BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutane...BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and muscle.Thus,timely and multiple surgical operations are needed for the treatment.Meanwhile,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.CASE SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region.The symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and uroschesis.The results of postoperative pathology met the diagnosis.Based on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were given.The outcome of the treatment was satisfactory.The patient recovered quickly and achieved ideal anal function and morphology.CONCLUSION Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.展开更多
Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied fo...Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.展开更多
BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and ...BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.展开更多
Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evalua...Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.展开更多
In this editorial,we comment on the article by Meng et al.Chronic hepatitis B(CHB)is a significant global health problem,particularly in developing countries.Hepatitis B virus(HBV)infection is one of the most importan...In this editorial,we comment on the article by Meng et al.Chronic hepatitis B(CHB)is a significant global health problem,particularly in developing countries.Hepatitis B virus(HBV)infection is one of the most important risk factors for cirrhosis and hepatocellular carcinoma.Prevention and treatment of HBV are key measures to reduce complications.At present,drug therapy can effectively control virus replication and slow disease progression,but completely eliminating the virus remains a challenge.Anti-HBV treatment is a long-term process,and there are many kinds of antiviral drugs with different mechanisms of action,it is essential to evaluate the safety and efficacy of these drugs to reduce side effects and improve patients’compliance.We will summarize the current status of CHB drug treatment,hoping to provide a reference for the selection of clinical antiviral drugs.展开更多
In this editorial,we comment on the article by Mu et al,published in the recent issue of the World Journal of Gastrointestinal Oncology.We pay special attention to the immune tolerance mechanism caused by hepatitis B ...In this editorial,we comment on the article by Mu et al,published in the recent issue of the World Journal of Gastrointestinal Oncology.We pay special attention to the immune tolerance mechanism caused by hepatitis B virus(HBV)infection,the pathogenesis of hepatocellular carcinoma(HCC),and the role of antiviral therapy in treating HCC related to HBV infection.HBV infection leads to systemic innate immune tolerance by directly inhibiting pattern recognition receptor recognition and antiviral signaling pathways,as well as by inhibiting the immune functions of macrophages,natural killer cells and dendritic cells.In addition,HBV leads to an immunosuppressive cascade by expressing inhibitory molecules to induce exhaustion of HBV-specific cluster of differentiation 8+T cells,ultimately leading to long-term viral infection.The loss of immune cell function caused by HBV infection ultimately leads to HCC.Long-term antiviral therapy can improve the prognosis of patients with HCC and prevent tumor recurrence and metastasis.展开更多
Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopi...Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.展开更多
This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinom...This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.展开更多
Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,im...Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or cytokines.Teplizumab is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target antigen.Preclinical and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of T1DM.The benefits have been apparent as early as six months to as long as seven years after therapy.It has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of age.In their recent metaanalysis published in the World Journal of Diabetes,Ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety profile.However,all the included randomized control trials have been conducted in high-income countries.High cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.展开更多
Background: Osteopathic manual treatment (OMT) has been reported to have positive initial results for subjects with chronic non-specific back pain in a rural safety-net hospital. However, the effects of OMT following ...Background: Osteopathic manual treatment (OMT) has been reported to have positive initial results for subjects with chronic non-specific back pain in a rural safety-net hospital. However, the effects of OMT following initial treatment have not been reported. Objective: To determine the effects of OMT for patients with chronic non-specific back pain in a rural safety-net hospital setting for an initial post-clinical and follow-up visit. Methods: A longitudinal, rolling admission, eleven-year study of cohort study with a primary complaint of chronic, non-specific back pain that had plateaued in improvement for a minimum of six months. One hundred and fifty-one subjects completed the first two study visits necessary for data collection, and fifty-nine subjects completed the follow-up visit after six months. Results: A two-way, mixed model, repeated measures ANOVA with pre- post1 and post2 (follow-up) treatment as the within variable and sex as the between subject variable showed a significant main effect from pre- to follow-up, (F (1, 57) = 21.171, P ηP2= 0.426), but not a significant interaction between time and sex (F (1, 57) = 0.279, P ηP2= 0.002). Conclusions: The results of this study support the hypothesis that OMT has a continued benefit in pain reduction and functional improvement beyond the initial treatment period. The rural, safety-net hospital setting made this study unique relative to the sample population.展开更多
Background: Conventional radiation therapy is a technique that uses ionizing radiation to destroy tumor cells. Along with surgery, chemotherapy, hormonotherapy and target therapy, it plays a crucial role in the manage...Background: Conventional radiation therapy is a technique that uses ionizing radiation to destroy tumor cells. Along with surgery, chemotherapy, hormonotherapy and target therapy, it plays a crucial role in the management of breast cancer by reducing its overall mortality and recurrences. Methods: We conducted a retrospective and descriptive study by using the records of patients treated in the radiotherapy department of the Douala General Hospital from January 2015 to December 2019. Data concerning radiation-induced toxicities were collected using a pre-established and pre-tested survey and transferred to the CTCAE Version 4.0 software. Data analysis was performed using SPSS version 20.0. Results: A total of 206 records were selected. The average age was 46.7 ± 8.2 years. The most represented histological type was invasive ductal carcinoma (n = 187, 90.7%). Multimodality treatment was used in every patient in our series with chemotherapy, surgery, and adjuvant radiation therapy (n = 88, 42.7%) been the most represented. More than half of the participants (n = 108, 52.4%) received a total dose >50 grays, only 89 (43.2%) received the classical fractionation of 2 grays/cession, and the average duration of radiation therapy was 36.8 ± 15.4 days. We encountered 155 (75.2%) side effects. There were more acute toxicities than late toxicities, at 115 (74.1%) versus 40 (25.8%). The main acute lesions were radiodermatitis (68.6%), breast pain (16.5%), radiation pneumonitis (12.2%), and acute pericarditis (2.6%). As late lesions, we identified radiodermatitis (52.5%), radiation pneumonitis (32.5%), and lymphoedema (15%). A total dose >50 grays [p 0.001, OR: 2.7 (1.58 - 4.9)], and conservative surgery [p = 0.04, OR: 2.3 (1.3 - 4.1)], seemed to increase the occurrence of early side effects on bivariate analysis. However, after multivariate logistic regression, only a total dose >50 grays [p = 0.005, OR: 2.1 (1.1 - 6.7)] remained a predictive factor associated to early side effects. We found no factors related to late side effect occurrences. Conclusion: The frequency of side effects of radiation therapy for breast cancer at the Douala General Hospital remains relatively high. Both early and late lesions remained present with early toxicities been the most common. Meticulous strategies along with an enhancement of both human and materials resources are paramount in order to reduce their frequency and morbidity.展开更多
Background: The effects of radiation therapy can impact patients’ quality of life, leading to treatment interruptions and therefore sub-optimal outcomes. The main aim was to evaluate the preliminary effects of Ocoxin...Background: The effects of radiation therapy can impact patients’ quality of life, leading to treatment interruptions and therefore sub-optimal outcomes. The main aim was to evaluate the preliminary effects of Ocoxin cream® in the prevention of radiation therapy. Methods: Fifty patients were enrolled in an observational, longitudinal, prospective, single-centre clinical trial in the Department of Radiation Therapy at the National Institute of Oncology and Radiobiology in Havana, Cuba. The Radiation Therapy Oncology Group (RTOG) toxicity criteria were used to classify the radiation therapy, and the Dermatology Life Quality Index (DLQI) instrument was used to assess quality of life. Results: Patients who met the inclusion criteria were enrolled consecutively and were treated with teletherapy using a 60Co source with 1.25 MeV energy. 70.0% of the patients were head and neck cancer patients. No grade 3 - 4 radiation therapy was reported, nor were there any interruptions in radiation treatment due to skin toxicity. Radiation therapy was observed in only 14.0% of patients, and of these, only two patients developed grade 2 toxicity. The perception of quality of life before vs. after radiation therapy remained within an average range of “no effect” (at the start of radiation therapy) to “small effect” (at the end of radiation therapy). Conclusions: This clinical study is the first report of the use of Ocoxin cream® in cancer patients and demonstrates that it is able to prevent radiation therapy and reduce the severity of toxicity of treatment with ionising radiation.展开更多
Collecting duct carcinoma (CDC), or Bellini duct carcinoma, is a rare and aggressive subtype of renal cell carcinoma, accounting for 0.2% - 1% of cases. It often presents at an advanced stage with nonspecific symptoms...Collecting duct carcinoma (CDC), or Bellini duct carcinoma, is a rare and aggressive subtype of renal cell carcinoma, accounting for 0.2% - 1% of cases. It often presents at an advanced stage with nonspecific symptoms, requiring histopathology for diagnosis. Surgery remains the standard of care for localized disease, serving both diagnostic and therapeutic purposes, though adjuvant chemotherapy has shown limited efficacy. In metastatic CDC, the gemcitabine-cisplatin regimen is commonly used due to its resemblance to urothelial cancer and supportive data from prospective studies. Newer therapies offer promise in advanced cases. Immune checkpoint inhibitors, such as nivolumab alone or with ipilimumab, have shown benefits in patients with high PD-L1 expression. Targeted therapies like cabozantinib demonstrated efficacy and safety as first-line treatments in phase II trials, while sunitinib and sorafenib have shown responses in various case reports and cohorts. However, combining chemotherapy with bevacizumab did not improve outcomes in phase II trials. Despite therapeutic advances in urothelial cancers and clear cell renal tumors, the CDC entity remains a challenging malignancy, emphasizing the need for continued research to understand the true efficacy of treatment and to prolong survival in advanced disease.展开更多
BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need...BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.展开更多
Background Antibiotic therapy in infertility management is one of the most frequent and useful practices in sub-Saharan setting. Infertility of tubal origin and secondary to infections are the most prevalent. The curr...Background Antibiotic therapy in infertility management is one of the most frequent and useful practices in sub-Saharan setting. Infertility of tubal origin and secondary to infections are the most prevalent. The current study aimed to take stock of antibiotic therapy in infertility management without in Vitro Fertilization (IVF). Material and Methods A cross-sectional analytical study undertaken in University Clinics of Kinshasa and the Edith Medical Center, from January 2001 to December 2021. It involved 3754 patients who sought care for infertility and received antibiotics during the treatment. Results The mean age of the patients was 33.3 ± 5.7 years and ranged from 16 to 49 years. Most of them were nulliparous with secondary infertility. The average duration of infertility was 4.5 ± 3.6 years and ranged from 1 to 20 years. Most had a history of unsafe abortion and tubal obstruction. The pelvic infections were the main diagnosis. After antibiotic therapy, especially made of Doxycycline alone or in association 442 (8.8%) patients conceived. Conclusion In the low-income sub-Saharan setting, infection remained the common cause of infertility and doxycycline was found to be the most used and efficient antibiotics.展开更多
This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individua...This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individuals with mild-to-moderate traumatic brain injury (TBI). A total of 15 participants (7 males, 8 females, ages ranging from 20 to 78 years) diagnosed with mild-to-moderate TBI underwent 10 sessions of combined therapy. Cognitive performance was assessed using standardized neuropsychological tests before and after treatment, measuring cognitive processing speed, neural responsiveness, and executive function. The results demonstrated significant improvements across all metrics, including a 28.3 ms reduction in P300 latency, a 1.2 mV increase in P300 voltage, and reductions in completion times for the Trail-Making Tests A (14 seconds) and B (19 seconds). These findings suggest that multi-modality therapy may enhance cognitive recovery in TBI patients, with notable benefits across age and gender groups. Further research with larger sample sizes and extended follow-up is required to validate these results and explore their broader clinical applications.展开更多
In recent years,the progression of stem cell therapies has shown great promise in advancing the nascent field of regenerative medicine.Considering the non-regenerative nature of the mature central nervous system,the c...In recent years,the progression of stem cell therapies has shown great promise in advancing the nascent field of regenerative medicine.Considering the non-regenerative nature of the mature central nervous system,the concept that“blank”cells could be reprogrammed and functionally integrated into host neural networks remained intriguing.Previous work has also demonstrated the ability of such cells to stimulate intrinsic growth programs in post-mitotic cells,such as neurons.While embryonic stem cells demonstrated great potential in treating central nervous system pathologies,ethical and technical concerns remained.These barriers,along with the clear necessity for this type of treatment,ultimately prompted the advent of induced pluripotent stem cells.The advantage of pluripotent cells in central nervous system regeneration is multifaceted,permitting differentiation into neural stem cells,neural progenitor cells,glia,and various neuronal subpopulations.The precise spatiotemporal application of extrinsic growth factors in vitro,in addition to microenvironmental signaling in vivo,influences the efficiency of this directed differentiation.While the pluri-or multipotency of these cells is appealing,it also poses the risk of unregulated differentiation and teratoma formation.Cells of the neuroectodermal lineage,such as neuronal subpopulations and glia,have been explored with varying degrees of success.Although the risk of cancer or teratoma formation is greatly reduced,each subpopulation varies in effectiveness and is influenced by a myriad of factors,such as the timing of the transplant,pathology type,and the ratio of accompanying progenitor cells.Furthermore,successful transplantation requires innovative approaches to develop delivery vectors that can mitigate cell death and support integration.Lastly,host immune responses to allogeneic grafts must be thoroughly characterized and further developed to reduce the need for immunosuppression.Translation to a clinical setting will involve careful consideration when assessing both physiologic and functional outcomes.This review will highlight both successes and challenges faced when using human induced pluripotent stem cell-derived cell transplantation therapies to promote endogenous regeneration.展开更多
A nanomicelle(denoted as TPGS/Ppa)was fabricated via the coassembly of the amphiphilic D-α-tocopheryl polyethylene glycol 1000 succinate(TPGS)and the hydrophobic photosensitizer pyropheophorbide a(Ppa)for photodynami...A nanomicelle(denoted as TPGS/Ppa)was fabricated via the coassembly of the amphiphilic D-α-tocopheryl polyethylene glycol 1000 succinate(TPGS)and the hydrophobic photosensitizer pyropheophorbide a(Ppa)for photodynamic therapy(PDT).The obtained nanomicelle possessed a spherical structure with a diameter of(18.0±2.2)nm and a zeta potential of approximately -18 mV.Besides,the nanomicelle exhibited excellent photostability,biocompatibility,and phototoxicity,and could effectively reach the tumor region via the enhanced permeability and retention effect.Additionally,it could be found that the TPGS/Ppa nanomicelle exhibited higher phototoxicity against 4T1 murine mammary cancer cells than free Ppa.In the 4T1 tumor-bearing mouse model,the nanomicelle showed an excellent antitumor therapeutic effect.This study develops a new type of photodynamic nanomicelle TPGS/Ppa,which can increase the accumulation of drugs and prolong their tumor retention time,providing a feasible strategy for realizing the delivery of small-molecule hydrophobic drugs and tumor PDT.展开更多
Background: Individuals with coronary artery disease (CAD) who have undergone a percutaneous coronary intervention (PCI) are at an increased risk for adverse coronary events. Management with dual antiplatelet therapy ...Background: Individuals with coronary artery disease (CAD) who have undergone a percutaneous coronary intervention (PCI) are at an increased risk for adverse coronary events. Management with dual antiplatelet therapy (DAPT) has been indicated in this group, however, DAPT significantly increases the risk of bleeding. Objectives: This study aimed to evaluate aspirin versus clopidogrel and aspirin on major adverse cardiac and cerebrovascular events (MACCE) and risk of bleeding in individuals already on DAPT for one year after undergoing PCI. Methods: This was a single-center, double-arm, interventional, prospective study. A total of 956 individuals who had undergone PCI and were on DAPT for a year were enrolled. After calculating DAPT scores, individuals with DAPT scores ≥2 were assigned to the aspirin and clopidogrel group, and those with DAPT scores Results: The group on clopidogrel and aspirin demonstrated a significantly lower rate of MACCE when compared to those on aspirin alone (p = 0.003). However, stent thrombosis, stroke, and myocardial infarction (MI) did not significantly differ in an inter-group comparison. The rate of moderate bleeding was greater in the clopidogrel group;however, the difference was not found to be statistically significant (p = 0.19). Conclusions: Continuing DAPT for a period between 12 and 24 months after PCI in individuals with a DAPT score ≥2 had favorable outcomes in reducing coronary adverse events without resulting in significant bleeding.展开更多
Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP ...Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP remains challenging, particularly in patients with comorbidities or contraindications to standard therapies. Objectives: To evaluate the effectiveness of ozonated water as an adjunctive treatment for EP, delivered using a patented robotic therapy system designed for hygiene and infection prevention in non-self-sufficient patients. Methods: We report the case of a 90-year-old male patient with acute EP who received daily skin treatments with ozonated water in conjunction with supportive care, including rehydration and antibiotics. The intervention was facilitated by the robotic system “COPERNICO Surveillance & Prevention,” which ensured standardized hygiene practices and clinical documentation. Results: Within one week of treatment, the patient showed complete desquamation of necrotic skin, resolution of erythema, and significant metabolic recovery. Fever subsided, renal function improved, and the patient was discharged in stable condition. Follow-up confirmed sustained clinical improvement, and no adverse events were reported. Conclusions: Ozonated water demonstrated efficacy in alleviating the dermatological and systemic manifestations of EP in a high-risk elderly patient. This case highlights the potential of ozone therapy as a safe, cost-effective adjunctive treatment for EP and underscores the utility of robotic systems in managing complex dermatological conditions. Further research is warranted to validate these findings in larger cohorts.展开更多
基金the Young Talent Program of LongHua Hospital Shanghai University of Traditional Chinese Medicine,No.RC-2019-01-01and the Shanghai Three-year Action Plan of Further Accelerated Development in Traditional Chinese Medicine,No.ZY(2018-2020)-CCCX-1007.
文摘BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and muscle.Thus,timely and multiple surgical operations are needed for the treatment.Meanwhile,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.CASE SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region.The symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and uroschesis.The results of postoperative pathology met the diagnosis.Based on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were given.The outcome of the treatment was satisfactory.The patient recovered quickly and achieved ideal anal function and morphology.CONCLUSION Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.
文摘Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.
基金Supported by National High Level Hospital Clinical Research Funding(Youth Clinical Research Project of Peking University First Hospital),No.2023YC27Capital’s Funds for Health Improvement and Research,No.2022-2-40711National High Level Hospital Clinical Research Funding(Interdepartmental Research Project of Peking University First Hospital),No.2024IR20.
文摘BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.
文摘Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.
基金Supported by the Project of Guizhou Provincial Department of Science and Technology,No.Qiankehechengguo-LC[2024]109.
文摘In this editorial,we comment on the article by Meng et al.Chronic hepatitis B(CHB)is a significant global health problem,particularly in developing countries.Hepatitis B virus(HBV)infection is one of the most important risk factors for cirrhosis and hepatocellular carcinoma.Prevention and treatment of HBV are key measures to reduce complications.At present,drug therapy can effectively control virus replication and slow disease progression,but completely eliminating the virus remains a challenge.Anti-HBV treatment is a long-term process,and there are many kinds of antiviral drugs with different mechanisms of action,it is essential to evaluate the safety and efficacy of these drugs to reduce side effects and improve patients’compliance.We will summarize the current status of CHB drug treatment,hoping to provide a reference for the selection of clinical antiviral drugs.
基金Supported by the Natural Science Foundation of China,No.81970529the Natural Science Foundation of Jilin Province,No.20230508074RC and No.YDZJ202401218ZYTS.
文摘In this editorial,we comment on the article by Mu et al,published in the recent issue of the World Journal of Gastrointestinal Oncology.We pay special attention to the immune tolerance mechanism caused by hepatitis B virus(HBV)infection,the pathogenesis of hepatocellular carcinoma(HCC),and the role of antiviral therapy in treating HCC related to HBV infection.HBV infection leads to systemic innate immune tolerance by directly inhibiting pattern recognition receptor recognition and antiviral signaling pathways,as well as by inhibiting the immune functions of macrophages,natural killer cells and dendritic cells.In addition,HBV leads to an immunosuppressive cascade by expressing inhibitory molecules to induce exhaustion of HBV-specific cluster of differentiation 8+T cells,ultimately leading to long-term viral infection.The loss of immune cell function caused by HBV infection ultimately leads to HCC.Long-term antiviral therapy can improve the prognosis of patients with HCC and prevent tumor recurrence and metastasis.
文摘Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.
文摘This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.
文摘Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or cytokines.Teplizumab is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target antigen.Preclinical and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of T1DM.The benefits have been apparent as early as six months to as long as seven years after therapy.It has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of age.In their recent metaanalysis published in the World Journal of Diabetes,Ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety profile.However,all the included randomized control trials have been conducted in high-income countries.High cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.
文摘Background: Osteopathic manual treatment (OMT) has been reported to have positive initial results for subjects with chronic non-specific back pain in a rural safety-net hospital. However, the effects of OMT following initial treatment have not been reported. Objective: To determine the effects of OMT for patients with chronic non-specific back pain in a rural safety-net hospital setting for an initial post-clinical and follow-up visit. Methods: A longitudinal, rolling admission, eleven-year study of cohort study with a primary complaint of chronic, non-specific back pain that had plateaued in improvement for a minimum of six months. One hundred and fifty-one subjects completed the first two study visits necessary for data collection, and fifty-nine subjects completed the follow-up visit after six months. Results: A two-way, mixed model, repeated measures ANOVA with pre- post1 and post2 (follow-up) treatment as the within variable and sex as the between subject variable showed a significant main effect from pre- to follow-up, (F (1, 57) = 21.171, P ηP2= 0.426), but not a significant interaction between time and sex (F (1, 57) = 0.279, P ηP2= 0.002). Conclusions: The results of this study support the hypothesis that OMT has a continued benefit in pain reduction and functional improvement beyond the initial treatment period. The rural, safety-net hospital setting made this study unique relative to the sample population.
文摘Background: Conventional radiation therapy is a technique that uses ionizing radiation to destroy tumor cells. Along with surgery, chemotherapy, hormonotherapy and target therapy, it plays a crucial role in the management of breast cancer by reducing its overall mortality and recurrences. Methods: We conducted a retrospective and descriptive study by using the records of patients treated in the radiotherapy department of the Douala General Hospital from January 2015 to December 2019. Data concerning radiation-induced toxicities were collected using a pre-established and pre-tested survey and transferred to the CTCAE Version 4.0 software. Data analysis was performed using SPSS version 20.0. Results: A total of 206 records were selected. The average age was 46.7 ± 8.2 years. The most represented histological type was invasive ductal carcinoma (n = 187, 90.7%). Multimodality treatment was used in every patient in our series with chemotherapy, surgery, and adjuvant radiation therapy (n = 88, 42.7%) been the most represented. More than half of the participants (n = 108, 52.4%) received a total dose >50 grays, only 89 (43.2%) received the classical fractionation of 2 grays/cession, and the average duration of radiation therapy was 36.8 ± 15.4 days. We encountered 155 (75.2%) side effects. There were more acute toxicities than late toxicities, at 115 (74.1%) versus 40 (25.8%). The main acute lesions were radiodermatitis (68.6%), breast pain (16.5%), radiation pneumonitis (12.2%), and acute pericarditis (2.6%). As late lesions, we identified radiodermatitis (52.5%), radiation pneumonitis (32.5%), and lymphoedema (15%). A total dose >50 grays [p 0.001, OR: 2.7 (1.58 - 4.9)], and conservative surgery [p = 0.04, OR: 2.3 (1.3 - 4.1)], seemed to increase the occurrence of early side effects on bivariate analysis. However, after multivariate logistic regression, only a total dose >50 grays [p = 0.005, OR: 2.1 (1.1 - 6.7)] remained a predictive factor associated to early side effects. We found no factors related to late side effect occurrences. Conclusion: The frequency of side effects of radiation therapy for breast cancer at the Douala General Hospital remains relatively high. Both early and late lesions remained present with early toxicities been the most common. Meticulous strategies along with an enhancement of both human and materials resources are paramount in order to reduce their frequency and morbidity.
文摘Background: The effects of radiation therapy can impact patients’ quality of life, leading to treatment interruptions and therefore sub-optimal outcomes. The main aim was to evaluate the preliminary effects of Ocoxin cream® in the prevention of radiation therapy. Methods: Fifty patients were enrolled in an observational, longitudinal, prospective, single-centre clinical trial in the Department of Radiation Therapy at the National Institute of Oncology and Radiobiology in Havana, Cuba. The Radiation Therapy Oncology Group (RTOG) toxicity criteria were used to classify the radiation therapy, and the Dermatology Life Quality Index (DLQI) instrument was used to assess quality of life. Results: Patients who met the inclusion criteria were enrolled consecutively and were treated with teletherapy using a 60Co source with 1.25 MeV energy. 70.0% of the patients were head and neck cancer patients. No grade 3 - 4 radiation therapy was reported, nor were there any interruptions in radiation treatment due to skin toxicity. Radiation therapy was observed in only 14.0% of patients, and of these, only two patients developed grade 2 toxicity. The perception of quality of life before vs. after radiation therapy remained within an average range of “no effect” (at the start of radiation therapy) to “small effect” (at the end of radiation therapy). Conclusions: This clinical study is the first report of the use of Ocoxin cream® in cancer patients and demonstrates that it is able to prevent radiation therapy and reduce the severity of toxicity of treatment with ionising radiation.
文摘Collecting duct carcinoma (CDC), or Bellini duct carcinoma, is a rare and aggressive subtype of renal cell carcinoma, accounting for 0.2% - 1% of cases. It often presents at an advanced stage with nonspecific symptoms, requiring histopathology for diagnosis. Surgery remains the standard of care for localized disease, serving both diagnostic and therapeutic purposes, though adjuvant chemotherapy has shown limited efficacy. In metastatic CDC, the gemcitabine-cisplatin regimen is commonly used due to its resemblance to urothelial cancer and supportive data from prospective studies. Newer therapies offer promise in advanced cases. Immune checkpoint inhibitors, such as nivolumab alone or with ipilimumab, have shown benefits in patients with high PD-L1 expression. Targeted therapies like cabozantinib demonstrated efficacy and safety as first-line treatments in phase II trials, while sunitinib and sorafenib have shown responses in various case reports and cohorts. However, combining chemotherapy with bevacizumab did not improve outcomes in phase II trials. Despite therapeutic advances in urothelial cancers and clear cell renal tumors, the CDC entity remains a challenging malignancy, emphasizing the need for continued research to understand the true efficacy of treatment and to prolong survival in advanced disease.
文摘BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.
文摘Background Antibiotic therapy in infertility management is one of the most frequent and useful practices in sub-Saharan setting. Infertility of tubal origin and secondary to infections are the most prevalent. The current study aimed to take stock of antibiotic therapy in infertility management without in Vitro Fertilization (IVF). Material and Methods A cross-sectional analytical study undertaken in University Clinics of Kinshasa and the Edith Medical Center, from January 2001 to December 2021. It involved 3754 patients who sought care for infertility and received antibiotics during the treatment. Results The mean age of the patients was 33.3 ± 5.7 years and ranged from 16 to 49 years. Most of them were nulliparous with secondary infertility. The average duration of infertility was 4.5 ± 3.6 years and ranged from 1 to 20 years. Most had a history of unsafe abortion and tubal obstruction. The pelvic infections were the main diagnosis. After antibiotic therapy, especially made of Doxycycline alone or in association 442 (8.8%) patients conceived. Conclusion In the low-income sub-Saharan setting, infection remained the common cause of infertility and doxycycline was found to be the most used and efficient antibiotics.
文摘This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individuals with mild-to-moderate traumatic brain injury (TBI). A total of 15 participants (7 males, 8 females, ages ranging from 20 to 78 years) diagnosed with mild-to-moderate TBI underwent 10 sessions of combined therapy. Cognitive performance was assessed using standardized neuropsychological tests before and after treatment, measuring cognitive processing speed, neural responsiveness, and executive function. The results demonstrated significant improvements across all metrics, including a 28.3 ms reduction in P300 latency, a 1.2 mV increase in P300 voltage, and reductions in completion times for the Trail-Making Tests A (14 seconds) and B (19 seconds). These findings suggest that multi-modality therapy may enhance cognitive recovery in TBI patients, with notable benefits across age and gender groups. Further research with larger sample sizes and extended follow-up is required to validate these results and explore their broader clinical applications.
基金supported by Ohio State Start Up FundNational Institutes of Health(NIH)+12 种基金Department of Defense(DoD)Wings for Life Spinal Cord Research Foundation,Wings for Life Spinal Cord Research Foundation(Austria)California Institute of Regenerative Medicine(CIRM)International Spinal Research Trust(United Kingdom)Stanford University Bio-X Program Interdisciplinary Initiatives Seed Grant IIP-7Dennis Chan FoundationKlein Family FundLucile Packard Foundation for Children's HealthStanford Institute for Neuro-Innovation and Translational Neurosciences(SINTN)Saunders Family Neuroscience FundJames Doty Neurosurgery FundHearst Neuroscience FundEileen Bond Research Fund(to GP)。
文摘In recent years,the progression of stem cell therapies has shown great promise in advancing the nascent field of regenerative medicine.Considering the non-regenerative nature of the mature central nervous system,the concept that“blank”cells could be reprogrammed and functionally integrated into host neural networks remained intriguing.Previous work has also demonstrated the ability of such cells to stimulate intrinsic growth programs in post-mitotic cells,such as neurons.While embryonic stem cells demonstrated great potential in treating central nervous system pathologies,ethical and technical concerns remained.These barriers,along with the clear necessity for this type of treatment,ultimately prompted the advent of induced pluripotent stem cells.The advantage of pluripotent cells in central nervous system regeneration is multifaceted,permitting differentiation into neural stem cells,neural progenitor cells,glia,and various neuronal subpopulations.The precise spatiotemporal application of extrinsic growth factors in vitro,in addition to microenvironmental signaling in vivo,influences the efficiency of this directed differentiation.While the pluri-or multipotency of these cells is appealing,it also poses the risk of unregulated differentiation and teratoma formation.Cells of the neuroectodermal lineage,such as neuronal subpopulations and glia,have been explored with varying degrees of success.Although the risk of cancer or teratoma formation is greatly reduced,each subpopulation varies in effectiveness and is influenced by a myriad of factors,such as the timing of the transplant,pathology type,and the ratio of accompanying progenitor cells.Furthermore,successful transplantation requires innovative approaches to develop delivery vectors that can mitigate cell death and support integration.Lastly,host immune responses to allogeneic grafts must be thoroughly characterized and further developed to reduce the need for immunosuppression.Translation to a clinical setting will involve careful consideration when assessing both physiologic and functional outcomes.This review will highlight both successes and challenges faced when using human induced pluripotent stem cell-derived cell transplantation therapies to promote endogenous regeneration.
文摘A nanomicelle(denoted as TPGS/Ppa)was fabricated via the coassembly of the amphiphilic D-α-tocopheryl polyethylene glycol 1000 succinate(TPGS)and the hydrophobic photosensitizer pyropheophorbide a(Ppa)for photodynamic therapy(PDT).The obtained nanomicelle possessed a spherical structure with a diameter of(18.0±2.2)nm and a zeta potential of approximately -18 mV.Besides,the nanomicelle exhibited excellent photostability,biocompatibility,and phototoxicity,and could effectively reach the tumor region via the enhanced permeability and retention effect.Additionally,it could be found that the TPGS/Ppa nanomicelle exhibited higher phototoxicity against 4T1 murine mammary cancer cells than free Ppa.In the 4T1 tumor-bearing mouse model,the nanomicelle showed an excellent antitumor therapeutic effect.This study develops a new type of photodynamic nanomicelle TPGS/Ppa,which can increase the accumulation of drugs and prolong their tumor retention time,providing a feasible strategy for realizing the delivery of small-molecule hydrophobic drugs and tumor PDT.
文摘Background: Individuals with coronary artery disease (CAD) who have undergone a percutaneous coronary intervention (PCI) are at an increased risk for adverse coronary events. Management with dual antiplatelet therapy (DAPT) has been indicated in this group, however, DAPT significantly increases the risk of bleeding. Objectives: This study aimed to evaluate aspirin versus clopidogrel and aspirin on major adverse cardiac and cerebrovascular events (MACCE) and risk of bleeding in individuals already on DAPT for one year after undergoing PCI. Methods: This was a single-center, double-arm, interventional, prospective study. A total of 956 individuals who had undergone PCI and were on DAPT for a year were enrolled. After calculating DAPT scores, individuals with DAPT scores ≥2 were assigned to the aspirin and clopidogrel group, and those with DAPT scores Results: The group on clopidogrel and aspirin demonstrated a significantly lower rate of MACCE when compared to those on aspirin alone (p = 0.003). However, stent thrombosis, stroke, and myocardial infarction (MI) did not significantly differ in an inter-group comparison. The rate of moderate bleeding was greater in the clopidogrel group;however, the difference was not found to be statistically significant (p = 0.19). Conclusions: Continuing DAPT for a period between 12 and 24 months after PCI in individuals with a DAPT score ≥2 had favorable outcomes in reducing coronary adverse events without resulting in significant bleeding.
文摘Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP remains challenging, particularly in patients with comorbidities or contraindications to standard therapies. Objectives: To evaluate the effectiveness of ozonated water as an adjunctive treatment for EP, delivered using a patented robotic therapy system designed for hygiene and infection prevention in non-self-sufficient patients. Methods: We report the case of a 90-year-old male patient with acute EP who received daily skin treatments with ozonated water in conjunction with supportive care, including rehydration and antibiotics. The intervention was facilitated by the robotic system “COPERNICO Surveillance & Prevention,” which ensured standardized hygiene practices and clinical documentation. Results: Within one week of treatment, the patient showed complete desquamation of necrotic skin, resolution of erythema, and significant metabolic recovery. Fever subsided, renal function improved, and the patient was discharged in stable condition. Follow-up confirmed sustained clinical improvement, and no adverse events were reported. Conclusions: Ozonated water demonstrated efficacy in alleviating the dermatological and systemic manifestations of EP in a high-risk elderly patient. This case highlights the potential of ozone therapy as a safe, cost-effective adjunctive treatment for EP and underscores the utility of robotic systems in managing complex dermatological conditions. Further research is warranted to validate these findings in larger cohorts.
