Tzu Chi Medical Journal最新文献

Cell culture technologies are fundamental tool in biological research. Traditional two-dimensional (2D) cell culture methods, despite their widespread use and simplicity, fail to accurately replicate the physiological conditions of native tissues, leading to altered cellular behavior. Recent advancements in 3D culture techniques, combined with innovative fabrication methods such as photolithography, paper-based, and 3D printing, have substantially improved the fidelity of cell culture models. In parallel, numerical simulations have become indispensable for optimizing the design and performance of these systems, offering precise control microenvironmental factors such as fluid dynamics, nutrient and oxygen gradients, and shear stress within microfluidic platforms. These approaches for integration facilitate accurate modeling of cell-to-cell and cell-to-matrix interactions essential for physiological relation. Concurrently, the integration of multimaterial fabrication techniques provides scalable and customizable solutions for developing sophisticated microfluidic and cell culture systems. This review discusses recent developments in these fabrication methods and highlights their integration with numerical simulation for optimization design, explores their collective potential to advance biomedical research and applications.

Objectives: The role of LOC441461, a long noncoding RNA, differs in different cancer types, and its role in lung cancer remains unclear.

Materials and methods: We investigated the clinical significance of LOC441461 expression in lung cancer using bioinformatics analyses. To explore the biological function of LOC441461, we performed siRNA-mediated knockdown in lung cancer cells and evaluated its effects on cell proliferation, colony formation, apoptosis, and cell cycle progression.

Results: LOC441461 was found to be significantly overexpressed in lung adenocarcinoma (LUAD), and LOC441461 overexpression was significantly associated with poor prognosis in patients with LUAD. LOC441461 knockdown significantly inhibited cell growth and induced a modest but statistically significant increase in apoptosis in lung cancer cells. According to a cell cycle analysis, LOC441461 knockdown induced G0/G1 arrest in A549 cells; increased p21 and p27 expression; and reduced the levels of CDK4 and the cyclins A2, B1, and D1, similar to p53-dependent regulation. By contrast, H1299 cells exhibited G2/M accumulation with no change in p21 and p27 levels, suggesting a p53-independent mechanism.

Conclusion: Our findings indicate that high LOC441461 expression is correlated with worse prognosis in LUAD. These results support the potential of LOC441461 as a novel therapeutic and prognostic target in LUAD.

Congenital anomalies of the female genital tract, such as vaginal septa, arise from disruptions in Müllerian ducts and urogenital sinus development. Vaginal septa, including longitudinal and transverse types, are rare and often remain undiagnosed due to asymptomatic presentation. However, they can lead to significant complications such as dyspareunia, infertility, and obstructed labor. This narrative review aims to provide a detailed overview of the clinical presentation, diagnosis, and management of vaginal septum, with a particular focus on the challenges encountered during pregnancy and labor. A systematic search of PubMed, Web of Science, Scopus, and Embase identified 34 relevant articles, including 16 case reports detailing labor outcomes in women with vaginal septum. The review highlights that timely diagnosis through pelvic examination and imaging, such as magnetic resonance imaging or ultrasound, can prevent labor complications. Management options range from conservative observation in asymptomatic cases to surgical resection, which can be performed intrapartum or before delivery to facilitate vaginal birth. The presence of associated anomalies, including uterine malformations and renal agenesis, underscores the need for thorough evaluation. Postoperative outcomes are generally favorable, though careful surgical planning is essential to avoid complications such as restenosis or infection. Clinicians should remain highly vigilant for women with unexplained infertility, menstrual abnormalities, or labor obstruction. Early identification and individualized management of vaginal septum can optimize obstetric outcomes and preserve reproductive function. Future research should aim to improve early detection methods, refine surgical techniques, and investigate the genetic and embryological basis of these rare anomalies.

Lateral flow immunoassay (LFIA) is a widely recognized point-of-care diagnostic platform for detecting various analytes. It must meet the criteria of REASSURED, but poor sensitivity and lack of precision in test results remain the main bottlenecks of LFIA. Therefore, signal enhancement methods, such as devices, nanoprobes, or detection modes, can improve this platform. In this paper, many representative studies from the past decade on LFIA sensing platforms will be discussed in detail.

Autism spectrum disorder (ASD) is a group of diverse neurodevelopmental conditions characterized by deficits in social communication and interaction, as well as confined and repetitive patterns of behaviors, interests, or activities. Currently, there are no standardized techniques for predicting functional ability in children with ASD, which can lead to undetected clinical impairments and delayed targeted treatments. To address this issue, a scoping review was conducted following the preferred reporting items for systematic reviews and meta-analyses criteria. Twelve articles met the inclusion criteria for this review. This study summarized the potential tools and parameters that may benefit in predicting abilities used in the daily lives of children with ASD. The collected tools varied widely, including clinical questionnaires, physical symptoms, laboratory tests, and imaging studies. These tools provided descriptions of various functional abilities that are altered in ASD, offering insights into the diverse manifestations of the disorder and potential approaches for assessment and intervention.

Objectives: Proper catheter selection during right trans-radial coronary angiography reduces procedure duration, costs, and vascular complications. The correlation between aorta morphological parameters assessed through computed tomography (CT) and requirement for larger catheter size was investigated in this study.

Materials and methods: This observational study includes 206 patients who underwent right trans-radial coronary angiography and had already undergone coronary CT angiography at a recognized center from April 2023 to January 2025. Patients who completed angiography using a Judkins left (JL) 3.5 (Group 1) catheter were compared with patients who required catheter exchange with a JL 4 or larger (Group 2). Both groups had their CT images analyzed for four specific aortic morphological variables.

Results: A total of 167 patients formed Group 1, whereas 39 patients formed Group 2. The significant differences were detected in the maximal area and length of the ascending aorta among the four aortic CT variables. In multivariable logistic regression model, the strongest association with the need for JL4 or more catheter (Group 2) was found with the maximal area of the ascending aorta (odds ratio [OR] 31.82 [(95% confidence interval [CI]) 1.21-831.18], P < 0.001) followed by length of the ascending aorta (OR 29.97 [(95% CI) 1.06-845.08], P < 0.001). An ascending aorta maximal area cutoff value was 12.25 cm² (SN 94.9%, SP 95.2%) with the derived diameter of 3.94 cm.

Conclusion: Maximum area (with derived diameter) and ascending aortic length were the good predictors for suitable catheter selection during right trans-radial invasive coronary angiography.

Hemorrhagic stroke, mainly caused by intracerebral hemorrhage (ICH), is a severe neurological condition with high mortality and lasting disability. ICH involves bleeding into the brain parenchyma, hematoma formation, and subsequent edema and tissue damage, triggering inflammatory and degenerative responses that worsen secondary brain injury (SBI). Microglia, the brain's resident immune cells, are key mediators in this process. Their ability to sense, engulf, and clear hematoma-derived debris is essential for controlling neuroinflammation and promoting tissue repair. Central to microglial phagocytosis is lysosomal function. Lysosomes contain hydrolases - proteases, glycosidases, lipases, and nucleases - that degrade proteins, lipids, carbohydrates, and nucleic acids. This coordinated degradation ensures effective recycling of phagocytosed materials and clearance of cellular debris after hemorrhage. However, lysosomal dysfunction impairs microglial clearance capacity, leading to persistent inflammation, aggravated neuronal damage, and poor neurological recovery after ICH. This review focuses on the interplay between microglial activation, lysosomal function, and phagocytosis in hemorrhagic stroke. We examine how lysosomal impairment hinders hematoma resolution, propagates SBI, and delays functional recovery. In addition, we highlight emerging therapeutic strategies targeting the microglia-lysosome axis, such as enhancing lysosomal biogenesis and enzyme activity, as promising approaches to boost hematoma clearance and improve outcomes. Understanding and modulating microglial lysosomal function offers novel therapeutic avenues for ICH management, aiming to mitigate secondary injury and support neurological recovery.

End-stage kidney disease (ESKD) presents a major clinical burden, with maintenance hemodialysis (HD) patients facing high cardiovascular mortality and impaired quality of life (QoL). Despite advances from low-flux to high-flux HD and the introduction of hemodiafiltration (HDF), clearance of large middle molecules (LMMs >25 kDa) remains inadequate. These molecules contribute to inflammation, oxidative stress, atherogenesis, and mineral-bone disorders, all of which worsen patient outcomes. Expanded hemodialysis (HDx), utilizing medium cutoff membranes, represents a novel approach that combines diffusion and enhanced internal convection to improve LMMs removal, without the need for substitution fluid. This review explores the limitations of conventional HD, the pathological roles of LMMs, and the evolution of dialysis strategies aimed at enhancing solute clearance. Evidence from observational studies, randomized trials, and meta-analyses shows that HDx improves the removal of inflammatory LMMs, reduces hospitalization burden, preserves residual kidney function, and enhances patient-reported outcomes such as recovery time and symptom relief. Furthermore, HDx offers a practical and cost-effective alternative to online HDF (OL-HDF), particularly in the resource-limited settings, achieving comparable efficacy with shorter sessions and lower blood flow requirements. By addressing the key shortcomings of traditional HD and approaching the solute clearance profile of the native kidney, HDx offers a promising advancement in the care of ESKD patients.

Oral squamous cell carcinoma represents a significant public health challenge in Asia, where multimodal therapies, while extending survival, impose substantial biologic and psychosocial stress. Sustained activation of the sympathetic-adrenal-medullary axis and dysregulation of the hypothalamic-pituitary-adrenal axis increase catecholamines, cortisol, interleukin-6, and C-reactive protein, accelerating tumor progression, impairing treatment tolerance, and increasing cardiovascular risk. Betel quid chewing, prevalent in the region, exacerbates inflammation and contributes to cardiovascular comorbidities. Resilience, defined as the ability to restore physiologic and emotional homeostasis, modulates these pathways, with higher resilience linked to improved recovery, quality of life, and survival. Current evidence supports interventions including structured psychoeducation, cognitive-behavioral therapy, and peer mentoring to reduce anxiety and enhance treatment adherence. Smoking and betel quid cessation, alongside cardiometabolic optimization, mitigate inflammatory burden. Nonopioid strategies, including acupuncture, transcutaneous vagus nerve stimulation, and mindfulness, recalibrate neuro-immune signaling while minimizing opioid reliance. Enhanced recovery surgical protocols and omega-3 supplementation attenuate inflammatory responses and preserve lean mass. Emerging biomarkers such as heart rate variability and neutrophil-lymphocyte ratio show promise for real-time stress and inflammation monitoring. Digital health technologies and telerehabilitation extend intervention benefits postdischarge. Future research should focus on validating predictive biomarkers, developing resilience-stratified trials, integrating cardio-oncology surveillance, and implementing precision supportive care models that incorporate stress, inflammation, and resilience metrics to optimize oncologic and cardiovascular outcomes in this high-risk population.