2024年第3期4卷 341-346页

作者： Lixia Liu Zhenjie Hu department of Critical Care medicine The Fourth Hospital of Hebei Medical UniversityShijiazhuangHebeiChina

Acute kidney injury remains a serious condition with a high mortality risk. In the absence of any new drugs, renal replacement therapy (RRT) is the most important treatment option. Randomized controlled trials have concluded that in critically ill patients without an emergency indication for RRT, a watchful waiting strategy is safe;however, further delays in RRT did not seem to confer any benefit, rather was associated with potential harm. During this process, balancing the risks of complications due to an unnecessary intervention with the risk of not correcting a potentially life-threatening complication remains a challenge. Dynamic renal function assessment, especially dynamic assessment of renal demand-capacity matching, combined with renal biomarkers such as neutrophil gelatinase-associated lipocalin and furosemide stress test, is helpful to identify which patients and when the patients may benefit from RRT.

关键词： Acute kidney injury Renal replacement therapy Initiation timing Dynamic assessment Biomarkers

Role of doxycycline in the treatment of dengue infection: An open-label, randomized, controlled, pilot trial

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Asian Pacific Journal of Tropical medicine 2024年第4期17卷 160-165页

作者： Banothu Vinod Kumar Kajal Kamboj Ashok Kumar Pannu Ashok Kumar Yadav Mandip Bhatia Atul Saroch department of internal medicine PGIMER ChandigarhIndia department of Experimental medicine&Biotechnology PGIMER ChandigarhIndia

Objective:To measure the effect of doxycycline on inflammatory marker[IL-6,TNF-α,ferritin and C reactive protein(CRP)]levels in patients with dengue ***:A single-centre,open-label,parallel-group randomized controlled trial was done in PGIMER Chandigarh from June 2021 to October *** were randomized using a simple randomization process into two groups:the doxycycline treatment group(n=35)and the control group(n=34).Patients in the treatment group were given oral doxycycline 100 mg twice daily for five days along with standard treatment,whereas patients in the control group received only standard *** objective was to measure the effect of doxycycline on inflammatory markers in dengue ***:On comparative analysis at day 5,there was a statistically significant reduction in the median values of ferritin and CRP in cases compared to the control group(ferritin:P=0.006 and CRP:P=0.006).No significant reduction was noted in the levels of IL-6 and TNF-α.Conclusions:Doxycycline treatment led to a reduction of inflammatory markers in dengue infection.

关键词： Dengue Cytokine Doxycycline Serum ferritin C reactive protein

Ileal collision tumor associated with gastrointestinal bleeding: A case report and review of literature

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 628-634页

作者： Yu-Qi Wu Hong-Yan Wang Mu-Min Shao Lin Xu Xiao-Yan Jiang Shao-Ju Guo department of Gastroenterology Shenzhen Traditional Chinese Medicine HospitalThe Fourth Clinical Medical College of Guangzhou University of Chinese MedicineShenzhen 518033Guangdong ProvinceChina department of Pathology Shenzhen Traditional Chinese Medicine HospitalThe Fourth Clinical Medical College of Guangzhou University of Chinese MedicineShenzhen 518033Guangdong ProvinceChina

BACKGROUND Collision tumors involving the small intestine,specifically the combination of a hamartomatous tumor and a lipoma,are extremely *** our knowledge,no previous case report has described a collision tumor composed of two benign tumors of different origins in the small *** SUMMARY Here,we present the case of an 82-year-old woman who presented with hemorrhagic shock and was found to have a mass measuring approximately 50 mm×32 mm×30 mm in the terminal *** on computed tomography scan findings,the mass was initially suspected to be a lipoma.A subsequent colonoscopy revealed a pedunculated submucosal elevation consisting of two distinct parts with a visible demarcation line.A biopsy of the upper portion suggested a juvenile polyp(JP).Owing to the patient’s advanced age,multiple comorbidities,and poor surgical tolerance,a modified endoscopic submucosal dissection was *** examination of the excised mucosal mass revealed a lipoma at the base and a JP at the top,demonstrating evidence of rupture and associated *** patient’s overall health remained satisfactory,with no recurrence of hematochezia during the six-month follow-up *** This case report provides new evidence for the understanding of gastrointestinal collision tumors,emphasizing their diverse clinical presentations and histopathological *** also offers diagnostic and therapeutic insights as well as an approach for managing benign collision tumors.

关键词： Collision tumor Gastrointestinal bleeding Hamartomatous tumor Lipoma Modified endoscopic submucosal dissection Case report

Machine learning applications in stroke medicine:advancements,challenges,and future prospectives

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Neural Regeneration Research 2024年第4期19卷 769-773页

作者： Mario Daidone Sergio Ferrantelli Antonino Tuttolomondo internal medicine and Stroke Care Ward Department of Health PromotionMother and Child CareInternal Medicine and Medical SpecialtiesUniversity of Palermo Molecular and Clinical medicine PhD Program University of Palermo

Stroke is a leading cause of disability and mortality worldwide,necessitating the development of advanced technologies to improve its diagnosis,treatment,and patient *** recent years,machine learning techniques have emerged as promising tools in stroke medicine,enabling efficient analysis of large-scale datasets and facilitating personalized and precision medicine *** abstract provides a comprehensive overview of machine learning’s applications,challenges,and future directions in stroke *** introduced machine learning algorithms have been extensively employed in all the fields of stroke *** learning models have demonstrated remarkable accuracy in imaging analysis,diagnosing stroke subtypes,risk stratifications,guiding medical treatment,and predicting patient *** the tremendous potential of machine learning in stroke medicine,several challenges must be *** include the need for standardized and interoperable data collection,robust model validation and generalization,and the ethical considerations surrounding privacy and *** addition,integrating machine learning models into clinical workflows and establishing regulatory frameworks are critical for ensuring their widespread adoption and impact in routine stroke *** learning promises to revolutionize stroke medicine by enabling precise diagnosis,tailored treatment selection,and improved *** research and collaboration among clinicians,researchers,and technologists are essential for overcoming challenges and realizing the full potential of machine learning in stroke care,ultimately leading to enhanced patient outcomes and quality of *** review aims to summarize all the current implications of machine learning in stroke diagnosis,treatment,and prognostic *** the same time,another purpose of this paper is to explore all the future perspectives these techniques can provide in combating this disabling dis

关键词： cerebrovascular disease deep learning machine learning reinforcement learning stroke stroke therapy supervised learning unsupervised learning

Hepatic recompensation according to Baveno VII criteria via transjugular intrahepatic portosystemic shunt

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World Journal of Gastroenterology 2024年第12期30卷 1777-1779页

作者： Hossam Eldin Shaaban Abeer Abdellatef Hussein Hassan Okasha department of internal medicine and Gastroenterology NHTMRICairo 11796Egypt department of internal medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt

Transjugular intrahepatic portosystemic shunt is a therapeutic modality done through interventional *** is aimed to decrease portal pressure in special situations for patients with decompensated liver disease with portal *** represents a potential addition to the therapeutic modalities that could achieve hepatic recompensation in those patients based on Baveno VII criteria.

关键词： Decompensated liver cirrhosis Hepatic recompensation Baveno VII Portal hypertension

New perspectives in prognostication of hepatocellular carcinoma:The role and clinical implications of transient receptor potential family genes

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2862-2864页

作者： Shi-Hao Guan Wen-Jing Hu Xin-Yu Wang Yue-Xia Gu De-Hua Zhou department of Plastic Surgery Qingpu Branch of Zhongshan Hospital Affiliated to Fudan UniversityShanghai 201700China department of Nursing Shanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200434China department of Thyroid Breast and Vascular SurgeryShanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200434China department of Gastrointestinal Surgery Shanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200434China

The study titled“Transient receptor potential-related risk model predicts prognosis of hepatocellular carcinoma patients”is a significant contribution to hepatocellular carcinoma(HCC)research,highlighting the role of transient receptor potential(TRP)family genes in the disease’s progression and *** data from The Cancer Genome Atlas database,it establishes a new risk assessment model,emphasizing the interaction of TRP genes with tumor proliferation pathways,key metabolic reactions like retinol metabolism,and the tumor immune ***,the overexpression of the TRPC1 gene in HCC correlates with poorer patient survival outcomes,suggesting its potential as a prognostic biomarker and a target for personalized therapy,particularly in strategies combining immunotherapy and anti-TRP agents.

关键词： Hepatocellular carcinoma Transient receptor potential channels TRPC1 gene Tumor immune microenvironment Cancer prognosis Bioinformatics in cancer research

The value of the INFECTIONS scoring system in identifying bacterial infections among patients presenting at the emergency department of a middle-income country:A pilot study

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Chinese Journal of Traumatology 2024年第2期27卷 77-82页

作者： Dooshanveer C.Nuckchady department of internal medicine Victoria HospitalCandosMauritius

Purpose:To investigate which scoring system is the most accurate tool in predicting mortality among the infected patients who present to the emergency department in a middle-income country,and to validate a new scoring system to predict bacterial ***:This was a retrospective,single-center study among patients who were admitted via the emergency department of a public *** patients who were started on antibiotics were included in the study,while patients aged0.85;however,these scoring systems failed to predict whether patients were truly *** INFECTIONS(short for impaired mental status,not conscious,fast heart rate,elevated creatinine,high temperature,on inotrope,low oxygen,high neutrophils and high sugar)model reached an AUROC of 0.88 to more accurately predict the infectious state of a ***:Middle-income countries should use the qSOFA or universal vital assessment score to identify the sickest patients in emergency *** INFECTIONS score may help recognize patients with bacterial infections,but it should be further validated in multiple countries prior to widely use.

关键词： Prognosis Mortality Bacterial infection INFECTIONS scoring system Sequential organ failure assessment Prediction

Extracorporeal membrane oxygenation as a bridging therapy for patients with thiamine deficiency-induced pulmonary arterial hypertension

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World Journal of Emergency medicine 2024年第2期15卷 147-149页

作者： Fangfang Qiu Weixing Dai Tengyue Huang Min Li department of Intensive Care Unit the Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000China department of Intensive Care Unit the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve *** deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 *** clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.

关键词： vitamin hypertension arterial

Depletion of anti-CD47mAb in plasma by genetically modified cells for pre-transfusion testing

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Genes & Diseases 2024年第5期11卷 102-104页

作者： Fei Wang Wenting Wang Xiaoshuang Wu Zhixin Liu Yafen Wang Rong Zhang Shunli Gu Qunxing An Yaozhen Chen Xingbin Hu department of Transfusion medicine Xijing HospitalFourth Military Medical UniversityXi’anShaanxi 710032China Xi’an Medical University Xi’anShaanxi 710021China

Allogeneic red blood cell(RBC)transfusion is commonly performed in medical practice because of its efficacy and low-risk ***,pre-transfusion tests are susceptible to monoclonal antibody(mAb)interference.1 Currently,mAb therapies are being developed to treat many diseases,such as ***,certain mAbs,such as anti-CD38mAb and anti-CD47mAb,can bind to RBC membranes;this binding interferes with pre-transfusion tests.2 CD47 has gained considerable attention in recent years because of its potential as a therapeutic target for hematologic malignancies and solid tumors.3 The binding of anti-CD47mAb to RBCs may lead to false-positive results in pan-agglutination tests and cause delays and risks in establishing compatible RBCs for transfusion.

关键词： CD47 transfusion diseases