Endoscopic ultrasound elastography for differentiating between pancreatic adenocarcinoma and inflammatory masses:A meta-analysis

AIM:To evaluate the accuracy of endoscopic ultrasound(EUS)elastography for differentiating between pancreatic ductal adenocarcinoma(PDAC)and pancreatic inflammatory masses(PIM).METHODS:Electronic databases(updated to December 2012)and manual bibliographical searches were carried out.A meta-analysis of all diagnostic clinical trials evaluating the accuracy of EUS elastography in differentiating PDAC from PIM was conducted.Heterogeneity was assessed among the studies.The metaanalysis was performed to evaluate the accuracy of EUS elastography in differentiating PDAC from PIM in homogeneous studies.RESULTS:Ten studies involving 781 patients were included in the analysis.Significant heterogeneity in sensitivity was observed among the studies(Cochran Q test=24.16,df=9,P=0.0041,I2=62.8%),while heterogeneity in specificity was not observed(Cochran Q test=5.93,df=9,P=0.7473,I2=0.0%).The area under the curve under the Sports Rights Owners Coalition was 0.8227.Evaluation of heterogeneity suggested that the different diagnostic standards used in the included studies were the source of heterogeneity.In studies using the color pattern as the diagnostic standard,the pooled sensitivity,specificity,positive likelihood ratio(LR),negative LR and diagnostic OR were0.99(0.97-1.00),0.76(0.67-0.83),3.36(2.39-4.72),0.03(0.01-0.07)and 129.96(47.02-359.16),respectively.In studies using the hue histogram as the diagnostic standard,the pooled sensitivity,specificity,positive LR,negative LR and diagnostic OR were 0.92(0.89-0.95),0.68(0.57-0.78),2.84(2.05-3.93),0.12(0.08-0.19)and 24.69(12.81-47.59),respectively.CONCLUSION:EUS elastography is a valuable method for the differential diagnosis between PDAC and PIM.And a preferable diagnostic standard should be explored and improvements in specificity are required.

CCNO mutation as a cause of primary ciliary dyskinesia:A case report

BACKGROUND Primary ciliary dyskinesia(PCD)is an uncommon and genetically diverse condition.According to reports,most patients had more than 50 visits before being diagnosed with PCD,and the age at diagnosis was mostly in preschool,with an average age of about(10.9±14.4)years old.CCNO is a pathogenic gene that regulates the cell cycle,and its mutation is linked to the uncommon human genetic disorder PCD.Although the prevalence of the CCNO mutation is regarded to be exceptionally low,new reports of this mutation have increased in comparison to prior ones.PCD patients with CCNO are rare,and the incidence rate is no more than 2%in whole PCD patients.CASE SUMMARY Here,we report a case of a young Chinese woman diagnosed with PCD,who was found to carry the CCNO gene by whole exon gene sequencing.In this case,a young non-smoking Chinese female exhibiting recurrent cough and sputum at birth.Chest computed tomography(CT)showed bronchiectasis with infection,and sinus CT showed chronic sinusitis.However,the patient had no visceral transposition and no history of infertility.Under electron microscope,it was found that cilia were short and reduced in number,and no power arm of cilia was observed.Whole exon sequencing analysis of the genome of the patient showed that the patient carried CCNO pathogenic gene,exon c.303C>A nonsense mutation and c.248_252dup frameshift mutation.Her clinical symptoms and CT images were improved after two months of treatment with aerosol inhalation and oral azithromycin.CONCLUSION The results showed that CCNO is an important cause of PCD.More mutant genes that may contribute to genetically diverse disorders like PCD have been discovered as sequencing technology has advanced.Furthermore,the increase of genetic information makes it easier to diagnose uncommon diseases in clinical practice.

A simple,universal and multifunctional template agent for personalized treatment of bone tumors

Bone tumors occur in bone or its accessory tissues.Benign bone tumors are easy to cure and have good prognosis,while malignant bone tumors develop rapidly and have poor and high mortality.So far,there is no satisfactory treatment method.Here,we designed a universal template vector for bone tumor therapy that simultaneously meets the needs of bone targeting,tumor killing,osteoclast suppression,and tumor imaging.The template is composed of a polydopamine(PDA)core and a multifunctional surface.PDA has excellent biosafety and photothermal performance.In this study,alendronate sodium(ALN)is grafted to enable its general bone targeting function.PDA core can carry a variety of chemotherapy drugs,and the rich ALN group can carry a variety of metal ions with an imaging function.Therefore,more personalized treatment plans can be designed for different bone tumor patients.In addition,the PDA core enables photothermal therapy and enhanced chemotherapy.Through template drug Doxorubicin(DOX)and template imaging ion Fe(II),we systematically verified the therapeutic effect,imaging effect,and inhibition of bone dissolution of the agent on Osteosarcoma(OS),a primary malignant bone tumor,in vivo.In conclusion,our work provides a more general template carrier for the clinical treatment of bone tumors,through which personalized treatment of bone tumors can be achieved.

2000至2021年线上医学教学研究的热点与演化

目的本文总结我国线上医学教学在2000至2021年的发展历程、热点和前沿,以期为今后相关研究提供参考和借鉴。方法采用文献计量学方法,以线上医学教学为主题的3972篇论文作为资料来源,利用CiteSpace文献计量软件对2000至2021年期间年发文量和关键词进行分析。结果2000至2018年,年发文量从18篇增长至239篇,年均发文量增长率为15.5%;2019至2021年,年发文量从240篇增长至732篇,年均发文量增长率74.6%。关键词聚类分析形成5类主题,前5位高中心性关键词分别为网络教学、教学改革、线上教学、教学方式和医学教育。近3年的前沿主题突现词为自主学习、实践教学和慕课。结论2019年以来,线上医学教学相关研究发文量增长明显加速,涵盖学科范围不断扩大,新兴技术应用不断增多,教学理念不断变革。以学导教、主动学习和线上线下教学融合等内容是当前的研究热点。如何加强在线课堂即时交互性,培养学生自我管理能力和终身学习理念,推动线上教学与虚拟现实等新技术融合,提升教学质量是今后研究的重要方向。