Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies

Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.

Guidelines for the standardized diagnosis and treatment of non-specific orbital inflammation(2024)

Non-specific orbital inflammation(NSOI)is a noninfectious orbital inflammation.Although it is often considered the most common diagnosis in orbital biopsies,it is an exclusionary diagnosis that requires ruling out systemic disease or other possible causes.Its characteristics include acute orbital signs and symptoms,including pain,proptosis,periorbital edema,chemosis,diplopia,and visual impairment.The clinical manifestations and histological findings of NSOI are heterogeneous,without specific diagnostic criteria or treatment guidelines,which poses significant challenges for diagnosis and treatment.This guideline provides a detailed description of the definition,classification,diagnosis,and treatment of NSOI.

Intestinal Behçet's disease: A review of clinical diagnosis and treatment

Behçet's disease(BD)is a chronic inflammatory disorder prone to frequent re-currences,with a high predilection for intestinal involvement.However,the ef-ficacy and long-term effects of surgical treatment for intestinal BD are unknown.In the current issue of World J Gastrointest Surg,Park et al conducted a retrospec-tive analysis of 31 patients with intestinal BD who received surgical treatment.They found that elevated C-reactive protein levels and emergency surgery were poor prognostic factors for postoperative recurrence,emphasizing the adverse impact of severe inflammation on the prognosis of patients with intestinal BD.This work has clinical significance for evaluating the postoperative condition of intestinal BD.The editorial attempts to summarize the clinical diagnosis and treatment of intestinal BD,focusing on the impact of adverse factors on surgical outcomes.We hope this review will facilitate more precise postoperative management of patients with intestinal BD by clinicians.

Guidelines for diagnosis and treatment of advanced breast cancer in China(2022 edition)

Breast cancer is the most common cancer among women worldwide.It has been estimated that about 416000 new cases and over 117000 deaths of breast cancer occurred in China in 2020.Among the new cases of breast cancer diagnosed each year,3-10%have distant metastasis at the time of initial diagnosis.In addition,approxi-mately 30%of patients with early-stage breast cancer may eventually experience recurrence or metastases.The 5-year survival rate of patients with advanced breast cancer is only 20%with a median overall survival of 2-3 years.Although advanced breast cancer remains incurable at present,new therapeutic options and multidisci-plinary treatment could be utilized to alleviate symptoms,improve quality of life,and prolong patients’survival.The choice of treatment regimens for patients with advanced breast cancer is very important,and the optimal treatment strategy beyond the first-and second-line therapy is often lacking.Herein,the China Advanced Breast Cancer Guideline Panel discussed and summarized recent clinical evidence,updated the guidelines for the diag-nosis and treatment of advanced breast cancer based on the 2020 edition,and formulated the“Guidelines for diagnosis and treatment of advanced breast cancer in China(2022 edition)”for clinicians’reference.

Research Progress of Ultrasound Radiomics in The Diagnosis and Treatment of Breast Cancer

With the advancement of medical research in recent years and the frequent occurrence of different types of cancer, breast cancer has gradually attracted the public’s attention. The incidence of breast cancer is rising, mainly affecting women with a high mortality rate. According to the clinical treatment effect, early diagnosis and early treatment can effectively control the mortality of breast cancer and improve patient’s quality of life. Ultrasound radiomics is an emerging field that can extract quantitative high-dimensional data from ultrasound images. Recently, ultrasound radiomics has been widely used in the clinical treatment of breast cancer. This paper analyzed the research progress of ultrasound radiomics in the diagnosis and treatment of breast cancer.

Chinese quality control indices for standardized diagnosis and treatment of renal cancer(2022 edition)

Renal cancer is one of the most common malignancies of the urinary system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of renal cancer is challenging due to the great differences in the diagnosis and treatment of renal cancer in different regions.The Renal Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of renal cancer.The Renal Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of renal cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of renal cancer patients.A panel of experts with renal cancer surgery,renal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of renal cancer.The Indices includes 20 items that cover all key areas in the diagnosis and treatment of renal cancer,such as standard diagnosis,surgery treatment,systemic treatment,and prognostic evaluation.

A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication

Helicobacter pylori (H. pylori) affects nearly half of the world’s population and, thus, is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with peptic ulcer disease, gastric ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Various diagnostic methods exist to detect infection, and the choice of one method or another depends on several factors, such as accessibility, advantages and disadvantages of each method, cost, and the age of patients. Once H. pylori infection is diagnosed, the clinician decides whether treatment is necessity, according to the patient’s clinical condition. Typically, eradication of H. pylori is recommended for treatment and prevention of the infection. Cure rates with the standard triple therapy are acceptable, and effective quadruple therapies, sequential therapies, and concomitant therapies have been introduced as key alternatives to treat H. pylori infection. In this work, we review the main diagnostic methods used to identify H. pylori infection and to confirm eradication of infection. In addition, key factors related to treatment are reviewed.

Endoscopic diagnosis and management of gallbladder carcinoma in minimally invasive era:New needs,new models

Gallbladder cancer(GBC)is a rare and lethal malignancy;however,it represents the most common type of biliary tract cancer.Patients with GBC are often diagnosed at an advanced stage,thus,unfortunately,losing the opportunity for curative surgical intervention.This situation leads to lower quality of life and higher mortality rates.In recent years,the rapid development of endoscopic equipment and techniques has provided new avenues and possibilities for the early and minimally invasive diagnosis and treatment of GBC.This editorial comments on the article by Pavlidis et al.Building upon their work,we explore the new needs and corresponding models for managing GBC from the endoscopic diagnosis and treatment perspective.

Endoscopic Methods in the Diagnosis and Treatment of Pancreatic Cancer

Endoscopic methods are widely used in the diagnosis and palliative treatment of pancreatic cancer. The most sensitive method in early diagnosis is endosonography (EUS) which can also provide histological diagnosis. Diagnostic ERCP became a rather rare procedure as a consequence of wide availability of Magnetic Resonance Cholangiopancreatography (MRCP) but ERCP assisted intraductal methods have gained importance (brush-cytology, intraductal ultrasound, optical coherence tomography) and finally, peroral pancreatoscopy has become technically feasible but available only in some specialized centers. Minimally invasive endoscopic methods play an important role in the palliative treatment of unresectable pancreatic cancer which represents the majority of cases. EUS-guided histological confirmation of adenocarcinoma is crucial in the election of chemotherapy. Celiac plexus blockade and endoscopic biliary and pancreatic stent placement contribute to pain reduction, drainage of obstructed bile duct and assure a better quality of life.

Etiology and Treatment Advances of Hematochezia in Infants Aged ≤3 Months

The incidence of hematochezia in infants aged three months or younger has shown an upward trend in recent years. This condition is characterized by visible bloody stools, which may appear bright red, dark red, jam-like, or mucus-purulent bloody stools, and is often accompanied by positive fecal occult blood tests, with or without additional systemic clinical symptoms. The etiology is multifactorial, potentially influenced by the maternal health status during pregnancy, neonatal diseases or treatments received in the NICU, and the methods used for establishing enteral and parenteral nutrition. Notably, allergic factors have gained prominence in recent years. This paper reviews recent studies to elucidate the incidence, primary causes, and current treatment approaches for early infant hematochezia, providing a reference for clinical practice.

Advances in Etiology and Treatment of Cutaneous Squamous Cell Carcinoma

Cutaneous Squamous Cell Carcinoma (CSCC) is a common skin malignancy with increasing incidence year by year and is the leading cause of death in patients with skin tumors other than melanoma. The pathogenesis of Cutaneous Squamous Cell Carcinoma has not yet been clarified, limiting the development of related molecular targeted therapies. Surgical resection, radiotherapy, photodynamic therapy and gene therapy can be selected according to the site of disease and histological differentiation. This article reviews the research on the etiology, pathogenesis and treatment of squamous cell carcinoma in recent years.

Cervical Myelopathy: Diagnostic Aspects, Surgical Treatment and Evolution of Patients Operated upon in Yaounde

Introduction: Although cervical myelopathy is the most common degenerative cervical spine pathology in adults, the indications and approaches of surgical treatment have not yet been clearly defined in the literature. Very few studies exist regarding these aspects in our setting, and they are mostly outdated. This study aimed to describe the diagnostic aspects, current surgical treatment with technical improvements, and progression in patients. Patients and Methods: We conducted a multicentre retrospective descriptive study over a 10-year period between January 2011 and January 2020 in three referral centres in Yaoundé. All patients who underwent surgery for cervical myelopathy were included. Results: Fifty-two patients were recruited. The rate of operated cervical myelopathies among all degenerative spinal pathologies was 14.05%. The M/F sex ratio was 3/1, and the average age was 52 ± 10 years. All included patients had gait problems, 90.38% demonstrated motor deficiency, and 67.30% experienced at least three levels of compression. Surgery was decided based on the Nurick grade;a posterior approach was applied to 86.54% of patients. Postoperative progression showed a neurological improvement of 82% with an average follow-up of 4 years. Conclusion: In this study, the patients who underwent surgery were relatively young, their clinical presentations were mostly advanced, and surgical management showed good results in well-selected cases.

Beyond the stomach: An updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment

Helicobacter pylori (H. pylori) is an extremely common, yet underappreciated, pathogen that is able to alter host physiology and subvert the host immune response, allowing it to persist for the life of the host. H. pylori is the primary cause of peptic ulcers and gastric cancer. In the United States, the annual cost associated with peptic ulcer disease is estimated to be $6 billion and gastric cancer kills over 700000 people per year globally. The prevalence of H. pylori infection remains high (> 50%) in much of the world, although the infection rates are dropping in some developed nations. The drop in H. pylori prevalence could be a double-edged sword, reducing the incidence of gastric diseases while increasing the risk of allergies and esophageal diseases. The list of diseases potentially caused by H. pylori continues to grow; however, mechanistic explanations of how H. pylori could contribute to extragastric diseases lag far behind clinical studies. A number of host factors and H. pylori virulence factors act in concert to determine which individuals are at the highest risk of disease. These include bacterial cytotoxins and polymorphisms in host genes responsible for directing the immune response. This review discusses the latest advances in H. pylori pathogenesis, diagnosis, and treatment. Up-to-date information on correlations between H. pylori and extragastric diseases is also provided.

Transurethral seminal vesiculoscopy in the diagnosis and treatment of persistent or recurrent hemospermia： a single- institution experience

The diagnosis and treatment of hemospermia presents significant difficulty, especially if it persists or recurs. In this retrospective study, we assessed whether transurethral seminal vesiculoscopy is feasible and effective in the diagnosis and treatment of hemospermia. To address this complex condition, we report our experience in a population of patients treated with transurethral seminal vesiculoscopy. From February 2006 to July 2008, 72 hemospermic patients underwent transurethral seminal vesiculoscopy examination and treatment at our urology center. Transurethral seminal vesiculoscopy was performed by a 7-F or 8-F rigid ureteroscope. The endoscopic procedure was conducted through the normal anatomic route of the seminal tracts. In this series, the mean follow-up period was 21.7 months. Definite diagnosis was made for 93.1% patients, and 94.4% patients were cured or showed a decrease in their symptoms. Postoperative complications were not observed in the study. Our study proves that transurethral seminal vesiculoscopy is effective in the diagnosis and treatment of hemospermia with minimal complication.

Research Progress on Diagnosis and Treatment of Chronic Osteomyelitis

We review the representatives literatures on chronic osteomyelitis,sum up the new insights in recent years into diagnostic options and treatment regimens,analyze the advantages and disadvantages of various diagnostic approaches and treatment strategies,and propose areas of interest to make current diagnostic and treatment strategies more specific.

Current Status of Diagnosis And Treatment of Primary Breast Cancerin Beijing,2008

Objective：To investigate the status of diagnosis and treatment of primary breast cancer in Beijing,2008.Methods：All the patients who were diagnosed as primary breast cancer in Beijing in 2008 were enrolled in this study.Information of these patients,including the features of tumors,clinical diagnosis and treatment was collected,and filled in the well-designed questionnaire forms by trained surveyors.The missing data were partly complemented through telephone interviews.Results：A total of 3473 Beijing citizens were diagnosed as primary breast cancer（25 patients with synchronal bilateral breast cancer） in Beijing,2008.Of them 82.09% were symptomatic.19.02% and 34.11% were diagnosed using fine needle aspiration biopsy（FNAB） and core needle biopsy（CNB）,respectively.15.92% received sentinel lymph node biopsy（SLNB） and 24.27% received breast conserving surgery（BCS）.Among 476 cases with Her-2 positive,only 96 received anti-Her-2 therapy.We found that the standardization level varied in hospitals of different grades,with higher level in Grade-III hospitals.Of note,some breast cancer patients received non-standard primary tumor therapy：65.63% of the patients with ductal carcinoma in situ（DCIS） received axillary lymph node dissection and 36.88% received chemotherapy;25.89% of the patients underwent breast conserving surgery without margin status;12.10% of the patients received chemotherapy less than 4 cycles.Conclusion：Although most breast cancer patients received basic medical care,the mode of diagnosis and treatment should be improved and should be standardized in the future in Beijing.

Chinese Society of Clinical Oncology (CSCO) diagnosis and treatment guidelines for colorectal cancer 2018(English version)

Contents1. General guidelines for diagnosis and treatment of colorectal cancer2. Diagnostic principles for colorectal cancer2.1 Colorectal cancer screening of asymptomatic healthy population2.2 Basic diagnostic principles2.2.1 Colorectal cancer diagnosis2.2.2 Appendix on colorectal cancer imaging staging and diagnosis2.3 Principles of pathological diagnosis2.4 Staging.

Diagnosis and treatment of solid-pseudopapillary tumor of the pancreas

BACKGROUND: Solid-pseudopapillary tumor (SPT) of the pancreas is a rare exocrine pancreatic tumor. Despite the increasing recognition of the tumor in recent years, its pathogenesis and apparent therapeutic algorithm remain unclear. This study was designed to define the clinical, imaging, and pathologic features and to improve the diagnosis and treatment of this rare disease. METHOD: The clinical, imaging, and pathologic findings of 9 SPT patients managed in our hospital between 2001 and 2005 were retrospectively analyzed, and related literatures were reviewed. RESULTS: In the 9 patients aged from 14 to 68 years, 8 were female and 1 male. The mean age of these patients at diagnosis was 30 years. Initially, 8 patients complained of vague abdominal pain and one patient had pancreatic mass detected incidentally by abdominal CT. The levels of blood and urine amylase and tumor markers were all within the normal range. B-US, CT and MRI demonstrated that tumors were well encapsulated and contained some degree of internal hemorrhage or cystic degeneration. The mean transverse diameter of these tumors was 5.4 cm (range, 2-10.5 cm). The tumors were located at the head (2 patients), body (2), body and tail junction (4), and tail (1) of the pancreas. Surgical procedures included pancreaticoduodenectomy, distal pancreatectomy, distal pancreatectomy with splenectomy, and enucleation. Histological examination showed solidified cystic areas and papillary protrusions. Two malignant tumors demonstrated retroperitoneal metastases and vascular invasion. Follow-up for 2.5 years on average showed that one patient died of tumor recurrence at 10 months and the rest were alive. CONCLUSIONS: SPT exhibits unique clinical and pathologic features and is readily diagnosed by its characteristic imaging and histological appearance. Surgical resection of the primary tumor and metastases is the treatment of choice.

From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world

Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.

Chinese guidelines for diagnosis and treatment of primary lung cancer 2018 (English version)

Contents1. Overview2. Screening and diagnosis2.1 Risk factors for lung cancer2.1.1 Smoking and passive smoking2.1.2 Indoor pollution2.1.3 Indoor radon exposure2.1.4 Outdoor air pollution2.1.5 Occupational factors2.1.6 Family history of lung cancer and genetic susceptibility2.1.7 Other factors.