Ménétrier's disease (MD) is a relatively rare special type of gastritis in clinical practice.This article reports the multiple diagnosis and treatment processes of a patient with MD in the northwest plateau region,reviews relevant literature,and summarizes the ultrasonic features of gastrointestinal contrast-enhanced ultrasound in this case and their value in the diagnosis and treatment process.Furthermore,this article discusses the key points of imaging differentiation of MD from chronic hypertrophic gastritis,multiple gastric polyps,gastric cancer,and gastric lymphoma.
The establishment and development of neonatal intensive care unit(NICU)have significantly increased the survival rate of premature infants.However,the diagnosis,treatment,and surgeries performed in NICU may expose neonates to more noxious stimuli.As the neonatal period is crucial for brain development,these noxious stimuli may cause irreversible damage to the neonatal nervous system.Existing clinical studies have shown that repetitive noxious stimuli during the neonatal period can lead to poor brain development,persistent hyperalgesia,and various sequelae.However,the underlying mechanisms remain unclear,and effective treatment methods are lacking.This article summarizes the effects of repetitive noxious stimuli during the neonatal period on neural development and the complications,aiming to provide a basis for the neonatal analgesia management and the prevention and treatment of related sequelae.
Gastric contrast-enhanced ultrasound includes oral contrast-enhanced ultrasound (OCUS) and double contrast-enhanced ultrasound (DCEUS),which can provide valuable clinical information about tumor morphology,vascular characteristics,and treatment responses.OCUS can clearly identify the gastric wall structure and the extent and depth of lesions by applying oral contrast agents.DCEUS,based on OCUS combined with venography,can display the anatomical and perfusion characteristics of lesions.In recent years,gastric contrast agents and imaging techniques have developed rapidly.However,the clinical application of gastric contrast-enhanced ultrasound is still in the developmental stage.This article reviews the clinical status of OCUS and DCEUS in the screening,diagnosis,staging,pathological typing,and treatment evaluation of gastric cancer.Studies have shown that gastric contrast-enhanced ultrasound has high sensitivity and specificity in the assessment of diagnosis and T-staging of gastric cancer.Furthermore,gastric contrast-enhanced ultrasound has the advantages of being cost-effective,convenient,non-invasive,free from radiation exposure,real-time,and easy to repeat.In the diagnosis and treatment of gastric cancer,it is expected to become one of the important imaging assessment tools.
Objective To investigate the effects of folate deficiency on changes in histone H3 lysine 4 (H3K4) mono-methylation (me1)-marked enhancers and the molecular mechanism underpinning the folate deficiency-induced neural tube defects (NTD). Methods Mouse embryonic stem cells (mESCs) were cultured in the folate-free DMEM medium (folate-deficient group) and the DMEM medium containing 4 mg/L folate (normal control group),respectively.Chromatin immunoprecipitation sequencing (ChIP-seq) was performed for H3K4me1. The mouse model of folate-induced NTD was established,and transcriptome sequencing (RNA-seq) was performed for the brain tissue of fetal mice to reveal the differential expression profiles.The results were validated through real-time quantitative polymerase chain reaction (RT-qPCR).The activity of the differential peak regions of H3K4me1 was verified through the luciferase reporter assay. Results The folate content in the mESCs cultured in the folate-free medium reduced compared with that in the normal control group (P=0.008).The H3K4me1-maked enhancers in the mESCs cultured in the folate-free medium induced significant changes in intronic regions,and these changes were concentrated in metabolic and energy metabolism processes (q=9.56×10-48,P=1.28×10-47).The differentially expressed genes harboring H3K4me1-marked enhancers in mESCs were mainly enriched in the Wnt signaling pathway (q=0.004,P=0.004 7).ChIP-qPCR results confirmed that H3K4me1 binding decreased in the differential peak regions of the Ldlrap1 gene (P=0.008),Camta1 gene (P=0.002),and Apc2 gene (P=0.012).The H3K4 demethylase inhibitor T-448 effectively reversed the H3K4me1 binding in the differential peak regions of the aforementioned genes (P=0.01).The results of RNA-seq for the brain tissue of NTD fetal mice showed significant enrichment of the differentially expressed genes in the Wnt signaling pathway (P=1.52×10-5).The enrichment of differential peak regions of H3K4me1-marked enhancers in Apc2,Ldlrap1,and Camta1 genes in the brain tissue also showed significant changes.The differential peak region in Apc2 exhibited transcription factor activity (P=0.020). Conclusion Folate deficiency may affect changes in H3K4me1-marked enhancers to participate in the regulation of neural tube closure genes,thereby inducing the occurrence of NTD.
Head and neck squamous cell carcinoma(HNSCC) associated with a poor prognosis and diminished quality of life for patients is the most prevalent pathological type among head and neck tumors. Currently,the standard treatment modalities comprise systemic therapies(including chemotherapy,targeted therapy,and immunotherapy) and local therapies(surgery and radiotherapy).Immunotherapy,characterized by high specificity and low toxicity,is progressively expanding from advanced palliative care to the stage of locally advanced curative treatment and has demonstrated promising efficacy.This review summarizes the latest advances in immunotherapy for HNSCC,aiming to provide reference for optimizing clinical management strategies and facilitating the clinical research.
Objective To evaluate the diagnostic value of intestinal ultrasound (IUS) for organic lesions in the intestines of patients with chronic abdominal pain or diarrhea. Methods The IUS signs in 263 patients with chronic abdominal pain or diarrhea were retrospectively analyzed.With the endoscopic examination results as the gold standard,comparison was performed for the IUS signs between the groups with positive and negative endoscopic results,as well as between the inflammatory bowel disease group and the non-specific intestinal inflammation group of positive cases.Furthermore,the detection rates of IUS in different intestinal segments were analyzed to evaluate the accuracy of IUS in the diagnosis and localization of intestinal lesions. Results Among the 263 patients,194 (73.8%) and 69 (26.2%) patients were in the groups with positive and negative endoscopic results,respectively.The diagnosis sensitivity,specificity,and accuracy of IUS were 82.0%,71.0%,and 79.1%,respectively.The proportions of positive IUS signs in the group with positive endoscopic results were higher than that in the group with negative endoscopic results (all P<0.001).The proportions of positive IUS signs in the inflammatory bowel disease group were higher than those in the non-specific bowel inflammation group (all P<0.001).When the lesion was located in the ileum,ileocecal region,and colon,IUS demonstrated good consistency with endoscopic results in locating the lesion (kappa=0.642,0.686,and 0.601,respectively),with sensitivity and specificity of 82.7% (95%CI=75.4%-88.6%) and 81.5% (95%CI=73.5%-87.9%),73.7% (95%CI=62.3%-83.1%) and 93.0% (95%CI=88.4%-96.2%),and 68.9% (95%CI=58.3%-78.2%) and 89.6% (95%CI=84.1%-93.7%),respectively. Conclusions IUS can be used for screening the patients with chronic abdominal pain or diarrhea to detect organic lesions in the intestines. Moreover,it can effectively locate the affected intestinal segment,which is helpful for the monitoring and follow-up of intestinal diseases.
Objective To evaluate the diagnostic value of ultrasound in chronic appendicitis. Methods A retrospective analysis was conducted on the ultrasound imaging features of the appendixes in 68 patients with chronic appendicitis (chronic appendicitis group) confirmed by pathological results at the Affiliated Hospital of Inner Mongolia Medical University from January 2023 to December 2024,as well as 85 healthy volunteers (normal appendix group) of different ages with no history of abdominal pain during the same period.Multivariate Logistic regression was employed to investigate the sensitivity and specificity of different variables in diagnosing chronic appendicitis. Results The chronic appendicitis group had higher appendix diameter (Z=-8.47,P<0.001),unilateral wall thickness (Z=-7.16,P<0.001),and submucosal thickness (Z=-9.73,P<0.001) than the normal appendix group.Appendix diameter (OR=3.11,95%CI=1.37-7.02,P=0.006) and submucosal thickness (OR=5 492.73,95%CI=89.53-336 984.13,P<0.001) were identified as independent factors for diagnosing chronic appendicitis,while gender,age,unilateral wall thickness,and intraluminal conditions had no significant impact on the diagnosis of chronic appendicitis (all P>0.05).When appendix diameter combined with submucosal thickness was used as a joint diagnostic indicator,the model demonstrated the best performance,with the sensitivity of 92.65%,the specificity of 97.65%,and the accuracy increasing to 95.42%. Conclusion The combined use of appendix diameter and submucosal thickness can significantly improve the accuracy,specificity,and reliability of ultrasound in diagnosing chronic appendicitis.
Objective To analyze the research status of in situ simulation in the medical field and explore its hotspots and trends. Methods Relevant literature was searched in China National Knowledge Infrastructure and Web of Science core collection from the inception to February 2024.CiteSpace 6.3.R1 was used to analyze the authors,institutions,and keywords and draw visual knowledge maps. Results A total of 25 Chinese articles and 438 English articles were included.Only 14 English articles were from China.In Chinese articles,the authors with the largest number of articles were Dai Hengmao and Liu Shangkun,and the institution with the largest number of articles was Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.There was little cooperation between the authors and institutions.In English articles,the author and institution with the largest number of articles was Auerbach Marc and Yale University,respectively,and the cooperation between authors and institutions was close.Emergency medicine,emergency event handling,and on-the-job training were the keywords with high frequency in Chinese articles.Patient safety,medical education,and cardiac arrest were the keywords with high frequency in English articles.A total of 4 clusters were generated for Chinese keywords and 13 clusters for English keywords. Conclusions The application of in situ simulation in the medical field is still in the initial stage,and the development is not balanced at home and abroad.The number of articles published and the cooperation between authors and institutions in China obviously lags behind those abroad.Treatment and care of emergency critical patients,emergency event handling and skill training,identification of latent safety threats,improvement of readiness,and promotion of medical quality improvement are the future research hotspots and research trends in this field.
Objective To investigate the internalized weight bias and weight control beliefs regarding the current status,influencing factors,and impacts on eating behaviors of women losing weight. Methods A convenient sampling method was used to select the females who underwent physical examination in the Peking Union Medical College Hospital from August to December 2023.The general information questionnaire,Weight Bias Internalization Scale,Weight Control Belief Questionnaire,and Chinese version of Three-Factor Eating Questionnaire were utilized for investigation.Latent class analysis was conducted to explore the potential categories based on the characteristics of internalized weight bias and weight control beliefs.Univariate analysis and multiple-factor linear regression analysis were performed to explore influencing factors of potential categories and their effects on eating behaviors. Results A total of 518 subjects were included in this study.The internalized weight bias and weight control beliefs could be classified into three potential categories: low weight bias tolerance type(53.7%),medium weight bias persistence type(29.5%),and high weight bias overcritical type(16.8%).Logistic regression analysis showed that body mass index,unmarriage,and divorce were the influencing factors of the high weight bias overcritical type.The scores of non-control eating and emotional eating in medium weight bias persistence type and high weight bias overcritical type were higher than those in low weight bias tolerance type(all P<0.001). Conclusions The attitudes of Chinese women towards body weight can be categorized into low weight bias tolerance type,medium weight bias persistence type,and high weight bias overcritical type.The high weight bias overcritical type is characterized by high weight bias and high personal responsibility attribution,and it is closely associated with negative eating behaviors.A high body mass index,unmarriage,and divorce are high-risk factors for developing the high weight bias overcritical type.
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