BACKGROUND Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension(LSPH).The hemorrhage is fatal and requires safe and effective interventions.AIM To evaluate the clinical sa...BACKGROUND Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension(LSPH).The hemorrhage is fatal and requires safe and effective interventions.AIM To evaluate the clinical safety and efficacy of modified endoscopic ultrasound(EUS)-guided selective N-butyl-2-cyanoacrylate(NBC)injections for gastric variceal hemorrhage in LSPH.METHODS A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted.Preoperative EUS evaluations were performed.Enrolled patients were divided into modified and conventional groups according to the NBC injection technique.The final selection of NBC injection technique depended on the patients’preferences and clinical status.The technical and clinical success rates,operation time,NBC doses,perioperative complications,postoperative hospital stay,and recurrent bleeding rates were analyzed,respectively.RESULTS A total of 27 patients were enrolled.No statistically significant differences were observed between the two groups regarding baseline characteristics.In comparison to patients in the conventional group,patients in the modified group demonstrated significantly reduced NBC doses(2.0±0.6 mL vs 3.1±1.0 mL;P=0.004)and increased endoscopic operation time(71.9±11.9 min vs 22.5±6.7 min;P<0.001).Meanwhile,the two groups had no significant difference in the technical and clinical success rates,perioperative complications,postoperative hospital stay,and recurrent bleeding rates.CONCLUSION Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage,with advantages of reduced injection dose and no radiation risk.Drawbacks were time consumption and technical challenge.展开更多
Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice ...Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice is brain region–specific,particularly involving the corticolimbic system,including the ventral tegmental area,nucleus accumbens,prefrontal cortex,amygdala,and hippocampus.Determining how brain-derived neurotrophic factor participates in stress processing in different brain regions will deepen our understanding of social stress psychopathology.In this review,we discuss the expression and regulation of brain-derived neurotrophic factor in stress-sensitive brain regions closely related to the pathophysiology of depression.We focused on associated molecular pathways and neural circuits,with special attention to the brain-derived neurotrophic factor–tropomyosin receptor kinase B signaling pathway and the ventral tegmental area–nucleus accumbens dopamine circuit.We determined that stress-induced alterations in brain-derived neurotrophic factor levels are likely related to the nature,severity,and duration of stress,especially in the above-mentioned brain regions of the corticolimbic system.Therefore,BDNF might be a biological indicator regulating stress-related processes in various brain regions.展开更多
BACKGROUND With the development of percutaneous coronary intervention(PCI),the number of interventional procedures without implantation,such as bioresorbable stents(BRS)and drug-coated balloons,has increased annually....BACKGROUND With the development of percutaneous coronary intervention(PCI),the number of interventional procedures without implantation,such as bioresorbable stents(BRS)and drug-coated balloons,has increased annually.Metal drug-eluting stent unloading is one of the most common clinical complications.Comparatively,BRS detachment is more concealed and harmful,but has yet to be reported in clinical research.In this study,we report a case of BRS unloading and successful rescue.This is a case of a 59-year-old male with the following medical history:“Type 2 diabetes mellitus”for 2 years,maintained with metformin extended-release tablets,1 g PO BID;“hypertension”for 20 years,with long-term use of metoprolol sustained-release tablets,47.5 mg PO QD;“hyperlipidemia”for 20 years,without regular medication.He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours,on February 20,2022 at 15:35.Electrocardiogram results showed sinus rhythm,ST-segment elevation in leads I and avL,and poor R-wave progression in leads V1–3.High-sensitivity troponin I level was 4.59 ng/mL,indicating an acute high lateral wall myocardial infarction.The patient’s family requested treatment with BRS,without implanta-tion.During PCI,the BRS became unloaded but was successfully rescued.The patient was followed up for 2 years;he had no episodes of angina pectoris and was in generally good condition.CONCLUSION We describe a case of a 59-year-old male experienced BRS unloading and successful rescue.By analyzing images,the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations.We discuss preventive measures for BRS unloading.展开更多
The hypothalamic-pituitary-adrenal axis regulates the secretion of glucoco rticoids in response to environmental challenges.In the brain,a nuclear receptor transcription fa ctor,the glucocorticoid recepto r,is an impo...The hypothalamic-pituitary-adrenal axis regulates the secretion of glucoco rticoids in response to environmental challenges.In the brain,a nuclear receptor transcription fa ctor,the glucocorticoid recepto r,is an important component of the hypothalamicpituitary-a d renal axis's negative feedback loop and plays a key role in regulating cognitive equilibrium and neuroplasticity.The glucoco rticoid receptor influences cognitive processes,including glutamate neurotransmission,calcium signaling,and the activation of brain-derived neurotrophic factor-mediated pathways,through a combination of genomic and non-genomic mechanisms.Protein interactions within the central nervous system can alter the expression and activity of the glucocorticoid receptor,there by affecting the hypothalamic-pituitary-a d renal axis and stress-related cognitive functions.An appropriate level of glucocorticoid receptor expression can improve cognitive function,while excessive glucocorticoid receptors or long-term exposure to glucoco rticoids may lead to cognitive impairment.Patients with cognitive impairment-associated diseases,such as Alzheimer's disease,aging,depression,Parkinson's disease,Huntington's disease,stroke,and addiction,often present with dysregulation of the hypothalamic-pituitary-adrenal axis and glucocorticoid receptor expression.This review provides a comprehensive overview of the functions of the glucoco rticoid receptor in the hypothalamic-pituitary-a d renal axis and cognitive activities.It emphasizes that appropriate glucocorticoid receptor signaling fa cilitates learning and memory,while its dysregulation can lead to cognitive impairment.This provides clues about how glucocorticoid receptor signaling can be targeted to ove rcome cognitive disability-related disorders.展开更多
Global warming and algal blooms have been two of the most pressing problems faced by the world today.In recent decades,numerous studies indicated that global warming promoted the expansion of algal blooms.However,rese...Global warming and algal blooms have been two of the most pressing problems faced by the world today.In recent decades,numerous studies indicated that global warming promoted the expansion of algal blooms.However,research on how algal blooms respond to global warming is scant.Global warming coupled with eutrophication promoted the rapid growth of phytoplankton,which resulted in an expansion of algal blooms.Algal blooms are affected by the combined effects of global warming,including increases in temperatures,CO_(2)concentration,and nutrient input to aquatic systems by extreme weather events.Since the growth of phytoplankton requires CO_(2),they appear to act as a carbon sink.Unfortunately,algal blooms will release CH4,CO_(2),and inorganic nitrogen when they die and decompose.As substrate nitrogen increases from decompose algal biomass,more N2O will be released by nitrification and denitrification.In comparison to CO_(2),CH4has 28-fold and N2O has 265-fold greenhouse effect.Moreover,algal blooms in the polar regions may contribute to melting glaciers and sea ice(will release greenhouse gas,which contribute to global warming)by reducing surface albedo,which consequently would accelerate global warming.Thus,algal blooms and global warming could form feedback loops which prevent human survival and development.Future researches shall examine the mechanism,trend,strength,and control strategies involved in this mutual feedback.Additionally,it will promote global projects of environmental protection combining governance greenhouse gas emissions and algal blooms,to form a geoengineering for regulating the cycles of carbon,nitrogen,and phosphorus.展开更多
The challenge of diagnosis delay in inflammatory bowel disease(IBD)has emerged as a significant concern for both patients and healthcare professionals.The widely accepted notion that there is an extended time frame fr...The challenge of diagnosis delay in inflammatory bowel disease(IBD)has emerged as a significant concern for both patients and healthcare professionals.The widely accepted notion that there is an extended time frame from the onset of symptoms to the definitive diagnosis is often attributed to the heterogeneity of IBD and the non-specificity of clinical manifestations.Specific to patients with Crohn’s disease,the issue of delayed diagnosis appears to be more pronounced across different regions globally.The intricate interplay of real-world factors has led to debates regarding the primary contributors to these diagnostic delays.Drawing a comparison solely between patients and physicians and implicating the latter as the predominant influence factor may fall into a simplistic either-or logical trap that may obscure the truth.This letter,grounded in published evidence,explores areas for improvement in a forthcoming paper within the field,hoping to pinpoint the culprit behind the diagnosis delay issue for IBD patients rather than simply attributing it to so-called“physician-dependent factors”.Our objective is to motivate healthcare providers and policymakers in relevant fields to reflect on strategies for addressing this problem to reduce diagnostic delays and enhance patient outcomes.展开更多
This editorial comments on the article“Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection”.We focus on the importance of paying more att...This editorial comments on the article“Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection”.We focus on the importance of paying more attention to postendoscopic submucosal dissection(ESD)gastric cancer recurrence in patients with early gastric cancer(EGC)and how to manage it effectively.ESD has been a wellknown treatment and the mainstay for EGC,with the advantages of less invasion and fewer complications when compared with traditional surgical procedures.Despite a lower local recurrence rate after ESD,the problem of postoperative recurrence in patients with EGC has become increasingly non-ignorable with the global popularization of ESD technology and the increasing number of post-ESD patients.展开更多
BACKGROUND Diaphragmatic paralysis is typically associated with phrenic nerve injury.Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.CASE SUM...BACKGROUND Diaphragmatic paralysis is typically associated with phrenic nerve injury.Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.CASE SUMMARY We report a 39-week-old newborn delivered via vaginal forceps who presented with tachypnea but without showing other birth-trauma-related manifestations.The infant was initially diagnosed with pneumonia.However,the newborn still exhibited tachypnea despite effective antibiotic treatment.Chest radiography revealed right diaphragmatic elevation.M-mode ultrasonography revealed decreased movement of the right diaphragm.The infant was subsequently diagnosed with diaphragmatic paralysis.After 4 weeks,tachypnea improved.Upon re-examination using M-mode ultrasonography,the difference in bilateral diaphragmatic muscle movement was smaller than before.CONCLUSION Appropriate use of M-mode ultrasound to quantify diaphragmatic excursions could facilitate timely diagnosis and provide objective evaluation.展开更多
This editorial comments on the article by Alzerwi.We focus on the development course,present challenges,and future perspectives of medical education.Modern medical education is gradually undergoing significant and pro...This editorial comments on the article by Alzerwi.We focus on the development course,present challenges,and future perspectives of medical education.Modern medical education is gradually undergoing significant and profound changes worldwide.The emergence of new ideas,methodologies,and techniques has created opportunities for medical education developments and brought new concerns and challenges,ultimately promoting virtuous progress in medical education reform.The sustainable development of medical education needs joint efforts and support from governments,medical colleges,hospitals,researchers,administrators,and educators.展开更多
We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational fra...We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.展开更多
Ulcerative colitis(UC)is a chronic inflammatory bowel disease that presents significant treatment challenges due to its complexity,especially in terms of the various side effects that traditional medications may bring...Ulcerative colitis(UC)is a chronic inflammatory bowel disease that presents significant treatment challenges due to its complexity,especially in terms of the various side effects that traditional medications may bring during the chronic course of the disease.Traditional Chinese medicine(TCM)has emerged as a promising complementary therapy for UC.Based on the latest research,our editorial explored the current issues and potential essential research directions for TCM in treating UC.We anticipate that future high-quality research will pave the way for the optimization of TCM formulas for UC and their broader global application.展开更多
The behavior issues of preschoolers are closely related to their parents'parenting styles.This editorial discusses the value and strategies for solving behavior issues in preschoolers from the perspectives of mind...The behavior issues of preschoolers are closely related to their parents'parenting styles.This editorial discusses the value and strategies for solving behavior issues in preschoolers from the perspectives of mindfulness and mindful parenting.We expect that upcoming studies will place greater emphasis on the behavioral concerns of preschoolers and the parenting practices that shape them,particularly focusing on proactive interventions for preschoolers'behavioral issues.展开更多
This editorial comments on an article recently published by López del Hoyo et al.The metaverse,hailed as"the successor to the mobile Internet",is undoubtedly one of the most fashionable terms in recent ...This editorial comments on an article recently published by López del Hoyo et al.The metaverse,hailed as"the successor to the mobile Internet",is undoubtedly one of the most fashionable terms in recent years.Although metaverse development is a complex and multifaceted evolutionary process influenced by many factors,it is almost certain that it will significantly impact our lives,including mental health services.Like any other technological advancements,the metaverse era presents a double-edged sword for mental health work,which must clearly understand the needs and transformations of its target audience.In this editorial,our primary focus is to contemplate potential new needs and transformation in mental health work during the metaverse era from the pers-pective of multimodal emotion recognition.展开更多
BACKGROUND Left-sided portal hypertension(LSPH),also known as sinistral portal hypertension or regional portal hypertension,refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis.N-b...BACKGROUND Left-sided portal hypertension(LSPH),also known as sinistral portal hypertension or regional portal hypertension,refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis.N-butyl-2-cyanoacrylate(NBC)has been widely used in the endoscopic hemostasis of portal hypertension,but adverse events including renal or pulmonary thromboembolism,mucosal necrosis and gastrointestinal(GI)bleeding may occur after treatment.Herein,we report successfully managing gastric variceal(GV)hemorrhage secondary to LSPH using modified endoscopic ultrasound(EUS)-guided selective NBC injections.CASE SUMMARY A 35-year-old man was referred to our hospital due to an upper GI hemorrhage.Gastroscopy revealed GV hemorrhage and computed tomography venography(CTV)confirmed LSPH.The patient requested endoscopic procedures and rejected surgical therapies including splenectomy.EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose.The“sandwich”method using undiluted NBC and hypertonic glucose was applied.No complications occurred.The patient was followed up regularly after discharge.Three months later,the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH.No recurrent GI hemorrhage was reported during this follow-up period.CONCLUSION EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.展开更多
基金Program for Youth Innovation in Future Medicine,Chongqing Medical University,China,No.W0138.
文摘BACKGROUND Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension(LSPH).The hemorrhage is fatal and requires safe and effective interventions.AIM To evaluate the clinical safety and efficacy of modified endoscopic ultrasound(EUS)-guided selective N-butyl-2-cyanoacrylate(NBC)injections for gastric variceal hemorrhage in LSPH.METHODS A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted.Preoperative EUS evaluations were performed.Enrolled patients were divided into modified and conventional groups according to the NBC injection technique.The final selection of NBC injection technique depended on the patients’preferences and clinical status.The technical and clinical success rates,operation time,NBC doses,perioperative complications,postoperative hospital stay,and recurrent bleeding rates were analyzed,respectively.RESULTS A total of 27 patients were enrolled.No statistically significant differences were observed between the two groups regarding baseline characteristics.In comparison to patients in the conventional group,patients in the modified group demonstrated significantly reduced NBC doses(2.0±0.6 mL vs 3.1±1.0 mL;P=0.004)and increased endoscopic operation time(71.9±11.9 min vs 22.5±6.7 min;P<0.001).Meanwhile,the two groups had no significant difference in the technical and clinical success rates,perioperative complications,postoperative hospital stay,and recurrent bleeding rates.CONCLUSION Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage,with advantages of reduced injection dose and no radiation risk.Drawbacks were time consumption and technical challenge.
基金supported financially by the National Natural Science Foundation of China,No.82071272(to YZ).
文摘Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice is brain region–specific,particularly involving the corticolimbic system,including the ventral tegmental area,nucleus accumbens,prefrontal cortex,amygdala,and hippocampus.Determining how brain-derived neurotrophic factor participates in stress processing in different brain regions will deepen our understanding of social stress psychopathology.In this review,we discuss the expression and regulation of brain-derived neurotrophic factor in stress-sensitive brain regions closely related to the pathophysiology of depression.We focused on associated molecular pathways and neural circuits,with special attention to the brain-derived neurotrophic factor–tropomyosin receptor kinase B signaling pathway and the ventral tegmental area–nucleus accumbens dopamine circuit.We determined that stress-induced alterations in brain-derived neurotrophic factor levels are likely related to the nature,severity,and duration of stress,especially in the above-mentioned brain regions of the corticolimbic system.Therefore,BDNF might be a biological indicator regulating stress-related processes in various brain regions.
基金Supported by Health Commission of Hunan Province,No.202203014389Chinese Medicine Research Project of Hunan Province,No.A2023051the Natural Science Foundation of Hunan Province,No.2024JJ9414.
文摘BACKGROUND With the development of percutaneous coronary intervention(PCI),the number of interventional procedures without implantation,such as bioresorbable stents(BRS)and drug-coated balloons,has increased annually.Metal drug-eluting stent unloading is one of the most common clinical complications.Comparatively,BRS detachment is more concealed and harmful,but has yet to be reported in clinical research.In this study,we report a case of BRS unloading and successful rescue.This is a case of a 59-year-old male with the following medical history:“Type 2 diabetes mellitus”for 2 years,maintained with metformin extended-release tablets,1 g PO BID;“hypertension”for 20 years,with long-term use of metoprolol sustained-release tablets,47.5 mg PO QD;“hyperlipidemia”for 20 years,without regular medication.He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours,on February 20,2022 at 15:35.Electrocardiogram results showed sinus rhythm,ST-segment elevation in leads I and avL,and poor R-wave progression in leads V1–3.High-sensitivity troponin I level was 4.59 ng/mL,indicating an acute high lateral wall myocardial infarction.The patient’s family requested treatment with BRS,without implanta-tion.During PCI,the BRS became unloaded but was successfully rescued.The patient was followed up for 2 years;he had no episodes of angina pectoris and was in generally good condition.CONCLUSION We describe a case of a 59-year-old male experienced BRS unloading and successful rescue.By analyzing images,the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations.We discuss preventive measures for BRS unloading.
基金supported by the National Natural Science Foundation of China,No.82371444(to YZ)the Natural Science Foundation of Hubei Province,No.2022CFB216(to XC)the Key Research Project of Ministry of Science and Technology of China,No.2022ZD021160(to YZ)。
文摘The hypothalamic-pituitary-adrenal axis regulates the secretion of glucoco rticoids in response to environmental challenges.In the brain,a nuclear receptor transcription fa ctor,the glucocorticoid recepto r,is an important component of the hypothalamicpituitary-a d renal axis's negative feedback loop and plays a key role in regulating cognitive equilibrium and neuroplasticity.The glucoco rticoid receptor influences cognitive processes,including glutamate neurotransmission,calcium signaling,and the activation of brain-derived neurotrophic factor-mediated pathways,through a combination of genomic and non-genomic mechanisms.Protein interactions within the central nervous system can alter the expression and activity of the glucocorticoid receptor,there by affecting the hypothalamic-pituitary-a d renal axis and stress-related cognitive functions.An appropriate level of glucocorticoid receptor expression can improve cognitive function,while excessive glucocorticoid receptors or long-term exposure to glucoco rticoids may lead to cognitive impairment.Patients with cognitive impairment-associated diseases,such as Alzheimer's disease,aging,depression,Parkinson's disease,Huntington's disease,stroke,and addiction,often present with dysregulation of the hypothalamic-pituitary-adrenal axis and glucocorticoid receptor expression.This review provides a comprehensive overview of the functions of the glucoco rticoid receptor in the hypothalamic-pituitary-a d renal axis and cognitive activities.It emphasizes that appropriate glucocorticoid receptor signaling fa cilitates learning and memory,while its dysregulation can lead to cognitive impairment.This provides clues about how glucocorticoid receptor signaling can be targeted to ove rcome cognitive disability-related disorders.
基金Supported by the Chongqing Water Conservancy Bureau Project(No.5000002021BF40001)the National Natural Science Foundation of China(No.41601537)+1 种基金the Opening Fund of the State Key Laboratory of Environmental Geochemistry(No.SKLEG2021202)the Strategic Pilot Science and Technology(Class A,No.XDA23040303)。
文摘Global warming and algal blooms have been two of the most pressing problems faced by the world today.In recent decades,numerous studies indicated that global warming promoted the expansion of algal blooms.However,research on how algal blooms respond to global warming is scant.Global warming coupled with eutrophication promoted the rapid growth of phytoplankton,which resulted in an expansion of algal blooms.Algal blooms are affected by the combined effects of global warming,including increases in temperatures,CO_(2)concentration,and nutrient input to aquatic systems by extreme weather events.Since the growth of phytoplankton requires CO_(2),they appear to act as a carbon sink.Unfortunately,algal blooms will release CH4,CO_(2),and inorganic nitrogen when they die and decompose.As substrate nitrogen increases from decompose algal biomass,more N2O will be released by nitrification and denitrification.In comparison to CO_(2),CH4has 28-fold and N2O has 265-fold greenhouse effect.Moreover,algal blooms in the polar regions may contribute to melting glaciers and sea ice(will release greenhouse gas,which contribute to global warming)by reducing surface albedo,which consequently would accelerate global warming.Thus,algal blooms and global warming could form feedback loops which prevent human survival and development.Future researches shall examine the mechanism,trend,strength,and control strategies involved in this mutual feedback.Additionally,it will promote global projects of environmental protection combining governance greenhouse gas emissions and algal blooms,to form a geoengineering for regulating the cycles of carbon,nitrogen,and phosphorus.
基金Supported by the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Tibet Autonomous Region,No.XZ2024ZR-ZY100(Z).
文摘The challenge of diagnosis delay in inflammatory bowel disease(IBD)has emerged as a significant concern for both patients and healthcare professionals.The widely accepted notion that there is an extended time frame from the onset of symptoms to the definitive diagnosis is often attributed to the heterogeneity of IBD and the non-specificity of clinical manifestations.Specific to patients with Crohn’s disease,the issue of delayed diagnosis appears to be more pronounced across different regions globally.The intricate interplay of real-world factors has led to debates regarding the primary contributors to these diagnostic delays.Drawing a comparison solely between patients and physicians and implicating the latter as the predominant influence factor may fall into a simplistic either-or logical trap that may obscure the truth.This letter,grounded in published evidence,explores areas for improvement in a forthcoming paper within the field,hoping to pinpoint the culprit behind the diagnosis delay issue for IBD patients rather than simply attributing it to so-called“physician-dependent factors”.Our objective is to motivate healthcare providers and policymakers in relevant fields to reflect on strategies for addressing this problem to reduce diagnostic delays and enhance patient outcomes.
基金Supported by Program for Youth Innovation in Future Medicine,Chongqing Medical University,No.W0138.
文摘This editorial comments on the article“Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection”.We focus on the importance of paying more attention to postendoscopic submucosal dissection(ESD)gastric cancer recurrence in patients with early gastric cancer(EGC)and how to manage it effectively.ESD has been a wellknown treatment and the mainstay for EGC,with the advantages of less invasion and fewer complications when compared with traditional surgical procedures.Despite a lower local recurrence rate after ESD,the problem of postoperative recurrence in patients with EGC has become increasingly non-ignorable with the global popularization of ESD technology and the increasing number of post-ESD patients.
基金Supported by Sichuan Provincial Science&Technology Program,No.2022JDKP0040Sichuan Provincial Health Commission Program,No.21PJ168+1 种基金Deyang Municipal Science&Technology Program,No.2021SZZ068College-level Project of Chengdu University of Traditional Chinese Medicine,No.YYZX2021026 and No.YYZX2021020.
文摘BACKGROUND Diaphragmatic paralysis is typically associated with phrenic nerve injury.Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.CASE SUMMARY We report a 39-week-old newborn delivered via vaginal forceps who presented with tachypnea but without showing other birth-trauma-related manifestations.The infant was initially diagnosed with pneumonia.However,the newborn still exhibited tachypnea despite effective antibiotic treatment.Chest radiography revealed right diaphragmatic elevation.M-mode ultrasonography revealed decreased movement of the right diaphragm.The infant was subsequently diagnosed with diaphragmatic paralysis.After 4 weeks,tachypnea improved.Upon re-examination using M-mode ultrasonography,the difference in bilateral diaphragmatic muscle movement was smaller than before.CONCLUSION Appropriate use of M-mode ultrasound to quantify diaphragmatic excursions could facilitate timely diagnosis and provide objective evaluation.
基金Supported by Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Program for Youth Innovation in Future Medicine,Chongqing Medical University,No.W0138Natural Science Foundation of Tibet Autonomous Region,No.XZ2024ZR-ZY100(Z).
文摘This editorial comments on the article by Alzerwi.We focus on the development course,present challenges,and future perspectives of medical education.Modern medical education is gradually undergoing significant and profound changes worldwide.The emergence of new ideas,methodologies,and techniques has created opportunities for medical education developments and brought new concerns and challenges,ultimately promoting virtuous progress in medical education reform.The sustainable development of medical education needs joint efforts and support from governments,medical colleges,hospitals,researchers,administrators,and educators.
基金Supported by Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Program for Youth Innovation in Future Medicine,Chongqing Medical University,No.W0138.
文摘We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.
基金Supported by Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Tibet Autonomous Region,No.XZ2024ZR-ZY100(Z).
文摘Ulcerative colitis(UC)is a chronic inflammatory bowel disease that presents significant treatment challenges due to its complexity,especially in terms of the various side effects that traditional medications may bring during the chronic course of the disease.Traditional Chinese medicine(TCM)has emerged as a promising complementary therapy for UC.Based on the latest research,our editorial explored the current issues and potential essential research directions for TCM in treating UC.We anticipate that future high-quality research will pave the way for the optimization of TCM formulas for UC and their broader global application.
基金Supported by The Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305The Natural Science Foundation of Tibet Autonomous Region,No.XZ2024ZR-ZY100(Z).
文摘The behavior issues of preschoolers are closely related to their parents'parenting styles.This editorial discusses the value and strategies for solving behavior issues in preschoolers from the perspectives of mindfulness and mindful parenting.We expect that upcoming studies will place greater emphasis on the behavioral concerns of preschoolers and the parenting practices that shape them,particularly focusing on proactive interventions for preschoolers'behavioral issues.
基金Supported by Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Tibet Autonomous Region,No.XZ2024ZR-ZY100(Z).
文摘This editorial comments on an article recently published by López del Hoyo et al.The metaverse,hailed as"the successor to the mobile Internet",is undoubtedly one of the most fashionable terms in recent years.Although metaverse development is a complex and multifaceted evolutionary process influenced by many factors,it is almost certain that it will significantly impact our lives,including mental health services.Like any other technological advancements,the metaverse era presents a double-edged sword for mental health work,which must clearly understand the needs and transformations of its target audience.In this editorial,our primary focus is to contemplate potential new needs and transformation in mental health work during the metaverse era from the pers-pective of multimodal emotion recognition.
文摘BACKGROUND Left-sided portal hypertension(LSPH),also known as sinistral portal hypertension or regional portal hypertension,refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis.N-butyl-2-cyanoacrylate(NBC)has been widely used in the endoscopic hemostasis of portal hypertension,but adverse events including renal or pulmonary thromboembolism,mucosal necrosis and gastrointestinal(GI)bleeding may occur after treatment.Herein,we report successfully managing gastric variceal(GV)hemorrhage secondary to LSPH using modified endoscopic ultrasound(EUS)-guided selective NBC injections.CASE SUMMARY A 35-year-old man was referred to our hospital due to an upper GI hemorrhage.Gastroscopy revealed GV hemorrhage and computed tomography venography(CTV)confirmed LSPH.The patient requested endoscopic procedures and rejected surgical therapies including splenectomy.EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose.The“sandwich”method using undiluted NBC and hypertonic glucose was applied.No complications occurred.The patient was followed up regularly after discharge.Three months later,the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH.No recurrent GI hemorrhage was reported during this follow-up period.CONCLUSION EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.
