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Jennings Williams postete ein Update vor 12 Monaten
Abdominal aortic aneurysm(AAA)is a common aortic degenerative disease in the elderly,and its incidence is gradually increasing with the aging of the population.There are no specific drugs available to delay the expansion of AAA.Once the aneurysm ruptures,the mortality will exceed 90%,which seriously threatens the life of patients.Given the high incidence of AAA in the elderly,this review discusses the role of vascular aging in the pathogenesis of AAA,involving chronic inflammation,oxidative stress,mitochondrial dysfunction,protein homeostasis imbalance,increased apoptosis and necrosis,extracellular matrix remodeling,nutritional sensing disorders,epigenetic changes,and increased pro-aging factors.Meanwhile,several potential aging-related drug targets of AAA are listed.This review provides new ideas for basic and translational medical research of AAA.Liver metastasis is not rare during the course of neuroendocrine neoplasms.The methods for treating neuroendocrine neoplasm with liver metastasis(NENLM)are diversifying,which exposes the limitations of the early therapeutic response assessment based on only morphological changes.The emerging imaging biomarkers can sensitively describe changes in response to treatment from the functional level,providing new ideas for the therapeutic response evaluation of NENLM.In this paper,we reviewed the status quo and the latest research progress of imaging assessment for early therapeutic response of NENLM,aiming to provide reference for assessing the response and further exploring the treatment-related biomarkers.Clinical genomics mainly studies the clinical application of genomics in diagnosis,treatment decision,and prognosis prediction.Artificial intelligence enables the processing of complex and massive data in genomics which are difficult to be dealt with traditional algorithms and techniques.At present,artificial intelligence is involved in many tasks of clinical genomics,such as variant calling and classification,imaging and genetic diagnosis,electronic health record-based genetic diagnosis,and prediction of drug effect and adverse reaction.This review elaborates the application of artificial intelligence in different aspects of clinical genomics.Insomnia is a subjective experience of difficulty in falling asleep and/or maintaining sleep accompanied by the impairment of daytime social functioning due to insufficient sleep quality or quantity to meet normal physiological needs.It has chronic damage to all the human body systems and is the most common sleep disorder.The main mechanism for the occurrence and maintenance of insomnia is the hyperarousal hypothesis,and microarousal,as a cortical arousal,is also involved in the formation of the hyperarousal mechanism.The mechanism and clinical significance of microarousal were reviewed and summarized in this paper in order to guide the clinical work.The biofilm formation is a dynamic process of bacterial growth,and the extracellular components can encase these microorganisms,making them more resistant to antibiotics and host immune attack.The formation of antibiotic-resistant bacterial biofilms will be a major challenge for the treatment and control of clinical infections.Klebsiella pneumoniae is a common clinical pathogen.Hypervirulent K.pneumoniae and carbapenem-resistant K.pneumoniae can cause serious infectious diseases,and the formation of its biofilm will aggravate this situation.In-depth research on the formation of K.pneumoniae biofilm and its regulatory mechanism can shed light on clinical anti-infection treatment and control.This article mainly reviews the latest research progress in the effects of fimbriae,polysaccharides,quorum sensing systems,and efflux pumps on the formation of K.pneumoniae biofilm and their regulatory mechanisms.A good hydration status is important to the exercise performance and cognitive function of exercisers.The effective restoration of fluid balance after exercise is helpful to prevent dehydration,maintain body fluid balance,accelerate fatigue recovery,and enhance exercise performance.As the most effective sports nutrition supplement,sports beverage has different ingredients and formulas,and also has various effects.To provide clues for the development of sports beverage,this article reviews the types,components,effects,and mechanisms of sports beverage currently used in post-exercise fluid restoration.Objective To explore the cause and the treatment strategies of iliac limb occlusion after endovascular abdominal aortic aneurysm repair(EVAR). Methods The patients receiving EVAR in PUMC Hospital from January 2015 to December 2020 were retrospectively analyzed.Sixteen(2.7%)cases of iliac limb occlusion were identified,among which 6,9,and 1 cases underwent surgical bypass,endovascular or hybrid procedure,and conservative treatment,respectively. Results Fifteen cases were successfully treated.During the 10.6-month follow-up,2 cases receiving hybrid treatment underwent femoral-femoral bypass due to re-occlusion of the iliac limb. Conclusions Iliac limb occlusion mostly occurs in the acute phase after EVAR,and endovascular or hybrid treatment can be the first choice for iliac limb occlusion.It is suggested to focus on the risk factors for prevention.Objective To establish an artificial intelligence model based on B-mode thyroid ultrasound images to predict central compartment lymph node metastasis(CLNM)in patients with papillary thyroid carcinoma(PTC). Methods We retrieved the clinical manifestations and ultrasound images of the tumors in 309 patients with surgical histologically confirmed PTC and treated in the First Medical Center of PLA General Hospital from January to December in 2018.The datasets were split into the training set and the test set.We established a deep learning-based computer-aided model for the diagnosis of CLNM in patients with PTC and then evaluated the diagnosis performance of this model with the test set. Result The accuracy,sensitivity,specificity,and area under receiver operating characteristic curve of our model for predicting CLNM were 80%,76%,83%,and 0.794,respectively. Conclusion Deep learning-based radiomics can be applied in predicting CLNM in patients with PTC and provide a basis for therapeutic regimen selection in clinical practice.Objective To explore the roles of conventional ultrasound and contrast-enhanced ultrasound in distinguishing between benign and malignant thyroid nodules with calcification. Methods A total of 102 solid thyroid nodules with calcification in 76 patients were evaluated by conventional ultrasound alone and conventional ultrasound combined with contrast-enhanced ultrasound.The features obtained through conventional ultrasound alone and that combined with contrast-enhanced ultrasound were scored,and the diagnostic performance of the two methods was analyzed based on the final pathological results. Results The distribution of microcalcification(P1(P=0.039),unclear boundary(P=0.027),ring enhancement around nodules(P=0.000),and the degree(P=0.000)and uniformity(P=0.001)of enhancement for the non-calcified part were statistically different between benign and malignant nodules.Compared with conventional ultrasound alone,conventional ultrasound combined with contrast-enhanced ultrasound significantly improved the area under the curve(0.841 vs.0.701,P less then 0.001)and specificity(97.06% vs. 44.12%,P=0.007),without significant change in sensitivity(67.55% vs. 73.53%,P=0.727). Conclusions The combination with contrast-enhanced ultrasound can improve the performance of conventional ultrasound in the differential diagnosis of benign and malignant thyroid solid nodules with calcification.Eight malignant signs include solid,hypoechoic,microcalcification,aspect ratio,and blurred edges detected by conventional ultrasound,and non-circular enhancement around nodules,low enhancement and non-uniform enhancement of solid parts detected by contrast-enhanced ultrasound.A solid thyroid nodule with calcification presenting five or more malignant signs highly suggests malignancy.Objective To determine whether the signaling activation of bone morphogenetic protein 2(BMP2)can induce myeloid-derived suppressor cells(MDSC)to secret transforming growth factor β(TGF-β),further enhancing the differentiation and infiltration of regulatory T lymphocytes(Treg)into tumor tissue. Methods The BMP2-induced mRNA and protein expression of TGF-β in MDSC was detected by quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay(ELISA),respectively.The effect of BMP2-induced TGF-β secretion by MDSC on Treg differentiation was then determined by flow cytometry.Finally,we implanted the recombined human bone morphogenetic protein 2(rhBMP2)collagen gels into tumor-burdened mice to examine the role of BMP2 in Treg differentiation via MDSC-secreted TGF-β in vivo.The protein levels of TGF-β in peripheral blood and tumor tissue were detected by ELISA,and the infiltration of Treg cells in tumor tissue was detected by immunofluorescence assay. Results BMP2 up-regulated the mRNA and protein levels of TGF-β in MDSC in vitro.TGF-β secreted by the MDSC exposed to BMP2 treatment could induce the differentiation of Treg cells in vitro.Local implantation of rhBMP2 could increase the level of TGF-β protein in peripheral blood and tumor tissue of mice,further enhancing the infiltration of Treg cells into tumors. Conclusion BMP2 signaling activation can induce the differentiation of Treg cells by promoting the secretion of TGF-β in MDSC,and subsequently promote the infiltration of Treg cells into tumors.Objective To observe the patients after transvaginal mesh(TVM)implantation surgery by using transperineal ultrasound(TPUS),compare the diagnosis of pelvic organ prolapse(POP)by TPUS and clinical examination[according to the Pelvic Organ Prolapse Quantification(POP-Q)system published by the International Continence Society],and to explore the role of ultrasound in postoperative evaluation as well as the high-risk factors of post-surgery POP recurrence. Selleck PIK-75 Methods This is a retrospective study based on the POP-Q records and TPUS data sets of patients within 6 months after TVM surgery during September 2013 and November 2019.The diagnostic results of TPUS and POP-Q were compared.The incidences of hiatal ballooning and levator avulsion were separately compared between the TPUS group and the control group. Results A total of 147 patients were enrolled.The Kappa values between TPUS and POP-Q in the diagnosis of anterior and posterior compartment POP were 0.268(P=0.000)and 0.235(P=0.001),respectively.There were altogether 37 cases diagnosed inconsistently between TPUS and POP-Q,including 14(9.52%)cases of anterior compartment prolapse and 23(15.65%)cases of posterior compartment prolapse.TPUS diagnosed 32 more cases of prolapse than POP-Q,which included 13(8.84%)cases of anterior compartment prolapse and 19(12.93%)cases of posterior compartment prolapse.The incidence of hiatal ballooning in the TPUS prolapse group was significantly higher than control group(51.35% vs.33.94%,χ2=3.950,P=0.047).The incidence of levator avulsion showed no significant difference between the two groups(P=1.000). Conclusions TPUS diagnosis of POP after TVM surgery has consistency with the POP-Q diagnosis of International Continence Society.TPUS can detect more POP cases,and thus it may act as a supplement for clinical diagnosis.Hiatal ballooning is associated with POP recurrence after TVM surgery.