BACKGROUND The incidence of chronic kidney disease(CKD)has dramatically increased in recent years,with significant impacts on patient mortality rates.Previous studies have identified multiple risk factors for CKD,but ...BACKGROUND The incidence of chronic kidney disease(CKD)has dramatically increased in recent years,with significant impacts on patient mortality rates.Previous studies have identified multiple risk factors for CKD,but they mostly relied on the use of traditional statistical methods such as logistic regression and only focused on a few risk factors.AIM To determine factors that can be used to identify subjects with a low estimated glomerular filtration rate(L-eGFR<60 mL/min per 1.73 m^(2))in a cohort of 1236 Chinese people aged over 65.METHODS Twenty risk factors were divided into three models.Model 1 consisted of demographic and biochemistry data.Model 2 added lifestyle data to Model 1,and Model 3 added inflammatory markers to Model 2.Five machine learning methods were used:Multivariate adaptive regression splines,eXtreme Gradient Boosting,stochastic gradient boosting,Light Gradient Boosting Machine,and Categorical Features+Gradient Boosting.Evaluation criteria included accuracy,sensitivity,specificity,area under the receiver operating characteristic curve(AUC),F-1 score,and balanced accuracy.RESULTS A trend of increasing AUC of each was observed from Model 1 to Model 3 and reached statistical significance.Model 3 selected uric acid as the most important risk factor,followed by age,hemoglobin(Hb),body mass index(BMI),sport hours,and systolic blood pressure(SBP).CONCLUSION Among all the risk factors including demographic,biochemistry,and lifestyle risk factors,along with inflammation markers,UA is the most important risk factor to identify L-eGFR,followed by age,Hb,BMI,sport hours,and SBP in a cohort of elderly Chinese people.展开更多
BACKGROUND This case-control study compared the short-term clinical efficacy of natural orifice specimen extraction surgery(NOSES) using a prolapsing technique and the conventional laparoscopic-assisted approach for l...BACKGROUND This case-control study compared the short-term clinical efficacy of natural orifice specimen extraction surgery(NOSES) using a prolapsing technique and the conventional laparoscopic-assisted approach for low rectal cancer.AIM To further explore the application value of the transanal placement of the anvil and to evaluate the short-term efficacy of NOSES for resecting specimens of low rectal cancer, as well as to provide a theoretical basis for its extensive clinical application.METHODS From June 2015 to June 2018, 108 consecutive laparoscopic-assisted low rectal cancer resections were performed at our center. Among them, 26 specimens were resected transanally using a prolapsing technique(NOSES), and 82 specimens were resected through a conventional abdominal wall small incision(LAP). A propensity score matching method was used to select 26 pairs of matched patients, and their perioperative data were analyzed.RESULTS The baseline data were comparable between the two matched groups. All 52 patients underwent the surgery successfully. The operative time, blood loss,number of harvested lymph nodes, postoperative complication rate,circumferential margin involvement, postoperative follow-up data, and postoperative anal function were not statistically significant. The NOSES group had shorter time to gastrointestinal function recovery(2.6 ± 1.0 d vs 3.4 ± 0.9 d, P= 0.006), shorter postoperative hospital stay(7.1 ± 1.7 d vs 8.3 ± 1.1 d, P = 0.003),lower pain score(day 1: 2.7 ± 1.8 vs 4.6 ± 1.9, day 3: 2.0 ± 1.1 vs 4.1 ± 1.2, day 5: 1.7± 0.9 vs 3.3 ± 1.0, P < 0.001), a lower rate of additional analgesic use(11.5% vs61.5%, P = 0.001), and a higher satisfaction rate in terms of the aesthetic appearance of the abdominal wall after surgery(100% vs 23.1%, P < 0.001).CONCLUSION NOSES for low rectal cancer can achieve satisfactory short-term efficacy and has advantages in reducing postoperative pain, shortening the length of postoperative hospital stay, and improving patients' satisfaction in terms of a more aesthetic appearance of the abdominal wall.展开更多
In recent years,natural orifice specimen extraction surgery(NOSES),a novel minimally invasive surgical technique,has become a focus in the surgical field,and has been initially applied in gastric surgery in many natio...In recent years,natural orifice specimen extraction surgery(NOSES),a novel minimally invasive surgical technique,has become a focus in the surgical field,and has been initially applied in gastric surgery in many national medical centers worldwide.In addition,this new surgical technique was launched in major hospitals in China.With an increasing number of patients who have accepted this new surgical technique,NOSES has provided new prospects for the treatment of gastric cancer(GC),which may achieve a better outcome for both patients and surgeons.More and more experts and scholars from different countries and regions are currently paying close attention to NOSES for the treatment of GC.However,there are only a few reports of its use in GC.This review focuses on the research progress in NOSES for radical gastrectomy in recent years.We also discuss the challenges and prospects of NOSES in clinical practice.展开更多
Fibrosis is the hyperactivation of fibroblasts that results in excessive accumulation of extracellular matrix,which is involved in numerous pathological changes and diseases.Adipose-derived stem cells(ASCs)are promisi...Fibrosis is the hyperactivation of fibroblasts that results in excessive accumulation of extracellular matrix,which is involved in numerous pathological changes and diseases.Adipose-derived stem cells(ASCs)are promising seed cells for regenerative medicine due to their bountiful source,low immunogenicity and lack of ethical issues.Their anti-fibrosis,immunomodulation,angiogenesis and other therapeutic effects have made them suitable for treating fibrosis-related diseases.Here,we review the literature on ASCs treating fibrosis,elaborate and discuss their mechanisms of action,changes in disease environment,ways to enhance therapeutic effects,as well as current preclinical and clinical studies,in order to provide a general picture of ASCs treating fibrotic diseases.展开更多
BACKGROUND Colorectal cancer is one of the most common cancers globally.In China,its prevalence ranks fourth and fifth among females and males,respectively.Presently,treatment of rectal cancer follows a multidisciplin...BACKGROUND Colorectal cancer is one of the most common cancers globally.In China,its prevalence ranks fourth and fifth among females and males,respectively.Presently,treatment of rectal cancer follows a multidisciplinary comprehensive treatment approach involving surgery,radiotherapy,chemotherapy,and targeted therapy.With deepening theoretical and molecular research on colorectal cancer,randomized controlled trials(RCTs)on colorectal cancer have made significant progress.However,many RCTs have shortfalls.AIM To investigate the RCTs of global colorectal cancer spanning from 2008 to 2018.To provide suggestions for conducting Chinese RCTs of colorectal cancer.METHODS PubMed and Web of Science databases were searched to obtain RCTs of colorectal cancer carried out between January 1,2008,and January 1,2018.The bibliometric method was used for statistical analysis of the publication years,countries/regions,authors,institutions,source journals,quoted times,key words,and authors.RESULTS Colorectal cancer RCTs showed an upward trend between 2008 to 2018;the top 10 research institutions in the included literature were from the United States,the United Kingdom,and other countries with a high incidence of colorectal cancer.Most of the related research journals are sponsored by European and American countries.The 15 most cited studies involved international multicenter clinical research,having few participants from Chinese research institutions.Network visualization using key words showed that RCTs on colorectal cancer focus on screening,disease-free survival,drug treatment,surgical methods,clinical trials,quality of life,and prognosis.The result of the coauthorship network analysis showed that Chinese researchers are less involved in international exchanges compared to those from leading publication countries.CONCLUSION High-quality RCTs are increasingly favored by leading international journals.However,there is still a large gap in clinical research between China and leading countries.Researchers should implement standardized and accurate clinical trials,strengthen international multicenter cooperation,and emphasize quality control.展开更多
BACKGROUND Multicystic biliary hamartoma(MCBH)is a rare hamartomatous nodule of the liver,which has recently been described as a new category of hepatic nodular cystic lesion.Most of them are benign.The imaging findin...BACKGROUND Multicystic biliary hamartoma(MCBH)is a rare hamartomatous nodule of the liver,which has recently been described as a new category of hepatic nodular cystic lesion.Most of them are benign.The imaging findings are similar to those of many other hepatic cystic lesions,but MCBH also has some notable features,such as large cysts,smooth cyst walls,and lack of communication with the hepatic duct.Due to the non-specific radiology,preoperative diagnosis is difficult,and is usually diagnosed by postoperative pathology.Complete resection is the best treatment option,and the postoperative prognosis is good.CASE SUMMARY When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.CONCLUSION When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.展开更多
The purpose of this study was to establish a method for measuring the knee valgus angle from the ana- tomical and mechanical axes on three-dimensional reconstruction imaging models, and to use this method for estimati...The purpose of this study was to establish a method for measuring the knee valgus angle from the ana- tomical and mechanical axes on three-dimensional reconstruction imaging models, and to use this method for estimating an average knee valgus angle value for northern Chinese adults. Computed tomographic angiography data in DICOM format for 128 normal femurs from 64 adult subjects were chosen for analysis. After the femur images were subjected to three-dimensional reconstruction, the deepest point in the intercondylar notch （point A）, the midpoint of the medullary cavity 20 cm above the knee-joint line （point B）, and the landmark of the femoral head rotation center （point C） were identified on each three-dimensional model. The knee valgus angle was defined as the angle enclosed by the distal femoral anatomical axis （line AB） and the femoral mechanical axis （line AC）. The average （mean＋SD） of knee valgus angle for the 128 femurs was 6.20°±1.20° （range, 3.05° to 10.64°）. Significant positive correlations were found between the knee valgus angles of the right and left sides and between the knee valgus angle and age. During total knee arthroplasty, choosing a valgus cut angle of approximately 6° may achieve a good result in reestablishing the natural mechanical alignment of the lower extremity for patients of northern Chinese ethnicity. Larger valgus cut angles should be chosen for older patients.展开更多
The soft-hard tissue interface of the human periodontium is responsible for periodontal homeostasis and is essential for normal oral activities.This softhard tissue interface is formed by the direct insertion of fibro...The soft-hard tissue interface of the human periodontium is responsible for periodontal homeostasis and is essential for normal oral activities.This softhard tissue interface is formed by the direct insertion of fibrous ligaments into the bone tissue.It differs from the unique four-layer structure of the fibrocartilage interface.This interface is formed by a combination of physical,chemical,and biological factors.The physiological functions of this interface are regulated by different signaling pathways.The unique structure of this soft-hard tissue interface has inspired scientists to construct biomimetic gradient structures.These biomimetic systems include nanofiber scaffolds,cell sheets,and hydrogels.Exploring methods to repair this soft-hard tissue interface can help solve clinically unresolved problems.The present review examines the structure of the soft-hard tissue interface of the periodontium and the factors that influence the development of this interface.Relevant regulatory pathways and biomimetic reconstruction methods are also presented to provide ideas for future research on interfacial tissue engineering.展开更多
基金Supported by the Kaohsiung Armed Forces General HospitalThe study protocol was approved by the Institutional Review Board of the Tri-Service General Hospital,National Defense Medical Center(IRB No.:KAFGHIRB 109-46).
文摘BACKGROUND The incidence of chronic kidney disease(CKD)has dramatically increased in recent years,with significant impacts on patient mortality rates.Previous studies have identified multiple risk factors for CKD,but they mostly relied on the use of traditional statistical methods such as logistic regression and only focused on a few risk factors.AIM To determine factors that can be used to identify subjects with a low estimated glomerular filtration rate(L-eGFR<60 mL/min per 1.73 m^(2))in a cohort of 1236 Chinese people aged over 65.METHODS Twenty risk factors were divided into three models.Model 1 consisted of demographic and biochemistry data.Model 2 added lifestyle data to Model 1,and Model 3 added inflammatory markers to Model 2.Five machine learning methods were used:Multivariate adaptive regression splines,eXtreme Gradient Boosting,stochastic gradient boosting,Light Gradient Boosting Machine,and Categorical Features+Gradient Boosting.Evaluation criteria included accuracy,sensitivity,specificity,area under the receiver operating characteristic curve(AUC),F-1 score,and balanced accuracy.RESULTS A trend of increasing AUC of each was observed from Model 1 to Model 3 and reached statistical significance.Model 3 selected uric acid as the most important risk factor,followed by age,hemoglobin(Hb),body mass index(BMI),sport hours,and systolic blood pressure(SBP).CONCLUSION Among all the risk factors including demographic,biochemistry,and lifestyle risk factors,along with inflammation markers,UA is the most important risk factor to identify L-eGFR,followed by age,Hb,BMI,sport hours,and SBP in a cohort of elderly Chinese people.
基金Supported by National Natural Science Foundation of China,No.81500430 and No.U1304802(to Lin XH)Basic and Frontier Technology Research Program of Henan Province,No.162300410101(to Hu JH)+1 种基金Wu Jieping Medical Foundation of Clinical Research Special Fund,No.320.2710.1836(to Hu JH)The Henan Science and Technology Planning Project,No.182102310544(to Lin XH)
文摘BACKGROUND This case-control study compared the short-term clinical efficacy of natural orifice specimen extraction surgery(NOSES) using a prolapsing technique and the conventional laparoscopic-assisted approach for low rectal cancer.AIM To further explore the application value of the transanal placement of the anvil and to evaluate the short-term efficacy of NOSES for resecting specimens of low rectal cancer, as well as to provide a theoretical basis for its extensive clinical application.METHODS From June 2015 to June 2018, 108 consecutive laparoscopic-assisted low rectal cancer resections were performed at our center. Among them, 26 specimens were resected transanally using a prolapsing technique(NOSES), and 82 specimens were resected through a conventional abdominal wall small incision(LAP). A propensity score matching method was used to select 26 pairs of matched patients, and their perioperative data were analyzed.RESULTS The baseline data were comparable between the two matched groups. All 52 patients underwent the surgery successfully. The operative time, blood loss,number of harvested lymph nodes, postoperative complication rate,circumferential margin involvement, postoperative follow-up data, and postoperative anal function were not statistically significant. The NOSES group had shorter time to gastrointestinal function recovery(2.6 ± 1.0 d vs 3.4 ± 0.9 d, P= 0.006), shorter postoperative hospital stay(7.1 ± 1.7 d vs 8.3 ± 1.1 d, P = 0.003),lower pain score(day 1: 2.7 ± 1.8 vs 4.6 ± 1.9, day 3: 2.0 ± 1.1 vs 4.1 ± 1.2, day 5: 1.7± 0.9 vs 3.3 ± 1.0, P < 0.001), a lower rate of additional analgesic use(11.5% vs61.5%, P = 0.001), and a higher satisfaction rate in terms of the aesthetic appearance of the abdominal wall after surgery(100% vs 23.1%, P < 0.001).CONCLUSION NOSES for low rectal cancer can achieve satisfactory short-term efficacy and has advantages in reducing postoperative pain, shortening the length of postoperative hospital stay, and improving patients' satisfaction in terms of a more aesthetic appearance of the abdominal wall.
基金Supported by Chongqing Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science and Technology Bureau),No.2022ZDXM016.
文摘In recent years,natural orifice specimen extraction surgery(NOSES),a novel minimally invasive surgical technique,has become a focus in the surgical field,and has been initially applied in gastric surgery in many national medical centers worldwide.In addition,this new surgical technique was launched in major hospitals in China.With an increasing number of patients who have accepted this new surgical technique,NOSES has provided new prospects for the treatment of gastric cancer(GC),which may achieve a better outcome for both patients and surgeons.More and more experts and scholars from different countries and regions are currently paying close attention to NOSES for the treatment of GC.However,there are only a few reports of its use in GC.This review focuses on the research progress in NOSES for radical gastrectomy in recent years.We also discuss the challenges and prospects of NOSES in clinical practice.
基金Supported by the National Natural Science Foundation of China,No.81670444and the CAMS Innovation Fund for Medical Sciences(CIFMS),No.2020-I2MC&T-A-004.
文摘Fibrosis is the hyperactivation of fibroblasts that results in excessive accumulation of extracellular matrix,which is involved in numerous pathological changes and diseases.Adipose-derived stem cells(ASCs)are promising seed cells for regenerative medicine due to their bountiful source,low immunogenicity and lack of ethical issues.Their anti-fibrosis,immunomodulation,angiogenesis and other therapeutic effects have made them suitable for treating fibrosis-related diseases.Here,we review the literature on ASCs treating fibrosis,elaborate and discuss their mechanisms of action,changes in disease environment,ways to enhance therapeutic effects,as well as current preclinical and clinical studies,in order to provide a general picture of ASCs treating fibrotic diseases.
基金Key Research and Promotion Projects of Henan Province,No.202102310094Wu Jieping Medical Foundation of Clinical Research Special Fund,No.320.2710.1836+1 种基金Henan University Graduate“Excellence Program”,No.SYL18060141Henan Province Medical Science and Technology Project Joint Development Project,No.2018020331.
文摘BACKGROUND Colorectal cancer is one of the most common cancers globally.In China,its prevalence ranks fourth and fifth among females and males,respectively.Presently,treatment of rectal cancer follows a multidisciplinary comprehensive treatment approach involving surgery,radiotherapy,chemotherapy,and targeted therapy.With deepening theoretical and molecular research on colorectal cancer,randomized controlled trials(RCTs)on colorectal cancer have made significant progress.However,many RCTs have shortfalls.AIM To investigate the RCTs of global colorectal cancer spanning from 2008 to 2018.To provide suggestions for conducting Chinese RCTs of colorectal cancer.METHODS PubMed and Web of Science databases were searched to obtain RCTs of colorectal cancer carried out between January 1,2008,and January 1,2018.The bibliometric method was used for statistical analysis of the publication years,countries/regions,authors,institutions,source journals,quoted times,key words,and authors.RESULTS Colorectal cancer RCTs showed an upward trend between 2008 to 2018;the top 10 research institutions in the included literature were from the United States,the United Kingdom,and other countries with a high incidence of colorectal cancer.Most of the related research journals are sponsored by European and American countries.The 15 most cited studies involved international multicenter clinical research,having few participants from Chinese research institutions.Network visualization using key words showed that RCTs on colorectal cancer focus on screening,disease-free survival,drug treatment,surgical methods,clinical trials,quality of life,and prognosis.The result of the coauthorship network analysis showed that Chinese researchers are less involved in international exchanges compared to those from leading publication countries.CONCLUSION High-quality RCTs are increasingly favored by leading international journals.However,there is still a large gap in clinical research between China and leading countries.Researchers should implement standardized and accurate clinical trials,strengthen international multicenter cooperation,and emphasize quality control.
文摘BACKGROUND Multicystic biliary hamartoma(MCBH)is a rare hamartomatous nodule of the liver,which has recently been described as a new category of hepatic nodular cystic lesion.Most of them are benign.The imaging findings are similar to those of many other hepatic cystic lesions,but MCBH also has some notable features,such as large cysts,smooth cyst walls,and lack of communication with the hepatic duct.Due to the non-specific radiology,preoperative diagnosis is difficult,and is usually diagnosed by postoperative pathology.Complete resection is the best treatment option,and the postoperative prognosis is good.CASE SUMMARY When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.CONCLUSION When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.
基金supported by the Norman Bethune B Program of Jilin University(No.2012216)the Science and Technology Development Program of Jilin Province(No.20100750),China
文摘The purpose of this study was to establish a method for measuring the knee valgus angle from the ana- tomical and mechanical axes on three-dimensional reconstruction imaging models, and to use this method for estimating an average knee valgus angle value for northern Chinese adults. Computed tomographic angiography data in DICOM format for 128 normal femurs from 64 adult subjects were chosen for analysis. After the femur images were subjected to three-dimensional reconstruction, the deepest point in the intercondylar notch （point A）, the midpoint of the medullary cavity 20 cm above the knee-joint line （point B）, and the landmark of the femoral head rotation center （point C） were identified on each three-dimensional model. The knee valgus angle was defined as the angle enclosed by the distal femoral anatomical axis （line AB） and the femoral mechanical axis （line AC）. The average （mean＋SD） of knee valgus angle for the 128 femurs was 6.20°±1.20° （range, 3.05° to 10.64°）. Significant positive correlations were found between the knee valgus angles of the right and left sides and between the knee valgus angle and age. During total knee arthroplasty, choosing a valgus cut angle of approximately 6° may achieve a good result in reestablishing the natural mechanical alignment of the lower extremity for patients of northern Chinese ethnicity. Larger valgus cut angles should be chosen for older patients.
基金Shaanxi Key Scientific and Technological Innovation Team of China,Grant/Award Number:2020TD-033National Key Research and Development Program of China,Grant/Award Numbers:2022YFC2405900,2022YFC2405901+1 种基金National Natural Science Foundation of China,Grant/Award Numbers:81870805,82325012National Clinical Research Center for Oral Diseases of China,Grant/Award Number:LCA202004。
文摘The soft-hard tissue interface of the human periodontium is responsible for periodontal homeostasis and is essential for normal oral activities.This softhard tissue interface is formed by the direct insertion of fibrous ligaments into the bone tissue.It differs from the unique four-layer structure of the fibrocartilage interface.This interface is formed by a combination of physical,chemical,and biological factors.The physiological functions of this interface are regulated by different signaling pathways.The unique structure of this soft-hard tissue interface has inspired scientists to construct biomimetic gradient structures.These biomimetic systems include nanofiber scaffolds,cell sheets,and hydrogels.Exploring methods to repair this soft-hard tissue interface can help solve clinically unresolved problems.The present review examines the structure of the soft-hard tissue interface of the periodontium and the factors that influence the development of this interface.Relevant regulatory pathways and biomimetic reconstruction methods are also presented to provide ideas for future research on interfacial tissue engineering.
