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Therapeutic types and advantages of functionalized nanoparticles in inducing ferroptosis in cancer therapy. 功能化纳米粒子在癌症治疗中诱导铁变态反应的治疗类型和优势。
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-14 DOI: 10.1080/07853890.2024.2396568
Ziying Wang,Miaomiao Zhao,Xiaotong Huang,Yuxin Wang,Wentong Li,Jianhong Qiao,Xiao Yang
BACKGROUNDThe clinical efficacy of cancer treatment protocols remains unsatisfactory; however, the emergence of ferroptosis-driven therapy strategies has renewed hope for tumor treatment, owing to their remarkable tumor suppression effects. Biologically based small-molecule inducers are used in conventional method to induce ferroptosis. Nevertheless, some molecular drugs have limited solubility, poor ability to target cells, and fast metabolism, which hinder their ability to induce ferroptosis over a prolonged period. Fortunately, further investigations of ferroptosis and the development of nanotechnology have demonstrated that nanoparticles (NPs) are more efficient in inducing ferroptosis than drugs alone, which opens up new perspectives for cancer therapy.OBJECTIVEIn order to organize a profile of recent advance in NPs for inducing ferroptosis in cancer therapy, and NPs were comprehensively classified in a new light.Materials and methods: We comprehensively searched the databases such as PubMed and Embase. The time limit for searching was from the establishment of the database to 2023.11. All literatures were related to "ferroptosis", "nanoparticles", "nanodelivery systems", "tumors", "cancer".RESULTSWe summarized and classified the available NPs from a new perspective. The NPs were classified into six categories based on their properties: (1) iron oxide NPs (2) iron - based conversion NPs (3) core-shell structure (4) organic framework (5) silica NPs (6) lipoprotein NPs. According to the therapeutic types of NPs, they can be divided into categories: (1) NPs induced ferroptosis-related immunotherapy (2) NPs loaded with drugs (3) targeted therapy of NPs (4) multidrug resistance therapy (5) gene therapy with NPs (6) energy conversion therapy.CONCLUSIONSThe insights gained from this review can provide ideas for the development of original NPs and nanodelivery systems, pave the way for related nanomaterials application in clinical cancer therapy, and advance the application and development of nanotechnology in the medical field.
背景癌症治疗方案的临床疗效仍不尽如人意,然而,铁突变驱动的治疗策略因其显著的肿瘤抑制作用而为肿瘤治疗带来了新的希望。基于生物的小分子诱导剂是诱导铁氧化的传统方法。然而,一些分子药物的溶解度有限、靶向细胞的能力差、代谢快,这阻碍了它们长期诱导铁氧化的能力。目的:为了梳理近年来纳米粒子在癌症治疗中诱导铁变态反应的进展,并从新的角度对纳米粒子进行全面分类:我们全面检索了 PubMed 和 Embase 等数据库。材料:我们全面检索了 PubMed 和 Embase 等数据库,检索时限为数据库建立后至 2023 年。所有文献均与 "铁中毒"、"纳米颗粒"、"纳米给药系统"、"肿瘤"、"癌症 "相关。根据纳米粒子的特性,我们将其分为六类:(1)氧化铁纳米粒子(2)铁基转换纳米粒子(3)核壳结构(4)有机框架(5)二氧化硅纳米粒子(6)脂蛋白纳米粒子。根据 NPs 的治疗类型,可将其分为以下几类:(1)NPs 诱导的铁突变相关免疫疗法(2)NPs 负载药物(3)NPs 靶向疗法(4)多药耐药性疗法(5)NPs 基因疗法(6)能量转换疗法。结论本综述所获得的见解可为原创性 NPs 和纳米给药系统的开发提供思路,为相关纳米材料在临床癌症治疗中的应用铺平道路,并推动纳米技术在医学领域的应用和发展。
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引用次数: 0
Targeting pericyte retention in Diabetic Retinopathy: a review 针对糖尿病视网膜病变中的周细胞滞留:综述
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-13 DOI: 10.1080/07853890.2024.2398200
Forrest Bohler, Lily Bohler, Varna Taranikanti
Diabetic retinopathy is a common yet severe complication of diabetes mellitus and is the leading cause of blindness in middle-aged adults. After years of poorly managed hyperglycemia, complications...
糖尿病视网膜病变是糖尿病常见而严重的并发症,也是中年人失明的主要原因。在多年的高血糖管理不善之后,并发症...
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引用次数: 0
Transcriptional profile changes caused by noise-induced tinnitus in the cochlear nucleus and inferior colliculus of the rat. 噪声诱发的耳鸣在大鼠耳蜗核和下丘引起的转录谱变化
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-13 DOI: 10.1080/07853890.2024.2402949
Xinmiao Xue,Peng Liu,Chi Zhang,Zhiwei Ding,Li Wang,Yuke Jiang,Wei-Dong Shen,Shiming Yang,Fangyuan Wang
INTRODUCTIONTinnitus is a prevalent and disabling condition characterized by the perception of sound in the absence of external acoustic stimuli. The hyperactivity of the auditory pathway is a crucial factor in the development of tinnitus. This study aims to examine genetic expression variations in the dorsal cochlear nucleus (DCN) and inferior colliculus (IC) following the onset of tinnitus using transcriptomic analysis. The goal is to investigate the relationship between hyperactivity in the DCN and IC.METHODSTo confirm the presence of tinnitus behavior, we utilized the gap pre-pulse inhibition of the acoustic startle (GPIAS) response paradigm. In addition, we conducted auditory brainstem response (ABR) tests to determine the baseline hearing thresholds, and repeated the test one week after subjecting the rats to noise exposure (8-16 kHz, 126 dBHL, 2 h). Samples of tissue were collected from the DCN and IC in both the tinnitus and non-tinnitus groups of rats. We employed RNA sequencing and quantitative PCR techniques to analyze the changes in gene expression between these two groups. This allowed us to identify any specific genes or gene pathways that may be associated with the development or maintenance of tinnitus in the DCN and IC.RESULTSOur results demonstrated tinnitus-like behavior in rats exposed to noise, as evidenced by GPIAS measurements. We identified 61 upregulated genes and 189 downregulated genes in the DCN, along with 396 upregulated genes and 195 downregulated genes in the IC. Enrichment analysis of the DCN revealed the involvement of ion transmembrane transport regulation, synaptic transmission, and negative regulation of neuron apoptotic processes in the development of tinnitus. In the IC, the enrichment analysis indicated that glutamatergic synapses and neuroactive ligand-receptor interaction pathways may significantly contribute to the process of tinnitus development. Additionally, protein-protein interaction (PPI) networks were constructed, and 9 hub genes were selected based on their betweenness centrality rank in the DCN and IC, respectively.CONCLUSIONSOur findings reveal enrichment of differential expressed genes (DEGs) associated with pathways linked to alterations in neuronal excitability within the DCN and IC when comparing the tinnitus group to the non-tinnitus group. This indicates an increased trend in neuronal excitability within both the DCN and IC in the tinnitus model rats. Additionally, the enriched signaling pathways within the DCN related to changes in synaptic plasticity suggest that the excitability changes may propagate to IC.NEW AND NOTEWORTHYOur findings reveal gene expression alterations in neuronal excitability within the DCN and IC when comparing the tinnitus group to the non-tinnitus group at the transcriptome level. Additionally, the enriched signaling pathways related to changes in synaptic plasticity in the differentially expressed genes within the DCN suggest that the excitability changes may pr
导言耳鸣是一种常见的致残性疾病,其特征是在没有外部声刺激的情况下感知声音。听觉通路的过度活跃是耳鸣发生的关键因素。本研究旨在通过转录组分析,研究耳鸣发生后耳蜗背核(DCN)和下丘(IC)的基因表达变化。方法为了确认耳鸣行为的存在,我们采用了间隙前脉冲抑制声惊跳(GPIAS)反应范式。此外,我们还进行了听性脑干反应(ABR)测试以确定基线听阈,并在大鼠暴露于噪声(8-16 kHz、126 dBHL、2 h)一周后重复该测试。我们采集了耳鸣组和非耳鸣组大鼠的直流神经网和集成电路组织样本。我们采用 RNA 测序和定量 PCR 技术来分析这两组之间基因表达的变化。结果我们的结果表明,暴露于噪声的大鼠出现了类似耳鸣的行为,GPIAS 测量结果也证明了这一点。我们在 DCN 中发现了 61 个上调基因和 189 个下调基因,在 IC 中发现了 396 个上调基因和 195 个下调基因。对直流神经网的富集分析表明,离子跨膜转运调节、突触传递和神经元凋亡过程的负调控参与了耳鸣的发生。在 IC 中,富集分析表明,谷氨酸能突触和神经活性配体-受体相互作用途径可能在耳鸣发生过程中起重要作用。结论我们的研究结果表明,与耳鸣组和非耳鸣组相比,在耳鸣组和集成电路中,与神经元兴奋性改变有关的通路相关的差异表达基因(DEGs)出现了富集。这表明耳鸣模型大鼠的直流神经网和集成电路内的神经元兴奋性均呈上升趋势。此外,DCN 中与突触可塑性变化有关的信号通路的丰富表明,兴奋性变化可能会传播到 IC。此外,在直流神经网中差异表达的基因中,与突触可塑性变化有关的信号通路丰富,这表明兴奋性变化可能会传播到集成电路。
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引用次数: 0
Clinical characteristics and pregnancy outcomes in pregnant women with TB: a retrospective cohort study. 结核病孕妇的临床特征和妊娠结局:一项回顾性队列研究。
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-13 DOI: 10.1080/07853890.2024.2401108
Jiayu Wen,Jian-Qing He
PURPOSEThe influence of pregnancy on tuberculosis (TB) has not been well studied. This study aimed to investigate the demographics, clinical characteristics and outcomes of pregnant-related TB compared with the general population with TB.METHODSWe retrospectively analysed medical records of women during pregnancy or within six months postpartum with active TB who were admitted to the West China Hospital between 2011 and 2022. According to age, gender and admission time, the general population with active TB was matched at a ratio of 1:2, and the demographics, clinical characteristics and outcomes were compared.RESULTSAll the participants in both the pregnant and non-pregnant groups were females, averaging 26 years old, with a majority of Han nationality (72.4% vs. 69.5%, respectively). The two groups were comparable (p < .05). Pregnant TB cases showed higher rates of fever (61% vs. 35%), dyspnoea (39.9% vs. 18.7%), neurological symptoms (34.4% vs. 11.0%) and miliary TB (24.5% vs. 10.9%) compared to non-pregnant cases (p < .05). Additionally, the pregnant group exhibited lower red blood cell counts (3.62 × 109/L vs. 4.37 × 109/L), lower albumin levels (31.20 g/L vs. 40.40 g/L) and elevated inflammatory markers (p < .05). Pregnant women with TB had severe outcomes, with 16.3% requiring intensive care unit (ICU) care and a 3.3% TB-related mortality rate - higher than local averages. In contrast, the non-pregnant group had lower rates (0.8% for ICU admission, and no TB-related deaths). Moreover, active TB during pregnancies led to a high rate of spontaneous abortion (34.1%), with military pulmonary TB identified as the sole risk factor for severe TB in pregnancies (OR: 3.6; 95% CI: 1.15, 11.34).CONCLUSIONSManifestations of TB in pregnant women differ from those in the general population with TB. Pregnancy complicated with active TB greatly harms the mother and foetus and requires special attention in the future.
目的:有关妊娠对结核病(TB)影响的研究还不多。方法 我们回顾性分析了 2011 年至 2022 年期间华西医院收治的妊娠期或产后 6 个月内患有活动性肺结核的妇女的病历。结果妊娠组和非妊娠组均为女性,平均年龄 26 岁,汉族占多数(分别为 72.4% 和 69.5%)。两组数据具有可比性(P < .05)。与非孕期病例相比,孕期肺结核病例出现发热(61% 对 35%)、呼吸困难(39.9% 对 18.7%)、神经症状(34.4% 对 11.0%)和粟粒性肺结核(24.5% 对 10.9%)的比例更高(P < .05)。此外,孕妇组的红细胞计数较低(3.62 × 109/L vs. 4.37 × 109/L),白蛋白水平较低(31.20 g/L vs. 40.40 g/L),炎症指标升高(P < .05)。患结核病的孕妇病情严重,16.3%的孕妇需要重症监护室(ICU)治疗,3.3%的孕妇死于结核病,高于当地平均水平。相比之下,非孕妇组的发病率较低(0.8%的孕妇需要入住重症监护室,无结核病相关死亡病例)。此外,妊娠期活动性肺结核导致自然流产率较高(34.1%),军事肺结核被确定为妊娠期严重肺结核的唯一风险因素(OR:3.6;95% CI:1.15,11.34)。妊娠合并活动性肺结核会对母亲和胎儿造成极大的伤害,今后需要特别关注。
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引用次数: 0
Evaluation of silent brain injury in patients undergoing aorto-ostial coronary stent implantation 评估主动脉支架植入术患者的无声脑损伤
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-13 DOI: 10.1080/07853890.2024.2402950
Ufuk Yildirim, Abdulkadir Kara, Muhammet Uyanik, Ahmet Onur Kocasari, Ahmet Cinar, Metin Coksevim, Bahattin Avci, Korhan Soylu, Okan Gulel
Aorto-ostial (AO) coronary interventions may be associated with multiple problems, including the potential embolization of atherothrombotic debris into the aorta and systemic circulation. Such embo...
主动脉--肋骨(AO)冠状动脉介入可能会带来多种问题,包括动脉粥样血栓碎屑可能栓塞到主动脉和全身循环中。这种栓塞...
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引用次数: 0
Reclaiming the concept of professionalism in the digital context: a principle-based concept analysis. 在数字化背景下重拾专业精神概念:基于原则的概念分析。
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-12 DOI: 10.1080/07853890.2024.2398202
Shaista Salman Guraya,Salman Yousuf Guraya,Fiza Rashid-Doubell,Salim Fredericks,Denis W Harkin,Mohd Zarawi Bin Mat Nor,Muhamad Saiful Bahri Yusoff
BACKGROUNDThere has been an alarming surge in the usage of social networking sites (SNSs) by healthcare professionals (HCPs) without adherence to the principles of professionalism. The widespread use of SNSs in medical practices has been coupled with reports of breaches of professional behaviors. Despite the benefits of SNSs, skepticism prevails about a clearly defined role for SNSs within medicine based upon the core principles of professionalism. Thus, there is a need to understand the manifestations of professionalism in the digital context, classically known as e-professionalism. This study systematically examines HCPs' perceptions of e-professionalism to advance a thorough understanding of e-professionalism.METHODSThis concept analysis was performed using the principle-based approach of Penrod and Hupcey. In January 2023, we searched the databases of PubMed and ISI Web of Science for English-language articles specific to 'e-professionalism' in the medical field. The final selected research corpus of 63 articles was analyzed in this study.RESULTSA comprehensive analysis of the selected articles highlighted that e-professionalism is an epistemologically mature and distinct concept by a standard definition. However, inconsistencies in conceptual meanings were reported due to varied interpretations despite digital literacy. The pragmatic utility showed a lack of sound methodological and philosophical paradigms. Perhaps the rapid technological advancements and manifestations have hampered linguistic maturity. However, logically, e-professionalism is perceived as an extension of conventional professionalism but with a focus on a distinct framework with a set of attributes to be digitally relevant.CONCLUSIONThis study identifies a scarcity of research about the collective perspective of essential stakeholders, underpinning the need to further explore e-professionalism due to its emerging complex nature within the digital context. There is also a recognition that a framework is essential to guide future HCPs to yield a profound understanding and to provide remediation strategies in the rapidly advancing medical field in digital realm.
背景医疗保健专业人员(HCP)在不遵守专业原则的情况下使用社交网站(SNS)的情况急剧增加,令人担忧。在医疗实践中广泛使用 SNS 的同时,也有关于违反职业行为的报道。尽管 SNS 有诸多益处,但人们普遍怀疑 SNS 是否能根据专业精神的核心原则在医疗领域发挥明确的作用。因此,有必要了解专业精神在数字环境中的表现形式,也就是通常所说的电子专业精神。本研究系统性地考察了 HCPs 对电子专业主义的看法,以推进对电子专业主义的全面理解。方法本概念分析采用了 Penrod 和 Hupcey 的基于原则的方法。2023 年 1 月,我们在 PubMed 和 ISI Web of Science 数据库中搜索了医学领域有关 "电子专业主义 "的英文文章。结果对所选文章的综合分析突出表明,根据标准定义,电子专业主义是一个在认识论上成熟且独特的概念。然而,尽管具有数字素养,但由于对数字素养的解释各不相同,概念含义也不一致。实用性表明缺乏合理的方法论和哲学范式。也许技术的快速发展和表现阻碍了语言的成熟。然而,从逻辑上讲,电子专业主义被认为是传统专业主义的延伸,但其重点是具有一系列与数字相关属性的独特框架。人们还认识到,在数字领域快速发展的医疗领域,必须有一个框架来指导未来的医疗保健人员深刻理解并提供补救策略。
{"title":"Reclaiming the concept of professionalism in the digital context: a principle-based concept analysis.","authors":"Shaista Salman Guraya,Salman Yousuf Guraya,Fiza Rashid-Doubell,Salim Fredericks,Denis W Harkin,Mohd Zarawi Bin Mat Nor,Muhamad Saiful Bahri Yusoff","doi":"10.1080/07853890.2024.2398202","DOIUrl":"https://doi.org/10.1080/07853890.2024.2398202","url":null,"abstract":"BACKGROUNDThere has been an alarming surge in the usage of social networking sites (SNSs) by healthcare professionals (HCPs) without adherence to the principles of professionalism. The widespread use of SNSs in medical practices has been coupled with reports of breaches of professional behaviors. Despite the benefits of SNSs, skepticism prevails about a clearly defined role for SNSs within medicine based upon the core principles of professionalism. Thus, there is a need to understand the manifestations of professionalism in the digital context, classically known as e-professionalism. This study systematically examines HCPs' perceptions of e-professionalism to advance a thorough understanding of e-professionalism.METHODSThis concept analysis was performed using the principle-based approach of Penrod and Hupcey. In January 2023, we searched the databases of PubMed and ISI Web of Science for English-language articles specific to 'e-professionalism' in the medical field. The final selected research corpus of 63 articles was analyzed in this study.RESULTSA comprehensive analysis of the selected articles highlighted that e-professionalism is an epistemologically mature and distinct concept by a standard definition. However, inconsistencies in conceptual meanings were reported due to varied interpretations despite digital literacy. The pragmatic utility showed a lack of sound methodological and philosophical paradigms. Perhaps the rapid technological advancements and manifestations have hampered linguistic maturity. However, logically, e-professionalism is perceived as an extension of conventional professionalism but with a focus on a distinct framework with a set of attributes to be digitally relevant.CONCLUSIONThis study identifies a scarcity of research about the collective perspective of essential stakeholders, underpinning the need to further explore e-professionalism due to its emerging complex nature within the digital context. There is also a recognition that a framework is essential to guide future HCPs to yield a profound understanding and to provide remediation strategies in the rapidly advancing medical field in digital realm.","PeriodicalId":8371,"journal":{"name":"Annals of medicine","volume":"46 1","pages":"2398202"},"PeriodicalIF":4.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142210097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Noninvasive prenatal screening and diagnosis of two fetuses with Williams syndrome in a cohort of 19,607 pregnancies. 在 19 607 例孕妇中,对两名患有威廉姆斯综合征的胎儿进行了无创产前筛查和诊断。
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-12 DOI: 10.1080/07853890.2024.2402071
Weiqiang Liu,Jinshuang Song,Yanmei Zhu,Tong Zhang,Xiaoyi Cong,Xiaojin Luo,Liang Hu
BACKGROUNDThis study aimed to evaluate the efficiency of noninvasive prenatal screening (NIPS) technology in screening for microdeletions in the 7q11.23 region.METHODS19,607 pregnant women underwent NIPS in our hospital. Maternal peripheral cell-free foetal DNA (cffDNA) was routinely screened for aneuploidy by cffDNA enrichment and simultaneously analyzed for pathogenic copy number variants (CNVs). The Williams syndrome (WS) 7q11.23 region was targeted in this study. Chromosomal microarray analysis (CMA) was used to verify the screen-positive samples.RESULTSThe mean concentration of cffDNA before and after enrichment increased from 9.44% to 19.32%, with a statistically significant difference. Two out of 19,607 samples tested for CNVs were found to have a heterozygous deletion at the 7q11.23 region, indicating a high risk for WS. CMA results confirmed the 1.5 megabase (Mb) deletions at the 7q11.23 region in amniotic fluid samples. One of the two WS foetuses had a small left ventricle by ultrasound screening, and the other did not have a significant cardiovascular abnormality phenotype.CONCLUSIONSNIPS screening for Williams syndrome can be achieved by enriching cell-free foetal DNA and improving bioinformatic analysis algorithms.
背景本研究旨在评估无创产前筛查(NIPS)技术在筛查 7q11.23 区域微缺失方面的效率。母体外周无细胞胎儿 DNA(cffDNA)通过 cffDNA 富集进行非整倍体常规筛查,并同时分析致病拷贝数变异(CNV)。本研究以威廉姆斯综合征(WS)7q11.23 区域为目标。结果富集前后 cffDNA 的平均浓度从 9.44% 增加到 19.32%,差异有统计学意义。在 19,607 份 CNV 检测样本中,有两份样本被发现在 7q11.23 区域有杂合性缺失,表明 WS 风险很高。CMA结果证实,羊水样本中的7q11.23区域存在1.5兆碱基(Mb)缺失。结论通过富集无细胞胎儿 DNA 和改进生物信息分析算法,可以实现威廉姆斯综合征的 NIPS 筛查。
{"title":"Noninvasive prenatal screening and diagnosis of two fetuses with Williams syndrome in a cohort of 19,607 pregnancies.","authors":"Weiqiang Liu,Jinshuang Song,Yanmei Zhu,Tong Zhang,Xiaoyi Cong,Xiaojin Luo,Liang Hu","doi":"10.1080/07853890.2024.2402071","DOIUrl":"https://doi.org/10.1080/07853890.2024.2402071","url":null,"abstract":"BACKGROUNDThis study aimed to evaluate the efficiency of noninvasive prenatal screening (NIPS) technology in screening for microdeletions in the 7q11.23 region.METHODS19,607 pregnant women underwent NIPS in our hospital. Maternal peripheral cell-free foetal DNA (cffDNA) was routinely screened for aneuploidy by cffDNA enrichment and simultaneously analyzed for pathogenic copy number variants (CNVs). The Williams syndrome (WS) 7q11.23 region was targeted in this study. Chromosomal microarray analysis (CMA) was used to verify the screen-positive samples.RESULTSThe mean concentration of cffDNA before and after enrichment increased from 9.44% to 19.32%, with a statistically significant difference. Two out of 19,607 samples tested for CNVs were found to have a heterozygous deletion at the 7q11.23 region, indicating a high risk for WS. CMA results confirmed the 1.5 megabase (Mb) deletions at the 7q11.23 region in amniotic fluid samples. One of the two WS foetuses had a small left ventricle by ultrasound screening, and the other did not have a significant cardiovascular abnormality phenotype.CONCLUSIONSNIPS screening for Williams syndrome can be achieved by enriching cell-free foetal DNA and improving bioinformatic analysis algorithms.","PeriodicalId":8371,"journal":{"name":"Annals of medicine","volume":"22 1","pages":"2402071"},"PeriodicalIF":4.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142210121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What eliminates the chance for cure: a multi-center evaluation on 10-year follow-up of gallbladder cancer after surgical resection. 是什么消除了治愈的机会:一项关于胆囊癌手术切除后 10 年随访的多中心评估。
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-12 DOI: 10.1080/07853890.2024.2402072
Zuyi Ma,Zhenchong Li,Jiasheng Cao,Jia Sun,Shanzhou Huang,Qi Zhou,Binglu Li
Curative resection stands as the sole potential cure for gallbladder cancer (GBC); nevertheless, a dearth of knowledge persists regarding long-term follow-up data and prognostic factors that hinder achieving a cure post-surgery. A retrospective cohort study was conducted by analyzing pathologically confirmed initial resections for GBC between 2000 and 2013 across three Chinese medical centers. The concept of observed cure refers to a 10-year survival period devoid of any disease recurrence. Employing a semiparametric proportional hazards mixture cure model enabled the identification of clinicopathological factors impeding a cure for GBC post-surgery. In our current study, a total of 331 patients were included, with a follow-up period exceeding a decade. The median overall survival (OS) was recorded at 31.6 months, with 39 patients (11.78%) achieving a 10-year OS, classified as 10-year survivors. Within this subset, 36 patients reached a 10-year relapse-free survival, denoting cure, and yielding an observed cure rate of 10.88%. Notably, factors such as combined surgical resection involving invaded organs, positive lymph node metastasis, and R1 resection (below 1%) were identified as virtually precluding a cure. Additionally, patients with T3-4 stage, hepatic invasion, advanced AJCC stage or poor tumor differentiation exhibited a low likelihood of achieving cure (below 5%). The discovery of these prognostic factors holds significant value in tailoring individualized treatment strategies and enhancing clinical decision-making processes.
治愈性切除术是唯一可能治愈胆囊癌(GBC)的方法;然而,有关长期随访数据和阻碍术后治愈的预后因素的知识仍然匮乏。通过分析 2000 年至 2013 年期间三家中国医疗中心经病理证实的 GBC 初次切除病例,我们开展了一项回顾性队列研究。观察治愈的概念是指10年生存期内无任何疾病复发。采用半参数比例危险混合治愈模型可以确定阻碍GBC术后治愈的临床病理因素。在我们目前的研究中,共纳入了 331 例患者,随访时间超过十年。中位总生存期(OS)为 31.6 个月,其中 39 名患者(11.78%)的 OS 达到了 10 年,被归类为 10 年生存者。在这个子集中,有 36 名患者达到了 10 年无复发生存期,即治愈,观察到的治愈率为 10.88%。值得注意的是,合并涉及受侵器官的手术切除、淋巴结转移阳性、R1切除(低于1%)等因素被认为几乎排除了治愈可能。此外,T3-4期、肝脏受侵、AJCC分期晚期或肿瘤分化差的患者获得治愈的可能性较低(低于5%)。这些预后因素的发现对于定制个体化治疗策略和改善临床决策过程具有重要价值。
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引用次数: 0
Predicting BRCA mutation and stratifying targeted therapy response using multimodal learning: a multicenter study. 利用多模式学习预测 BRCA 基因突变并对靶向治疗反应进行分层:一项多中心研究。
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-11 DOI: 10.1080/07853890.2024.2399759
Yi Li,Xiaomin Xiong,Xiaohua Liu,Mengke Xu,Boping Yang,Xiaoju Li,Yu Li,Bo Lin,Bo Xu
BACKGROUNDThe status of BRCA1/2 genes plays a crucial role in the treatment decision-making process for multiple cancer types. However, due to high costs and limited resources, a demand for BRCA1/2 genetic testing among patients is currently unmet. Notably, not all patients with BRCA1/2 mutations achieve favorable outcomes with poly (ADP-ribose) polymerase inhibitors (PARPi), indicating the necessity for risk stratification. In this study, we aimed to develop and validate a multimodal model for predicting BRCA1/2 gene status and prognosis with PARPi treatment.METHODSWe included 1695 slides from 1417 patients with ovarian, breast, prostate, and pancreatic cancers across three independent cohorts. Using a self-attention mechanism, we constructed a multi-instance attention model (MIAM) to detect BRCA1/2 gene status from hematoxylin and eosin (H&E) pathological images. We further combined tissue features from the MIAM model, cell features, and clinical factors (the MIAM-C model) to predict BRCA1/2 mutations and progression-free survival (PFS) with PARPi therapy. Model performance was evaluated using area under the curve (AUC) and Kaplan-Meier analysis. Morphological features contributing to MIAM-C were analyzed for interpretability.RESULTSAcross the four cancer types, MIAM-C outperformed the deep learning-based MIAM in identifying the BRCA1/2 genotype. Interpretability analysis revealed that high-attention regions included high-grade tumors and lymphocytic infiltration, which correlated with BRCA1/2 mutations. Notably, high lymphocyte ratios appeared characteristic of BRCA1/2 mutations. Furthermore, MIAM-C predicted PARPi therapy response (log-rank p < 0.05) and served as an independent prognostic factor for patients with BRCA1/2-mutant ovarian cancer (p < 0.05, hazard ratio:0.4, 95% confidence interval: 0.16-0.99).CONCLUSIONSThe MIAM-C model accurately detected BRCA1/2 gene status and effectively stratified prognosis for patients with BRCA1/2 mutations.
背景 BRCA1/2 基因的状态在多种癌症的治疗决策过程中起着至关重要的作用。然而,由于费用高昂和资源有限,目前患者对 BRCA1/2 基因检测的需求尚未得到满足。值得注意的是,并不是所有 BRCA1/2 基因突变的患者都能在使用聚(ADP-核糖)聚合酶抑制剂(PARPi)后获得良好的治疗效果,这表明有必要进行风险分层。在这项研究中,我们旨在开发并验证一个多模式模型,用于预测 BRCA1/2 基因状态和 PARPi 治疗的预后。方法我们纳入了来自三个独立队列的 1417 名卵巢癌、乳腺癌、前列腺癌和胰腺癌患者的 1695 张切片。利用自我注意机制,我们构建了一个多实例注意模型(MIAM),从苏木精和伊红(H&E)病理图像中检测 BRCA1/2 基因状态。我们进一步结合 MIAM 模型中的组织特征、细胞特征和临床因素(MIAM-C 模型)来预测 BRCA1/2 基因突变和 PARPi 治疗后的无进展生存期(PFS)。使用曲线下面积(AUC)和 Kaplan-Meier 分析评估了模型的性能。结果在四种癌症类型中,MIAM-C 在识别 BRCA1/2 基因型方面的表现优于基于深度学习的 MIAM。可解释性分析表明,高关注区域包括高级别肿瘤和淋巴细胞浸润,这与 BRCA1/2 基因突变相关。值得注意的是,高淋巴细胞比率是 BRCA1/2 基因突变的特征。此外,MIAM-C 还能预测 PARPi 治疗反应(对数秩 p <0.05),并作为 BRCA1/2 突变卵巢癌患者的独立预后因素(p <0.05,危险比:0.4,95% 置信区间:0.16-0.99)。结论MIAM-C 模型能准确检测 BRCA1/2 基因状态,并有效对 BRCA1/2 突变患者的预后进行分层。
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引用次数: 0
Using cluster analysis to explore COVID-19 vaccine booster hesitancy by levels of medical mistrust in fully vaccinated US adults 使用聚类分析法,根据已完全接种疫苗的美国成年人对医疗的不信任程度,探讨他们对 COVID-19 疫苗加强剂的犹豫态度
IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-11 DOI: 10.1080/07853890.2024.2401122
Kirsten Paulus, Sarah Bauerle Bass, Whitney Cabey, Katie Singley, Caseem Luck, Ariel Hoadley, Molly Kerstetter, Alexandru-Mircea Rotaru, Elizabeth Knight, Swathi Murali, Shreya Verma, Imani Wilson-Shabazz, Heather Gardiner
Underlying causes of vaccine hesitancy could significantly affect successful uptake of the SARS-CoV2 vaccine booster doses during new waves of COVID-19. Booster rates among US adults are far below ...
疫苗接种犹豫不决的根本原因可能会严重影响在 COVID-19 新一轮接种中 SARS-CoV2 疫苗强化剂的成功接种率。美国成年人的强化接种率远远低于...
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引用次数: 0
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Annals of medicine
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