Inhibiting the formation of neutrophil extracellular trapping: a potential mechanism of Chinese medicine in the treatment of ischemic stroke

Ischemic stroke(IS)is the main killer that endangers the health and life of middle-aged and elderly people worldwide.Inflammatory response plays a key regulatory role in the pathogenesis of IS.After cerebral ischemia,leukocytes rapidly accumulate,penetrate blood vessels and infiltrate brain tissue,thereby activating pro-inflammatory factors in the infarct area to exacerbate nerve damage.Neutrophil extracellular traps(NETs)are fibrous mesh structures released by activated neutrophils outside the cell,which can clear pathogens and cell debris,induce inflammatory responses and exacerbate cerebral ischemia-reperfusion(CI/R)injury.Various traditional Chinese medicines and their main components can improve neurological function defects after IS,and inhibit the formation of NETs,which opens up a new direction for the study of traditional Chinese medicines in the prevention and treatment of IS.

Electroencephalogram findings in 10 patients with post-stroke epilepsy:A retrospective study

BACKGROUND Post-stroke epilepsy is a common and easily overlooked complication of acute cerebrovascular disease.Long-term seizures can seriously affect the prognosis and quality of life of patients.Electroencephalogram(EEG)is the simplest way to diagnose epilepsy,and plays an important role in predicting seizures and guiding medication.AIM To explore the EEG characteristics of patients with post-stroke epilepsy and improve the detection rate of inter-seizure epileptiform discharges.METHODS From January 2017 to June 2020,10 patients with post-stroke epilepsy in our hospital were included.The clinical,imaging,and EEG characteristics were collected.The stroke location,seizure type,and ictal and interictal EEG manifestations of the patients with post-stroke epilepsy were then retrospectively analyzed.RESULTS In all 10 patients,epileptiform waves occurred in the side opposite to the stroke lesion during the interictal stage;these manifested as sharp wave,sharp-wave complex,or spike discharges in the anterior head lead of the side opposite to the lesion.CONCLUSION In EEG,epileptiform waves can occur in the side opposite to the stroke lesion in patients with post-stroke epilepsy.

Quercetin Alleviates Lipopolysaccharide-Induced Cardiac Inflammation via Inhibiting Autophagy and Programmed Cell Death

Objective The aim of this study is to explore the potential modulatory role of quercetin against Endotoxin or lipopolysaccharide(LPS)induced septic cardiac dysfunction.Methods Specific pathogen-free chicken embryos(n=120)were allocated untreated control,phosphate buffer solution(PBS)vehicle,PBS with ethanol vehicle,LPS(500 ng/egg),LPS with quercetin treatment(10,20,or 40 nmol/egg,respectively),Quercetin groups(10,20,or 40 nmol/egg).Fifteenday-old embryonated eggs were inoculated with abovementioned solutions via the allantoic cavity.At embryonic day 19,the hearts of the embryos were collected for histopathological examination,RNA extraction,real-time polymerase chain reaction,immunohistochemical investigations,and Western blotting.Results They demonstrated that the heart presented inflammatory responses after LPS induction.The LPS-induced higher mRNA expressions of inflammation-related factors(TLR4,TNFα,MYD88,NF-κB1,IFNγ,IL-1β,IL-8,IL-6,IL-10,p38,MMP3,and MMP9)were blocked by quercetin with three dosages.Quercetin significantly decreased immunopositivity to TLR4 and MMP9 in the treatment group when compared with the LPS group.Quercetin significantly decreased protein expressions of TLR4,IFNγ,MMP3,and MMP9 when compared with the LPS group.Quercetin treatment prevented LPS-induced increase in the mRNA expression of Claudin 1 and ZO-1,and significantly decreased protein expression of claudin 1 when compared with the LPS group.Quercetin significantly downregulated autophagyrelated gene expressions(PPARα,SGLT1,APOA4,AMPKα1,AMPKα2,ATG5,ATG7,Beclin-1,and LC3B)and programmed cell death(Fas,Bcl-2,CASP1,CASP12,CASP3,and RIPK1)after LPS induction.Quercetin significantly decreased immunopositivity to APOA4,AMPKα2,and LC3-II/LC3-I in the treatment group when compared with the LPS group.Quercetin significantly decreased protein expressions of AMPKα1,LC3-I,and LC3-II.Quercetin significantly decreased the protein expression to CASP1 and CASP3 by immunohistochemical investigation or Western blotting in treatment group when compared with LPS group.Conclusion Quercetin alleviates cardiac inflammation induced by LPS through modulating autophagy,programmed cell death,and myocardiocytes permeability.

Present situation of minimally invasive surgical treatment for early gastric cancer

Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.

A Case of Fahr’s Disease with Epilepsy as the First Symptom in Infancy

Background: Fahr’s disease, also recognized as Idiopathic Basal Ganglia Calcification (IBGC) or Primary Familial Brain Calcification (PFBC), was first identified by the German neurologist Karl Theodor Fahr in 1930. This rare condition, which involves the calcification of the basal ganglia and presents significant treatment challenges, is most commonly diagnosed in middle-aged adults and is notably uncommon in children. Purpose: We report a case of a younger patient and review this disease as an aid to early detection and diagnosis of the disease. Case Introduction: In this report, we present a unique case of Fahr’s disease in a child, where epilepsy manifested as the initial symptom during infancy. In this report, we present a case of Fahr’s disease in a child who presented with epilepsy as the first symptom in infancy. The child had no imaging abnormalities at the onset of the seizure, and subsequent antiepileptic drugs were reduced and discontinued, and when the seizure recurred 3 years later, a perfect cranial CT revealed symmetrical calcifications in the brain, which gradually worsened, and subsequently the child was unable to take care of himself and had regression of his psychomotor development, and the family requested discharge from the hospital, and then the child died during the follow-up visit. Conclusion: The disease is currently associated with a number of disorders for which there is no specific treatment, and half of all patients currently have a well-defined gene, emphasizing more importantly the importance of genetic counseling for parents known to be at risk prior to conception.

Clinical characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy:A report of 40 cases

瞄准：总结表现必需品并且分析遥远的宙斯帮助机器人的 laparoscopic 胆囊炎的特征。方法：帮助机器人的 laparoscopic 胆囊炎在在 2004 年 5 月和 2005 年 7 月之间的 40 个病人被执行。操作过程和许多临床的参数被记录并且分析。结果：四十个 laparoscopic 胆囊炎过程成功地与宙斯机器的系统被完成。并且没有手术后的复杂并发症。全部的操作时间，系统安装时间和表现时间是 100.3 +/- 18.5 min， 27.7 +/- 8.8 min 和 65.6 +/- 18.3 min 分别地。失血和手术后的医院停留是 30.6 +/- 10.2 mL 和 2.8 +/- 0.8 d 分别地。为起作用的地调整使用的照相机空地时间和时间是 1.1+/- 1.0 min 和 2.0 +/- 0.8 min 分别地。起作用的错误是 7.5% 。结论：跟随 laparoscopic 操作的原则的帮助机器人的 laparoscopic 胆囊炎有特定的表现必需品。它保存最低限度地侵略的外科的好处并且提供控制操作地的提高的能力，精确、稳定的起作用的操作。

Clinical characteristics and prognosis of triple-negative breast cancer

客观我们调查了临床的特征，和三元组否定的乳癌的预示的因素。130 个三元组否定的乳癌病人在临床的特征和预后上被考察的方法。所有情况是免疫组织化学决定的雌激素受体，孕酮受体，和 HER2/neu 的表示的缺乏。结果 17.1% 所有乳癌病人(774 个案例) 是三元组否定的乳癌，并且 68.9% 三元组否定的乳癌病人(91 个案例) 是绝经前的。53.8% 病人(71 个案例) 与 T2 尺寸有肿瘤，并且(52 个病人) 他们中的 39.4% 个有淋巴节点转移。没有淋巴节点转移，在有淋巴节点转移的病人的恶化的率在病人显然比那高(P = 0.001 ) 。后续的中部的时间是 63 个月。33 案例 relapsed 和 20 个病人死了。23 个病人有至少二机关转移。5 年的没有疾病、全面的幸存率是 73.8% 和 85.7% 。结论三元组否定的乳癌病人通常在治疗以后在 2 3 年里有多重远转移的高率。淋巴节点的地位是最重要的预示的因素。有淋巴节点转移的三元组否定的胸 caner 病人有差的预后。

Clinical Study of Qingluo Tongbi Granules in Treating 63 Patients with Rheumatoid Arthritis of the Type of Yin-deficiency and Heat in Collaterals

The study is to observe the therapeutic effects of Qingluo Tongbi Granules (清络通痹颗粒QTG) in patients with rheumatoid arthritis (RA) and the changes of immune indexes. In this series there are 63 patients with RA of the type of yin-deficiency and heat in collaterals treated with QTG as the treated group and 55 patients of the same type treated with Tripterygium glycosides as the control group. As a results, in the treated group, the curative rate is 9.52% and markedly effective rate 38.10%, with a total effective rate of 90.48%, while the corresponding rates in the control group are 0, 20.00% and 83.64%, respectively. The curative effect in the treated group is better than that in the control group (P<0.05). Besides, no obvious adverse reactions are found in the treated group. Therefore it is concluded that as a new medicinal preparation QTG is safe and effective in the treatment of RA.

Effects of the number of neoadjuvant therapy cycles on clinical outcomes, safety, and survival in patients with metastatic colorectal cancer undergoing metastasectomy

The controversial outcomes in patients with metastatic colorectal cancer(mCRC)highlight the need for developing effective systemic neoadjuvant treatment strategies to improve clinical results.The optimal treatment cycles in patients with mCRC for metastasectomy remain undefined.This retrospective study compared the efficacy,safety,and survival of cycles of neoadjuvant chemotherapy/targeted therapy for such patients.Sixty-four patients with mCRC who received neoadjuvant chemotherapy/targeted therapy following metastasectomy were enrolled between January 2018 and April 2022.Twenty-eight patients received 6 cycles of chemotherapy/targeted therapy,whereas 36 patients received≥7 cycles(median,13;range,7–20).Clinical outcomes,including response,progression-free survival(PFS),overall survival(OS),and adverse events,were compared between these two groups.Of the 64 patients,47(73.4%)were included in the response group,and 17(26.6%)were included in the nonresponse group.The analysis revealed chemotherapy/targeted therapy cycle and pretreatment serum carcinoembryonic antigen(CEA)level as independent predictors of the response as well as overall survival and chemotherapy/targeted therapy cycle as an independent predictor of progression(all p<0.05).Furthermore,our results revealed shorter operation time,lower estimated operative blood loss,higher response rate,lower progression rate,and higher survival rate in≥7 cycles of chemotherapy/targeted therapy group(all p<0.05),but no statistical differences in adverse events were observed between the two groups(all p>0.05).The median OS and PFS were 48 months(95%CI,40.855–55.145)and 28 months(95%CI,18.952–37.48)in the≥7-cycle group and 24 months(95%CI,22.038–25.962)and 13 months(95%CI,11.674–14.326)in the 6-cycle group,respectively(both p<0.001).The oncological outcomes in the≥7-cycle group were significantly better than those in the 6-cycle group,without significant increases in adverse events.However,prospective randomized trials are mandatory to confirm the potential advantages of cycle numbers of neoadjuvant chemotherapy/targeted therapy.

Formation process of extension knee joint contracture following external immobilization in rats

BACKGROUND Current research lacks a model of knee extension contracture in rats.AIM To elucidate the formation process of knee extension contracture.METHODS We developed a rat model using an aluminum external fixator.Sixty male Sprague-Dawley rats with mature bones were divided into the control group(n=6)and groups that had the left knee immobilized with an aluminum external fixator for 1,2,and 3 d,and 1,2,3,4,6,and 8 wk(n=6 in each group).The passive extension range of motion,histology,and expression of fibrosis-related proteins were compared between the control group and the immobilization groups.RESULTS Myogenic contracture progressed very quickly during the initial 2 wk of immobilization.After 2 wk,the contracture gradually changed from myogenic to arthrogenic.The arthrogenic contracture progressed slowly during the 1^(st) week,rapidly progressed until the 3^(rd) week,and then showed a steady progression until the 4^(rd) week.Histological analyses confirmed that the anterior joint capsule of the extended fixed knee became increasingly thicker over time.Correspondingly,the level of transforming growth factor beta 1(TGF-β1)and phosphorylated mothers against decapentaplegic homolog 2(p-Smad2)in the anterior joint capsule also increased with the immobilization time.Over time,the cross-sectional area of muscle fibers gradually decreased,while the amount of intermuscular collagen and TGF-β1,p-Smad2,and p-Smad3 was increased.Unexpectedly,the amount of intermuscular collagen and TGF-β1,p-Smad2,and p-Smad3 was decreased during the late stage of immobilization(6-8 wk).The myogenic contracture was stabilized after 2 wk of immobilization,whereas the arthrogenic contracture was stabilized after 3 wk of immobilization and completely stable in 4 wk.CONCLUSION This rat model may be a useful tool to study the etiology of joint contracture and establish therapeutic approaches.

High expression of the circadian clock gene NPAS2 is associated with progression and poor prognosis of gastric cancer:A singlecenter study

BACKGROUND The prognostic assessment of patients after surgical resection of gastric cancer(GC)patients is critical.However,the role of the circadian clock gene NPAS2 expression in GC remains unknown.AIM To explore the relationship between NPAS2 and the survival prognosis of GC patients and clarify its role in evaluating GC prognosis.METHODS The tumor tissues and clinical data of 101 patients with GC were collected retrospectively.Immunohistochemical staining(IHC)was used to detect the expression of NPAS2 protein in GC and adjacent tissues.Univariate and multivariate Cox regression analysis was used to determine the independent prognostic factors of GC,and a nomogram prediction model was established.The receiver operating characteristic(ROC)curve,the ROC area under the curve,the calibration curve,and C-index were used to evaluate the predictive effectiveness of the model.Kaplan Meier analysis was used to compare the risk stratification of subgroups according to the median score in the nomogram model of each patient.RESULTS Microarray IHC analysis showed that the positive rate of NPAS2 protein expression in GC tissues was 65.35%,which was significantly higher than 30.69%in adjacent tissues.The high expression of NPAS2 was correlated with tumor-node-metastasis(TNM)stage(P<0.05),pN stage(P<0.05),metastasis(P<0.05),venous invasion(P<0.05),lymphatic invasion(P<0.05),and lymph node positive(P<0.05)of GC.Kaplan Meier survival analysis showed that the 3-year overall survival(OS)of patients with high NPAS2 expression was significantly shortened(P<0.0001).Univariate and multivariate COX regression analysis showed that TNM stage(P=0.009),metastasis(P=0.009),and NPAS2 expression(P=0.020)were independent prognostic factors of OS in GC patients for 3 years.The nomogram prediction model based on independent prognostic factors has a C-Index of 0.740(95%CI:0.713-0.767).Furthermore,subgroup analysis showed that the 3-year OS time of the high-risk group was significantly lower than that of the low-risk group(P<0.0001).CONCLUSION NPAS2 is highly expressed in GC tissues and is closely related to worse OS in patients.Therefore,the evaluation of NPAS2 expression may be a potential marker for GC prognosis evaluation.Notably,the nomogram model based on NPAS2 can improve the accuracy of GC prognosis prediction and assist clinicians in postoperative patient management and decision-making.

Co-infection of Chlamydia psittaci and Tropheryma whipplei: A case report

BACKGROUND The co-infection of Chlamydia psittaci(C.psittaci)and Tropheryma whipplei(T.whipplei)is unusual,and the detection of pathogenic microorganisms is particularly important for patients with severe diseases or poor experience in treatment.Early identification of pathogens can significantly improve the prognosis of the patients.Targeted next-generation sequencing(tNGS)is currently widely used in clinical practice for various infectious diseases,including respiratory infections,to achieve early,accurate,and rapid microbial diagnosis.CASE SUMMARY We report a case of a 40-year-old female patient with a history of contact with parrots who was diagnosed with C.psittaci and T.whipplei infection through bronchial lavage fluid targeted next generation sequencing.After moxifloxacin treatment,the patient's symptoms improved significantly,and the imaging changes were obviously resolved.CONCLUSION Coinfection with C.psittaci and T.whipplei is not common.In this case,timely and accurate identification of both pathogens was achieved using tNGS.Moreover,the efficacy of monotherapy with moxifloxacin was confirmed.

Research progress of ginger in the treatment of gastrointestinal tumors

Cancer seriously endangers human health.Gastrointestinal cancer is the most common and major malignant tumor,and its morbidity and mortality are gradually increasing.Although there are effective treatments such as radio-therapy and chemotherapy for gastrointestinal tumors,they are often accom-panied by serious side effects.According to the traditional Chinese medicine and food homology theory,many materials are both food and medicine.Moreover,food is just as capable of preventing and treating diseases as medicine.Medicine and food homologous herbs not only have excellent pharmacological effects and activities but also have few side effects.As a typical medicinal herb with both medicinal and edible uses,some components of ginger have been shown to have good efficacy and safety against cancer.A mass of evidence has also shown that ginger has anti-tumor effects on digestive tract cancers(such as gastric cancer,colorectal cancer,liver cancer,laryngeal cancer,and pancreatic cancer)through a variety of pathways.The aim of this study is to investigate the mechanisms of action of the main components of ginger and their potential clinical applications in treating gastrointestinal tumors.

Guizhi-Shaoyao-Zhimu decoction attenuates rheumatoid arthritis by inhibiting mast cell degranulation

Background:In this study,we investigated whether prophylactic treatment with Guizhi-Shaoyao-Zhimu decoction(GSZ)could delay the onset of rheumatoid arthritis by targeting mast cells.Methods:Collagen-induced arthritis was used to evaluate the effect of GSZ in preventing arthritis and joint destruction.Immunohistochemical staining revealed the accumulation of histamine H4 receptor and tryptase alpha/beta-1 in the ankle joint of the model.Then,we explored the effect of GSZ serum on fibroblast-like synoviocytes using standard transwell invasion and migration assays.Real-time quantitative polymerase chain reaction and western blot were used to detect the expression of toll-like receptor 4(TLR4)/myeloid differentiationfactor 88(MyD88)/nuclear factor-κB p65(NF-κB p65).Results:The results showed that pre-rheumatoid arthritis treatment with GSZ could reduce inflammation and maintain cartilage structure in the collagen-induced arthritis model.Moreover,GSZ significantly blocked mast cell degranulation and inhibited the TLR4/MyD88/NF-κB p65 pathway.Since the combined activation of mast cells via TLR4 and immune complexes enhances inflammation in synovial tissue,we concluded that GSZ may block mast cell degranulation by inhibiting the TLR4/MyD88/NF-κB p65 pathway and thus influence rheumatoid arthritis onset.Conclusion:Taken together,our data suggested that GSZ may be a promising therapeutic decoction for the prophylactic treatment of rheumatoid arthritis.

Efficacy and safety of anti-vascular endothelial growth factor agents on corneal neovascularization: A meta-analysis

BACKGROUND Corneal neovascularization(CoNV)is the second major cause of blindness.Vascular endothelial growth factor(VEGF)inhibitors,e.g.,bevacizumab,have been used to prevent CoNV.AIM We conducted an updated systematic review and meta-analysis of clinical trials to examine the efficacy and safety of anti-VEGF in CoNV.METHODS A literature search was conducted using three electronic databases.Mean difference(MD),standard mean difference(SMD),and relative risk(RR)are used to estimate the effect size.RESULTS Nine randomized controlled and three non-randomized trials were obtained.The pooled results demonstrated a significant reduction of CoNV area/Length(SMD=-1.17,95%CI:-1.58 to-0.75),best corrected visual acuity(MD=-0.54,95%CI:-0.91 to-0.17),and graft rejection(RR=0.44,95%CI:0.24 to 0.8)and failure(RR=0.39,95%CI:0.19 to 0.78)rates in the anti-VEGF group than the placebo group.A non-significant reduction of the epithelial defect was also observed in the bevacizumab group compared with the placebo(RR=0.56,95%CI:0.30 to 1.06).Compared with a placebo,the unsynthesizable trials also support that bevacizumab improves visual acuity,CoNV,graft rejection,and failure rates.Trials reporting other comparisons revealed the superiority of combined remedy with bevacizumab compared to other treatments in reducing CoNV.CONCLUSION Anti-VEGF agents,mainly bevacizumab,are an effective and safe treatment for CoNV of all causes and prevent corneal graft rejection and failure in corneal transplantation.

孤立性肺结节的循证医学影像处理

孤立性肺结节（solitary pulmonary nodule,SPN）定义为被肺实质包绕的直径≤3 cm的圆形/类圆形不透明影。大多数吸烟者的薄层CT扫描均可以发现SPN,其中大部分直径〈7 mm。在过去,如偶然发现此类结节临床采用2年以上随访,包括3,6,12,18,24个月的CT随访。该方案使随访者接受的辐射量增加。结节形态特性,如形状、边缘特征、空洞、位置等难以准确鉴别良恶性结节。当首次检查中的SPN不能定性时,应评估包括患者年龄和吸烟史等危险因素。Fleischner学会2005年指南指明所有4 mm或更小的结节中至少99%为良性;当结节直径为5-9 mm时,最佳策略是随访。随访检查的时间点依据结节大小（4-6,6-8 cm）和患者病史而不一,特别是是否存在恶性肿瘤低危/高危因素。直径〉8 mm的非钙化结节高度提示恶性肿瘤,此时应考虑额外检查如造影剂增强CT,正电子发射断层扫描（positron emission tomography,PET）,经皮肺穿刺活检,胸腔镜切除术或电视辅助胸腔镜切除术。

Puerarin enhances superoxide dismutase activity and inhibits RAGE and VEGF expression in retinas of STZ-induced early diabetic rats

Objective:To investigate the effects of puerarin on the activity of superoxide dismutase(SOD), and expressions of advanced glycation end-product(AGE) receptor(RAGE) and vascular endothelial growth factor(VEGF) in retinas of streptozotocin(STZ)-induced early diabetic rats. Methods:Diabetic rat models were established by inducing diabetes via intra-peritoneal injection of STZ.Rats were randomly divided into normal(control),diabetic(DM),and DM+ puerarin groups.After intra-gastric administration of puerarin(500 mg/kg/day for 4 weeks),levels of SOD and malondialdehyde(MDA) were determined in serum and retina.mRNA and protein expression levels of RAGE and VEGF in retinas were determined by real-lime polymerase chain reaction(RT-PCR)(mRNA) and Western blot analysis(protein levels).Results:There was significantly lower SOD activity and significantly higher MDA in serum and retinas of the DM group compared with the two other groups(P【0.05).After treatment with puerarin,SOD activity increased and MDA content decreased in this group(P【0.05).mRNA and protein expression levels of RACE and VECF in the DM group were significantly higher than those of the other groups (P【0.05),and decreased after puerarin treatment(P【0.05).Conclusions:Puerarin is able to enhance SOD activity,and inhibit RAGE and VEGF expressions in retinas of STZ-induced early diabetic ruts.

Application of curved ablation in liver cancer with special morphology or location: Report of two cases

BACKGROUND Liver cancer is one of the most common malignant tumors with a high incidence and mortality.Hepatitis-liver cirrhosis-liver cancer is known as the trilogy of liver cancer.At present,due to significant development of imaging interventions,they occupy an irreplaceable position in the field of liver cancer treatment,especially ultrasound-guided ablation.Because patients with liver cancer often present with liver cirrhosis,which leads to morphological deformation of the liver,it is difficult to perform a linear ablation of liver cancer in the areas near the phrenic top and within large blood vessels,among others.The present study reports on two cases of liver cancer that have been subjected to curvilinear ablation.After 1 mo,magnetic resonance imaging showed complete ablation,demonstrating that ultrasound-guided curved ablation is feasible and effective in the treatment of liver cancer.CASE SUMMARY Two patients were treated at the Liver Disease Department of the Xixi Hospital Affiliated to Zhejiang University of Chinese Medicine in 2019.Because the first liver cancer patient’s tumor was located close to the diaphragm,it was difficult to complete a straight needle ablation procedure in one session.In order to achieve accurate and minimally invasive treatment of this tumor,a curved needle ablation procedure was designed.The second patient presented with a hepatic cyst in front of the tumor.In order not to damage the hepatic cyst,a looper needle ablation technique was used.The procedure was successfully completed in both cases.CONCLUSION Curved ablation is a new technique that can be used to treat tumors situated in a variety of locations,providing new ideas for interventional techniques.Its operation difficulty is higher and further animal experiments are necessary to improve the operation procedure.

Early detection of diabetic kidney disease: Present limitations and future perspectives

Diabetic kidney disease(DKD) is one of the most common diabetic complications, as well as the leading cause of chronic kidney disease and end-stage renal disease around the world. To prevent the dreadful consequence, development of new assays for diagnostic of DKD has always been the priority in the research field of diabetic complications. At present, urinary albumin-to-creatinine ratio and estimated glomerular filtration rate(eG FR) are the standard methods for assessing glomerular damage and renal function changes in clinical practice. However, due to diverse tissue involvement in different individuals, the so-called "non-albuminuric renal impairment" is not uncommon, especially in patients with type 2 diabetes. On the other hand, the precision of creatinine-based GFR estimates is limited in hyperfiltration status. These facts make albuminuria and eG FR less reliable indicators for early-stage DKD. In recent years, considerable progress has been made in the understanding of the pathogenesis of DKD, along with the elucidation of its genetic profiles and phenotypic expression of different molecules. With the help of ever-evolving technologies, it has gradually become plausible to apply the thriving information in clinical practice. The strength and weakness of several novel biomarkers, genomic, proteomic and metabolomic signatures in assisting the early diagnosis of DKD will be discussed in this article.

恶性肿瘤骨转移及骨相关疾病临床诊疗中国专家共识(英文)

Since 1980s, palliative medicine has been an independent educational project. The development of palliative care in China started in the early 1990s. During the last 18 years, we have seen an increasing allocation of resources to palliative care, the establishment of an academic chair in palliative medicine, and more focused interest and awareness of the need for palliative care in the society at large. So the doctors in China have established principles of treatment on clinical diagnosis and treatment of malignant tumor bone metastases and bone related complications. In order to share our experience with the world, after two years’ preparation, the top-level experts in palliative medicine have written the consensus statement on clinical diagnosis and treatment of malignant tumor bone metastases and bone related complications. The overview includes not only the achievements in the world, but the hands-on experience in clinic, especially the experience in combination of TCM and Western medicine. We hope that the publication of this consensus statement will contribute to the palliative medicine development in this field, thus bring benefits to the majority of patients.