Imaging characteristics and treatment strategies for carotid artery occlusion caused by skull base fracture

The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of traumatic brain injury.Traumatic skull base fracture is one of the causes of traumatic internal carotid artery occlusion.If not detected early and treated in time,the prognosis of patients is poor.This editorial makes a relevant analysis of this disease.

Treatment strategies for nodal and gastrointestinal follicular lymphoma:Current status and future development

In recent years,therapies for follicular lymphoma (FL) have steadily improved.A series of phase Ⅲ trials comparing the effect of rituximab with chemotherapy vs chemotherapy alone in treating FL have indicated significant improvements in progression-free survival (PFS) and overall survival.Recent studies have found that prolonged response durations and PFS were obtained with maintenance therapy using rituximab or interferon after completion of first line therapy.For patients with relapsed or refractory FL,phase Ⅱ studies have assessed the effectiveness of combination therapies using a Toll-like receptor-9 agonist (1018ISS),oblimersen sodium (a Bcl-2 antisense oligonucleotide),bendamustine,and rituximab,as well as veltuzumab,a new humanized anti-CD20 antibody,and epratuzumab.In addition,the effectiveness of yttrium-90 ibritumomab tiuxetan and iodine-131 tositumomab as radioimmunotherapies has been reported.Furthermore,three phase Ⅲ studies on an idiotype vaccine are near completion.Unfortunately,these vaccines,which appeared highly effective in phase Ⅰ and Ⅱ trials,do not appear to result in prolonged PFS.This report will summarize the current knowledge on therapies for treatment of FL,and will conclude with a brief discussion of feasiblefuture options for effective treatments.Lastly,we added descriptions of the management of gastrointestinal FL,which is considered to be controversial because it is rare.

Age-at-injury effects of microglial activation following traumatic brain injury： implications for treatment strategies

Traumatic brain injury（TBI）remains one of the leading causes of disability and death in infants and children.Studies have demonstrated that the youngest age group（especially≤4 years old）exhibit worse functional outcome following moderate to severe TBI compared to older children or adults（Anderson et al.,2005;Emami et al.,2017）.These data suggest that age-at-injury may be an important determinant of outcome,

Analysis of treatment strategies of traditional Chinese medicine for COVID-19 in tropical regions based on the pathogens of dampness and heat

Objective:To summarize the treatment strategies of Traditional Chinese Medicine(TCM)for COVID-19 in tropical regions based on the pathogens of dampness and heat.Methods:For heat pathogen,analyzing heat in the superficies,lung and Yang Ming based on the different locations.Based on the progress of the disease,analyzing the stage of toxin and Qi deficiency induced by heat.For dampness pathogen,analyzing endogenous and external dampness based on the different locations.Analyzing dampness pathogen's special disease location—Moyuan and special symptom of dry cough with less sputum caused by sticky and stagnant characteristic of dampness.Results:The treatment strategies for heat and dampness pathogen were summarized.Conclusion:In the tropics,the pathogens of dampness and heat occur frequently and clinical treatments need to be dialectical.

Advances in diagnosis and treatment strategies of thymic carcinoid

Thymic carcinoid is a rare neuroendocrine tumor with unclear risk factors and controversial classifications. Its clinical manifestations vary from asymptomatic to many nonspecific symptoms,among which endocrine abnormality seems to be associated with poor prognosis. Quantitative and qualitative analysis of ACTH and prognosis could become a topic in the future. Image studies show no specificity both in CT and PET/CT,but are of great value in clinical staging of thymic carcinoid. Ki67 has been found to be a powerful tool for grading neuroendocrine tumors and further studies should be made. The diagnosis of thymic carcinoid mainly depends on pathology and immunohistochemistry plays a key role in differential diagnosis at present. Radical resection is the first choice in treatment,and target therapy becomes possible with the development in molecular pathology. However,since the rarity of thymic carcinoid,there is no practical clinical staging or standard guideline to instruct clinical practice. Thus,support of International Thymic Malignancy Interest Group( ITMIG) seems to be of great significance in case collection and resource sharing of thymic diseases. In this paper,we are going to put forward a strategy available in clinical application for diagnoisis and treatment of thymic carcinoid by using a new clinical staging system.

The clinical features and treatment strategies of thoracic ossification of posterior longitudinal ligament

Objective To study the clinical features and surgical strategies of thoracic spinal stenosis caused by ossification of posterior longitudinal ligament(OPLL).Methods From January 2004 to March 2009,21 cases of tho-racic spinal stenosis

Controversies around the treatment of peritoneal metastases of colorectal cancer

In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology.Surgical resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal origin.Nevertheless,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the liver.Another tool is required in those patients to achieve more local control of the disease.Surgical groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin C.These patients present with complex surgical issues to manage,and consequently a large burden of complications has to be anticipated.Therefore,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

Treatment strategies for Parkinson's disease

Parkinson’s disease （PD） is caused by progressive degeneration of dopamine （DA） neurons in the substantia nigra pars compacta （SNpc）, resulting in the deficiency of DA in the striatum. Thus, symptoms are developed, such as akinesia, rigidity and tremor. The aetiology of neuronal death in PD still remains unclear. Several possible mechanisms of the degeneration of dopaminergic neurons are still elusive. Various mechanisms of neuronal degeneration in PD have been proposed, including formation of free radicals, oxidative stress, mitochondrial dysfunction, excitotoxicity, calcium cytotoxicity, trophic factor deficiency, inflammatory processes, genetic factors, environmental factors, toxic action of nitric oxide, and apoptosis. All these factors interact with each other, inducing a vicious cycle of toxicity causing neuronal dysfunction, atrophy and finally cell death. Considerable evidence suggests that free radicals and oxidative stress may play key roles in the pathogenesis of PD. However, currently, drug therapy cannot completely cure the disease. DA replacement therapy with levodopa （L-Dopa）, although still being a gold standard for symptomatic treatment of PD, only alleviates the clinical symptoms. Furthermore, patients usually experience severe side effects several years after the L-Dopa treatment. Until now, no therapy is available to stop or at least slow down the neurodegeneration in patients. Therefore, efforts are made not only to improve the effect of L-Dopa treatment for PD, but also to investigate new drugs with both antiparkinsonian and neuroprotective effects. Here, the advantages and limitations of current and future therapies for PD were dicussed. Current therapies include dopaminergic therapy, DA agonists, MAO-B inhibitor, COMT inhibitors, anticholinergic drugs, surgical procedures such as pallidotomy and more specifically deep brain stimulation of the globus pallidus pars interna （GPi） or subthalamic nucleus （STN）, and stem cell transplantation.

Advances in treatment strategies for COVID-19:Insights from other coronavirus diseases and prospects

The coronavirus disease 2019(COVID‐19)pandemic is the third human disease outbreak caused by an emerging coronavirus in the 21st century.Caused by severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2),the COVID‐19 pandemic has been the most devastating,with millions of deaths.Medical countermeasures are needed to limit the number of infections and fatalities.Here,we discuss advances in clinical and research‐based treatment methods for SARS‐CoV‐2 that were initially derived from treatments for other coronaviruses.Recent advances in SARS‐CoV‐2 treatments,from traditional drugs and immunotherapies to artificial intelligence to predict potential future treatment methods,are summarized and discussed.

Drug resistance mechanisms in cancers:Execution of prosurvival strategies

One of the quintessential challenges in cancer treatment is drug resistance.Several mechanisms of drug resistance have been described to date,and new modes of drug resistance continue to be discovered.The phenomenon of cancer drug resistance is now widespread,with approximately 90% of cancer-related deaths associated with drug resistance.Despite significant advances in the drug discovery process,the emergence of innate and acquired mechanisms of drug resistance has impeded the progress in cancer therapy.Therefore,understanding the mechanisms of drug resistance and the various pathways involved is integral to treatment modalities.In the present review,I discuss the different mechanisms of drug resistance in cancer cells,including DNA damage repair,epithelial to mesenchymal transition,inhibition of cell death,alteration of drug targets,inactivation of drugs,deregulation of cellular energetics,immune evasion,tumor-promoting inflammation,genome instability,and other contributing epigenetic factors.Furthermore,I highlight available treatment options and conclude with future directions.

The current role of dendritic cells in the progression and treatment of colorectal cancer

Colorectal cancer(CRC)is the third most common cancer and the second leading cause of cancer-related deaths worldwide.Dendritic cells(DCs)constitute a heterogeneous group of antigen-presenting cells that are important for initiating and regulating both innate and adaptive immune responses.As a crucial component of the immune system,DCs have a pivotal role in the pathogenesis and clinical treatment of CRC.DCs cross-present tumor-related antigens to activate T cells and trigger an antitumor immune response.However,the antitumor immune function of DCs is impaired and immune tolerance is promoted due to the presence of the tumor microenvironment.This review systematically elucidates the specific characteristics and functions of different DC subsets,as well as the role that DCs play in the immune response and tolerance within the CRC microenvironment.Moreover,how DCs contribute to the progression of CRC and potential therapies to enhance antitumor immunity on the basis of existing data are also discussed,which will provide new perspectives and approaches for immunotherapy in patients with CRC.

Depression and anxiety disorders in chronic obstructive pulmonary disease patients:Prevalence,disease impact,treatment

Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that often co-occurs with depression and anxiety,worsening disease progression and reducing quality of life.A thorough review of the existing literature was conducted,including searches in PubMed,Embase,PsycINFO,and Cochrane Library databases up to 2024.This review encompasses a critical analysis of studies reporting on the prevalence,impact,and management of depression and anxiety in COPD patients.We found a high prevalence of psychological comorbidities in COPD patients,which were associated with worse disease outcomes,including increased exacerbations,hospitalizations,and reduced health-related quality of life.Diagnosing and managing these conditions is complex due to overlapping symptoms,necessitating a comprehensive patient care approach.While there has been progress in understanding COPD comorbidities,there is a need for more personalized and integrated treatments.This review emphasizes the need for increased awareness,tailored treatment plans,and further research for effective interventions.

Unlocking the diagnostic potential of vascular endothelial growth factor and interleukin-17: Advancing early detection strategies for hepatocellular carcinoma

Tian et al investigated the diagnostic value of serum vascular endothelial growth factor(VEGF)and interleukin-17(IL-17)in primary hepatocellular carcinoma(PHC).Their retrospective study,published in the World Journal of Gastrointestinal Surgery,revealed that the serum levels of VEGF and IL-17 are significantly elevated in PHC patients compared with healthy controls.These biomarkers are closely associated with pathological features such as tumor metastasis and clinical tumor node metastasis stage.A receiver operating characteristic analysis further confirmed the diagnostic efficacy thereof,suggesting that VEGF and IL-17 could serve as valuable tools for early detection and treatment guidance.This study underscores the potential of integrating these biomarkers into clinical practice to increase diagnostic accuracy and improve patient management in PHC.

Clinical Presentation and Treatment Strategies for Ulcerative Colitis： A Retrospective Study of 247 Inpatients

Objective: Complementary and alternative medicine, particularly herbal therapy, is widely used by patients with ulcerative colitis(UC), but controlled data are limited. To describe the clinical presentation and treatment strategies for UC in inpatients from Shanghai, China and to improve the therapeutic outcomes for patients with UC. Methods: Medical records from 247 patients with UC who were admitted to Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between January 2008 and June 2013 were analyzed for gender, age, course of the disease, clinical type, extent and severity of the disease, treatment strategies, and therapeutic outcomes. Results: Gender ratios and disease onset of inpatients with UC in the Shanghai area were consistent with other reports in the literature. In contrast to previous studies, most patients exhibited disease of the left colon, over half of the patients had problems of the rectum or sigmoid colon, and most patients had either mild or moderate UC. Comparison of Sutherland Disease Actirity Index scores for patients treated with Chinese medicine(CM) and those treated with integrated CM and Western medicine revealed significant reductions in scores for both groups after treatment(P<0.01), with no significant difference in therapeutic effects between groups(P=0.938). Conclusions: Herbal medicine has been widely used in patients with mild to moderate disease and as adjunct therapy in patients with moderate to severe disease. Therefore, the strategy was proposed for the treatment of UC with CM therapy based on 2 steps according to the stage of the disease, even in the clinical setting.

Challenges and solutions in patient treatment strategies for stage Ⅱ colon cancer

Colorectal cancer remains one of the most common cancers worldwide and,despite improvements in treatment options for late-stage metastatic cancer,there are still questions surrounding how best to treat early-stage disease patients.Some recent advances have been made in the staging of cancer and improving the risk assessment of strategies for patient treatment.A number of high-risk features have been proposed that may help to stratify stage Ⅱ cancer patients into groups that will truly benefit from adjuvant chemotherapy.Diagnostic tests are becoming available to measure these biomarkers,utilizing both currently available and novel technologies.This review will describe the challenges in treatment decisions for early-stage colon cancer and how personalized medicine can assist clinicians in making the best treatment choices for patients with stage Ⅱ colon cancer in particular.

Treatment strategy and therapy based on immune response in patients with gastric cancers

In this editorial,we highlight the significance of a retrospective study“Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis”performed by Liu et al.The authors utilized data collected from gastric cancer(GC)patients and assessed immunotherapy effectiveness and survival status.They found significant differences in treatment response.Because immunotherapy seems to be a beneficial strategy for advanced GC patients,strati-fication of the data based on metastasis status may further improve treatment strategies.

Strategies of surgical treatment of the spinal metastatic tumors

Objective To study the clinical features, surgical treatments and the prognosis of the 103 patients with the metastatic tumors in the spine. Methods From Jan. 1996 to Dec. 2001,103 cases were treated by operation in our department, there were 62 males and 41 females, aging from 33 to 79 years old (average,59 years). The lesions were located at cervical spines in 34 cases, thoracic spines in 39,lumbar spines in 25 and sacrum in 5. The patients underwnet anterior, prosterior,combined or staged antero-posterior operations based on the location of lesions in the spine. Most of the patients were adopted vertebral reconstruction and internal fixation depending on the conditions. Preoperative clinical evaluation included of general conditions,X-ray films,CT scan.MRI and ECT in odrer to decide the endurance of the patient to the surgical treatment. The operation was only considered when the patient could have the expected survival time more than 6 months. Operative indications, surgical methods and prognosis

Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment

Non-classical manifestations of autoimmune hepatitis can delay diagnosis and treatment. Our aims were to describe the clinical phenotypes that can confound the diagnosis, detail scoring systems that can ensure their recognition, and outline advances in treatment that can improve their outcome. Prime source and review articles in English were selected throuqh Medline from 1970-2008 and assimilated into personal libraries spanning 32 years. Acute severe or asymptomatic presentations and atypical histological findings,including centrilobular zone 3 necrosis and concurrent bile duct changes, are compatible with the diagnosis. Cholangiographic abnormalities may be present in children and adults with the disease, and autoimmune hepatitis must be considered in patients without autoantibodies or with antimitochondrial antibodies and no other cholestatic features. Asymptomatic patients frequently become symptomatic; mild disease can progress; and there are no confident indices that justify withholding treatment. Two diagnostic scoring systems with complementary virtues have been developed to evaluate patients with confusing features. Normal liver tests and tissue constitute the optimal end point of treatment, and the first relapse is an indication for long- term azathioprine therapy. Cyclosporine, tacrolimus and mycophenolate mofetil are promising salvage therapies,and budesonide with azathioprine may be a superior frontline treatment. We conclude that the non-classical phenotypes of autoimmune hepatitis can be recognized promptly, diagnosed accurately, and treated effectively.

Assessing the effects of alternative fuel treatments to reduce wildfire exposure

Effective landscape-scale fuel management strategies are essential for reducing wildfire risk in Mediterranean fire-prone areas.In this study,the minimum travel time(MTT)fire-spread algorithm as implemented in FlamMap was applied to assess the potential of alternative fuel treatments for lowering wildfire losses in a 5,740-ha study area in eastern Sardinia,Italy.Twenty-seven wildfires at 10-m resolution were simulated considering three wind speeds(15,18,and 21 km h-1)to compare fuel treatments:no treatment(NT),irrigated agroforestry areas with shrub clearing(T1),prescribed fire in eucalyptus stands(T2),and irrigated grasslands(T3).The simulations replicated a recent large wildfire that occurred in the study area(Orrìwildfire,2019)and considered the weather and fuel moisture conditions associated with this event.The average wildfire exposure outputs(burned area,probability of burning,conditional flame length,potential crown fire occurrence,and surfaces withflame lengths above 2.5 m)decreased after fuel treatments,compared to no treatment.T1 was the most effective strategy in mitigating wildfire hazards and provided the most significant performance for several wildfire exposure indicators.Treating only 0.5%of the study area(~30 ha)resulted in a decrease in all wildfire exposure metrics to~10%within the study area.In addition,the total surface characterized by high flame length(average>2.5 m)was the lowest in the T1 treatment.This study can help land and fire managers optimize fuel treatment opportunities and wildfire risk mitigation strategies in Mediterranean areas.

The Evaluation Characteristics of Type B Aortic Intramural Hematoma and Ten Years Treatment Outcomes

Background: Type B aortic intramural hematoma (IMH-B) is recognized as a subset of aortic dissection. The evolution of uncomplicated IMH-B is very difficult to predict. How and when to deal with this disease is unclear. The present study constructed two models to explore this problem. One is the morphology evolution model, which explored the risk factors and predictors for the IMH-B patients. Another is the predictive model confirmed the predictors and the time for invasive treatment of uncomplicated IMH-B patients. Objective: To explore the evolution predictors and detect the time for invasive treatment of uncomplicated IMH-B patients. Methods: Themorphology evolution model demonstrated that all 81 patients were diagnosis with CTA images. The initial and follow-up data were retrospectively studied. The evolution data were collection and measurement from initial and follow-up CTA images data. The predictive model showed that predictors of progression were detected with cox regression analysis. Results: All 81IMH-B patients were followed-up ranged from 1.2 to 36 months (median, 22 months). 26 patients accepted invasive treatment (24 underwent TEVAR and 2 underwent Surgery). 55 patients received medical treatment. Invasive treatment (IT) group overall events are 1/26 (3.8%); medical treatment (MT) group overall events are 33/55 (60.0%); IT group vs. MT group: p < 0.001. Moreover, we found that most events related aorta occurred within 30 days. Multivariate Cox regression analysis MDAD (hazard ratio, 3.58;95% CI, 1.25- 5.78;p < 0.001), MDAHT (hazard ratio, 4.26;95% CI, 0.85 - 7.84;p < 0.001), and IMH with PAU (hazard ratio, 3.58;95% CI, 1.02 - 5.63;p < 0.001) were confirmed as the independent predictors. Conclusions: MDAD > 45 mm, MDAHT > 10 mm, and IMH with PAU may be the important predictors for uncomplicated IMH-B patients. Most adverse aorta related events occurred within 30 days. It would be careful follow-up, closely observe for these patients within 30 days, and take necessary treatment strategies in time.