The applications and challenges of artificial intelligence in colonoscopy

It has been widely acknowledged that colonoscopy is the most effective method of preventing colorectal cancer because it can detect and remove precursor lesions,thereby reducing both incidence and mortality.Among these approaches,standardized colonoscopy stands out as the most efficacious method for early-stage colorectal cancer identification.Artificial intelligence is a rapidly expanding field in gastrointestinal endoscopy.This article presents a comprehensive review of the advantages and clinical evidence supporting the application of artificial intelligence in colonoscopy while also discussing prospects for utilizing artificial intelligence-assisted endoscopy in diagnosing colorectal cancer.

Low-temperature 3D-printed collagen/chitosan scaffolds loaded with exosomes derived from neural stem cells pretreated with insulin growth factor-1 enhance neural regeneration after traumatic brain injury

There are various clinical treatments for traumatic brain injury,including surgery,drug therapy,and rehabilitation therapy;howeve r,the therapeutic effects are limited.Scaffolds combined with exosomes represent a promising but challenging method for improving the repair of traumatic brain injury.In this study,we determined the ability of a novel 3D-printed collagen/chitosan scaffold loaded with exosomes derived from neural stem cells pretreated with insulin-like growth factor-1(3D-CC-INEXOS) to improve traumatic brain injury repair and functional recove ry after traumatic brain injury in rats.Composite scaffolds comprising collagen,chitosan,and exosomes derived from neural stem cells pretreated with insulin-like growth fa ctor-1(INEXOS) continuously released exosomes for 2weeks.Transplantation of 3D-CC-INExos scaffolds significantly improved motor and cognitive functions in a rat traumatic brain injury model,as assessed by the Morris water maze test and modified neurological seve rity scores.In addition,immunofluorescence staining and transmission electron microscopy showed that3D-CC-INExos implantation significantly improved the recove ry of damaged nerve tissue in the injured area.In conclusion,this study suggests that transplanted3D-CC-INExos scaffolds might provide a potential strategy for the treatment of traumatic brain injury and lay a solid foundation for clinical translation.

Four kinds of antibody positive paraneoplastic limbic encephalitis: A rare case report

BACKGROUND It is not uncommon to develop autoimmune encephalitis and paraneoplastic neurological syndromes(PNS).4 kinds of antibody-positive autoimmune paraneoplastic limbic encephalitis(PLE)have not been reported.CASE SUMMARY PNS are distant effects of cancer on the nervous system,rather than syndromes in which cancer directly invades and metastasizes to the nerves and/or muscle tissues.If the limbic lobe system of the brain is involved,this will result in PLE.The detection of patients with PNS is challenging since tumors that cause paraneoplastic neurologic disorders are often asymptomatic,obscure,and thus easily misdiagnosed or missed.Currently,single-or double-antibody-positive paraneoplastic marginal encephalitis has been reported.However,no cases of three or more-antibody-positive cases have been reported.Here,we report a case of PLE that is anti-collapsing response-mediator protein-5,anti-neuronal nuclear antibody-type 1,anti-aminobutyric acid B receptor,and anti-glutamate deglutase positive,and address relevant literature to improve our understanding of the disease.CONCLUSION This article reports on the management of a case of PLE with four positive antibodies,a review of the literature,in order to raise awareness among clinicians.

Protein Disulfide Isomerase A2 Is Correlated with Immune Infiltrates and Is a Novel Prognostic Biomarker in Glioma Patients

Objective Protein disulfide isomerase A2(PDIA2),a member of the protein disulfide isomerase family,plays a key role in the folding of nascent proteins in the endoplasmic reticulum by forming disulfide bonds,together with enzymes such as thiol isomerase,oxidase,and reductase.This study investigated the clinical significance and potential functions of PDIA2 in glioma.Methods The expression of PDIA2 in gliomas was explored using The Cancer Genome Atlas and Gene Expression Omnibus databases.We analyzed the clinical characteristics of glioma patients and the prognostic and diagnostic value of PDIA2 expression.Kaplan-Meier and Cox regression analyses were used to examine the effect of PDIA2 expression on overall survival,progression-free interval,and disease-specific survival.Furthermore,we performed Gene Set Enrichment Analysis and immune infiltration analysis to investigate the functions of PDIA2.PDIA2 mRNA and protein expression was evaluated in cell lines and glioma tissues.Results PDIA2 was expressed at low levels in glioma patients.Kaplan-Meier survival analysis showed that glioma patients with low PDIA2 levels had a worse prognosis than those with high PDIA2 levels.Receiver operating characteristic curve analysis indicated the diagnostic and prognostic ability of PDIA2(area under the curve=0.918).Pathways associated with PD1,PI3K/AKT,cancer immunotherapy via PD1 blockade,Fceri-mediated NF-kB activation,FOXM1,and DNA repair were enriched in glioma patients with low levels of PDIA2.PDIA2 expression levels were negatively correlated with immune cell infiltrate levels.Conclusion PDIA2 levels are significantly downregulated in glioma.PDIA2 expression may be a potential biomarker for the diagnosis and prognosis of glioma patients.

Epidemic Japanese B encephalitis combined with contactinassociated protein-like 2 antibody-positive autoimmune encephalitis:A case report

BACKGROUND It is not uncommon to develop viral encephalitis.Epidemic Japanese B encephalitis infection combined with contactin-associated protein-like 2(CASPR-2)antibody-positive autoimmune encephalitis has not been reported at present.In clinical work,we need to consider more options.CASE SUMMARY A 32-year-old male worker presented with headache,fever and call-unresponsive presentation.Complete cranial magnetic resonance image showed symmetrical abnormal signals in bilateral medial temporal lobe,bilateral thalamus and basal ganglia.Improved lumbar puncture showed that cerebrospinal fluid protein and cell count increased significantly.Viral encephalitis was considered,and the patient's consciousness still increased rapidly after antiviral treatment.Further detection of Cerebrospinal fluid Japanese B encephalitis virus Polymerase Chain Reaction positive,serum autoimmune encephalitis antibody showed CASPR-2 antibody positive(1:320),the patient's condition gradually improved after plasma exchange treatment.3 mo later,the serum CASPR-2 antibody was negative and the patient's condition was stable.CONCLUSION This article reports the world’s first case of Epidemic Japanese B encephalitis infection combined with CASPR-2 antibody-positive autoimmune encephalitis,with a view to raising awareness.

Rare cause of cerebral venous sinus thrombosis:Spontaneous intracranial hypotension syndrome:A case report

BACKGROUND Spontaneous intracranial hypotension syndrome is a relatively uncommon neurological disorder of unknown etiology with a good prognosis.Cerebral venous sinus thrombosis is a specific type of cerebrovascular disease caused by multiple etiologies of cerebral venous sinus or vein thrombosis that obstructs cerebral venous return and is associated with impaired cerebrospinal fluid absorption;this entity is rarely seen clinically.Spontaneous intracranial hypotension syndrome is one of the causes of cerebral venous sinus thrombosis,and the probability of their combined occurrence is only 1%-2%.As such,it is easily overlooked clinically,thus increasing the difficulty of diagnosis and treatment.CASE SUMMARY A 29-year-old young woman presented with postural headache.Lumbar puncture suggested a pressure of 50 mmH2O(normal 80 mmH2O-180 mmH2O),and magnetic resonance imaging cerebral venography suggested thrombosis of the supratentorial sinus.These findings were considered indicative of cerebral venous sinus thrombosis due to spontaneous intracranial hypotension syndrome after ruling out immunological causes,tumor,infection,abnormal coagulation mechanism,and hypercoagulable state,etc.She was treated with rehydration and low-molecular heparin anticoagulation for 15 d,and follow-up magnetic resonance imaging cerebral venography suggested resolution of the thrombus.The patient had complete improvement of her headache symptoms.CONCLUSION Spontaneous intracranial hypotension syndrome is one of the rare causes of cerebral venous sinus thrombosis,which is frequently misdiagnosed or missed and deserves consideration by clinicians during differential diagnosis.Dehydration should be avoided in such patients,and early rehydration and anticoagulation therapy are effective treatment options.

Caregiver burden:A concept analysis

Objective:Caregiver burden is used frequently within the nursing literature.It has not yet been clearly defined as there are different opinions regarding this concept.The purpose of this paper is to provide clarity surrounding the concept caregiver burden.Methods:An electronic search of MEDLINE,CINAHL,Health Source Nursing/Academic Edition and Academic Search Complete(ASC)of EBSCO,China National Knowledge Infrastructure(CNKI)and Google Scholar were searched with a limit of 10 years and published in the English or Chinese language.The paper adopted the framework by Walker and Avant.The attributes,antecedents,consequences and uses of the concept were identified.Results:At total of 33 articles were included.The three attributes of caregiver burden were identified as self-perception,multifaceted strain,and over time.The antecedents included insufficient financial resources,multiple responsibility conflict,lack of social activities.The consequences of caregiver burden resulted in negative change which included decreased care provision,decrease in quality of life,physical and psychological health deterioration.Conclusion:A definition of caregiver burden was developed.Tools to measure caregiver burden were identified.The findings from this analysis can be used in nursing practice,nursing education,research and administration.

Nerve growth factor alleviates cerebral infarction and neurologic deficits by regulating VEGF,SDF-1 and S100A12 expression through PI3K pathway

Stroke remains the leading cause of death and disability worldwide,which destroys the quality of patients’lives and thus is becoming a heavy burden to the society.However,the current therapeutic approaches are far from satisfaction.The objective of this study is to elucidate the impact of nerve growth factor(NGF)on the brain damage induced by cerebral ischemia and its potential molecular mechanism.Middle cerebral artery occlusion(MCAO)rats were used as animal models and neurological functions were evaluated by modified Neurological Severity Score(NSS).Brain cell apoptosis was analyzed by TUNEL-positive staining while brain infarct size was determined according to 2% 2,3,5-triphenyltetrazolium chloride(TCC)staining volume.Rats receiving NGF demonstrated significantly alleviated brain damage,reflected by a substantial improvement in the neurobehavioral outcome,a decrease in brain cell apoptosis and shrinkage of brain infarct volume.Further analysis revealed a markedly elevated circulating vascular endothelial growth factor(VEGF)and stromal cell-derived factor 1(SDF-1)levels as well as a significant downregulation of SA10012 expression in NGF treated group compared with the untreated group.Strikingly,the protective effect of NGF on cerebral ischemic injury was abolished in rats treated with both NGF and PI3K inhibitors,indicating that phosphoinositide-3-kinase(PI3K)signaling is essential for NGF function.In conclusion,NGF treatment might be a potential therapeutic approach against cerebral infarction by downregulating SA10012 expression and upregulating VEGF,SDF-1 in a PI3K signaling dependent manner.

Successful Management of Wound Dehiscence after Total Knee Arthroplasty by Topically Using Recombinant Basic Fibroblast Growth Factor

Wound complications are estimated to be affected in about 9% of TKA patients, which may increase the risk of deep periprosthetic infection and results in re-operation, joint fusion, or amputation. Here we have reported a female patient who suffered wound rupture due to early post-operation mobilization and weight-bearing. The wound dehiscence was successfully managed by applying recombinant basic fibroblast growth factor-2 and anti-infective treatment without removing prosthetic joint.

A review of the research on music therapy in hospice care

Objective:To summarize the research progress of music therapy in hospice care and to provide reference for further research.Methods:A wide range of literatures on music therapy and hospice care at home and abroad were searched and read,and the literature was integrated,judged,analyzed,and summarized.Results:The related research on music therapy in hospice care mainly focused on western developed countries such as Europe and the United States.China is still in the stage of theoretical exploration,lacking qualitative research based on case investigation and empirical research based on data statistics.Conclusions:Music therapy supports the management of symptoms in hospice care,which can meet the diverse needs of patients and their family members including physical,psychological,social,and spiritual.

Mental health is as important as physical health: The degree and influencing factors of self-perceived burden in elderly patients with essential hypertension

Objective: The purpose of the study is to investigate the degree and influencing factors of self-perceived burden in elderly patients with essential hypertension in China's Mainland. Methods:The study used the cross-sectional investigation method and the patients were recruited from six tertiary hospitals in Chengdu, China. A convenience sample of 451 elderly patients with essential hypertension was included in this study. Multiple linear regression analysis was performed as well. Results: Results showed that the score of elderly essential hypertension patients’self-perceived burden was 27.96 ± 6.04, which was at medium degree. According to Spearman's r test the anxiety, depression and medication compliance with Self-perceived burden (SPB) of elderly hypertension patients were statistically significant (r=0.372, 0.899,0.438,P=0.000,respectively). Single factor analysis showed that the difference of patients’ gender, place of residence, monthly per capita income, marital status, whether can afford medical expenses and number of complications in SPB scores was statistically significant (P<0.05). Multiple regression analysis also showed that anxiety, medication compliance, age and marital status were the main influencing factor of SPB of elderly hypertension patients (P<0.05). Conclusion: Our care workers should pay attention to the self-perceived burden of elderly patients with essential hypertension, and omnibearing, systematic nursing should be supplied to decrease the self-perceived burden of them.

Neoadjuvant chemotherapy for patients with locally advanced penile cancer:an updated evidence

Neoadjuvant chemotherapy(NAC)has shown promising results in patients with locally advanced penile cancer.However,no consensus exists on its applications for locally advanced penile cancer.Thus,it is unclear which kind of chemotherapy regimen is the best choice.Consequently,a systematic search of PubMed,Web of Science,and EMBASE was performed in March 2021 to assess the efficacy and safety of NAC for the treatment of patients with locally advanced penile cancer.The Newcastle–Ottawa Scale was used to assess the risk of bias in each study.This study synthesized 14 published studies.The study revealed that patients who achieved an objective response to NAC obtained a better survival outcome compared with those who did not achieve an objective response.In addition,the objective response rates(ORRs)and pathological complete response(pCR)rates were 0.57 and 0.11,respectively.The incidence of grade≥3 toxicity was 0.36.Subgroup analysis found that the ORR and pCR of the taxane–platinum(TP)regimen group performed better than those of the nontaxane–platinum(NTP)regimen group(0.57 vs 0.54 and 0.14 vs 0.07,respectively).Moreover,the TP regimen group had more frequent toxicity than the NTP regimen group(0.41 vs 0.26).However,further studies were warranted to confirm the findings.

Progress of Traditional Chinese Medicine Therapy in Preventing and Treating Radiation Enteritis

At present,there is no unified clinical approach for the treatment of radiation enteritis(RE).Clinically,its treatment is mainly based on nutritional support,mucosal protective agents,somatostatin,and microecological preparations.On the basis of syndrome differentiation and treatment,traditional Chinese medicine(TCM)is mainly used for internal administration,enteroclysis,acupuncture,and Tuina.It shows significant advantages in relieving the adverse reactions of radiotherapy and exhibits significant preventive and therapeutic effects against RE.This article reviews two aspects of TCM on RE,including internal and external administration,to explore and develop an effective and reliable standardized Chinese medicine program.

Semiquantitative assessment of iodine extravasation in acute ischemic stroke after mechanical thrombectomy

Iodine extravasation is commonly seen in stroke patients after successful mechanical thrombectomy.Iodine extravasation may be associated with patient prognosis,and more iodine extravasation is highly associated with the development of severe hemorrhagic transformation(HT).Hence,it is essential to identify early hemorrhage after intra-artery therapy and the imaging indicators that can predict late hemorrhage transformation.

Oxytocin receptor variant rs53576 genotype is associated with dysphoric arousal symptoms of DSM-5 posttraumatic stress disorder in Chinese earthquake survivors

Purpose:Evidence suggests that the oxytocin receptor(OXTR)gene may be involved in the psychopathology of posttraumatic stress disorder(PTSD).This study aimed to investigate the effects of OXTR rs53576 genotype on PTSD symptoms introduced in the Diagnostic and Statistical Manual,Fifth Edition(DSM-5).Methods:This study was a cross-sectional study conducted among 1140 adults who had personally experienced the Wenchuan earthquake.PTSD symptoms were measured with the PTSD checklist for DSM-5.A custom-by-design 2×48-Plex SNPscan TM Kit were used to determine the OXTR rs53576.Multiple regression models were used to analyze the independent and interactive effects of OXTR rs53576 genotype and earthquake exposure on the severity of total PTSD symptoms and different dimensions of PTSD symptoms.Results:The results revealed that the rs53576 genotype could significantly predict PTSD symptoms(β=0.055,p=0.045).Further analysis showed that the rs53576 genotype was only significantly associated with dysphoric arousal symptoms of PTSD(β=0.080,p=0.005).The rs53576 genotype×earthquake exposure interaction had no significant effect on different symptom clusters(p>0.05).Conclusion:This study showed that the rs53576 genotype was only associated with the dysphoric arousal symptoms but not with other symptom clusters of PTSD.These findings support the role of the OXTR on the psychopathology of PTSD and help us to understand the genetic basis of PTSD.