Biomedical Journal最新文献_第9页

Macrophage Regulation of Hypothalamic-Pituitary-Adrenal and Gonadal Axis Homeostasis and Hormonal Output. 巨噬细胞调节下丘脑-垂体-肾上腺和性腺轴稳态和激素输出。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-27 DOI: 10.1016/j.bj.2025.100866

Conan J O O'Brien

Macrophages are critical immune cells present in virtually every tissue, where they contribute to tissue homeostasis beyond their traditional immune roles. Past and recent evidence highlights their involvement in endocrine regulation, particularly within the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes. This review explores the ontogeny and function of macrophages residing in the hypothalamus, pituitary, adrenals, and gonads, emphasizing their contributions to hormonal output and endocrine homeostasis. Macrophages in the hypothalamus and pituitary modulate neuroendocrine signalling, impacting stress and reproductive hormone production. In the adrenal glands, distinct macrophage subsets regulate glucocorticoid and mineralocorticoid synthesis, influencing systemic metabolism and blood pressure. Gonadal macrophages contribute to steroidogenesis and fertility, with roles in testosterone production, ovarian folliculogenesis, and corpus luteum maintenance. The emerging understanding of macrophage regulation of endocrine function may seed novel therapeutic approaches for endocrine disorders. Future research should further elucidate the molecular mechanisms underlying macrophage regulation of hormone production and explore their implications for metabolic, immune, and reproductive health.

巨噬细胞是一种重要的免疫细胞，几乎存在于每个组织中，在那里它们有助于组织稳态，而不是传统的免疫角色。过去和最近的证据强调它们参与内分泌调节，特别是在下丘脑-垂体-肾上腺（HPA）和下丘脑-垂体-性腺（HPG）轴。本文综述了巨噬细胞存在于下丘脑、垂体、肾上腺和性腺中的个体发生和功能，重点介绍了它们在激素输出和内分泌稳态中的作用。下丘脑和垂体中的巨噬细胞调节神经内分泌信号，影响应激和生殖激素的产生。在肾上腺中，不同的巨噬细胞亚群调节糖皮质激素和矿皮质激素的合成，影响全身代谢和血压。性腺巨噬细胞在睾酮产生、卵巢卵泡生成和黄体维持中发挥作用，有助于类固醇生成和生育。对巨噬细胞调节内分泌功能的新认识可能为内分泌疾病的治疗开辟新的途径。未来的研究应进一步阐明巨噬细胞调节激素产生的分子机制，并探讨其对代谢、免疫和生殖健康的影响。

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引用次数: 0

Macrophages of the Heart: Homeostasis and Disease. 心脏巨噬细胞：稳态与疾病。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-27 DOI: 10.1016/j.bj.2025.100867

Koketso C Mabatha, Pheletso Letuka, Olukayode Aremu, Michael Z Zulu

Cardiac macrophages (CMs) are the most abundant immune cell type in the heart. They are critical for maintaining cardiac homeostasis and in the orchestration of immune responses to ischemic and non-ischemic cardiomyopathies. Their functions are highly heterogeneous and regulated by their tissue microenvironment. CMs have high plasticity, which allows them to perform various functions in the myocardium to bring about homeostasis within the cardiovascular system (CVS). CMs also play critical roles in coronary development and angiogenesis, tissue repair and remodeling, cardiac conduction and in the clearance of necrotic and apoptotic cells. However, there is a paucity of studies on the biology of cardiac macrophages in both steady state and disease, especially, in humans. In this review, we discuss the multifaceted roles of CMs in the heart, focusing on their ontogeny, homeostatic functions and immunological responses during inflammation and reparative processes post-injury. We highlight the heterogeneity of CMs in their ontogeny, phenotypes and functions as well as their roles in the pathogenesis of pathological conditions such as myocarditis, myocardial fibrosis and heart failure. Understanding the unique characteristics of cardiac macrophages in the cardiac milieu is critical for the development of macrophage-specific therapeutic interventions to alleviate the global burden of cardiovascular disease (CVD). Therefore, future studies should focus on further improving the understanding of the biology of cardiac macrophages to harness their potential as therapeutic targets for cardiovascular disorders.

心脏巨噬细胞（CMs）是心脏中最丰富的免疫细胞类型。它们对于维持心脏稳态和协调对缺血性和非缺血性心肌病的免疫反应至关重要。它们的功能是高度异质性的，并受其组织微环境的调节。CMs具有很高的可塑性，这使得它们可以在心肌中发挥各种功能，实现心血管系统内的稳态。CMs还在冠状动脉发育和血管生成、组织修复和重塑、心脏传导以及坏死和凋亡细胞的清除中发挥关键作用。然而，关于心脏巨噬细胞在稳定状态和疾病中的生物学研究，特别是在人类中，缺乏研究。在这篇综述中，我们讨论了CMs在心脏中的多方面作用，重点是它们的个体发生、体内平衡功能和炎症和损伤后修复过程中的免疫反应。我们强调了CMs在个体发生、表型和功能方面的异质性，以及它们在心肌炎、心肌纤维化和心力衰竭等病理条件的发病机制中的作用。了解心脏环境中巨噬细胞的独特特征对于开发巨噬细胞特异性治疗干预措施以减轻全球心血管疾病（CVD）负担至关重要。因此，未来的研究应侧重于进一步提高对心脏巨噬细胞生物学的理解，以利用其作为心血管疾病治疗靶点的潜力。

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引用次数: 0

PAI-1, hematopoietic stem cell, and chronic myeloid leukemia PAI-1，造血干细胞和慢性髓性白血病。

IF 4.4 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-18 DOI: 10.1016/j.bj.2025.100854

Naoto Takahashi , Hideo Harigae

The new treatment goal for chronic myeloid leukemia (CML) is treatment-free remission, which requires the achievement and maintenance of a deep molecular response (DMR) using a tyrosine kinase inhibitor (TKI). However, only a limited number of patients achieve or maintain DMR. TM5614, a PAI1 inhibitor, can bring quiescent hematopoietic stem cells from the bone marrow niche into the cell cycle. Thus, the combination of TM5614 and TKI may eradicate CML cells. Currently, a phase III clinical trial is confirming the efficacy of TM5614 and TKI combination therapy.

慢性髓性白血病（CML）的新治疗目标是无治疗缓解，这需要使用酪氨酸激酶抑制剂（TKI）实现和维持深度分子反应（DMR）。然而，只有少数患者达到或维持DMR。TM5614是一种PAI1抑制剂，可使骨髓小生境中的静止造血干细胞进入细胞周期。因此，TM5614和TKI联合使用可以根除CML细胞。目前，一项III期临床试验正在证实TM5614和TKI联合治疗的疗效。

引用次数: 0

m6A landscape is more pervasive when Trypanosoma brucei exits the cell cycle 当布氏锥虫退出细胞周期时，m6A 的分布更为普遍。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.bj.2024.100728

Lúcia Serra , Sara Silva Pereira , Idálio J. Viegas , Henrique Machado , Lara López-Escobar , Luisa M. Figueiredo

N6-methyladenosine (m⁶A) is an mRNA modification with important roles in gene expression. In African trypanosomes, this post-transcriptional modification is detected in hundreds of transcripts, and it affects the stability of the variant surface glycoprotein (VSG) transcript in the proliferating blood stream form. However, how the m⁶A landscape varies across the life cycle remains poorly defined. Using full-length, non-fragmented RNA, we immunoprecipitated and sequenced m⁶A-modified transcripts across three life cycle stages of Trypanosoma brucei – slender (proliferative), stumpy (quiescent), and procyclic forms (proliferative). We found that 1037 transcripts are methylated in at least one of these three life cycle stages. While 21% of methylated transcripts are common in the three stages of the life cycle, globally, each stage has a distinct methylome. Interestingly, 47% of methylated transcripts are detected in the quiescent stumpy form only, suggesting a critical role for m⁶A when parasites exit the cell cycle and prepare for transmission by the tsetse fly. In this stage, we found that a significant proportion of methylated transcripts encodes for proteins involved in RNA metabolism, which is consistent with their reduced transcription and translation. Moreover, we found that not all major surface proteins are regulated by m⁶A, as procyclins are not methylated, and that, within the VSG repertoire, not all VSG transcripts are demethylated upon parasite differentiation to procyclic form. This study reveals that the m⁶A regulatory landscape is specific to each life cycle stage, becoming more pervasive as T. brucei exits the cell cycle.

N6-甲基腺苷（m6A）是一种在基因表达中起重要作用的 mRNA 修饰。在非洲锥虫中，这种转录后修饰可在数百个转录本中检测到，而且会影响增殖血流形态中变异表面糖蛋白（VSG）转录本的稳定性。然而，m6A 在整个生命周期中的变化情况仍不十分明确。我们使用全长、非碎裂的 RNA，对布氏锥虫三个生命周期阶段--纤细型（增殖型）、粗壮型（静止型）和原环状型（增殖型）--的 m6A 修饰转录本进行了免疫沉淀和测序。我们发现，有 1037 个转录本在这三个生命周期阶段中至少有一个阶段被甲基化。虽然 21% 的甲基化转录本在生命周期的三个阶段中很常见，但总体而言，每个阶段都有一个独特的甲基化组。有趣的是，47%的甲基化转录本仅在静止期的残体中被检测到，这表明当寄生虫退出细胞周期并准备被采采蝇传播时，m6A 起着关键作用。在这一阶段，我们发现相当一部分甲基化转录本编码参与 RNA 代谢的蛋白质，这与它们的转录和翻译减少是一致的。此外，我们还发现并非所有主要的表面蛋白都受 m6A 的调控，因为原环蛋白并没有被甲基化，而且在 VSG 基因库中，并非所有的 VSG 转录本都会在寄生虫分化为原环形态时被去甲基化。这项研究揭示了 m6A 的调控格局是每个生命周期阶段所特有的，随着布氏原虫退出细胞周期而变得更加普遍。

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引用次数: 0

Activating transcription factor 3 is an antitumor gene synergizing with growth differentiation factor 15 to modulate cell growth in human bladder cancer 激活转录因子 3 是一种抗肿瘤基因，可与生长分化因子 15 协同调节人类膀胱癌细胞的生长。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.bj.2024.100756

Syue-Ting Chen , Kang-Shuo Chang , Wei-Yin Lin , Shu-Yuan Hsu , Hsin-Ching Sung , Yu-Hsiang Lin , Tsui-Hsia Feng , Chen-Pang Hou , Horng-Heng Juang

Background

The functions of activating transcription factor 3 (ATF3) within the human bladder remain unexplored. This study delves into the expressions, functions, and regulatory mechanisms of ATF3 in human bladder cancer.

Material and methods

Gene expressions were determined by immunoblot, RT-qPCR, and reporter assays. Assays of Ki67, colony formation, Matrigel invasion, and the xenograft animal study were used to assess the cell proliferation, invasion, and tumorigenesis in vitro and in vivo. Silico analysis from TCGA database examined the correlations between GDF15 and ATF3 expressions, clinicopathologic features, and progression-free survival rates.

Results

Silico analysis confirmed that ATF3 is an antitumor gene, and the expression positively correlates with GDF15 in bladder cancer tissues. Multivariate analysis revealed that low ATF3/GDF15 but not a single low expression of ATF3 is an independent prognostic factor for progression-free survival of bladder cancer patients. Ectopic overexpression of ATF3 downregulated cell proliferation and invasion in bladder cancer cells in vitro, while ATF3-knockdown reversed these results. Knockdown of ATF3 upregulated EMT markers to enhance cell invasion in vitro and downregulated GDF15, NDRG1, and KAI-1 to elevate tumor growth in vivo. The activation of metformin on ATF3 and GDF15 in bladder cancer cells was blocked by SB431542, a TGFβ receptor inhibitor. ATF3 positively regulated GDF15 expression in bladder cancer cells through a feedback loop.

Conclusions

Our results identify that ATF3 is a metformin-upregulated antitumor gene. Results of Silico analysis align with cell-based studies suggesting that low ATF3/GDF15 could be a negative prognostic marker for bladder cancer.

背景：活化转录因子3（ATF3）在人类膀胱中的功能仍有待探索。本研究探讨了 ATF3 在人类膀胱癌中的表达、功能和调控机制：通过免疫印迹、RT-qPCR 和报告基因检测确定基因表达。Ki67、集落形成、Matrigel侵袭和异种动物实验用于评估体外和体内的细胞增殖、侵袭和肿瘤发生。来自TCGA数据库的Silico分析检验了GDF15和ATF3表达、临床病理特征和无进展生存率之间的相关性：结果：Silico分析证实，ATF3是一种抗肿瘤基因，其在膀胱癌组织中的表达与GDF15呈正相关。多变量分析显示，ATF3/GDF15的低表达是膀胱癌患者无进展生存期的独立预后因素，而非单一的低表达。体外异位过表达 ATF3 会降低膀胱癌细胞的增殖和侵袭，而敲除 ATF3 则会逆转这些结果。敲除ATF3会上调EMT标记物，从而增强体外细胞侵袭，并下调GDF15、NDRG1和KAI-1，从而促进体内肿瘤生长。二甲双胍对膀胱癌细胞中ATF3和GDF15的激活作用被TGFβ受体抑制剂SB431542阻断。ATF3通过反馈环路正向调节膀胱癌细胞中GDF15的表达：我们的研究结果表明，ATF3 是二甲双胍上调的抗肿瘤基因。Silico分析结果与基于细胞的研究结果一致，表明低ATF3/GDF15可能是膀胱癌的一个负面预后标志。

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引用次数: 0

Pharmaceutical cost savings from the treatment of oncology patients in clinical trials 临床试验中治疗肿瘤患者节省的医药成本。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.bj.2024.100742

Borja Gómez Mediavilla , Paloma Lanza-León , Virginia Martínez Callejo , David Cantarero-Prieto , María Lanza Postigo , Matilde Salcedo Lambea , Yolanda Blanco Mesonero , María Ochagavia Sufrategui , Ignacio Durán , Carmen María Sarabia Cobo

Objective

The aim of this study was twofold: to assess the annual pharmaceutical savings associated with the treatment of cancer patients at Marqués de Valdecilla University Hospital and to estimate the cost of innovative antineoplastic therapies that patients receive as experimental treatment, both during clinical trials throughout 2020.

Material and methods

An observational and financial analysis of the drug cost related to clinical trials was applied. Direct cost savings to the Regional Health System of Cantabria and the cost of innovative therapies used as an experimental treatment in clinical trials were quantified.

Results

This study includes 38 clinical trials with a sample of 101 patients. The clinical trials analyzed provide a total cost savings of €603,350.21 and an average cost saving of €6630.22 per patient. Furthermore, the total investment amounts to €789,892.67, with an average investment of €15,488.09 per patient.

Conclusions

Clinical trials are essential for the advancement of science. Furthermore, clinical trials can be a significant source of income for both hospitals and Regional Health Systems, contributing to their financial sustainability.

目的：这项研究有两个目的：评估巴尔德西亚侯爵大学医院每年在治疗癌症患者方面节省的药品费用；估算患者在 2020 年临床试验期间作为试验性治疗接受创新抗肿瘤疗法的费用：对与临床试验相关的药物成本进行了观察和财务分析。对坎塔布里亚地区卫生系统直接节省的费用和临床试验中作为试验性治疗的创新疗法的费用进行了量化：这项研究包括38项临床试验，样本为101名患者。所分析的临床试验共节约成本603,350.21欧元，平均每位患者节约成本6,630.22欧元。此外，总投资额为 789,892.67 欧元，每位患者平均投资额为 15,488.09 欧元：临床试验对科学进步至关重要。此外，临床试验还是医院和地区医疗系统的重要收入来源，有助于其财务可持续性。

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引用次数: 0

Hirsutella sinensis polysaccharides and Parabacteroides goldsteinii reduce lupus severity in imiquimod-treated mice Hirsutella sinensis 多糖和 Parabacteroides goldsteinii 可减轻咪喹莫特治疗小鼠狼疮的严重程度。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.bj.2024.100754

Shih-Hsin Chang , Yun-Fei Ko , Jian-Ching Liau , Cheng-Yeu Wu , Tsong-Long Hwang , David M. Ojcius , John D. Young , Jan Martel

Background

The incidence of autoimmune diseases is increasing in developed countries, possibly due to the modern Western diet and lifestyle. We showed earlier that polysaccharides derived from the medicinal fungus Hirsutella sinensis produced anti-inflammatory, anti-diabetic and anti-obesity effects by modulating the gut microbiota and increasing the abundance of the commensal Parabacteroides goldsteinii in mice fed with a high-fat diet.

Methods

We examined the effects of the prebiotics, H. sinensis polysaccharides, and probiotic, P. goldsteinii, in a mouse model of imiquimod-induced systemic lupus erythematosus.

Results

The fungal polysaccharides and P. goldsteinii reduced markers of lupus severity, including the increase of spleen weight, proteinuria, and serum levels of anti-DNA auto-antibodies and signal transducer and activator of transcription 4 (STAT4). Moreover, the polysaccharides and P. goldsteinii improved markers of kidney and liver functions such as creatinine, blood urea nitrogen, glomerulus damage and fibrosis, and serum liver enzymes. However, the prebiotics and probiotics did not produce consistent improvements in gut microbiota composition, colonic histology, or expression of tight junction proteins in colon tissues.

Conclusions

Our results indicate that H. sinensis polysaccharides and the probiotic P. goldsteinii can reduce lupus markers in imiquimod-treated mice. These prebiotics and probiotics may therefore be added to other interventions conducive of a healthy lifestyle in order to counter autoimmune diseases.

背景：在发达国家，自身免疫性疾病的发病率正在上升，这可能与现代西方饮食和生活方式有关。我们早些时候研究发现，从药用真菌中华大孔菌中提取的多糖通过调节肠道微生物群和增加高脂饮食喂养的小鼠体内共生菌 Parabacteroides goldsteinii 的丰度，产生抗炎、抗糖尿病和抗肥胖的作用：我们在咪喹莫特诱导的系统性红斑狼疮小鼠模型中研究了益生菌中华蘑菇多糖和益生菌金丝桃的作用：结果：真菌多糖和金孢子菌降低了狼疮严重程度的指标，包括脾脏重量增加、蛋白尿、血清中抗 DNA 自身抗体和转录信号转导子和激活子 4（STAT4）的水平。此外，金丝桃多糖和金丝桃还能改善肝肾功能指标，如肌酐、血尿素氮、肾小球损伤和纤维化以及血清肝酶。然而，益生元和益生菌并不影响肠道微生物群的组成、结肠组织学或结肠组织中紧密连接蛋白的表达：我们的研究结果表明，中华猪多糖和益生菌金丝桃可以减少咪喹莫特治疗小鼠的狼疮指标。因此，这些益生元和益生菌可与其他有利于健康生活方式的干预措施相结合，以对抗自身免疫性疾病。

{"title":"Hirsutella sinensis polysaccharides and Parabacteroides goldsteinii reduce lupus severity in imiquimod-treated mice","authors":"Shih-Hsin Chang , Yun-Fei Ko , Jian-Ching Liau , Cheng-Yeu Wu , Tsong-Long Hwang , David M. Ojcius , John D. Young , Jan Martel","doi":"10.1016/j.bj.2024.100754","DOIUrl":"10.1016/j.bj.2024.100754","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of autoimmune diseases is increasing in developed countries, possibly due to the modern Western diet and lifestyle. We showed earlier that polysaccharides derived from the medicinal fungus <em>Hirsutella sinensis</em> produced anti-inflammatory, anti-diabetic and anti-obesity effects by modulating the gut microbiota and increasing the abundance of the commensal <em>Parabacteroides goldsteinii</em> in mice fed with a high-fat diet.</div></div><div><h3>Methods</h3><div>We examined the effects of the prebiotics, <em>H. sinensis</em> polysaccharides, and probiotic, <em>P. goldsteinii</em>, in a mouse model of imiquimod-induced systemic lupus erythematosus.</div></div><div><h3>Results</h3><div>The fungal polysaccharides and <em>P. goldsteinii</em> reduced markers of lupus severity, including the increase of spleen weight, proteinuria, and serum levels of anti-DNA auto-antibodies and signal transducer and activator of transcription 4 (STAT4). Moreover, the polysaccharides and <em>P. goldsteinii</em> improved markers of kidney and liver functions such as creatinine, blood urea nitrogen, glomerulus damage and fibrosis, and serum liver enzymes. However, the prebiotics and probiotics did not produce consistent improvements in gut microbiota composition, colonic histology, or expression of tight junction proteins in colon tissues.</div></div><div><h3>Conclusions</h3><div>Our results indicate that <em>H. sinensis</em> polysaccharides and the probiotic <em>P. goldsteinii</em> can reduce lupus markers in imiquimod-treated mice. These prebiotics and probiotics may therefore be added to other interventions conducive of a healthy lifestyle in order to counter autoimmune diseases.</div></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":"48 2","pages":"Article 100754"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of excess charge mitigation in electromagnetic hygiene: An integrative review 缓解过量电荷在电磁卫生中的作用：综合评述。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.bj.2024.100801

Isaac A. Jamieson , J. Nigel B. Bell , Paul Holdstock

The electromagnetic characteristics of many environments have changed significantly in recent decades. This is in large part due to the increased presence of equipment that emits electromagnetic radiation and materials that may often readily gain excess charge. The presence of excess charge can often increase the risk of infection from pathogens and the likelihood of individuals experiencing compromised performance, respiratory problems, and other adverse health issues from increased uptake of particulate matter. It is proposed that adopting improved electromagnetic hygiene measures, including optimized humidity levels, to reduce the presence of inappropriate levels of electric charge can help reduce the likelihood of ill health, infection, and poor performance arising from contaminant inhalation and deposition, plus reduce the likelihood of medical devices and other electronic devices getting damaged and/or having their data compromised. It is suggested that such measures should be more widely adopted within clinical practice guidelines and water, sanitation, and hygiene programs.

近几十年来，许多环境的电磁特性都发生了显著变化。这在很大程度上是由于发射电磁辐射的设备和材料越来越多，而这些设备和材料往往很容易获得过量电荷。过量电荷的存在往往会增加病原体感染的风险，以及个人因吸收更多微粒物质而出现性能受损、呼吸系统问题和其他不良健康问题的可能性。建议采取改进的电磁卫生措施，包括优化湿度水平，以减少不适当电荷水平的存在，这有助于降低因污染物吸入和沉积而导致健康不良、感染和性能低下的可能性，并降低医疗设备和其他电子设备受损和/或数据受损的可能性。建议在临床实践指南以及水、环境卫生和个人卫生计划中更广泛地采用此类措施。

引用次数: 0

Which outcomes are key to the pre-intervention assessment profile of a child with developmental coordination disorder? A systematic review and meta-analysis 哪些结果是发育协调障碍儿童干预前评估概况的关键？系统回顾与荟萃分析。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.bj.2024.100768

Bouwien Smits-Engelsman , Marisja Denysschen , Jessica Lust , Dané Coetzee , Ludvík Valtr , Marina Schoemaker , Evi Verbecque

Background

Purpose of this study was to determine what key aspects of function should be incorporated to make up a pre-intervention assessment profile of a child with Developmental Coordination Disorder (DCD); more specifically, what aspects of functioning are implicated in DCD and what is their relative impact?

Methods

A systematic review and meta-analysis were conducted, for which Pubmed, Web of Science, Scopus and Proquest were searched (last update: April 2023, PROSPERO: CRD42023461619). Case-control studies were included to determine point estimates for performances on field-based tests in different domains of functioning. The risk of bias was assessed, and the level of evidence was estimated. Random-effect meta-analyses were performed to calculate the pooled standardized mean differences for domains of functioning and subgrouping was done for clinically relevant subdomains. Heterogeneity was determined with I².

Results

121 papers were included for analyses. Data of 5923 children with DCD were included (59.8% boys) and 23 619 Typically Developing (TD) children (45.8% boys). The mean (SD) age of the DCD group was 10.3y (1.2) and 9.3y (1.3) for the TD children. Moderate evidence was found for motor performance, executive functions, sensory processing and perceptions, cognitive functions and sports and leisure activities to be affected in children with DCD.

Conclusion

Differences between the two groups varied per domain of functioning. This emphasizes the diversity present within children with DCD and provides a rationale for explaining the heterogeneity in this patient group. Yet, results highlight the potential involvement of all these domains and call for clinicians to be alert not only to examine motor skill difficulties but also other aspects of function. Results indicate the need to develop an individualized pre-intervention multi-dimensional assessment profile for each child with DCD. It also supports the important role that clinicians play in an interdisciplinary team to tackle the difficulties encountered by children with DCD.

研究背景本研究的目的是确定在对发育协调障碍（DCD）儿童进行干预前评估时，应纳入哪些关键的功能方面；更具体地说，哪些功能方面与 DCD 有关，以及它们的相对影响是什么？对 Pubmed、Web of Science、Scopus 和 Proquest 进行了系统回顾和荟萃分析（最后更新时间：2023 年 4 月，PROSPERO：CRD42023461619）。其中包括病例对照研究，以确定不同功能领域的现场测试表现的点估计值。对偏倚风险进行了评估，并对证据水平进行了估计。进行随机效应荟萃分析以计算功能领域的集合标准化均值差异，并对临床相关的子领域进行分组。异质性用I2确定：共纳入 121 篇论文进行分析。共纳入了 5 923 名患有 DCD 的儿童（59.8% 为男孩）和 23 619 名发育正常（TD）儿童（45.8% 为男孩）的数据。DCD 组儿童的平均（标清）年龄为 10.3 岁（1.2），TD 组儿童的平均（标清）年龄为 9.3 岁（1.3）。研究发现，中等程度的证据表明，DCD儿童的运动表现、执行功能、感觉处理和知觉、认知功能以及运动和休闲活动会受到影响：结论：两组儿童在各个功能领域的差异各不相同。这强调了 DCD 儿童的多样性，并为解释这一患者群体的异质性提供了理论依据。然而，研究结果强调了所有这些领域的潜在参与性，并呼吁临床医生不仅要警惕运动技能方面的困难，还要注意功能的其他方面。研究结果表明，有必要为每名儿童发育迟缓症患者制定个性化的干预前多维评估档案。它还支持临床医生在跨学科团队中发挥重要作用，以解决 DCD 儿童遇到的困难。

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引用次数: 0

Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis 晚期肝细胞癌肝移植：关于门静脉肿瘤血栓的争议。

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal

Pub Date : 2025-04-01 DOI: 10.1016/j.bj.2024.100757

Kun-Ming Chan , Wei-Chen Lee

Liver transplantation (LT) is considered the ideal treatment for hepatocellular carcinoma (HCC) concurrent with underlying cirrhotic liver disease. As well-known, LT for HCC based on the Milan criteria has shown satisfactory outcomes. However, numerous expanded transplantation criteria were proposed to benefit more patients for LT and showed comparable survivals as well. In addition, a modest expansion of transplantation criteria for HCC may be acceptable on the basis of the consensus within the transplantation community. Nonetheless, LT in patients with advanced HCC and portal vein tumor thrombosis (PVTT) recently has received attention and has been reported by many transplantation centers despite being contraindicated. Of those, the LT outcomes in certain HCC patients with PVTT were favorable. Additionally, the advancement of multimodality treatments and the evolution of systemic therapies have emerged as promising therapeutic options for downstaging advanced HCC prior to LT. Somehow, advanced HCC with PVTT could be downstaged to become eligible for LT through these multidisciplinary approaches. Although the available evidence of LT for HCC with PVTT is limited, it is hoped that LT may soon be more widely indicated for these patients. Nevertheless, several unknown factors associated with LT for HCC remain to be explored. Herein, this review aimed to update the developments in LT for patients with advanced HCC.

肝移植（LT）被认为是治疗并发肝硬化的肝细胞癌（HCC）的理想方法。众所周知，以米兰标准为基础的肝癌LT治疗效果令人满意。然而，为了让更多患者受益于LT治疗，许多扩大移植标准被提出，并显示出相当的存活率。此外，根据移植界的共识，适度扩大 HCC 移植标准也是可以接受的。尽管如此，晚期 HCC 和门静脉肿瘤血栓形成（PVTT）患者的 LT 近来受到了关注，尽管有禁忌症，但许多移植中心仍有相关报道。其中，某些伴有门静脉瘤栓形成的 HCC 患者的 LT 结果良好。此外，多模式疗法的发展和全身疗法的演变已成为在 LT 前对晚期 HCC 进行分期的有前途的治疗方案。通过这些多学科方法，晚期HCC伴PVTT患者可以通过降期治疗获得LT治疗资格。尽管现有证据表明LT治疗伴有PVTT的HCC的效果有限，但我们希望LT能在不久的将来更广泛地应用于这些患者。尽管如此，仍有一些与 HCC LT 相关的未知因素有待探索。本综述旨在介绍晚期 HCC 患者 LT 的最新进展。

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引用次数: 0