ObjectiveTo summarize a comprehensive overview of the mechanism of ferroptosis and its associated microRNAs in the occurrence and development of hepatocellular carcinoma (HCC), and to offer novel insights and potential avenues for tumor marker screening and targeted treatment in clinical hepatocellular carcinoma patients. MethodThe literatures on the basic and clinical application research of ferroptosis and related microRNA in the occurrence, development and prognosis of HCC at home and abroad in recent years were reviewed and summarized, and the research progress of microRNA regulating ferroptosis in HCC was summarized. ResultsMicroRNA, a type of non-coding small RNA, had the ability to regulate gene expression at the post-transcriptional and translational levels. It held promising potential in the diagnosis and treatment of HCC. Ferroptosis, on the other hand, was a form of cell death triggered by iron-dependent lipid peroxidation. It played a crucial role in the development of HCC. A series of miRNAs related to ferroptosis might act as HCC growth regulators to regulate the growth of cancer cells, or reverse the drug resistance of cancer cells, thereby promoting or inhibiting the occurrence and progression of HCC. ConclusionsMicroRNA can regulate the occurrence and development of HCC through the ferroptosis pathway and may become tumor markers for the early diagnosis of HCC. Additionally, microRNA may also serve as a related therapeutic target and provide a new treatment option for HCC.
Objective To explore effects of zinc on the contents of cycl in D2, cycl in-dependent kinase 4 (CDK4), and their DNA and total cellular protein in human umbil ical cord blood-drived mesenchymal stem cells (hUCBMSCs). Methods hUCBMSCs were isolated and cultured by density gradient centrifugation adherence method in vitro. At the serial subcultivation, the hUCBMSCs were randomly divided into 7 groups. In control group, hUCBMSCs were cultured with DMEM medium (containing 15%FBS). In treatment groups, hUCBMSCs were cultured with DMEM medium (containing 15%FBS plusZnSO4•7H2O). The final concentrations of zinc were 0.5, 1.5, 2.5, 3.5, 4.5, and 5.5 mg/L, respectively. The cellular surface antigens of CD29, CD34, CD44, and CD45 at the 3rd generation of hUCBMSCs were detected by flow cytometry. MTT assay was used to detect cell activity of the 3rd generation of hUCBMSCs. The optimum concentration of zinc was selected by the results of MTT as experimental group. The cell growth curves of experimental group and control group were drown by counting cell. The cell surface antigen, reproductive cycle, and DNA content were detected by flow cytometry motheds. The contents of cycl in D2 and CDK4 were detected by Western blot method. Results The positive expression rates of CD29 and CD44 were more than 70% in hUCBMSCs. The cell activity of 2.5 mg/L treatment group was superior to other treatment groups, as experimental group. At 7, 14, and 28 days, the contents of DNA, total cellular protein, cycl in D2, and CDK4 of hUCBMSCs were significantly higher in experimental group than those in control group (P lt; 0.01). The percentage of hUCBMSCs at S stage and prol iferation index in experimental group were also significantly higher than those in control group (P lt; 0.01). Conclusion Zinc (0.5-4.5 mg/L) has the promoting effect on the hUCBMSCs activity, and 2.5 mg/L is the optimal concentration. Zinc (2.5 mg/L) can accelerate the prol iferation and DNA reproduction of hUCBMSCs and increase the contents of cycl in D2 , CDK4, and cellular total protein.
Objective To evaluate the survival outcomes of segmentectomy versus lobectomy for T1c non-small cell lung cancer (NSCLC). Methods We searched PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), CNKI (China National Knowledge Infrastructure), and Wanfang Data, with the search time limit set from the inception of the databases to February 2024. Three researchers independently screened the literature, extracted relevant information, and evaluated the risk of bias of the included literature according to the Newcastle-Ottawa Scale (NOS). Meta-analysis was conducted using STATA 15.1. Hazard ratios (HRs) and their 95% confidence interval were pooled using an inverse variance-weighted approach, and heterogeneity was assessed using I-square (I2) statistic and Cochran’s Q test. Results A total of 8 retrospective cohort studies were included, involving 7,433 patients. The NOS scores of the included studies were all higher than 7 points. Among the 7 433 patients enrolled in eight eligible studies published from 2004 to 2022. The pooled adjusted HR found that patients who underwent lobectomy had significantly higher five-year OS compared to those who underwent lobectomy (adjusted HR=1.11, 95%CI 0.99-1.24, P=0.042). Compared with lobectomy, segmentectomy shows no significant difference in adjusted three-year OS and adjusted five-year LCSS of patients with T1c NSCLC (three-year OS: adjusted HR=0.88, 95%CI 0.62-1.24, P=0.468; five-year LCSS: adjusted HR=1.10, 95%CI 0.80-1.51, P=0.556). Moreover, there were no differences in the five-year adjusted RFS, and adverse events after the segmentectomy group were significantly less than those in the lobectomy group (five-year RFS: adjusted HR=1.23, 95%CI 0.82 to 1.85, P=0.319; complications: OR=0.57, 95%CI0.37 to 0.90, P=0.015). Subgroup analysis based on whether patients received neoadjuvant therapy showed that among studies that excluded patients who received neoadjuvant therapy, no significant difference in 5-year adjusted OS was observed between segmentectomy and lobectomy (adjusted HR=1.02, 95%CI 0.81 to 1.28, P=0.870). Conclusion Segmentectomy and lobectomy showed no significant difference in long-term survival in stage T1c NSCLC patients, with segmentectomy associated with fewer postoperative complications. Further high-quality research is needed to confirm the comparative efficacy and safety of lobectomy and segmentectomy for T1c NSCLC patients.
Artificial intelligence has been extensively applied in healthcare services recently, and clinical decision support systems driven by artificial intelligence are one of the applications. Early-stage clinical evaluation of artificial intelligence (AI)-based clinical decision support systems lies between preclinical development (in silico), offline validation, and large-scale trials, but few AI-related clinical studies have addressed human factors evaluations and reported the implementation environment, user characteristics, selection process and algorithm identification of AI systems. In order to bridge the development-to-implementation gap in clinical artificial intelligence and to promote the transparent and standardized reporting of early-stage clinical studies of AI-based decision support systems. A reporting guideline for the developmental and exploratory clinical investigations of decision support systems driven by artificial intelligence (DECIDE-AI) was published in 2022. This paper aimed to interpret the background, development process and key items of the DECIDE-AI guideline and promote its understanding as well as dissemination in China.
ObjectiveTo summarize the technique and effectiveness of double metatarsal osteotomy for treating severe hallux valgus with increased distal metatarsal articular angle (DMAA).MethodsBetween June 2014 and December 2017, 64 patients (94 feet) of severe hallux valgus with an increased DMAA were treated with the double metatarsal osteotomy (distal metatarsal Reverdin osteotomy+proximal metatarsal open wedge osteotomy) combined with Akin osteotomy and soft tissue surgery to correct the deformity. There were 10 males (15 feet) and 54 females (79 feet) with an average age of 44.5 years (range, 26-66 years), including 34 of unilateral foot and 30 of bilateral feet. The Maryland metatarsophalangeal joint score of the American Orthopaedic Foot and Ankle Society (AOFAS) was 54.3±7.4 and the visual analogue scale (VAS) score was 6.0±2.0. The pre- and post-operative AOFAS score, VAS score, DMAA, hallux valgus angle (HVA), first-second intermetatarsal angle (1-2IMA), and the first metatarsal length (FML) were recorded and compared.ResultsAll incisions healed by first intention. All patients were followed up 12-15 months, with an average of 13.2 months. The complications occurred in 4 feet, including 1 foot of hallux stiffness, 1 foot of numbness at the edge of the wound, 1 foot of metastatic metatarsalgia, and 1 foot of metatarsal bone necrosis. At 1 year after operation, the Maryland metatarsal joint score of AOFAS was 89.2±7.4, showing significant difference compared with preoperative score (t=18.427, P=0.000); and the effectiveness was rated as excellent in 78 feet, good in 12 feet, poor in 3 feet, and bad in 1 foot, with an excellent and good rate of 95.7%. The VAS score was 1.5±2.0, showing significant difference compared with the preoperative score (t=10.238, P=0.000). The X-ray films showed that the osteotomies achieved bony healing at 3 months after operation. There were significant differences (P<0.05) in HVA, 1-2IMA, and DMAA between preoperation and 6 months and 1 year after operation; but no significant difference was found in FML between preoperation and 1 year after operation (t=0.136, P=0.863).ConclusionFor the patients with severe hallux valgus with increased DMAA, the double metatarsal osteotomy can significantly relieve the clinical symptoms and improve the imaging parameters with less postoperative complications.
Objective To explore the research trends of traditional Chinese exercise in the rehabilitation of chronic obstructive pulmonary disease (COPD). Methods The Web of Science core collection database was searched to collect literature on traditional Chinese exercise for COPD rehabilitation published from 2004 to 2023. VOSviewer was used for bibliometric analysis of publication year, author, publication institution and country, citation and co-citation information. Results A total of 125 publications were included. No relevant publication was published from 2004 to 2008. Since 2009, the overall number of publications had shown a fluctuating upward trend, with no publications in 2012. From 2019 to 2023, the number of publications on related topics remained at a high level. Reached maximum publication volume in 2020. The annual citation frequency also showed a fluctuating increase, reaching its peak in 2022. Based on comprehensive analysis, Peter M. Wayne and Wu Weibing were the authors with high productivity, high citation, and frequent collaborations. The country with the highest number of publications was China, and the highest institution was Shanghai University of Sport. Initially, the keywords focused on rehabilitation, exercise testing, aerobic exercise, resistance exercise, and respiratory muscle strength. As the times progressed, the focus shifted to lung function, exercise tolerance, and mental health. The current trends included self-management and telemedicine. Conclusions Traditional Chinese exercises have been widely applied in the clinical practice of COPD rehabilitation, showing an upward trend. Facilitating patient self-management and establishing the role and significance of traditional Chinese exercises in remote healthcare for COPD patients may be the focus of future research.
Objective To explore the clinical effect of ventricular septal defect repair and lung allograft (simply as "heart repair and lung transplant") in the treatment of ventricular septal defect complicated with severe pulmonary hypertension. Methods A 21-year-old female patient with ventricular septal defect and severe pulmonary hypertension was treated with cardiopulmonary bypass (CPB) under general anesthesia, and then right lung transplantation was performed, and then left lung transplantation was performed after changing body position. Results The operation was conducted successively. The intraoperative CPB support time was 90 minutes, and the blood loss was 2000 mL. Extracorporeal membrane oxygenation was removed on the second day after operation, the ventilator was evacuated on the third day, and the patient recovered and discharged on the 38th day. Postoperative echocardiography showed significant improvement in pulmonary artery pressure. Conclusion For patients with simple congenital heart disease complicated with severe pulmonary hypertension, "heart repair and lung transplant" can improve their quality of life.