Objective To review the research process of telomerase reverse transcriptase (TERT) in the restoration of neurological diseases. Methods The related l iterature on TERT in the restoration of neurological diseases was extensively reviewed and comprehensively analyzed. Results TERT was the significant component of telomerase and the critical regulator of telomerase activity. It played an important role in the pathomechanism of neurological diseases including tumors,neurodevelopmental deficits, and nerve injury. TERT was becoming a research focus in the reparative therapy of neurological diseases. Conclusion TERT has manifested its great academic significance and appl ication prospects in the reparative therapy of neurological diseases, which deserves a further investigation.
Objective To investigate the value of adenosine deaminase (ADA) for the diagnosis of tuberculous serous cavity fluidify. Methods The literatures on the application of ADA for the diagnosis of tuberculous serous cavity fluidify in the database including PUBMED and CNKI were reviewed. Results Studies including randomized controlled trial or meta-analysis have performed to determine the level of ADA in the effusion of tuberculous serous cavity fluidify. These studies have sufficiently proved that ADA is a specific and sensitive method for the diagnosis of extrapulmonary tuberculosis. Most of the studies have determined the optimal cut-off value of ADA in the effusion of tuberculous serous cavity fluidify. Conclusion Measurement of ADA in the effusion of tuberculous serous cavity fluidify is widely used as a fast, convenient, safe and effective adjunctive diagnostic method of tubeculosis in clinic.
Objective To investigate the effect of a new suturing method called two-layer closure and to compare this with the traditional four-layer suturing method. Methods A randomized controlled trial was conducted in patients admitted from January to April 2008. A total of 124 eligible patients were divided into 2 groups. Sixty-one patients in the trial group received two-layer closure, while 63 in the control group received four-layer closure. The baseline conditions before the operation, incision parameters, and the recovery of the body and incision after the operation were compared between the 2 treatment groups. Results The baseline characteristics of the groups were similar. No significant differences were observed in terms of the length of hospital stay, time to food intake, time to ground activity, and time to first passage of gas by anus (Pgt;0.05). However, the incidence of fever after the operation was significantly lower in the trial group compared with the control group (P=0.014). The healing level of the incisions was comparable between the 2 groups (Pgt;0.05). As for complications after the operation, no cases of incision infection or incision granuloma or sinus tract were reported. However, 3 cases of active hemorrhage and 2 cases of incision split occurred in the control group. Moreover, the incidence of incision liquefaction in the trial group was significantly lower than that in the control group (P=0.03). Conclusion For abdominal median incision, two-layer closure is associated with smaller incision trauma, less stimulation from extraneous materials, as well as more accurate anatomic replacement compared with the traditional four-layer closure. However, further studies need to be conducted to determine whether the new suturing method of twolayer closure is effective and safe for other kinds of incision.
Congenital toxoplasmosis is one of the most common types of intrauterine infection, with the triad of retinal choroiditis, intracranial calcification, and hydrocephalus as the main clinical manifestations, which can lead to serious sequelae such as cerebral palsy, cognitive impairment and visual impairment. Therefore, early diagnosis and early treatment are important to improve the prognosis of patients. Recommended treatment options include pyrimethamine, sulfadiazine combined with folic acid, or new drugs such as azithromycin and atorvastatin. This article reviews the research progress of epidemiology, clinical manifestations, diagnosis and treatment of congenital toxoplasmosis, in order to provide a reference for clinicians to improve their understanding of clinical diagnosis and treatment of this disease.
The administration of radioactive iodine-131 (131I) is one of the representative traditional targeted therapy for post-surgical differentiated thyroid carcinoma (DTC). As DTC tumor cells largely preserve the capability of thyroid follicular epithelial cells, including the expression of the sodium iodide symporter (NIS), 131I can be selectively internalized by these cells once introduced into the body. The simultaneous emitting of both γ-ray and β-ray from 131I featured its unique theranostic value in managing DTC, through γ-ray to detect the residual thyroid tissue and DTC lesions via nuclear medical imaging, while through β-ray to yield the precise tumoricidal effect as well as remnant thyroid ablation. This theranostic potential of 131I significantly enhances progression-free survival, disease-specific survival, and overall survival in DTC patients with residual/recurrent/metastatic lesions as long as they are capable of iodine uptake. Nevertheless, the clinical application of 131I, despite its “precise” treatment philosophy, remains far from precision medicine while clinical practice, which urges further refinement in pre-treatment assessment, dosage tailoring, and post-treatment efficacy evaluation to fully capitalize on its theranostic benefits. Recently, with the accumulation of evidence-based medical data, 131I treatment has evolved with respect to treatment principles, pre-treatment risk stratification, post-treatment dynamic assessment, and comprehensive patient management, with an aim to optimize the diagnostic and therapeutic precision of 131I. Here we briefly review and update the recent advance on 131I management on DTC.
ObjectiveThe current medical questionnaire resources are mainly processed and organized at the document level, which hampers user access and reuse at the questionnaire item level. This study aims to propose a multi-class classification of items in medical questionnaires in low-resource scenarios, and to support fine-grained organization and provision of medical questionnaires resources. MethodsWe introduced a novel, BERT-based, prompt learning approach for multi-class classification of items in medical questionnaires. First, we curated a small corpus of lung cancer medical assessment items by collecting relevant clinical assessment questionnaires, extracting function and domain classifications, and manually annotating the items with "function-domain" combination labels. We then employed prompt learning by feeding the customized template into BERT. The masked positions were predicted and filled, followed by mapping the populated text to labels. This process enables the multi-class classification of item texts in medical questionnaires. ResultsThe constructed corpus comprised 347 clinical assessment items for lung cancer, across nine "function-domain" labels. The experimental results indicated that the proposed method achieved an average accuracy of 93% on our self-constructed dataset, outperforming the runner-up GAN-BERT by approximately 6%. ConclusionThe proposed method can maintain robust performance while minimizing the cost of building medical questionnaire item corpora, illustrating its promotion value of research and practice in medical questionnaire classification.
Objective To Investigate the effects of lithocholic acid (LCA) on the balance between osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Methods Twelve 10-week-old SPF C57BL/6J female mice were randomly divided into an experimental group (undergoing bilateral ovariectomy) and a control group (only removing the same volume of adipose tissue around the ovaries), with 6 mice in each group. The body mass was measured every week after operation. After 4 weeks post-surgery, the weight of mouse uterus was measured, femur specimens of the mice were taken for micro-CT scanning and three-dimensional reconstruction to analyze changes in bone mass. Tibia specimens were taken for HE staining to calculate the number and area of bone marrow adipocytes in the marrow cavity area. ELISA was used to detect the expression of bone turnover markers in the serum. Liver samples were subjected to real-time fluorescence quantitative PCR (RT-qPCR) to detect the expression of key genes related to bile acid metabolism, including cyp7a1, cyp7b1, cyp8b1, and cyp27a1. BMSCs were isolated by centrifugation from 2 C57BL/6J female mice (10-week-old). The third-generation cells were exposed to 0, 1, 10, and 100 μmol/L LCA, following which cell viability was evaluated using the cell counting kit 8 assay. Subsequently, alkaline phosphatase (ALP) staining and oil red O staining were conducted after 7 days of osteogenic and adipogenic induction. RT-qPCR was employed to analyze the expressions of osteogenic-related genes, namely ALP, Runt-related transcription factor 2 (Runx2), and osteocalcin (OCN), as well as adipogenic-related genes including Adiponectin (Adipoq), fatty acid binding protein 4 (FABP4), and peroxisome proliferator-activated receptor γ (PPARγ). Results Compared with the control group, the body mass of the mice in the experimental group increased, the uterus atrophied, the bone mass decreased, the bone marrow fat expanded, and the bone metabolism showed a high bone turnover state. RT-qPCR showed that the expressions of cyp7a1, cyp8b1, and cyp27a1, which were related to the key enzymes of bile acid metabolism in the liver, decreased significantly (P<0.05), while the expression of cyp7b1 had no significant difference (P>0.05). Intervention with LCA at concentrations of 1, 10, and 100 μmol/L did not demonstrate any apparent toxic effects on BMSCs. Furthermore, LCA inhibited the expressions of osteogenic-related genes (ALP, Runx2, and OCN) in a dose-dependent manner, resulting in a reduction in ALP staining positive area. Concurrently, LCA promoted the expressions of adipogenic-related genes (Adipoq, FABP4, and PPARγ), and an increase in oil red O staining positive area. Conclusion After menopause, the metabolism of bile acids is altered, and secondary bile acid LCA interferes with the balance of osteogenic and adipogenic differentiation of BMSCs, thereby affecting bone remodelling.
Objective Telomerase reverse transcriptase (TERT) is the key factor to determine cell growth and l ifespan. Meanwhile, it is tightly related to resistance of cell to stress and apoptosis. However, up till now l ittle is known about the role TERT plays in nervous system. To investigate the effect of conditioned medium from astrocytes (AS) transfected with TERT on neurons subjected to hypoxia-ischemia-reperfusion (HI-RP) through construction of in vitro HI-RP model of neurons. Methods An eukaryote expression plasmids containing rat full length TERT gene was constructed as pcDNA3-TERT. Twenty newborn rats at age of 3 days were sacrificed and their cerebral cortex were collected for isolation and cultivationof AS. Then AS were transfected with pcDNA3-TERT through l iposomes mediation, and positive clones were selected by G418 and expanded for continuous culture to establ ish the plamid pcDNA3-TERT transfection group. Meanwhile, the empty plasmid pcDNA3 transfection group and the non-transfection group were establ ished as control. The expression of gl ial fibrillary acidic protein (GFAP), which was the specific marker of the AS, was detected by immunocytochemistry, as well as the expression of TERT. Astrocyte conditioned medium (ACM) of the plamid pcDNA3-TERT transfection group was collected as TERT-ACM, while the ACM of the empty plasmid pcDNA3 transfection group and the non-transfection group were collected respectively as p-ACM and ACM. Next, 60 rats at age of 1 day were sacrificed and their cerebral cortex were collected for isolation and cultivation of neurons. The neurons were randomly divided into experimental group and normal group, the experimental group were further divided into 4 groups including control group, ACM group, p-ACM group, and TERT-ACM group. The neurons of control group were subjected to HI damage in serum-free DMEM, and the neurons of ACM group, p-ACM group, and TERTACM group were subjected to HI damage in different medium which contained ACM, p-ACM, and TERT-ACM, respectively. After duration of HI for 3 hours under the environment with 5%CO2, 1%O2, and 94%N2; the neurons of experimental groups were placed in CO2 incubator to imitate RP for 3, 6, 18, 24, and 36 hours in vitro. The neurons of normal group were not subjected to HI and RP treatment. During the treatment of HI-RP, the survival ratio of neurons was detected by means of MTT, the lactate dehydrogenase (LDH) activity of neuron medium with LDH detection kit, and the neuronal apoptosis by means of TUNEL. Results The percentages of GFAP positive cells were 98%, 99%, and 98% in non-transfection group, plasmid pcDNA3-TERT transfection group, and plasmid pcDNA3 transfection group, respectively. There was no expression of TERT in no-transfection group and plasmid pcDNA3 transfection group, and the percentage of TERT positive cells in plasmid pcDNA3- TERT transfection group was 98%. Compared with normal group, the survival ratio of ......（余见正文）
Objective To document the effect of surgical steps, including penile degloving, plate transection, dorsal plication, and fasciocutaneous coverage, in primary hypospadias repair on penile length. Methods A consecutive series of 209 prepubertal boys with primary hypospadias repair was included with the age ranged from 10 to 97 months (mean, 31.7 months). Intraoperative stretched penile length (SPL) was measured before operation (n=209), and after each step, namely penile degloving (n=152), plate transection (n=139), dorsal plication (n=170), and fasciocutaneous coverage (n=209). SPLs before and after each steps or the entire operation were analyzed. The SPL was compared between plate transection group and plate preservation group, dorsal plication group and non-plication group, and plate preservation with plication group and plate preservation without plication group, respectively. Differences of SPL between before and after each steps were analyzed with factors including neourethra length, rest dorsal penile length, rest ventral penile length, preoperative SPL, and the degree of penile curvature after penile degloving, with multivariate linear regression analysis. ResultsAll the four steps resulted in SPL difference. The SPL increased after penile degloving and plate transection (P<0.05), and decreased after dorsal plication and fasciocutaneous coverage (P<0.05). The SPL increased after all steps were completed (P<0.05). In patients with plate transection, postoperative SPL increased when compared with that before operation (P<0.05). No significant difference was noted in patients without plate transection (P>0.05). And there was significant difference in the increased length of SPL between patients with and without plate transection (P<0.05). In patients with dorsal plication, a significant increase of postoperative SPL (P<0.05) was noted. No significant difference was noted in patients without dorsal plication (P>0.05). And there was no significant difference in increased length between patients with and without dorsal plication (P>0.05). When patients with plate transection were excluded, dorsal plication resulted in no significant difference on postoperative SPL (P>0.05). The increased length of SPL after penile degloving, dorsal plication, or cutanofascial coverage was not related to the neourethra length, the rest dorsal penile length, the rest ventral penile length, the preoperative SPL, and the degree of penile curvature (P>0.05). However, the neourethra length and preoperative SPL were the influencing factors for the increased length of SPL after plate transection (P<0.05). ConclusionThe main steps in primary hypospadias repair can change SPL. The lengthening effect of plate transection would not be counteracted by dorsal plication. Dorsal plication makes no significant difference on postoperative SPL.
ObjectiveTo construct a demand model for electronic medical record (EMR) data quality in regards to the lifecycle in machine learning (ML)-based disease risk prediction, to guide the implementation of EMR data quality assessment. MethodsReferring to the lifecycle in ML-based predictive model, we explored the demand for EMR data quality. First, we summarized the key data activities involved in each task on predicting disease risk with ML through a literature review. Second, we mapped the data activities in each task to the associated requirements. Finally, we clustered those requirements into four dimensions. ResultsWe constructed a three-layer structured ring to represent the demand model for EMR data quality in ML-based disease risk prediction research. The inner layer shows the seven main tasks in ML-based predictive models: data collection, data preprocessing, feature representation, feature selection and extraction, model training, model evaluation and optimization, and model deployment. The middle layer is the key data activities in each task; and the outer layer represents four dimensions of data quality requirements: operability, completeness, accuracy, and timeliness. ConclusionThe proposed model can guide real-world EMR data governance, improve its quality management, and promote the generation of real-world evidence.