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Liu M, Meng Y, Ouyang S, Zhai M, Yang L, Yang Y, Wang Y. Neuromodulation technologies improve functional recovery after brain injury: From bench to bedside. Neural Regen Res 2026; 21:506-520. [PMID: 39851132 DOI: 10.4103/nrr.nrr-d-24-00652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 11/05/2024] [Indexed: 01/26/2025] Open
Abstract
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited. This limited plasticity serves as a primary barrier to functional recovery after brain injury. Neuromodulation technologies represent one of the fastest-growing fields in medicine. These techniques utilize electricity, magnetism, sound, and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury. Therefore, this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury. Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury. However, studies report negative findings, potentially due to variations in stimulation protocols, differences in observation periods, and the severity of functional impairments among participants across different clinical trials. Additionally, we observed that different neuromodulation techniques share remarkably similar mechanisms, including promoting neuroplasticity, enhancing neurotrophic factor release, improving cerebral blood flow, suppressing neuroinflammation, and providing neuroprotection. Finally, considering the advantages and disadvantages of various neuromodulation techniques, we propose that future development should focus on closed-loop neural circuit stimulation, personalized treatment, interdisciplinary collaboration, and precision stimulation.
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Affiliation(s)
- Mei Liu
- Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University (The 904 Hospital of PLA), Wuxi, Jiangsu Province, China
| | - Yijing Meng
- Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University (The 904 Hospital of PLA), Wuxi, Jiangsu Province, China
| | - Siguang Ouyang
- Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University (The 904 Hospital of PLA), Wuxi, Jiangsu Province, China
| | - Meng'ai Zhai
- Department of Neurosurgery, The 904 Hospital of PLA, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Likun Yang
- Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University (The 904 Hospital of PLA), Wuxi, Jiangsu Province, China
| | - Yang Yang
- Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University (The 904 Hospital of PLA), Wuxi, Jiangsu Province, China
| | - Yuhai Wang
- Department of Neurosurgery, Wuxi Clinical College of Anhui Medical University (The 904 Hospital of PLA), Wuxi, Jiangsu Province, China
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Ogura T, Uba Y, Kanadani T, Bessho K, Nishikawa H. Stent-in-stent deployment for malignant hilar obstruction using multi-hole stent can prevent tumor ingrowth during 6-month cholangioscopic follow-up. Endoscopy 2025; 57:E99-E100. [PMID: 39909411 PMCID: PMC11798663 DOI: 10.1055/a-2518-5430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2025]
Affiliation(s)
- Takeshi Ogura
- Endoscopy Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yuki Uba
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takafumi Kanadani
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Kimi Bessho
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hiroki Nishikawa
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Yue X, Wang Y, Zheng R, Li L. The coping experiences in patients with hepatocellular carcinoma and their spouses following postoperative recurrence: A dyadic qualitative study. Asia Pac J Oncol Nurs 2025; 12:100665. [PMID: 40104041 PMCID: PMC11919323 DOI: 10.1016/j.apjon.2025.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 02/05/2025] [Indexed: 03/20/2025] Open
Abstract
Objective Dyadic coping practices can vary depending on cultural contexts, socioeconomic factors, and the stages of the cancer journey. This study aimed to explore the dyadic coping experiences of hepatocellular carcinoma (HCC) patients and their spouses following postoperative recurrence in the Chinese cultural context, where cancer recurrence is frequently seen as a death sentence, and family-centered care is prioritized. Methods A descriptive qualitative research design was used, involving face-to-face, in-depth semi-structured interviews with 13 pairs of hepatocellular carcinoma patients and their spouses at a tertiary cancer hospital from July to October 2023. The interview guide was designed based on the Actor-Partner Interdependence Model (APIM) framework. Data were analyzed using thematic analysis, and the study adhered to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. Results Three themes were identified: (1) active coping strategies, (2) negative coping tendencies, and (3) the need for systematic coping support. The majority of couples perceived hepatocellular carcinoma recurrence as a death sentence, which prompted them-especially the spouses-to adopt proactive strategies, such as striving to seek advanced treatments and concealing unfavorable information. In contrast, patients, particularly those with a hereditary hepatocellular carcinoma background, often exhibited passivity, withdrawal, and contemplation of treatment abandonment. Spouses frequently felt overwhelmed and unable to alleviate their partners' anxiety about recurrence and death, particularly in the absence of support from health care professionals. They expressed a strong need for professional guidance and targeted interventions to address end-of-life concerns, emphasizing the need for increased financial support, empowerment through knowledge, and access to peer support networks. Conclusions This research emphasizes the importance of recognizing the interdependent coping experiences of recurrent HCC patients and their spouses. Health care professionals are encouraged to implement culturally sensitive, dyadic interventions that foster collaborative coping, address death-related anxiety, and empower couples in managing recurrence together, thereby enhancing their coping strategies and confidence.
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Affiliation(s)
- Xian Yue
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yanhui Wang
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Ruishuang Zheng
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Laiyou Li
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Tian J, Wang W, Liu Y, Zhang X, Zhao H, Qu H. Role of endoscopic ultrasound as a predictor of histological healing in ulcerative colitis. Ann Med 2025; 57:2499961. [PMID: 40305512 PMCID: PMC12044909 DOI: 10.1080/07853890.2025.2499961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 04/01/2025] [Accepted: 04/14/2025] [Indexed: 05/02/2025] Open
Abstract
BACKGROUND Ulcerative colitis (UC) is a chronic inflammatory bowel disease with rising global prevalence.Histological healing (HH) is a key treatment target associated with better long-term outcomes. Although endoscopic ultrasound (EUS) is known to be related to both clinical and endoscopic activity in UC, its role in defining HH remains unclear. Therefore, this study was aimed at investigating the association between EUS and histological activity (HA), as well as the predictive potential of EUS for HH. METHOD In this cross-sectional analysis, 68 UC adults underwent EUS and colonoscopy with biopsies. We used the Mayo Endoscopic Score (MES) for endoscopic activity, the Nancy Index (NI) for biopsy grading, and the Endoscopic Ultrasound-Ulcerative Colitis (EUS-UC) score for EUS analysis, defining endoscopic remission as MES ≤ 1 and HH as NI ≤ 1.A receiver operating characteristic (ROC) curve was employed to evaluate the ability of the indices to predict HH. RESULTS Totally 23 patients (33.80%) achieved HH, while 45 (66.20%) showed HA. The EUS-UC scores were significantly lower in the HH group (p < 0.001) and correlated strongly with NI (ρ = 0.73). EUS-UC score was an independent risk factor for HH (adjusted OR = 1.918, 95% CI: 1.195-3.080, p = 0.007). The EUS-UC score demonstrated a strong predictive value for HH, with an AUC of 0.840, a sensitivity of 75.56%, and a specificity of 78.26%. CONCLUSION The EUS-UC score has a significant correlation with histological outcomes and shows strong potential as a reliable, invasive predictor of HH in UC, with implications for improved disease monitoring.
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Affiliation(s)
- Jin Tian
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Wei Wang
- Department of Gastroenterology, the First Affiliated Hospital of Shandong Second Medical University, Weifang People’s Hospital, Weifang, Shandong, China
| | - Yongshuai Liu
- Department of Gastroenterology, the First Affiliated Hospital of Shandong Second Medical University, Weifang People’s Hospital, Weifang, Shandong, China
| | - Xin Zhang
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Hanqing Zhao
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Hongmei Qu
- Department of Gastroenterology, the First Affiliated Hospital of Shandong Second Medical University, Weifang People’s Hospital, Weifang, Shandong, China
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Fan R, Chen Q, Gao S, Wang L, Mao S, Yan Z. A real-world study on the influence of unplanned reoperations on hospitalized patients using the diagnosis-related group. Ann Med 2025; 57:2473633. [PMID: 40038862 PMCID: PMC11884101 DOI: 10.1080/07853890.2025.2473633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 01/27/2025] [Accepted: 01/28/2025] [Indexed: 03/06/2025] Open
Abstract
OBJECTIVE The issue of unplanned reoperations poses significant challenges within healthcare systems, with assessing their impact being particularly difficult. The current study aimed to assess the influence of unplanned reoperations on hospitalized patients by employing the diagnosis-related group (DRG) to comprehensively consider the intensity and complexity of different medical services. METHODS A retrospective cohort study of surgical patients was conducted at a large tertiary hospital with two hospital districts employing data sourced from a DRG database. Hospital length of stay (LOS) and hospitalization costs were measured as the primary outcomes. Discharge to home was measured as the secondary outcome. Frequency matching based on DRG, regression modeling, subgroup comparison and sensitivity analysis were applied to evaluate the influence of unplanned reoperations. RESULTS We identified 20820 surgical patients distributed across 79 DRGs, including 188 individuals who underwent unplanned reoperations and 20632 normal surgical patients in the same DRGs. After DRG-based frequency matching, 564 patients (188 with unplanned reoperations, 376 normal surgical patients) were included. Unplanned reoperations led to prolonged LOS (before matching: adjusted difference, 12.05 days, 95% confidence interval [CI] 10.36-13.90 days; after matching: adjusted difference, 14.22 days, 95% CI 11.36-17.39 days), and excess hospitalization costs (before matching: adjusted difference, $4354.29, 95% CI: $3,817.70-$4928.67; after matching: adjusted difference, $5810.07, 95% CI $4481.10-$7333.09). Furthermore, patients who underwent unplanned reoperations had a reduced likelihood of being discharged to home (before matching: hazard ratio [HR] 0.27, 95% CI 0.23-0.32; after matching: HR 0.31, 95% CI 0.25-0.39). Subgroup analyses indicated that the outcomes across the various subgroups were mostly uniform. In high-level surgery subgroups (levels 3-4) and in relation to complex diseases (relative weight ≥ 2), the increase in hospitalization costs and LOS was more pronounce after unplanned reoperations. Similar results were observed with sensitivity analysis by propensity score matching and excluding short LOS. CONCLUSIONS Incorporating the DRG allows for a more effective assessment of the influence of unplanned reoperations. In managing such reoperations, mitigating their influence, especially in the context of high-level surgeries and complex diseases, remains a significant challenge that requires special consideration.
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Affiliation(s)
- Rui Fan
- Medical Quality Management Office, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Qifeng Chen
- Medical Administration Division, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Shang Gao
- Medical Quality Management Office, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Lili Wang
- Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
- Nursing Department, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Shuqi Mao
- Department of Hepatopancreatobiliary Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Zhiyu Yan
- Medical Quality Management Office, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
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Sun Y, Chen X, Ni J, Yu J. Peritoneal dialysis peritonitis due to Neisseria: clinicopathological features of 10 patients with a review of the literature. Ren Fail 2025; 47:2466820. [PMID: 40012242 PMCID: PMC11869343 DOI: 10.1080/0886022x.2025.2466820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 01/27/2025] [Accepted: 02/08/2025] [Indexed: 02/28/2025] Open
Abstract
BACKGROUND Peritoneal dialysis-associated peritonitis (PDAP) frequently arises as a complication in patients undergoing peritoneal dialysis. However, the understanding of the role of Neisseria, a gram-negative coccus, in PDAP is limited. METHODS This study retrospectively analyzed data for patients with Neisseria-associated PDAP who were treated at our center from January 2010 to June 2022. These patients were classified into the Neisseria group (Group N) and matched 1:2 by sex, age, dialysis duration, and residual kidney Kt/V with a coagulase-negative staphylococci group (Group CNS) and a Staphylococcus aureus group (Group S) as controls. Statistical analysis was conducted via SPSS 25.0 and was supplemented with a review of the relevant literature, to investigate clinical features, pathways of infection, and patient outcomes. RESULTS This study included 10 cases of Neisseria-associated PDAP, comprising 6 male and 4 female patients. The patients had an average age of 58.10 ± 14.52 years, and the average duration of peritoneal dialysis was 72.00 ± 46.99 months. Among these patients, 3 had first-time infections, while 7 had a prior history of PDAP. After treatment, 9 patients achieved medical cure, and 1 patient was transferred to hemodialysis (HD). Baseline comparisons across the 3 groups indicated notable differences in body temperature upon admission, which were statistically significant (p < 0.05), with patients in Group S having higher body temperatures compared to Group N and Group CNS. Compared with Group N, Group S presented a markedly elevated high-sensitivity C-reactive protein (hs-CRP) level, decreased serum albumin levels, reduced serum potassium levels, whereas Group CNS presented a significantly lower neutrophil percentage (N%) than did Group N (p < 0.05). Although survival analysis did not reveal statistically significant differences due to the limited sample size, Kaplan-Meier curves indicated a trend toward lower cure rates and slightly worse long-term outcomes in Group S than in Group N and Group CNS, with the latter 2 groups showing similar results. CONCLUSION Neisseria-associated PDAP generally has favorable outcomes, similar to those of CNS-related PDAP and better than those of S-related PDAP. Hypoalbuminemia, hypokalemia and elevated hs-CRP are key risk factors affecting outcomes, emphasizing the need to address them during treatment.
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Affiliation(s)
- Yue Sun
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Xinyu Chen
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Jun Ni
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Jin Yu
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
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Warang P, Singh G, Moshir M, Binazon O, Laghlali G, Chang LA, Wouters H, Vanhoenacker P, Notebaert M, Elhemdaoui N, Augustynková K, Steeland S, Ulrichts P, Baumeister J, Schotsaert M. Impact of FcRn antagonism on vaccine-induced protective immune responses against viral challenge in COVID-19 and influenza mouse vaccination models. Hum Vaccin Immunother 2025; 21:2470542. [PMID: 40028815 PMCID: PMC11881870 DOI: 10.1080/21645515.2025.2470542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 02/03/2025] [Accepted: 02/19/2025] [Indexed: 03/05/2025] Open
Abstract
Antagonism of the neonatal Fc receptor through an engineered antibody Fc fragment, such as efgartigimod, results in a decrease in immunoglobulin G levels. This approach is being evaluated as a therapeutic strategy for the treatment of IgG-mediated autoimmune diseases. Our goal was to evaluate the impact of mFc-ABDEG, a mouse-adapted antibody Fc fragment with a mode of action highly similar to efgartigimod, on vaccine-induced protective immune responses against viral infections. Therefore, mouse vaccination models for COVID-19 and influenza were employed, utilizing an mRNA COVID-19 vaccine (COMIRNATY) and an adjuvanted, inactivated quadrivalent influenza vaccine (Seqirus+AddaVax), respectively. In both models, vaccination induced robust humoral responses. As expected, animals treated with mFc-ABDEG had lower levels of virus-specific IgG, while virus-specific IgM responses remained unaffected. The COVID-19 vaccine induced a strong Th1-type T cell response irrespective of mFc-ABDEG treatment. Influenza vaccination resulted in a poor T cell induction, regardless of mFc-ABDEG treatment, due to the Th2-biased response that inactivated influenza vaccines typically induce. Importantly, mFc-ABDEG treatment had no effect on protective immunity against live viral challenges in both models. Vaccinated animals treated with mFc-ABDEG were equally protected as the non-treated vaccinated controls. These non-clinical data demonstrate that FcRn antagonism with mFc-ABDEG did not affect the generation of vaccine-induced protective humoral and cellular responses, or protection against viral challenges. These data substantiate the clinical observations that, although IgG titers were reduced, FcRn antagonism with efgartigimod did not impair the ability to generate new specific IgG responses, regardless of the timing of vaccination.
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Affiliation(s)
- Prajakta Warang
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gagandeep Singh
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mahan Moshir
- Department of Translational & Clinical Sciences, Argenx, Ghent, Belgium
| | - Ornella Binazon
- Department of Non-Clinical Pharmacology & Toxicology, Argenx, Ghent, Belgium
| | - Gabriel Laghlali
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lauren A. Chang
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | | | - Sophie Steeland
- Department of Translational & Clinical Sciences, Argenx, Ghent, Belgium
| | - Peter Ulrichts
- Department of Translational & Clinical Sciences, Argenx, Ghent, Belgium
| | - Judith Baumeister
- Department of Non-Clinical Pharmacology & Toxicology, Argenx, Ghent, Belgium
| | - Michael Schotsaert
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Denis C, Boucaud-Maitre D, Brunelin J, Jurek L, Vallet W, Demily C. Prevalence of attention deficit hyperactivity disorder in homeless children and adolescents: A systematic review and meta-analysis. DIALOGUES IN CLINICAL NEUROSCIENCE 2025; 27:86-97. [PMID: 40176288 DOI: 10.1080/19585969.2025.2486355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 01/13/2025] [Accepted: 03/21/2025] [Indexed: 04/04/2025]
Abstract
INTRODUCTION This systematic review and meta-analysis aimed to examine the prevalence of Attention deficit hyperactivity disorder (ADHD) in homeless children and adolescents, and the factors that may influence its prevalence. METHODS Relevant publications in Medline, Web of Science, Scopus and PsycINFO were systematically searched to identify studies on the prevalence of ADHD in homeless children and adolescents (≤19 years). The extracted data were pooled using a random-effects model. RESULTS Thirteen studies involving 2878 homeless children and adolescents were included (mean age: 12.0 years, sex F/M: 0.43). The prevalence rates of ADHD vary considerably across studies, ranging from 1.6% to 64.5%. The pooled prevalence of ADHD was 22.8% (95% CI 12.9-34.4%, I2 =98%). Meta-regression analyses indicated that age (slope = 0.046; p = .042) significantly increased ADHD prevalence. The prevalence of ADHD in studies with a mean age ≥ 12 years (43.1%, 95% CI 26.5-60.4%) was higher than those with a mean age < 12 years (13.1%, 95%CI 4.3-25.6). CONCLUSION Despite the high heterogeneity of the studies, we observed that ADHD could affect almost a quarter of homeless children and adolescents. Reintegrating them into care systems and ensuring access to public health interventions tailored for homeless families and youth is imperative for breaking the cycle of homelessness and improving long-term trajectories.
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Affiliation(s)
| | - Denis Boucaud-Maitre
- Centre Hospitalier le Vinatier, Bron, France
- Equipe EPICLIV, Université des Antilles, Fort-de-France, Martinique
| | - Jérôme Brunelin
- Centre Hospitalier le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron, France
| | - Lucie Jurek
- Centre Hospitalier le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, RESHAPE Inserm U1290, Lyon, France
| | - William Vallet
- Centre Hospitalier le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron, France
| | - Caroline Demily
- Centre Hospitalier le Vinatier, Bron, France
- Centre de Référence Maladies Rares Troubles du Comportement d'Origine Génétique (GénoPsy Lyon), Centre d'excellence Autisme iMIND, Le Vinatier Etablissement Lyonnais référent en psychiatrie et santé mentale, UMR 5229, CNRS & Université Lyon 1, Lyon, France
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Jiang H, Ren S, Zhang S, Luo X, He R, Wang SF, Yan JD, Zhou S, Yin C, Xiao Y, Li Z. Analyzing factors influencing hospitalization costs for five common cancers in China using neural network models. J Med Econ 2025; 28:615-624. [PMID: 40241623 DOI: 10.1080/13696998.2025.2494459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2025] [Accepted: 04/14/2025] [Indexed: 04/18/2025]
Abstract
BACKGROUND Malignant tumors are a major global health crisis, causing 25% of deaths in China, with lung, liver, thyroid, breast, and colon cancers being the most common. Understanding the factors influencing hospitalization costs for these cancers is crucial for public health and economics. This study aimed to identify key cost factors and develop a neural network model for predicting hospitalization costs, thereby providing tools to ease the financial burden on patients and healthcare systems. METHODS Data on hospitalization costs for 30,893 cancer patients from secondary or higher-level hospitals in Zhuhai, Guangdong Province, between 2017 and 2022, were analyzed. Neural network classification and feature importance analysis were used to determine the main factors influencing costs and to develop predictive models. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), with a 95% confidence interval (CI) calculated for the AUROC value. RESULTS The key factors influencing hospitalization costs for lung cancer are metastasis and malignant solid tumor (MST), with correlation coefficients of 0.126 and 0.086, respectively, both showing statistical significance (p < 0.05). For colon cancer, the key factors influencing hospitalization costs are mortality and coronary disease (CD), with correlation coefficients of 0.092 and 0.090, respectively, both demonstrating statistical significance (p < 0.05). The AUROC value for the lung cancer model is 0.9078 (95% CI = 0.8975-0.9186), and the AUROC value for the colon cancer model is 0.9017 (95% CI = 0.8848-0.9196). CONCLUSION This study confirmed the strong clinical applicability of the neural network predictive model in analyzing hospitalization costs for lung and colon cancer and revealed the factors that influence hospitalization costs for these cancers.
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Affiliation(s)
- Hong Jiang
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
- Statistical office, Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), Zhuhai, China
| | - Sinuo Ren
- School of Automation Science and Electrical Engineering, Beihang University, Beijing, China
| | - Shengbo Zhang
- Department of General Surgery, Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), Zhuhai, China
| | - Xudan Luo
- Department of Industrial Engineering and Operations Research, University of California, Berkeley, CA, USA
| | - Rui He
- Grammar and Cognition Lab, Department of Translation & Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Shuai Fei Wang
- Statistical office, Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), Zhuhai, China
| | - Jian Dong Yan
- Statistical office, Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), Zhuhai, China
| | - Shan Zhou
- Florida Research and Innovation Center, Cleveland Clinic, Port St. Lucie, FL, USA
| | - Chengliang Yin
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
| | - Ying Xiao
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
| | - Zhihuan Li
- Statistical office, Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), Zhuhai, China
- China Resources Power Intelligent Security Laboratory, Research Institute of Tsinghua University in Shenzhen, Shenzhen, China
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Sun S, Arif Aslam M, Ma EB, Lee G, Muhammad Ahmad Javaid H, Yoon S, Huh JY. Activation of CXCR7 exerts an inhibitory effect on adipogenesis through regulation of β-arrestin2/Wnt and AKT signalling. Adipocyte 2025; 14:2490258. [PMID: 40302245 PMCID: PMC12045560 DOI: 10.1080/21623945.2025.2490258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 01/22/2025] [Accepted: 03/29/2025] [Indexed: 05/02/2025] Open
Abstract
CXCR7, an alternative receptor for the inflammatory chemokine SDF-1, is involved in cell proliferation and migration. Recent studies have reported that CXCR7 also plays a role in adipose tissue. However, evidence regarding the role of CXCR7 and its ligands in adipocyte differentiation is limited. In this study, we aimed to elucidate changes in CXCR7 expression during adipocyte differentiation and the role of the SDF-1/CXCR7/CXCR4 axis in adipogenesis using recombinant SDF-1, the CXCR7 ligand CCX771, and small interfering RNAs. The results indicated that the levels of SDF-1 and its receptors, CXCR7 and CXCR4, decreased during the early stages of adipogenesis. Treatment with recombinant SDF-1 and CCX771 inhibited adipogenesis and lipid accumulation by inducing β-arrestin2, Wnt expression, and AKT phosphorylation and downregulating C/EBPα, PPARγ, and FABP4 expression. In contrast, knockdown of SDF-1 and CXCR7 in preadipocytes downregulated the β-arrestin2/Wnt and AKT pathway, leading to the induction of adipogenesis. Meanwhile, knockdown of CXCR4 had no significant effect. In mice, basal gene expression levels of SDF-1 and CXCR7 were higher in the stromal vascular fraction compared to mature adipocytes and were significantly upregulated by a high-fat diet. Our results provide new insights into the local role of the SDF-1-CXCR7 axis in adipocytes and offer additional benefits for the prevention of obesity-related metabolic disorders.
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Affiliation(s)
- Shiyue Sun
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
- Department of Anesthesia and Critical Care, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Muhammad Arif Aslam
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
| | - Eun Bi Ma
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Gahui Lee
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
- Department of Global Innovative Drugs, The Graduate School of Chung-Ang University, Seoul, Republic of Korea
| | - Hafiz Muhammad Ahmad Javaid
- Department of Anesthesia and Critical Care, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Somy Yoon
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
| | - Joo Young Huh
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
- Department of Global Innovative Drugs, The Graduate School of Chung-Ang University, Seoul, Republic of Korea
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11
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Sun Z, Chen Y, Su Q. Prenatal ultrasound for the diagnosis of the cerebellar abnormalities: a meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2453997. [PMID: 39864828 DOI: 10.1080/14767058.2025.2453997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 01/02/2025] [Accepted: 01/09/2025] [Indexed: 01/28/2025]
Abstract
OBJECTIVE Fetal cerebellar abnormalities are associated with neurodevelopmental disorders and structural brain malformations. Accurate and early diagnosis is crucial for prenatal counseling and planning postnatal interventions. While prenatal ultrasound is a key tool for detecting fetal brain abnormalities, variations in diagnostic accuracy across studies necessitate a systematic evaluation of its effectiveness in diagnosing cerebellar abnormalities. METHODS A comprehensive literature search was conducted across major databases to identify relevant studies on prenatal ultrasound for diagnosing cerebellar anomalies. Inclusion criteria included studies with clear diagnostic outcomes, diverse patient populations, and standardized ultrasound protocols. Meta-analytic techniques were employed to assess overall diagnostic accuracy, sensitivity, specificity, and heterogeneity using Meta Disk. The quality of the included studies was evaluated using the QUADAS-2 tool. RESULTS The meta-analysis included fifteen studies involving 1,902 fetuses with suspected cerebellar abnormalities. The pooled sensitivity and specificity of prenatal ultrasound were 0.83 (95% CI: 0.80-0.86) and 0.97 (95% CI: 0.96-0.98), respectively. The positive likelihood ratio was 7.96 (95% CI: 3.23-19.64), the negative likelihood ratio was 0.18 (95% CI: 0.09-0.36), and the odds ratio was 46.76 (95% CI: 14.06-155.53). The combined area under the curve (AUC) reached 0.93, indicating robust diagnostic performance. Heterogeneity was observed, influenced by factors such as gestational age at screening, operator expertise, and ultrasound equipment quality. CONCLUSIONS Prenatal ultrasound is a reliable tool for detecting cerebellar abnormalities with high sensitivity and specificity. However, variability in diagnostic performance suggests the need for standardized protocols and advanced imaging techniques to enhance accuracy. Future research should focus on integrating multiple imaging modalities to optimize prenatal screening outcomes.
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Affiliation(s)
- Zhen Sun
- Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, China
| | - Yanqiu Chen
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qichen Su
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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12
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Cai P, Zheng Y, Chen L, Fang Q, Lei Y, She Z. Association of serum N,N,N-trimethyl-5-aminovaleric acid, trimethylamine N-oxide, and trimethyllysine levels with gestational diabetes mellitus. J Matern Fetal Neonatal Med 2025; 38:2467999. [PMID: 39972978 DOI: 10.1080/14767058.2025.2467999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 01/27/2025] [Accepted: 02/10/2025] [Indexed: 02/21/2025]
Abstract
OBJECTIVE To investigate the association of serum N,N,N-trimethyl-5-aminovaleric acid (TMAVA), trimethylamine N-oxide (TMAO), and trimethyllysine (TML) levels with gestational diabetes mellitus (GDM). METHODS Seventy pregnant women from the Hunan Provincial Maternal and Child Health Care Hospital (March 2021 to October 2023) were enrolled in this study. Forty GDM patients with GDM were included in the GDM group (GDM), and 30 healthy controls were included (Con). Participants were further categorized into adverse and good outcome groups based on pregnancy outcomes. Serum TMAVA, TMAO, and TML levels were quantified using ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Correlations between biomarker levels and clinical indicators were assessed using Pearson and Spearman analyses. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate risk factors and predictive value. RESULTS Serum TMAVA, TMAO, and TML levels were significantly higher in the GDM group. TMAVA levels were positively correlated with fasting plasma glucose (FPG), fasting insulin (FINS), creatinine (Cr), TMAO, and TML. TMAO and TML positively correlated with FPG, 2-h postprandial glucose (2h PG), FINS, Cr, and uric acid (UA) levels, while TMAO negatively correlated with triglyceride (TG). Combined TMAVA, TMAO, and TML predicted GDM with an area under the curve (AUC) of 0.940 (95% CI: 0.883-0.997). Elevated TMAVA levels were associated with adverse pregnancy outcomes in GDM, with an AUC of 0.757 (95% CI: 0.612-0.902). CONCLUSIONS Elevated serum levels of TMAVA, TMAO, and TML were significantly associated with the occurrence of GDM and adverse pregnancy outcomes. The combined detection of these three biomarkers demonstrated superior accuracy in predicting GDM. Among them, TMAVA demonstrated the highest predictive efficiency for adverse pregnancy outcomes in women with GDM. These findings provide new biomarkers for early screening and risk assessment of GDM, offering promising applications in clinical practice.
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Affiliation(s)
- Pei Cai
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Yi Zheng
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Lulu Chen
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, China
- Changsha Duxact Biotech Co., Ltd., Changsha, China
| | - Qing Fang
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, China
- Changsha Duxact Biotech Co., Ltd., Changsha, China
| | - Yingjuan Lei
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Zhihua She
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
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13
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Wang Q, Mao X, Li Y, Mo G, Li D, Cao D, Chen G. The mechanistic action of mogroside V in the alleviation of oxidative aging. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2025; 53:166-180. [PMID: 40217568 DOI: 10.1080/21691401.2025.2486752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/21/2025] [Accepted: 03/19/2025] [Indexed: 04/14/2025]
Abstract
INTRODUCE Diseases related to oxidative ageing are becoming increasingly evident in younger individuals. In this study, we investigated the mechanisms underlying the actions of mogroside V when used to treat anti-oxidative ageing. METHODS We used D-galactose-induced LO2 cells and C57BL/6J mice as models to investigate the molecular mechanisms of mogroside V (MV) for the treatment of oxidative ageing. Network pharmacology was used to predict the targets of MV for the treatment of oxidative ageing. RESULTS By down-regulating the EGFR/p38/JNK pathway, MV significantly inhibited oxidative ageing and apoptosis in cells, reduced the levels of SA-β-galactosidase. In mice, compared with the model group, MV treatment (100 mg/kg·d) reduced MDA levels and significantly increased the levels of GSH and SOD; furthermore, the size and structure of the liver leaflet and glomeruli was arranged in a regular manner; the small intestine glands had decreased in size. Moreover, the expression levels of Ptp1b mRNA had increased significantly while the levels of c-Jun mRNA and protein were significantly reduced. MV also increased the proportion of beneficial bacteria in the small intestine, including Bacteroidales and Lactobacillaceae. CONCLUSION Our analyses revealed that MV can significantly reduce oxidative ageing caused by the accumulation of D-galactose.
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Affiliation(s)
- Qiannan Wang
- School of Basic Medicine, Guilin Medical University, Guangxi, China
| | - Xinyue Mao
- College of Pharmacy, Guilin Medical University, Guangxi, China
| | - Yulan Li
- College of Clinical Medicine, Guilin Medical University, Guangxi, China
| | - Gang Mo
- School of Basic Medicine, Guilin Medical University, Guangxi, China
| | - Dayu Li
- School of Basic Medicine, Guilin Medical University, Guangxi, China
| | - Deping Cao
- School of Basic Medicine, Guilin Medical University, Guangxi, China
| | - Gen Chen
- School of Basic Medicine, Guilin Medical University, Guangxi, China
- Key Experiment of Pathogen Biology, Guangxi Universities, Guangxi, China
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14
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Zhang Y, Bi Q, Zhang L, Zhu D. Preoperative Simulation and Three-Dimensional Model for the Operative Treatment of Tibiofibular Diaphyseal Fracture: A Randomized Controlled Clinical Trial. J INVEST SURG 2025; 38:2463351. [PMID: 39956543 DOI: 10.1080/08941939.2025.2463351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 02/01/2025] [Indexed: 02/18/2025]
Abstract
BACKGROUND In order to ascertain the safety and therapeutic efficacy of preoperative simulation in conjunction with three-dimensional (3D) printing modalities for the surgical management of tibiofibular diaphyseal fractures. We postulate that preoperative simulation and three-dimensional (3D) printing techniques have a significant impact on reducing the mean operative time, diminishing intraoperative blood loss, and decreasing the frequency of fluoroscopic. MATERIAL AND METHODS Sixty patients with tibiofibular diaphyseal fracture were divided into the conventional surgery group (n = 30) and the 3D printing group (n = 30). In the 3D printing group, preoperative equal-ratio fracture models prepared using the 3D printing technique were used to perform preoperative simulation, guide the real surgical operation, examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, frequency of fluoroscopies, Visual Analog Scale (VAS), and Johner-Wruhs Scale were recorded. RESULTS The operation time, blood loss, and the frequency of fluoroscopy during operation in the group with preoperative simulation and 3D printing were less than that in the conventional surgery group (p < 0.001). Meanwhile, the Visual Analog Scale (VAS) and Johner-Wruhs Scale were also improved in both groups. CONCLUSION The findings indicated that preoperative simulation and three-dimensional (3D) printing may facilitate the treatment of tibiofibular diaphyseal fractures, potentially enhancing preoperative planning and contributing to the precision and personalization of the surgical procedure. Thus, the application of this technology possesses considerable promise for future utilization in clinical practice. TRIAL REGISTRY Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100052379.
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Affiliation(s)
- Yin Zhang
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Qing Bi
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Li Zhang
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Danjie Zhu
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
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15
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Li Z, Liu J, Zhu S, Zhang M, Xu F, Jiao C, Huang X, Cheng Z, Zuo K. Membranous nephropathy concurrent with renal amyloidosis: a six-patient report and literature review. Ren Fail 2025; 47:2486562. [PMID: 40260523 PMCID: PMC12016244 DOI: 10.1080/0886022x.2025.2486562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 03/06/2025] [Accepted: 03/25/2025] [Indexed: 04/23/2025] Open
Abstract
The KDIGO 2021 guidelines suggest that individuals who test positive for serum anti-phospholipase A2 receptor (anti-PLA2R) antibodies may not require a renal biopsy to establish a diagnosis of membranous nephropathy (MN). However, it is imperative to acknowledge that MN can coexist with other chronic kidney diseases. In instances where MN is comorbid with IgA nephropathy, diabetic nephropathy, or focal segmental glomerulosclerosis, the therapeutic approach tends to be analogous. Nevertheless, there is a significant disparity in both the treatment regimen and the prognosis between MN and renal amyloidosis, with variations existing even among distinct subtypes of renal amyloidosis. Given that both MN and renal amyloidosis exhibit a predilection for the geriatric population, it is prudent to consider the possibility of MN concurrent with renal amyloidosis in elderly patients who test positive for serum anti-PLA2R antibodies. This consideration should precede a straightforward MN treatment strategy. In this report, we present six patients with MN concurrent with renal amyloidosis identified at our center over the past 14 years; in five of whom were positive for serum anti-PLA2R antibodies. We further elucidated the divergent clinicopathological characteristics and prognostic implications of these cases.
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Affiliation(s)
- Zhe Li
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Jing Liu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Shuhua Zhu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Mingchao Zhang
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Feng Xu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Chenfeng Jiao
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Xianghua Huang
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Zhen Cheng
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Ke Zuo
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
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16
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Ozarslan N, Mong C, Ategeka J, Li L, Buarpung S, Robinson JF, Kizza J, Kakuru A, Kamya MR, Dorsey G, Rosenthal PJ, Gaw SL. Placental malaria induces a unique methylation profile associated with fetal growth restriction. Epigenetics 2025; 20:2475276. [PMID: 40051167 PMCID: PMC11901535 DOI: 10.1080/15592294.2025.2475276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 02/21/2025] [Accepted: 02/24/2025] [Indexed: 03/12/2025] Open
Abstract
Fetal growth restriction (FGR) is associated with perinatal death and adverse birth outcomes, as well as long-term complications, including increased childhood morbidity, abnormal neurodevelopment, and cardio-metabolic diseases in adulthood. Placental epigenetic reprogramming associated with FGR may mediate these long-term outcomes. Placental malaria (PM), characterized by sequestration of Plasmodium falciparum-infected erythrocytes in placental intervillous space, is the leading global cause of FGR, but its impact on placental epigenetics is unknown. We hypothesized that placental methylomic profiling would reveal common and distinct mechanistic pathways of non-malarial and PM-associated FGR. We analyzed placentas from a US cohort with no malaria exposure (n = 12) and a cohort from eastern Uganda, a region with a high prevalence of malaria (n = 12). From each site, 8 cases of FGR and 4 healthy controls were analyzed. PM was diagnosed by placental histopathology. We compared the methylation levels of over 850K CpGs of the placentas using Infinium MethylationEPIC v1 microarray. Non-malarial FGR was associated with 65 differentially methylated CpGs (DMCs), whereas PM-FGR was associated with 133 DMCs, compared to their corresponding controls without FGR. One DMC (cg16389901, located in the promoter region of BMP4) was commonly hypomethylated in both groups. We identified 522 DMCs between non-malarial FGR vs. PM-FGR placentas, independent of differing geographic location or cellular composition. Placentas with PM-associated FGR have distinct methylation profiles compared to placentas with non-malarial FGR, suggesting novel epigenetic reprogramming in response to malaria. Larger cohort studies are needed to determine the distinct long-term health outcomes in PM-associated FGR pregnancies.
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Affiliation(s)
- Nida Ozarslan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Corina Mong
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - John Ategeka
- Infectious Diseases Research Collaboration, Uganda
| | - Lin Li
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Sirirak Buarpung
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Joshua F. Robinson
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Jimmy Kizza
- Infectious Diseases Research Collaboration, Uganda
| | - Abel Kakuru
- Infectious Diseases Research Collaboration, Uganda
| | - Moses R. Kamya
- Infectious Diseases Research Collaboration, Uganda
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Grant Dorsey
- Division of HIV, Global Medicine, and Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Philip J. Rosenthal
- Division of HIV, Global Medicine, and Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie L. Gaw
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
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17
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Shin S, Chen S, Xie K, Duhun SA, Ortiz-Cerda T. Evaluating the anti-inflammatory and antioxidant efficacy of complementary and alternative medicines (CAM) used for management of inflammatory bowel disease: a comprehensive review. Redox Rep 2025; 30:2471737. [PMID: 40056427 PMCID: PMC11892051 DOI: 10.1080/13510002.2025.2471737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2025] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic autoimmune condition whose pathogenesis has not been fully elucidated, and current treatments are not definitive and often carry several side effects. The Complementary and Alternative Medicine (CAM) offers a new approach to conventional medicine. However, their clinical application and mechanisms remain limited.Objective: The aim of this review is to evaluate the anti-inflammatory, impact on microbiota and antioxidant efficacy of currently available CAM for IBD.Methods: The literature collection was obtained from Google Scholar, MEDLINE, PubMed and Web of Science (WOS). Studies in both human and animal models, published in English language between 2018 and 2024, were selected. Sixty-seven studies were included in the current review after inclusion and exclusion screening processes.Results: Mostly, studies showed significant anti-inflammatory, gut microbiota restoring, antioxidant effects of polyphenols, polysaccharides, emodin, short-chain fatty acids (SCFA; including butyrate, propionate and acetate), and probiotics although some contrasting results were noted. Current evidence shows that polyphenols exhibit the most consistent result in alleviating IBD pathophysiology, primarily due to their significant SCFA-elevating effect.Discussion: Future studies may focus on human studies, narrowing down on individual factors which may change natural product's metabolism. Further research studies are also essential to obtain therapeutic recommendations.
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Affiliation(s)
- Sia Shin
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Siqi Chen
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Kangzhe Xie
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Suehad Abou Duhun
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tamara Ortiz-Cerda
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Departamento de Citología e Histología Normal y Patológica, Facultad de medicina, Universidad de Sevilla, Seville, Spain
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18
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Zhang L, Feng E, Baima S, Laba C, Suolang L, Cang J, De Q. High altitude renal syndrome: four elements or one source? Ren Fail 2025; 47:2482125. [PMID: 40179941 PMCID: PMC11983532 DOI: 10.1080/0886022x.2025.2482125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 02/28/2025] [Accepted: 03/15/2025] [Indexed: 04/05/2025] Open
Abstract
High Altitude Renal Syndrome (HARS) is a clinical syndrome characterized by polycythemia, hyperuricemia, hypertension, and albuminuria at high altitudes. This review emphasizes hypoxia-induced High Altitude Polycythemia (HAPC) as its core driver. In 2014, the 6th Qinghai International Conference on Mountain Medicine and High Altitude Physiology established international diagnostic criteria for HAPC (hemoglobin ≥210g/L in males, ≥190g/L in females). HAPC triggers systemic hypoxia, leading to hyperuricemia via uric acid overproduction and reduced renal excretion, hypertension from hemodynamic changes, and glomerular injury through erythrocytosis. Pathological mechanisms involve HIF-2α-mediated glomerular hypertrophy and podocyte damage. Treatment strategies target HAPC and downstream effects. Carbonic anhydrase inhibitors (e.g., acetazolamide) reduce hematocrit and improve oxygen saturation, but newer agents like methazolamide and dichlorphenamide offer equivalent efficacy with fewer side effects (e.g., reduced central nervous system toxicity). For severe cases, descending to lower altitudes remains the gold standard. Additional interventions include calcium channel blockers (nifedipine), urate-lowering drugs, and experimental therapies such as HIF-2α inhibitors (PT2385) and endothelin receptor antagonists (matitan). This analysis underscores HAPC as the primary etiology of HARS, advocating revised diagnostic criteria and treatment prioritization.
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Affiliation(s)
- Lei Zhang
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Erchao Feng
- Center for High Altitude Disease Diagnosis and Treatment/Renal Department, Shannan People’s Hospital Shannan City Tibet Autonomous Region, China
| | - Sezhen Baima
- Center for High Altitude Disease Diagnosis and Treatment/Renal Department, Shannan People’s Hospital Shannan City Tibet Autonomous Region, China
| | - Cangjue Laba
- Center for High Altitude Disease Diagnosis and Treatment/Renal Department, Shannan People’s Hospital Shannan City Tibet Autonomous Region, China
| | - Lazhen Suolang
- Center for High Altitude Disease Diagnosis and Treatment/Renal Department, Shannan People’s Hospital Shannan City Tibet Autonomous Region, China
| | - Ji Cang
- Center for High Altitude Disease Diagnosis and Treatment/Renal Department, Shannan People’s Hospital Shannan City Tibet Autonomous Region, China
| | - Qing De
- Center for High Altitude Disease Diagnosis and Treatment/Renal Department, Shannan People’s Hospital Shannan City Tibet Autonomous Region, China
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Lin X, Li H. Diverse processes in rotavirus vaccine development. Hum Vaccin Immunother 2025; 21:2475609. [PMID: 40126359 PMCID: PMC11934161 DOI: 10.1080/21645515.2025.2475609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 02/27/2025] [Accepted: 03/03/2025] [Indexed: 03/25/2025] Open
Abstract
Rotavirus is a major cause of severe diarrhea and mortality in children under five years of age, leading to approximately 128,500 deaths annually.1-3 Vaccination is the most effective strategy for preventing rotavirus infection. While two widely used vaccines, Rotarix and RotaTeq, have shown good efficacy in high-income countries, their effectiveness is lower in low- and middle-income countries due to factors such as malnutrition and poor sanitation.4-6 These challenges include complex vaccination schedules and high production costs. Researchers are working on novel vaccines, including inactivated virus and viral protein-based options, as well as virus-like particles and recombinant proteins.7-9 Improving vaccine stability and applicability is crucial for resource-limited settings, and global vaccination strategies are expected to significantly reduce infection burdens, improve child health, and contribute to the achievement of global health goals.10-14.
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Affiliation(s)
- Xiaochen Lin
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Yunnan Provincial Key Laboratory of Vaccine R&D for Major Infectious Diseases, Kunming, China
| | - Hongjun Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Yunnan Provincial Key Laboratory of Vaccine R&D for Major Infectious Diseases, Kunming, China
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Sheng J, Yang Y, Qiu Y, Lu C, Fu X. Solid and cystic intrapancreatic accessory spleen: report of 10 cases in a single institution. Ann Med 2025; 57:2463564. [PMID: 39927469 PMCID: PMC11812107 DOI: 10.1080/07853890.2025.2463564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/21/2024] [Accepted: 01/07/2025] [Indexed: 02/11/2025] Open
Abstract
BACKGROUND Precise diagnosis of intrapancreatic accessory spleen (IPAS) remains challenging due to its rarity and diverse presentations. Despite comprehensive examinations, including radiography and other diagnostic methods, the potential for malignancy cannot be excluded, often leading to unnecessary pancreatic surgeries. We review our institutional experience to provide insights for accurately distinguishing IPAS. METHODS We retrospectively reviewed 10 patients who underwent distal pancreatectomy for the lesion in the pancreas tail which was determined to be IPAS on final pathology at our institution between January 2020 and April 2024. The presenting symptoms, medical history, preoperative imaging, operative therapy, final pathology and postoperative course were evaluated. RESULTS Patient ages ranged from 30 to 72 (median 55.5), including six women and four men. Most patients were asymptomatic. One patient had the medical history of splenectomy. Lesions ranged from 1.4 to 7.3 cm (mean 2.9 cm). All lesions were located in the pancreatic tail. On radiologic evaluation, these lesions had both solid and cystic presentations. The most common operative approach was laparoscopic distal pancreatectomy and splenectomy. Four patients were diagnosed with epidermoid cysts arising in intrapancreatic accessory spleen (ECIPAS) on final pathologic evaluation. CONCLUSIONS IPAS are predominantly benign lesions which have solid and cystic presentations commonly mistaken for pancreatic neoplasms. Combining CT, MRI, EUS-FNA and nuclear medicine may enhance IPAS detection, though no definitive diagnostic method exists. Increased awareness of IPAS in the differential diagnosis of pancreatic tail tumors, coupled with advancements in imaging techniques could improve diagnostic accuracy and exclude malignancy, preventing unnecessary surgeries.
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Affiliation(s)
- Jianjie Sheng
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yifei Yang
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yudong Qiu
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Chenglin Lu
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xu Fu
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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Huang FJ, Fang YY, Wen JY, Li JJ, Lin Q, Su QY, Chen YY, Wang L, Zeng JJ, Chi BT, He RQ, Qin DY, Yang LH, Chen G. From PD-1/PD-L1 to tertiary lymphoid structures: Paving the way for precision immunotherapy in cholangiocarcinoma treatment. Hum Vaccin Immunother 2025; 21:2444697. [PMID: 39757910 DOI: 10.1080/21645515.2024.2444697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 12/07/2024] [Accepted: 12/16/2024] [Indexed: 01/07/2025] Open
Abstract
Cholangiocarcinoma (CCA) is a highly malignant hepatobiliary tumor characterized by limited treatment options and poor prognosis. The recent rise of immunotherapy has significantly influenced research in this field. This study presents a bibliometric analysis of 416 articles retrieved from the WOSCC, Wan fang Data, CNKI and VIP databases, spanning contributions from 32 countries, 589 institutions and 3,200 authors. The analysis identified "PD-L1," "PD-1" and "pembrolizumab" as central research foci, while "immune checkpoint inhibitors," "tumor immune microenvironment," "tertiary lymphoid structures" and "durvalumab" emerged as key areas of interest. These findings emphasize the pivotal role of immunotherapy in improving survival outcomes for CCA, and they highlight the significance of tertiary lymphoid structures within the tumor microenvironment as a promising target for future research. This study offers a strategic overview of the evolving landscape of CCA immunotherapy, providing valuable insights to guide future scientific endeavors in this domain.
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Affiliation(s)
- Fang-Ju Huang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Ye-Ying Fang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jia-Ying Wen
- Department of Radiotherapy, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jian-Jun Li
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Qian Lin
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Qin-Yan Su
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yi-Yang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Lei Wang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jian-Jia Zeng
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Bang-Teng Chi
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Rong-Quan He
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Di-Yuan Qin
- Department of Computer Science and Technology, School of Computer and Electronic Information, Guangxi University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Li-Hua Yang
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
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Ogura T, Uba Y, Kanadani T, Bessho K, Nishikawa H. Multi-hole metal stent can prevent cystic and pancreatic duct obstruction during endoscopic ultrasound-guided antegrade stenting combined with hepaticogastrostomy. Endoscopy 2025; 57:E163-E164. [PMID: 39961365 PMCID: PMC11832272 DOI: 10.1055/a-2528-0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Affiliation(s)
- Takeshi Ogura
- Endoscopy Center, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yuki Uba
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takafumi Kanadani
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Kimi Bessho
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hiroki Nishikawa
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
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23
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Ogura T, Uba Y, Kanadani T, Hattori N, Nishikawa H. Reintervention for recurrent biliary obstruction after stent-in-stent deployment of multi-hole self-expandable metal stents. Endoscopy 2025; 57:E181-E182. [PMID: 39978392 PMCID: PMC11842147 DOI: 10.1055/a-2534-3143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2025]
Affiliation(s)
- Takeshi Ogura
- Endoscopy Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yuki Uba
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takafumi Kanadani
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Nobuhiro Hattori
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hiroki Nishikawa
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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24
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Han X, Zhang B. Comparison of the value of transvaginal ultrasonography and MRI in the diagnosis of cesarean scar pregnancy: a meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2445661. [PMID: 39762030 DOI: 10.1080/14767058.2024.2445661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 12/13/2024] [Accepted: 12/16/2024] [Indexed: 01/11/2025]
Abstract
OBJECTIVE To compare the diagnostic value of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in cesarean scar pregnancy (CSP) by a method of meta-analysis. METHODS Studies on TVS and MRI for CSP were collected from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang data, and Chinese Scientific Journal Database (VIP database) until April 1, 2024. Stata 15.0 software was used for data analysis. Mann-Whitney U-test was applied to compare the diagnostic efficiency of the TVS and MRI groups. RESULTS Nine articles with 713 subjects were involved in this review. The pooled sensitivity (0.96, 95%CI: 0.94-0.97), specificity (0.90, 95%CI: 0.84-0.94), and DOR (197.28, 95%CI: 99.71-390.31) in the MRI group were higher than those (Sensitivity = 0.83, 95%CI: 0.77-0.87; Specificity= 0.74, 95%CI: 0.63-0.83; DOR = 13.66, 95%CI: 7.84-23.79) in the TVS group. The positive likelihood ratio and negative likelihood ratio of the MRI group were 9.56 (95%CI: 8.82-15.72) and 0.05 (95%CI: 0.03-0.07), while those of the TVS group were 3.21 (95%CI:2.18-4.74) and 0.24 (95%CI: 0.18-0.31), respectively. In the MRI and TVS groups, the area under the curve (AUC) of the summary receiver operating characteristic was 0.9497 and 0.86, respectively. The results of Mann-Whitney U-tests of the two groups showed significant differences in the pooled sensitivity (Z= -3.311, p < 0.001), specificity (Z= -2.123, p = 0.034), and DOR (Z= -3.272, p = 0.001). CONCLUSION Both MRI and TVS can effectively diagnose CSP. However, compared with TVS, MRI has better diagnostic accuracy for CSP, with higher sensitivity and specificity. Considering the good diagnostic accuracy of ultrasound, patients with ultrasound suspicion of CSP should be sent to a reference center where MRI can express its full diagnostic potential regarding depth, topography of invasion and myometral residue, which is useful for subsequent management.
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Affiliation(s)
- Xiao Han
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
| | - Boyang Zhang
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
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25
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Feng J, Zhang C, Bao J, Xu Q, Gan Y, Hu Y. A modified variable flip angle release device for endoscopic titanium clips. Endoscopy 2025; 57:E396-E397. [PMID: 40345255 PMCID: PMC12064323 DOI: 10.1055/a-2584-1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2025]
Affiliation(s)
- Jiaxing Feng
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, China
- Institute for Microbial Ecology, Department of Digestive Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Chunping Zhang
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, China
- Institute for Microbial Ecology, Department of Digestive Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Jiachen Bao
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, China
- Institute for Microbial Ecology, Department of Digestive Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Qingyu Xu
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, China
- Institute for Microbial Ecology, Department of Digestive Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Yutong Gan
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, China
- Institute for Microbial Ecology, Department of Digestive Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Yiqun Hu
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, China
- Institute for Microbial Ecology, Department of Digestive Disease, School of Medicine, Xiamen University, Xiamen, China
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26
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Darbà J, Ascanio M. Hepatocellular carcinoma: what are the differential costs compared to the general population? J Med Econ 2025; 28:471-478. [PMID: 40126406 DOI: 10.1080/13696998.2025.2484073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 03/20/2025] [Accepted: 03/21/2025] [Indexed: 03/25/2025]
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC), which accounts for about 90% of all primary liver cancer cases, is the fifth most common malignancy and the second leading cause of cancer-related mortality worldwide. This study aims to analyse the differential costs of HCC-related hospital admissions compared to the general population in Spain. METHODS A retrospective multicenter study analyzed inpatient admissions from a Spanish national discharge database, covering 90% of hospitals between 2010 and 2022. HCC-related admissions were identified using ICD-9 and ICD-10 codes, while control admissions were selected from the general population in the same database without an HCC diagnosis. The direct hospitalization cost was included, covering medical examinations, procedures, medications, surgeries, personnel and equipment. Statistical methods, including nearest-neighbor matching, propensity score matching, and a generalized linear model, were used to estimate differential costs and to ensure comparability based on age, gender, and Charlson Comorbidity Index (CCI). RESULTS A total of 199,670 HCC-related hospital admissions and 200,000 control admissions were analyzed. Most HCC-related admissions involved male patients (78%) aged 66-85 years, with an average CCI of 5.18. HCC-related admissions incurred significantly higher costs, with an estimated differential cost of €1,303.68 using GLM, €1,804.25 via propensity score matching, and €1,767.77 using nearest-neighbor matching. Total costs per HCC admission ranged between €1,000 and €31,000. CONCLUSIONS HCC-related hospital admissions impose a significantly higher economic burden due to the complexity of care. Given the high mortality and resource utilization, advancements in early detection, treatment, and cost-effective interventions are needed to improve patient outcomes and reduce healthcare costs.
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Affiliation(s)
- Josep Darbà
- Department of Economics, Universitat de Barcelona, Barcelona, Spain
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27
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Iglay K, Aldridge ML, Calcinai M, Wolford E, Ashrani AA. The global epidemiology of acquired factor X deficiency. Hematology 2025; 30:2476254. [PMID: 40151020 DOI: 10.1080/16078454.2025.2476254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 03/03/2025] [Indexed: 03/29/2025] Open
Abstract
OBJECTIVES To summarize available data and contribute to a broader understanding of the global incidence and prevalence of acquired factor X deficiency. METHODS A comprehensive review of English-language publications from PubMed and Embase was conducted. The majority of publications on acquired factor X deficiency were associated with light-chain (AL) amyloidosis. Therefore, this review is structured to assess publications reporting on (1) acquired factor X deficiency associated with AL amyloidosis or (2) acquired factor X deficiency associated with other causes. RESULTS The literature includes case reports, case-series, and limited population-based reports of the epidemiology of acquired factor X deficiency. Though no definitive global incidence or prevalence estimates for AL-amyloidosis-associated acquired factor X deficiency were identified, the finding that roughly 6-14% of patients with AL amyloidosis have factor X activity levels below 45-50% of normal highlights the rarity of acquired factor X deficiency associated with AL-amyloidosis. Indeed, AL amyloidosis itself is a rare disorder with an estimated annual incidence of ∼10 cases per million population. Only case reports were available to inform the epidemiology of acquired factor X deficiency not associated with AL amyloidosis. We identified 35 cases from 29 papers published from around the globe. At least 25 of those patients experienced a bleeding event, with factor X activity levels ranging from <1% to 39%. CONCLUSION More population-based data are needed to understand the epidemiology of acquired factor X deficiency; however, the limited data seem to indicate this condition is quite rare. The variation across papers in thresholds used to define deficiency highlights the need for a standardized definition to better inform drug development, resource allocation, and regulatory decision-making.
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Affiliation(s)
- Kristy Iglay
- Real-world Evidence and Patient Outcomes, CERobs Consulting, LLC, Wrightsville Beach, NC, USA
| | - Molly L Aldridge
- Real-world Evidence and Patient Outcomes, CERobs Consulting, LLC, Wrightsville Beach, NC, USA
| | | | - Eric Wolford
- Clinical Development, Kedrion Biopharma, Inc., Durham, NC, USA
| | - Aneel A Ashrani
- Division of Hematology, Department of Internal Medicine, Mayo Clinic-Rochester, Rochester, MI, USA
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28
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Takahashi S, Fujisawa T, Takasaki Y, Namima D, Tomishima K, Ishii S, Isayama H. Side-by-side placement of a novel slim 6-mm multi-hole covered self-expandable metallic stent for malignant hilar biliary obstruction. Endoscopy 2025; 57:E312-E313. [PMID: 40233932 PMCID: PMC12020676 DOI: 10.1055/a-2569-7582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2025]
Affiliation(s)
- Sho Takahashi
- Department of Gastroenterology, Jutendo University, Graduate School of Medicine, Tokyo, Japan
| | - Toshio Fujisawa
- Department of Gastroenterology, Jutendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Takasaki
- Department of Gastroenterology, Jutendo University, Graduate School of Medicine, Tokyo, Japan
| | - Daisuke Namima
- Department of Gastroenterology, Jutendo University, Graduate School of Medicine, Tokyo, Japan
| | - Ko Tomishima
- Department of Gastroenterology, Jutendo University, Graduate School of Medicine, Tokyo, Japan
| | - Shigeto Ishii
- Department of Gastroenterology, Jutendo University, Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Isayama
- Department of Gastroenterology, Jutendo University, Graduate School of Medicine, Tokyo, Japan
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Yang H, Chen Y, Peng X. An ideal portrait of the professional competence of clinical research nurses: A qualitative study. Asia Pac J Oncol Nurs 2025; 12:100682. [PMID: 40201532 PMCID: PMC11976228 DOI: 10.1016/j.apjon.2025.100682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2025] [Accepted: 03/05/2025] [Indexed: 04/10/2025] Open
Abstract
Objective This study aims to identify and define the ideal professional competencies of Clinical Research Nurses (CRNs) in China, focusing on the essential knowledge, skills, and personal attributes required for effective practice in clinical trials. Methods Interviews were conducted with CRNs, Nurse Managers (NMs), Principal Investigators (PIs), Sub-Investigators (SIs), Clinical Research Coordinators (CRCs), Clinical Research Associates (CRAs), and subjects. Thematic analysis was performed using Colaizzi's seven-step method to analyze interview data and identify key competencies. Results The study identified four primary themes that characterize the ideal CRN profile: (1) theoretical knowledge ability, (2) practical technical ability, (3) professional quality and ability, and (4) personal traits. A total of 21 specific indicators were delineated, reflecting the diverse expectations of various stakeholders in clinical trials. Conclusions The findings highlight the multifaceted nature of CRN competencies, emphasizing the importance of comprehensive training programs tailored to the needs of CRNs. This study provides a foundational framework for enhancing CRN training and professional development in China.
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Affiliation(s)
- Heng Yang
- Nursing Department, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Huazhong University of Science and Technology, Wuhan, China
| | - Yipei Chen
- Nursing Department, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Peng
- Nursing Department, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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30
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Aldali F, Deng C, Nie M, Chen H. Advances in therapies using mesenchymal stem cells and their exosomes for treatment of peripheral nerve injury: state of the art and future perspectives. Neural Regen Res 2025; 20:3151-3171. [PMID: 39435603 PMCID: PMC11881730 DOI: 10.4103/nrr.nrr-d-24-00235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/26/2024] [Accepted: 08/26/2024] [Indexed: 10/23/2024] Open
Abstract
"Peripheral nerve injury" refers to damage or trauma affecting nerves outside the brain and spinal cord. Peripheral nerve injury results in movements or sensation impairments, and represents a serious public health problem. Although severed peripheral nerves have been effectively joined and various therapies have been offered, recovery of sensory or motor functions remains limited, and efficacious therapies for complete repair of a nerve injury remain elusive. The emerging field of mesenchymal stem cells and their exosome-based therapies hold promise for enhancing nerve regeneration and function. Mesenchymal stem cells, as large living cells responsive to the environment, secrete various factors and exosomes. The latter are nano-sized extracellular vesicles containing bioactive molecules such as proteins, microRNA, and messenger RNA derived from parent mesenchymal stem cells. Exosomes have pivotal roles in cell-to-cell communication and nervous tissue function, offering solutions to changes associated with cell-based therapies. Despite ongoing investigations, mesenchymal stem cells and mesenchymal stem cell-derived exosome-based therapies are in the exploratory stage. A comprehensive review of the latest preclinical experiments and clinical trials is essential for deep understanding of therapeutic strategies and for facilitating clinical translation. This review initially explores current investigations of mesenchymal stem cells and mesenchymal stem cell-derived exosomes in peripheral nerve injury, exploring the underlying mechanisms. Subsequently, it provides an overview of the current status of mesenchymal stem cell and exosome-based therapies in clinical trials, followed by a comparative analysis of therapies utilizing mesenchymal stem cells and exosomes. Finally, the review addresses the limitations and challenges associated with use of mesenchymal stem cell-derived exosomes, offering potential solutions and guiding future directions.
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Affiliation(s)
- Fatima Aldali
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Chunchu Deng
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Mingbo Nie
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Hong Chen
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Kaushik A, Senapati S, Agrawal N, Ali SA, Habib S, Singh JP. Portable SERS for salivary-based detection of oral pre-malignant lesions and carcinomas: a step toward clinical implementation. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2025; 339:126298. [PMID: 40300230 DOI: 10.1016/j.saa.2025.126298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Revised: 04/17/2025] [Accepted: 04/24/2025] [Indexed: 05/01/2025]
Abstract
The rising incidence of oral cancer has emerged as a serious menace to our civilization. Modern dietary habits, lack of awareness, and delays in early detection are major contributing factors to the global spread of this issue. This work reports the promising findings for diagnostic accuracy of oral cancer in pre-malignant stages by analyzing surface enhanced Raman spectroscopy (SERS) profiles of different stages of oral cancer combined with multivariate analysis. Using 99 clinical samples from which 39 samples were from malignant stage, 28 from pre-malignant and 32 from healthy controls, SERS analysis was carried out by employing label-free silver nanorods as SERS substrates. The SERS spectra of malignant and pre-malignant samples manifest distinct peaks associated with varying concentrations of inorganic metabolites and proteins. Primarily, the elevated level of thiocyanate dominates the SERS spectra in malignant samples while antioxidants like uric acid, xanthine and hypoxanthine's are the key elements in the pre-malignant samples. A ratio-metric analysis of 2130 and 1435 cm-1 peak revealed that the pre-malignant lesions consistently lie between 2 and 3, whereas malignant samples have ratio greater than 3 due to higher intensity of thiocyanate peak. The multivariate analysis successfully separates between oral cancer positive and negative samples with a sensitivity and specificity of 93.5 and 92.7 % respectively. This study presents promising results for the early detection of oral cancer, which could assist clinicians in saving lives.
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Affiliation(s)
- Arvind Kaushik
- Department of Physics, Indian Institute of Technology Delhi, New Delhi 110016, India
| | - Sneha Senapati
- Department of Physics, Indian Institute of Technology Delhi, New Delhi 110016, India; School of Interdisciplinary Research (SIRe), IIT Delhi, New Delhi 110016, India
| | - Neha Agrawal
- Department of Periodontia and Community Dentistry, Dr. Z A Dental College, Aligarh Muslim University, Aligarh 202002, India
| | - Syed Amaan Ali
- Department of Periodontia and Community Dentistry, Dr. Z A Dental College, Aligarh Muslim University, Aligarh 202002, India
| | - Safia Habib
- Department of Biochemistry, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh 202002, India
| | - J P Singh
- Department of Physics, Indian Institute of Technology Delhi, New Delhi 110016, India.
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Aluyi-Osa G, Suleman A, Salati C, Spadea L, Gagliano C, Musa M, Zeppieri M. Multidisciplinary management of pituitary macroadenoma. World J Methodol 2025; 15:97694. [DOI: 10.5662/wjm.v15.i3.97694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 11/18/2024] [Accepted: 12/03/2024] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations. This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas, integrating neurosurgery, endocrinology, radiology, and pathology perspectives.
AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis, management, and rehabilitation of individuals with pituitary adenomas, to add to already preexisting knowledge, in managing these cases enhancing better ocular and systemic outcomes.
METHODS A search was conducted on an online publication database (PubMed) using the term “pituitary adenoma” including all results published over twenty years (2004-2024). Results were sorted for relevance, language, and completeness.
RESULTS A total of 176 records were returned. The guidelines of the PRISMA 2020 statement were followed in this study. A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates. Another 17 records were not available as full-length articles and were also excluded. The references of each included record was further searched for relevant publications. A total of 141 records were therefore used in this minireview.
CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact, modern therapeutic strategies offer effective management options. Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life. Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future
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Affiliation(s)
- Gladness Aluyi-Osa
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
| | - Ayuba Suleman
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy
- Mediterranean Foundation "G.B. Morgagni", 95125 Catania, Italy
| | - Mutali Musa
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
- Department of Optometry, University of Benin, Benin 300283, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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Chung J, Pierce J, Franklin C, Olson RM, Morrison AR, Amos-Landgraf J. Translating animal models of SARS-CoV-2 infection to vascular, neurological and gastrointestinal manifestations of COVID-19. Dis Model Mech 2025; 18:dmm052086. [PMID: 40195851 PMCID: PMC12010913 DOI: 10.1242/dmm.052086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2025] Open
Abstract
Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) initiated a global pandemic resulting in an estimated 775 million infections with over 7 million deaths, it has become evident that COVID-19 is not solely a pulmonary disease. Emerging evidence has shown that, in a subset of patients, certain symptoms - including chest pain, stroke, anosmia, dysgeusia, diarrhea and abdominal pain - all indicate a role of vascular, neurological and gastrointestinal (GI) pathology in the disease process. Many of these disease processes persist long after the acute disease has been resolved, resulting in 'long COVID' or post-acute sequelae of COVID-19 (PASC). The molecular mechanisms underlying the acute and systemic conditions associated with COVID-19 remain incompletely defined. Appropriate animal models provide a method of understanding underlying disease mechanisms at the system level through the study of disease progression, tissue pathology, immune system response to the pathogen and behavioral responses. However, very few studies have addressed PASC and whether existing models hold promise for studying this challenging problem. Here, we review the current literature on cardiovascular, neurological and GI pathobiology caused by COVID-19 in patients, along with established animal models of the acute disease manifestations and their prospects for use in PASC studies. Our aim is to provide guidance for the selection of appropriate models in order to recapitulate certain aspects of the disease to enhance the translatability of mechanistic studies.
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Affiliation(s)
- James Chung
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
| | - Julia Pierce
- Vascular Research Laboratory, Providence VA Medical Center, Providence, RI 02908, USA
- Department of Research, Ocean State Research Institute, Inc., Providence, RI 02908-4734, USA
- Department of Internal Medicine, Alpert Medical School of Brown University, Providence, RI 02908, USA
| | - Craig Franklin
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
| | - Rachel M. Olson
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
- Laboratory for Infectious Disease Research, University of Missouri, Columbia, MO 65211, USA
| | - Alan R. Morrison
- Vascular Research Laboratory, Providence VA Medical Center, Providence, RI 02908, USA
- Department of Research, Ocean State Research Institute, Inc., Providence, RI 02908-4734, USA
- Department of Internal Medicine, Alpert Medical School of Brown University, Providence, RI 02908, USA
| | - James Amos-Landgraf
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
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Dai Z, Chen H, Lu X, Cai H, Zhang L, Li J. Development of a fluorescence-based assay for screening of urate transporter 1 inhibitors (II): Optimization of fluorescent substrates and structure-activity relationships analysis. J Pharm Biomed Anal 2025; 262:116900. [PMID: 40252244 DOI: 10.1016/j.jpba.2025.116900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 04/10/2025] [Accepted: 04/10/2025] [Indexed: 04/21/2025]
Abstract
Urate transporter 1 (URAT1) inhibitors represent a promising therapeutic approach for hyperuricemia and gout. A non-radioactive cell-based platform for screening URAT1 inhibitors using 6-carboxyfluorescein (6-CFL) was previously established by our team. In this study, aiming to optimize our testing platform, 10 potential fluorescent substrates were screened from the commercially available fluoresceins using molecular docking and pKa prediction. Among them, dibromofluorescein (DBF) and diiodofluorescein (DIF) were identified as specific transport substrates for UTAR1 with significant fluorescence changes in cellular uptake. DBF and DIF exhibited Km values similar to that of 6-CFL. Using DBF or DIF as substrates, the IC50 values of the URAT1 inhibitors benzbromarone and lesinurad remained within the same order of magnitude as those obtained by 6-CFL. Notably, DBF enables visual detection, further extending the utility of this non-radioactive platform for in vitro screening of URAT1 inhibitors. Molecular dynamics (MD) simulations and free energy calculations were employed to compare the interactions and binding affinities of 6-CFL, DBF, and DIF with URAT1, respectively. Finally, structure-activity relationships (SARs) analysis was conducted to preliminarily identify substituents modulating the binding affinity of commercially available fluoresceins.
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Affiliation(s)
- Zhixi Dai
- MOE International Joint Research Laboratory on Synthetic Biology and Medicines, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, China
| | - Hongming Chen
- MOE International Joint Research Laboratory on Synthetic Biology and Medicines, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, China
| | - Xiaodan Lu
- MOE International Joint Research Laboratory on Synthetic Biology and Medicines, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, China
| | - Haojie Cai
- MOE International Joint Research Laboratory on Synthetic Biology and Medicines, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, China
| | - Lei Zhang
- MOE International Joint Research Laboratory on Synthetic Biology and Medicines, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, China
| | - Jing Li
- MOE International Joint Research Laboratory on Synthetic Biology and Medicines, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, China.
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Shin SH, Koh YS, Song S. Hepatic epithelioid hemangioendothelioma managed with minimally invasive surgery: A case report. World J Clin Cases 2025; 13:104924. [DOI: 10.12998/wjcc.v13.i22.104924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Revised: 03/22/2025] [Accepted: 04/14/2025] [Indexed: 05/14/2025] Open
Abstract
BACKGROUND Hepatic epithelioid hemangioendothelioma (HEHE) is a rare malignant vascular liver tumor diagnosed by histopathological evaluation. Standardized treatment is challenging because of its rarity; hepatectomy is preferred for solitary lesions and multiple transplantations. There is no consensus on the optimal treatment for HEHE; however, surgical excision is often considered effective. This report presents a case of initially suspected cholangiocarcinoma or renal cell carcinoma (RCC) metastasis, which was later confirmed as HEHE, with no recurrence during follow-up.
CASE SUMMARY A 52-year-old man with a history of left nephrectomy for RCC presented with an incidentally detected liver mass and nonspecific abdominal discomfort. Imaging revealed a 3-cm centripetal enhancing lesion in the right hepatic dome with indeterminate malignant potential. The patient underwent a laparoscopic right anterior sectionectomy and remained recurrence-free without complications during the 3-year follow-up period.
CONCLUSION Managing HEHE is challenging. Accurate diagnosis and surgical options, such as resection or transplantation, are essential with tailored multidisciplinary follow-up. The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Affiliation(s)
- Sang Hoon Shin
- Department of General Surgery, Chonnam National University Hwasun Hospital, Hwasun 519-763, South Korea
| | - Yang Seok Koh
- Department of General Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun 519-763, South Korea
| | - Sanghwa Song
- Department of General Surgery, Chonnam National University Hospital, Gwangju 5681, South Korea
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Zheng HJ, Zhang JD, Wang ZC, Yao LY. Abdominal cocoon syndrome in a 10-year-old young adolescent after abdominal operation: A case report and review of literature. World J Clin Cases 2025; 13:106122. [DOI: 10.12998/wjcc.v13.i22.106122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Revised: 04/07/2025] [Accepted: 04/21/2025] [Indexed: 05/14/2025] Open
Abstract
BACKGROUND Sclerosing encapsulating peritonitis (SEP), also known as abdominal cocoon syndrome, is rare in children. The etiology of primary SEP is believed to be associated with retrograde menstruation or viral peritonitis in young adolescent girls, whereas secondary SEP refers to SEP caused by other factors such as surgery, peritoneal dialysis, or tuberculosis. Secondary SEP is rare and lack diagnostic specificity in children. Given the potential to cause acute intestinal obstruction, surgical intervention is often required.
CASE SUMMARY We report the case of a 10-year-old girl with secondary SEP who was admitted to our center with acute bowel obstruction.
CONCLUSION In this report, we emphasized the imaging manifestations, diagnosis, and operative management of the case. Although postoperative SEP in children is rare, the long-term prognosis is favorable when accompanied with accurate diagnosis, appropriate perioperative management, and timely follow-up.
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Affiliation(s)
- Hong-Jun Zheng
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361006, Fujian Province, China
| | - Jing-Dong Zhang
- Department of Pediatric Surgery, Children's Medical Center, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Zhi-Chao Wang
- Department of Pediatric Surgery, Children's Medical Center, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Li-Yu Yao
- Department of Pediatric Surgery, Children's Medical Center, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
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Demirli Atici S, Canda AE, Terzi MC. Are current scales adequate for assessing quality of life after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy? World J Clin Cases 2025; 13:105884. [DOI: 10.12998/wjcc.v13.i22.105884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2025] [Revised: 04/05/2025] [Accepted: 04/21/2025] [Indexed: 05/14/2025] Open
Abstract
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis. Although these treatments can be lifesaving, patients often experience a significant decrease in their overall quality of life (QoL), especially in the early stages of recovery, owing to the physical burden of surgery and the effects of chemotherapy. Many traditional QoL questionnaires have been used to measure CRS and HIPEC. However, these classical current QoL assessment tools often fail to capture the unique challenges faced by this population, including bowel dysfunction, stoma-related distress, and long-term survivorship issues. Therefore, additional parameters that assess bowel function and stoma opening status and especially patient-reported outcome measures would be useful in QoL measurements to provide a more detailed understanding of recovery and general well-being in these patients.
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Affiliation(s)
- Semra Demirli Atici
- Department of General Surgery, Acibadem Kent Hospital, Izmir 35620, Türkiye
- KRC Clinic for Colorectal Surgery and Peritoneal Surface Malignancies, Izmir 35220, Türkiye
| | - Aras Emre Canda
- KRC Clinic for Colorectal Surgery and Peritoneal Surface Malignancies, Izmir 35220, Türkiye
- Department of General Surgery, Acibadem Kent Hospital, Izmir 35620, Türkiye
| | - Mustafa Cem Terzi
- KRC Clinic for Colorectal Surgery and Peritoneal Surface Malignancies, Izmir 35220, Türkiye
- Department of General Surgery, Acibadem Kent Hospital, Izmir 35620, Türkiye
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Shi DD, Tian J, Ding J. Adenosine deaminase in pleural effusion: Bridging diagnosis and the pathophysiology of inflammation. World J Clin Cases 2025; 13:106925. [DOI: 10.12998/wjcc.v13.i22.106925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Revised: 04/03/2025] [Accepted: 04/16/2025] [Indexed: 05/14/2025] Open
Abstract
This editorial underscores the importance of Maranhão et al’s study, which investigates pleural adenosine deaminase (P-ADA) as a biomarker for inflammatory pleural effusions. Despite advances in imaging, distinguishing between inflammatory and non-inflammatory causes of pleural effusion remains a diagnostic challenge. The authors conducted a rigorous retrospective cohort analysis of 157 patients (124 with inflammatory exudates and 33 with non-inflammatory transudates), establishing a robust cutoff value of P-ADA ≥ 9.00 U/L for diagnosing inflammatory diseases using receiver operating characteristic curve analysis and internal statistical calibration. This is the first study to define a standardized P-ADA threshold in a Brazilian cohort, addressing previous inconsistencies in cutoff values. Furthermore, the authors delved into the pathophysiological mechanisms underlying elevated P-ADA, linking it to purinergic signaling pathways and immune cell activation, particularly emphasizing the role of ADA2 isoforms in macrophages and lymphocytes. Their findings support P-ADA as a non-invasive, cost-effective biomarker for early diagnosis, treatment stratification, and minimizing the need for invasive procedures such as thoracentesis. This has particular relevance in resource-limited settings, where streamlined diagnostics can reduce healthcare costs and improve patient outcomes. Future studies must prioritize global validation, explore the integration of adenosine deaminase with additional biomarkers (e.g., interleukin 6, C-reactive protein), and support the development of point-of-care technologies.
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Affiliation(s)
- Dan-Dan Shi
- Department of Plastic Surgery, Zhongshan People’s Hospital, Zhongshan 528400, Guangdong Province, China
| | - Ju Tian
- Department of Burns and Plastic Surgery, Zhongshan People’s Hospital, Zhongshan 528400, Guangdong Province, China
| | - Jing Ding
- Department of Plastic Surgery, Zhongshan People’s Hospital, Zhongshan 528400, Guangdong Province, China
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Inoue Y, Yata Y, Yokota Y, Li ZL, Kawabata K. Acute pancreatitis after total aortic arch replacement leading to walled-off necrosis: A case report and review of literature. World J Clin Cases 2025; 13:104165. [DOI: 10.12998/wjcc.v13.i22.104165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2024] [Revised: 03/05/2025] [Accepted: 04/15/2025] [Indexed: 05/14/2025] Open
Abstract
BACKGROUND Although acute pancreatitis and walled-off necrosis (WON) are rare complications following aortic surgery, they are serious risk factors for postoperative mortality. Considering the poor general condition of the postoperative patient, more effective and less invasive treatments are favorable.
CASE SUMMARY A 67-year-old man was referred to our hospital for the treatment of WON after acute pancreatitis. He had undergone total aortic arch replacement due to aortic arch aneurysm and coronary artery bypass grafting due to angina pectoris 6 weeks prior in another hospital. On the second postoperative day, laboratory data and computed tomography showed that the patient had developed acute pancreatitis. Although conservative management (antibiotics, hydration, etc.) had helped in relieving the symptoms of acute pancreatitis, peripancreatic fluid collection (PFC) persisted, accompanied by duodenal obstruction and vomiting. Contrast-enhanced computed tomography showed that the heterogeneous enhancement and fluid collection in the pancreatic body and tail had increased, consistent with walled-off WON. We therefore performed endoscopic ultrasound-guided transluminal drainage for the PFC. As a result, the WON resolved gradually, resulting in improved oral intake.
CONCLUSION Acute pancreatitis is a rare gastrointestinal complication following thoracic and thoracoabdominal aortic aneurysm surgery. To the best of our knowledge, this is the first case of WON after aortic arch surgery treated with endoscopic ultrasound-guided transluminal drainage for PFC.
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Affiliation(s)
- Yuma Inoue
- Department of Gastroenterology, Hanwa Memorial Hospital, Osaka 558-0041, Japan
| | - Yutaka Yata
- Department of Gastroenterology, Hanwa Memorial Hospital, Osaka 558-0041, Japan
- Department of Hepatology, Osaka Metropolitan University, Osaka 545-0051, Japan
| | - Yuta Yokota
- Department of Gastroenterology, Hanwa Memorial Hospital, Osaka 558-0041, Japan
| | - Zhao-Liang Li
- Department of Gastroenterology, Takarazuka City Hospital, Takarazuka 665-0827, Hyōgo, Japan
| | - Kazumi Kawabata
- Department of Gastroenterology, Hanwa Memorial Hospital, Osaka 558-0041, Japan
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Bouayad A, El Oumri AA. Immunoglobulin G4 biomarkers and pathogenesis in immunoglobulin G4-related spinal pachymeningitis. World J Clin Cases 2025; 13:105331. [DOI: 10.12998/wjcc.v13.i22.105331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2025] [Revised: 04/01/2025] [Accepted: 04/09/2025] [Indexed: 05/14/2025] Open
Abstract
This letter to the editor highlights adding the diagnostic utility of immunoglobulin G4 (IgG4) measurements and its potential role in IgG4-related spinal pachymeningitis (IgG4-RSP) pathogenesis to the case reported by Chae TS et al, which focused on IgG4-RSP diagnosis based on magnetic resonance imaging findings and increased plasma IgG4 concentrations. A comprehensive understanding of both IgG4 serological and cerebrospinal fluid biomarkers is essential for managing this complex condition.
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Affiliation(s)
- Abdellatif Bouayad
- Laboratory of Immunology, Faculty of Medicine and Pharmacy Oujda, Mohammed First University, Oujda-Angad 4867, Oriental, Morocco
| | - Ahmed Amine El Oumri
- Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda-Angad 4867, Oriental, Morocco
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Yin L, Xu Y, Mu J, Leng Y, Ma L, Zheng Y, Li R, Wang Y, Li P, Zhu H, Wang D, Li J. CNKSR2 interactome analysis indicates its association with the centrosome/microtubule system. Neural Regen Res 2025; 20:2420-2432. [PMID: 39359098 PMCID: PMC11759008 DOI: 10.4103/nrr.nrr-d-23-01725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/27/2024] [Accepted: 03/04/2024] [Indexed: 10/04/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202508000-00031/figure1/v/2024-09-30T120553Z/r/image-tiff The protein connector enhancer of kinase suppressor of Ras 2 (CNKSR2), present in both the postsynaptic density and cytoplasm of neurons, is a scaffolding protein with several protein-binding domains. Variants of the CNKSR2 gene have been implicated in neurodevelopmental disorders, particularly intellectual disability, although the precise mechanism involved has not yet been fully understood. Research has demonstrated that CNKSR2 plays a role in facilitating the localization of postsynaptic density protein complexes to the membrane, thereby influencing synaptic signaling and the morphogenesis of dendritic spines. However, the function of CNKSR2 in the cytoplasm remains to be elucidated. In this study, we used immunoprecipitation and high-resolution liquid chromatography-mass spectrometry to identify the interactors of CNKSR2. Through a combination of bioinformatic analysis and cytological experiments, we found that the CNKSR2 interactors were significantly enriched in the proteome of the centrosome. We also showed that CNKSR2 interacted with the microtubule protein DYNC1H1 and with the centrosome marker CEP290. Subsequent colocalization analysis confirmed the centrosomal localization of CNKSR2. When we downregulated CNKSR2 expression in mouse neuroblastoma cells (Neuro 2A), we observed significant changes in the expression of numerous centrosomal genes. This manipulation also affected centrosome-related functions, including cell size and shape, cell proliferation, and motility. Furthermore, we found that CNKSR2 interactors were highly enriched in de novo variants associated with intellectual disability and autism spectrum disorder. Our findings establish a connection between CNKSR2 and the centrosome, and offer new insights into the underlying mechanisms of neurodevelopmental disorders.
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Affiliation(s)
- Lin Yin
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yalan Xu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Jie Mu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- College of Life Sciences, and School of Pharmacy, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Yu Leng
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Lei Ma
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yu Zheng
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong Province, China
| | - Ruizhi Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yin Wang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Peifeng Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Hai Zhu
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong Province, China
| | - Dong Wang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Jing Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
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Wang Y, Zhao Y, Liu Y, Wang J, Liu F. Effects of mesenchymal stem cells on repair of injured endometrium in mice. Tissue Cell 2025; 95:102827. [PMID: 40054304 DOI: 10.1016/j.tice.2025.102827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Revised: 02/21/2025] [Accepted: 02/25/2025] [Indexed: 05/15/2025]
Abstract
Endometrial damage severely affects women's reproductive health and function. Although various treatments are available, their efficacy remains generally unsatisfactory. Mesenchymal stem cells (MSCs) possess multidirectional differentiation abilities and immunoregulation. To evaluate whether direct MSC transplantation into the uterine cavity enhances endometrial thickness, an animal model with thin endometrium was developed by administering ethanol into the uterine cavity. Our study aimed to observe and compare repair effects about three types of MSCs on endometrial injury, including menstrual blood-derived MSCs (MenSCs), bone marrow MSCs (BMSCs), and umbilical cord-derived mesenchymal stem cells (UC-MSCs). HE and Masson staining were used to assess endometrial morphology and fibrosis in the third estrous period post-operation. Immunohistochemistry and western blot were utilized to detect the expression of marker proteins in endometrial tissue. Endometrial thickness and protein expression in the MSC transplantation groups showed a notable improvement compared to the control group, though still below normal levels. Among MSC transplantation groups, no statistical difference was observed between MenSC and BMSC groups in endometrial thickness or ItgαVβ3 expression, but MenSCs showed higher levels than UC-MSCs, with statistical significance. CK18 and Vimentin expression in the MenSC and BMSC groups were similarly higher than UC-MSCs, with no significant difference. VEGF expression indicated that MenSCs outperformed both BMSCs and UC-MSCs. In conclusion, all three types of MSCs improved endometrial thickness and regeneration when transplanted into the injured endometrium. MenSCs demonstrated the greatest potential in promoting endometrial regeneration and improving receptivity, suggesting a promising new approach for treating endometrial injury.
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Affiliation(s)
- Yang Wang
- Reproductive Medicine Department, Xingtai People's Hospital, Xingtai 054001, China
| | - Yuanxi Zhao
- Center for Reproductive Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Yuanke Liu
- Center for Reproductive Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Jingjing Wang
- Center for Reproductive Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Fang Liu
- Center for Reproductive Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050000, China.
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Liu KY, Li XB. Tired of the confusion around pleural effusions: Adenosine deaminase detection sets the record straight! World J Clin Cases 2025; 13:106945. [DOI: 10.12998/wjcc.v13.i21.106945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2025] [Revised: 03/27/2025] [Accepted: 04/07/2025] [Indexed: 04/27/2025] Open
Abstract
Pleural effusion, characterized by the accumulation of fluid in the pleural space, poses significant challenges in clinical practice, especially in determining whether it belongs to the inflammatory exudates or non-inflammatory transudates. Adenosine deaminase (ADA), an enzyme primarily produced by immune cells, particularly lymphocytes, increase in response to inflammatory conditions, including tuberculosis and malignancies. Elevated ADA levels in pleural have been shown to correlate with inflammatory exudates, making it a valuable biomarker for differentiating between inflammatory and non-inflammatory effusions. Moreover, numerous studies have demonstrated the treatment function of ADA in inflammation- related pleural effusion syndrome. Recently, research has established the values for the implication of ADA in diagnosing and managing pleural disease. Based on these findings, ADA becomes a reliable, non-invasive marker for early diagnosis and the appropriate treatment for pleural inflammation, ultimately improving patient outcomes.
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Affiliation(s)
- Kai-Yan Liu
- Department of Urology, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China
| | - Xiao-Bing Li
- Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China
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Zheng WX, Liu LY. Urgent thrombolysis followed by percutaneous coronary intervention for the simultaneous acute cardio-cerebral ischemic attack: A case report. World J Clin Cases 2025; 13:105816. [DOI: 10.12998/wjcc.v13.i21.105816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Revised: 03/04/2025] [Accepted: 03/21/2025] [Indexed: 04/27/2025] Open
Abstract
BACKGROUND Simultaneous acute ischemic stroke (AIS) and myocardial infarction (cardiocerebral ischemic attack) have rarely been reported in the literature. Currently, no clear evidence-based guidelines or clinical trials exist to determine the optimal therapeutic strategy for these patients.
CASE SUMMARY We present the case of a 27-year-old Chinese man who simultaneously experienced acute concomitant cerebrocardiac infarction (CCI) and painless ST-elevation myocardial infarction. The patient was successfully treated with elective percutaneous coronary intervention (PCI) after receiving urgent systemic thrombolysis at the standard dose for AIS.
CONCLUSION Urgent thrombolysis followed by elective PCI was an appropriate strategy for the management of simultaneous CCI.
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Affiliation(s)
- Wen-Xue Zheng
- Section 1 of Cadre Wards, The General Hospital of Western Theater Command, Chengdu 610036, Sichuan Province, China
| | - Ling-Yu Liu
- Department of Traditional Chinese Medicine, The General Hospital of Western Theater Command, Chengdu 610036, Sichuan Province, China
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He ZY, Cui T, Cui ZQ, Yan HX, Chen MX, Luo H. Effects of modified Yokoyama surgery combined with medial rectus muscle recession on esotropia in highly myopia athletes. World J Clin Cases 2025; 13:104918. [DOI: 10.12998/wjcc.v13.i21.104918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Revised: 02/25/2025] [Accepted: 04/02/2025] [Indexed: 04/27/2025] Open
Abstract
BACKGROUND Fixed esotropia in high myopia, characterized by irreversible inward ocular deviation and abduction limitation, presents unique therapeutic challenges for athletes requiring precise binocular coordination. The combination of Yokoyama surgery and medial rectus muscle recession has been proposed as an advanced technique addresses both myopia-induced globe displacement and muscular imbalance offering potential advantages over conventional strabismus surgery in this population.
AIM To investigate the effects of the modified Yokoyama surgery coupled with medial rectus muscle recession in restoring ocular motility and correcting esotropia among athletes with high myopia and fixed esotropia.
METHODS A retrospective study analyzed 30 highly myopia athletes (57 eyes) with fixed esotropia treated at our hospital from January 2022 to April 2024. The participants were allocated into two groups based on the surgical method: The traditional group (n = 15, 29 eyes) received conventional strabismus surgery, and the combined group (n = 15, 28 eyes) underwent modified Yokoyama surgery in combination with medial rectus muscle recession. Eye movement improvement, esotropia alleviation, and complications were compared preoperatively and at 1, 3, and 6 months post-treatment.
RESULTS Both surgical groups exhibited similar baseline scores (traditional: -4.04 ± 0.38 vs combined: -4.12 ± 0.45, P > 0.05), showing severe preoperative limitations in ocular motility. Following the intervention, the combined group achieved significantly better outcomes at both 1 month (combined: -2.25 ± 0.28 vs traditional: -2.67 ± 0.32) and 3 months (combined: -1.48 ± 0.28 vs traditional: -1.76 ± 0.43), with statistically significant improvements (P < 0.05). However, by 6 months, no significant difference was observed between the two groups (combined: -0.93 ± 0.13; traditional: -1.03 ± 0.18; P > 0.05). Prior to treatment, all patients in both groups exhibited a compensatory head posture (CHP). Following treatment, the incidence of CHP decreased to 6.67% in the combined group and 20.00% in the traditional group, both reductions being significant compared to pre-treatment levels (P < 0.05). Nevertheless, the difference in CHP incidence between the two groups after treatment was not significant (P > 0.05). The rates of improvement in esotropia showed an increasing trend in both groups at 1 month (46.43% vs 34.48%), 3 months (78.57% vs 51.728%), and 6 months (100.00% vs 89.66%) post-treatment. Notably, the combined group had a significantly higher improvement rate than the traditional group at the 3-month follow-up (P < 0.05). No significant difference was observed in the esotropia improvement rates between the two groups at 1 and 6 months post-treatment (P > 0.05). The combined group experienced slightly lower but not significant (combined group: 0.00% vs traditional: 3.45%) as opposed to the traditional group (3.45%; P > 0.05).
CONCLUSION The combination of modified Yokoyama surgery and medial rectus muscle recession provides effective and safe approach to improving in eye movement and esotropia in athletes with high myopia and fixed esotropia, offering reliable clinical benefits.
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Affiliation(s)
- Zi-Yang He
- School of Physical Education, Shanxi University, Taiyuan 030006, Shanxi Province, China
| | - Tan Cui
- Department of Ophthalmology, Xinghualing Central Hospital, Taiyuan 030032, Shanxi Province, China
| | - Zhi-Qi Cui
- School of Physical Education, Shanxi University, Taiyuan 030006, Shanxi Province, China
| | - Hui-Xia Yan
- Department of Ophthalmology, Xinghualing Central Hospital, Taiyuan 030032, Shanxi Province, China
| | - Mei-Xuan Chen
- Department of Ophthalmology, Xinghualing Central Hospital, Taiyuan 030032, Shanxi Province, China
| | - Hao Luo
- School of Physical Education, Shanxi University, Taiyuan 030006, Shanxi Province, China
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Montiel-López PA, García-Nuñez JC, Muro-Jiménez ML, Soto-Chávez AA, Martínez-Rodríguez VM, Rodríguez-Montaño R, Ruiz-Gutiérrez AC. Management of intrabony defects associated with the iatrogenic use of orthodontic elastic bands: A case report. World J Clin Cases 2025; 13:105685. [DOI: 10.12998/wjcc.v13.i20.105685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 02/22/2025] [Accepted: 03/10/2025] [Indexed: 04/09/2025] Open
Abstract
BACKGROUND The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation, thus ultimately leading to tooth loss.
CASE SUMMARY This clinical case involved a 27-year-old male patient who complained of persistent inflammation and bleeding in the upper anterior region of the gums, despite having undergone dental cleaning for at least 4 years. The dental and medical history indicated the use of removable orthodontic appliances for 8 years, after which braces were placed for 2 years. The intraoral evaluation revealed inflammation and localized suppuration in teeth 11 and 12. Measurements of 2-7 mm for probing depth and 1-5 mm for clinical attachment loss were detected, and combined bone loss was observed via radiographs. Based on the clinical and radiographic findings, localized stage III, grade C periodontitis was diagnosed. During subgingival debridement, two elastic bands emerged around the involved teeth. The bone defects persisted; therefore, they were surgically addressed using a papilla preservation flap and guided tissue regeneration (GTR).
CONCLUSION The use of elastic bands of various sizes and elasticities is often essential in multiple orthodontic treatments. However, it is crucial to perform a thorough check-up for each patient during treatment and at the end of treatment to remove any remaining residue of resin, metal bands, or orthodontic bands. Additionally, it is imperative to inform the patients of the importance of attending their follow-up appointments. The use of elastic bands in orthodontics requires special care; moreover, GTR is a management option for intrabony defects associated with the iatrogenic use of bands.
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Affiliation(s)
- Patricia A Montiel-López
- Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Juan C García-Nuñez
- Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Mari L Muro-Jiménez
- Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Alma A Soto-Chávez
- Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Vianeth M Martínez-Rodríguez
- Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Ruth Rodríguez-Montaño
- Department of Health and Illness as an Individual and Collective Process, University Center of Tlajomulco, University of Guadalajara, Tlajomulco de Zuñiga 45641, Jalisco, Mexico
| | - Alondra C Ruiz-Gutiérrez
- Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
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Byeon H. Innovative approaches to managing chronic multimorbidity: A multidisciplinary perspective. World J Clin Cases 2025; 13:102484. [DOI: 10.12998/wjcc.v13.i19.102484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2024] [Revised: 02/13/2025] [Accepted: 02/25/2025] [Indexed: 03/19/2025] Open
Abstract
The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems, necessitating the development of innovative management strategies to optimize patient care and system efficiency. The study by Fontalba-Navas et al investigates the implementation of a novel high complexity unit (HCU) specifically designed to improve the management of patients with chronic complex conditions. By adopting a multidisciplinary approach, the HCU aims to provide comprehensive, patient-centered care that enhances health outcomes and alleviates the strain on traditional hospital services. Utilizing a longitudinal analysis of data from the Basic Minimum Data Set, this study compares hospitalization metrics among the HCU, Internal Medicine, and other departments within a regional hospital throughout 2022. The findings reveal that the HCU's integrated care model significantly reduces readmission rates and boosts patient satisfaction compared to conventional care practices. The study highlights the HCU's potential as a replicable model for managing chronic multimorbidity, emphasizing its effectiveness in minimizing unnecessary hospitalizations and enhancing the overall quality of patient care. This innovative approach not only addresses the complexities associated with chronic multimorbid conditions but also offers a sustainable framework for healthcare systems confronting similar challenges.
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Affiliation(s)
- Haewon Byeon
- Worker's Care and Digital Health Lab, Department of Future Technology, Korea University of Technology and Education, Cheonan 31253, South Korea
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Mishra R, Patel H, Jamal A, Singh S. Potential role of large language models and personalized medicine to innovate cardiac rehabilitation. World J Clin Cases 2025; 13:98095. [DOI: 10.12998/wjcc.v13.i19.98095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 11/20/2024] [Accepted: 02/20/2025] [Indexed: 03/19/2025] Open
Abstract
Cardiac rehabilitation is a crucial multidisciplinary approach to improve patient outcomes. There is a growing body of evidence that suggests that these programs contribute towards reducing cardiovascular mortality and recurrence. Despite this, cardiac rehabilitation is underutilized and adherence to these programs has been a demonstrated barrier in achieving these outcomes. As a result, there is a growing focus on innovating these programs, especially from the standpoint of digital health and personalized medicine. This editorial discusses the possible roles of large language models, such as their role in ChatGPT, in further personalizing cardiac rehabilitation programs through simplifying medical jargon and employing motivational interviewing techniques, thus boosting patient engagement and adherence. However, these possibilities must be further investigated in the clinical literature. Likewise, the integration of large language models in cardiac rehabilitation will be challenging in its nascent stages to ensure accurate and ethical information delivery.
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Affiliation(s)
- Rishith Mishra
- School of Medicine, University of Missouri Kansas City, Kansas City, MO 64106, United States
| | - Hersh Patel
- School of Medicine, University of Missouri Kansas City, Kansas City, MO 64106, United States
| | - Aleena Jamal
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Som Singh
- School of Medicine, University of Missouri Kansas City, Kansas City, MO 64106, United States
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Jiang J, Shi HT, Wu J, Sha SM, Cai SX, Liu X. Successful treatment of depressed esophageal squamous papilloma with interferon- alpha 2a: A case report. World J Clin Cases 2025; 13:99311. [DOI: 10.12998/wjcc.v13.i19.99311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2024] [Revised: 01/27/2025] [Accepted: 02/26/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Esophageal squamous papilloma (ESP) is a rare benign tumor of the esophagus, typically characterized by an exophytic and warty appearance, with a diameter of less than 5 mm. Endoscopic resection is considered the most effective treatment for these tumors.
CASE SUMMARY In this paper, we discussed the pathogenesis, clinical characteristics, and therapeutic options of ESP based on our experience with a case presenting a depressed appearance and treated with interferon-alpha 2a (IFNα2a) injection.
CONCLUSION This paper reports the first successful clinical case of using the human IFNα2a for the treatment of ESP with a depressed endoscopic appearance. However, the efficacy of interferon treatment requires to validation in a large number of subsequent cases.
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Affiliation(s)
- Jiong Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Hai-Tao Shi
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Jie Wu
- Department of Pathology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Su-Mei Sha
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Shang-Xuan Cai
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Xin Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
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Maranhão BHF, Junior CTDS, Barillo JL, Souza JBS, Silva PS, Stirbulov R. Total adenosine deaminase cases as an inflammatory biomarker of pleural effusion syndrome. World J Clin Cases 2025; 13:101850. [DOI: 10.12998/wjcc.v13.i19.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Revised: 11/04/2024] [Accepted: 03/04/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Although inflammatory diseases commonly affect the pleura and pleural space, their mechanisms of action remain unclear. The presence of several mediators emphasizes the concept of pleural inflammation. Adenosine deaminase (ADA) is an inflammatory mediator detected at increased levels in the pleural fluid.
AIM To determine the role of total pleural ADA (P-ADA) levels in the diagnosis of pleural inflammatory diseases.
METHODS 157 patients with inflammatory pleural effusion (exudates, n = 124, 79%) and non-inflammatory pleural effusion (transudates, n = 33, 21%) were included in this observational retrospective cohort study. The P-ADA assay was tested using a kinetic technique. The performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). The ideal cutoff value for P-ADA in pleural inflammation was determined using the Youden index in the ROC curve.
RESULTS The transudates included congestive heart failure (n = 26), cirrhosis of the liver with ascites (n = 3), chronic renal failure (n = 3), and low total protein levels (n = 1). The exudate cases included tuberculosis (n = 44), adenocarcinoma (n = 37), simple parapneumonic effusions (n = 15), complicated parapneumonic effusions/empyema (n = 8), lymphoma (n = 7), and other diseases (n = 13). The optimal cutoff value of P-ADA was ≥ 9.00 U/L. The diagnostic parameters as sensitivity, specificity, positive and negative predictive values, positive and negative likelihood values, odds ratio, and accuracy were 77.69 (95%CI: 69.22-84.75); 68.75 (95%CI: 49.99-83.88); 90.38 and 44.90 (95%CI: 83.03-95.29; 30.67-59.77); 2.48 and 0.32 (95%CI: 2.21-11.2; 0.27-0.51); 7.65 (95%CI: 0.78-18.34), and 75.82 (95%CI: 68.24-82.37), respectively (χ² = 29.51, P = 0.00001). An AUC value of 0.8107 (95%CI: 0.7174-0.8754; P = 0.0000) was clinically useful. The Hosmer-Lemeshow test showed excellent discrimination.
CONCLUSION P-ADA biomarker has high diagnostic performance for pleural inflammatory exudates.
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Affiliation(s)
- Bernardo Henrique Ferraz Maranhão
- Department of Specialized Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270004, State of Rio de Janeiro, Brazil
| | | | - Jorge Luiz Barillo
- Department of Thoracic Surgery, General Hospital Santa Teresa, Petropolis 25680-003, Rio de Janeiro, Brazil
| | | | - Patricia Siqueira Silva
- Professor Mazzini Bueno Tuberculosis Research and Assistance Center, Federal Fluminense University, Niteroi 24020-080, Rio de Janeiro, Brazil
| | - Roberto Stirbulov
- Department of Clinics, Rua Baronesa de Itu, São Paulo 1231001, São Paulo, Brazil
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