Treatment Guidance Research Articles

NOS2 as a prognostic biomarker for early-onset colorectal cancer based on public data and clinical validation analysis

Early-onset colorectal cancer (EOCRC) was characterized by strong aggressiveness and high malignancy. The aim of this study was to screen suitable biomarkers for patients with EOCRC. EOCRC from The Cancer Genome Atlas Program (TCGA) database and Gene Expression Mapping (GEO) database were used to screen biomarkers for prognosis and treatment guidance. Clinical samples were used to verify the expression situation of these candidate biomarkers. The results showed the immune-related gene nitric oxide synthase 2 (NOS2) was independently associated with the poor prognosis of EOCRC patients in both TGCA and GEO database. The Immune Dysfunction and Exclusion (TIDE) analysis showed that multiple immunotherapy signatures, such as TIDE, Exclusion, and CAF, were difference among EOCRC patients with different risk scores, and significantly correlated with the expression of NOS2. Sensitivity analysis of chemotherapy drugs showed that NOS2 was significantly correlated with several chemotherapy drugs, such as MG.132_1862, BMS.754807_2171, and GEN.317_1926. Clinical validation analysis showed that the expression of NOS2 and its related genes CXCL1 and CXCL2 were significantly decreased in EOCRC patients. The results suggested that NOS2 can be used as a potential biomarker for EOCRC, which can be used for prognosis and guidance of immunotherapy and chemotherapy.

Mechanisms of T-cell Depletion in Tumors and Advances in Clinical Research.

T lymphocytes (T cells) are essential components of the adaptive immune system that play a vital role in identifying and eliminating infected and tumor cells. In tumor immunotherapy, T cells have emerged as a promising therapeutic strategy due to their high specificity, potent cytotoxic capability, long-lasting immune memory, and adaptability within immunotherapeutic approaches. However, tumors can evade the immune system by depleting T cells through various mechanisms, such as inhibitory receptor signaling, metabolic exhaustion, and physical barriers within the tumor microenvironment. This review provided an overview of the mechanisms underlying T-cell depletion in tumors and discussed recent advances in clinical research related to T-cell immunotherapy for tumors. It highlighted the need for in-depth studies on key issues such as indications, dosage, and sequencing of combined therapeutic strategies tailored to different patients and tumor types, providing practical guidance for individualized treatment. Future research on T-cell depletion would be necessary to uncover the fundamental mechanisms and laws of T-cell depletion, offering both theoretical insights and practical guidance for the selection and optimization of tumor immunotherapy. Furthermore, interdisciplinary, cross-disciplinary, and international collaborative innovations are necessary for developing more effective and safer treatments for tumor patients.

Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels.

The early assessment of heart failure (HF) risk in patients with acute coronary syndrome (ACS) can help reduce mortality. S100A8/A9 is not only rapidly released after myocardial ischemia, but is also involved in reperfusion injury, which is an important predictor of HF after ACS. We attempted to construct a reliable HF risk stratification tool for evaluating patients with ACS after reperfusion therapy based on S100A8/A9 dynamic changes. This prospective study included 3 independent cohorts of patients with ACS who received reperfusion therapy. The discovery cohort was divided into 2 subgroups: the longitudinal subgroup (n=264) with serum S100A8/A9 levels measured at admission and on days 1, 2, 3, and 4 postadmission, respectively, and the 2-point subgroup (n=798) with S100A8/A9 levels measured at admission and on day 1 postadmission, respectively. Validation cohorts 1 (n=1399) and 2 (n=1183) both had S100A8/A9 levels measured on day 1 postadmission. HF events included in-hospital HF events after the initial presentation and long-term HF events after discharge. The median follow-up for the discovery cohort, validation cohort 1, and validation cohort 2 was 4.2, 2.6, and 1.8 years, respectively. In the discovery cohort, S100A8/A9's predictive ability at day 1 surpassed other time points. Through the S100A8/A9-guided risk stratification, patients deemed high risk (>7900 ng/mL) exhibited a higher 1-year HF event rate (46% versus 2%, 38% versus 5%) than patients at low risk (<2100 ng/mL) in both validation cohorts. Among patients without left ventricular dysfunction after ACS, β-blocker therapy correlated with reduced 1-year HF events in intermediate-to- high-risk patients but not in low-risk patients. S100A8/A9 levels on day 1 accurately classified patients at varying risks of HF, serving as a robust tool for HF risk prediction and treatment guidance. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03752515.

Diaper Dermatitis Algorithm and Scoring Tool in the Neonatal Intensive Care Unit (NICU): A Quality Improvement Project.

The purpose of this quality improvement project was to implement and evaluate an algorithm for management and prevention of diaper dermatitis (DD) embedded in a scoring tool. The specific aim of the project was to decrease DD occurrences with a severity score of 3 to 4 by 25%. Quality improvement participants comprised 164 neonates; 89 were cared for prior to project implementation and 75 post-implementation. Data were collected over a 3-month period. The setting of this quality improvement project was a 98-bed, Level IV neonatal intensive care unit (NICU) located in the Midwestern United States (Oklahoma City, OK). The NICU is part of a freestanding children's hospital affiliated with a university. Diaper dermatitis occurrences and severity scores were collected prior to and 3 months after the protocol was implemented in the NICU. We collected pre-implementation data, followed by staff education concerning the DD protocol. We also provide guidance for protocol implementation at the bedside and in our Electronic Medical Record. Data on DD rates and severity were provided during the National Database for Nurse Quality Indicators (NDNQI) prevalence days the 4th quarter of 2020 and the 1st quarter of 2021. We compared data before and after protocol implementation to evaluate its effect on DD rates and severity. Analysis before and after implementation of the protocol showed no significant differences in DD occurrences or severity scores. The unintended introduction of water-based cleansing wipes was identified as a confounding factor that we believe influenced outcomes. The DD scoring system and algorithm were permanently implemented for DD score quantification, DD management and treatment guidance, and ease of DD documentation with interventions, despite non-significant group differences. Next steps for this project are to implement the water-based cleansing wipes facility wide, along with the scoring tool and DD prevention protocol.

The molecular code of kidney cancer: A path of discovery for gene mutation and precision therapy.

Renal cell carcinoma (RCC) is a malignant tumor with highly heterogeneous and complex molecular mechanisms. Through systematic analysis of TCGA, COSMIC and other databases, 24 mutated genes closely related to RCC were screened, including VHL, PBRM1, BAP1 and SETD2, which play key roles in signaling pathway transduction, chromatin remodeling and DNA repair. The PI3K/AKT/mTOR signaling pathway is particularly important in the pathogenesis of RCC. Mutations in genes such as PIK3CA, MTOR and PTEN are closely associated with metabolic abnormalities and tumor cell proliferation. Clinically, mTOR inhibitors and VEGF-targeted drugs have shown significant efficacy in personalized therapy. Abnormal regulation of metabolic reprogramming, especially glycolysis and glutamine metabolic pathways, provides tumor cells with continuous energy supply and survival advantages, and GLS1 inhibitors have shown promising results in preclinical studies. This paper also explores the potential of immune checkpoint inhibitors in combination with other targeted drugs, as well as the promising application of nanotechnology in drug delivery and targeted therapy. In addition, unique molecular mechanisms are revealed and individualized therapeutic strategies are explored for specific subtypes such as TFE3, TFEB rearrangement type and SDHB mutant type. The review summarizes the common gene mutations in RCC and their molecular mechanisms, emphasizes their important roles in tumor diagnosis, treatment and prognosis, and looks forward to the application prospects of multi-pathway targeted therapy, metabolic targeted therapy, immunotherapy and nanotechnology in RCC treatment, providing theoretical support and clinical guidance for individualized treatment and new drug development.

Mapping Theme Trends and Recognizing Hot Spots in Acute Spinal Cord Injury: A Bibliometric Analysis.

Acute spinal cord injury causes severe motor and sensory dysfunction, significantly burdening individuals and society. This study uses bibliometric analysis to identify research trends and key areas, providing insights for future advancements in treatment. Scientific publications on acute spinal cord injury were collected from PubMed and the Web of Science Core Collection between 2000 and 2022. Data were analyzed using Bibliometric, CiteSpace, and Bibliographic Item Co-occurrence Matrix Builder, with gCLUTO applied for co-word bicluster analysis based on MeSH term matrices. Two thousand five hundred thirteen publications on acute spinal cord injury were published, with the number of articles increasing annually from 38 to 268. Spinal cord has emerged as the leading journal in this field, and the United States maintains its dominant position in global research impact. The University of Toronto ranks first among research institutions, with significant contributions from researchers such as Fehlings and Kwon. Research on acute spinal cord injury primarily focuses on 7 key areas: metabolism, pharmacology, surgical timing, rehabilitation, pathology, clinical predictors, and diagnostic imaging. Our study reveals substantial growth in acute spinal cord injury research over the past 2 decades, emphasizing leading countries, researchers, institutions, and journals. Animal models remain pivotal in drug development for basic medicine and neuroscience. Consensus has been reached among experts regarding the timing of surgical intervention, while artificial intelligence and multidisciplinary approaches are emerging as promising avenues for comprehensive treatment. Additionally, ongoing research into spinal cord injury pathophysiology provides essential guidance for pharmacological and surgical treatments.

Assessing the Wrightington Classification System for elbow fracture-dislocations : an external reliability study.

Complex elbow fracture-dislocations often result in suboptimal outcomes and necessitate a thorough understanding of injury patterns to guide effective management and reduce adverse sequelae. The Wrightington Classification System (WCS) offers a comprehensive approach and considers both bony and soft-tissue disruption, providing clearer guidance for treatment. This is the first external study to assess the reliability of the WCS for elbow fracture-dislocations. A blinded study of patients with elbow fracture-dislocations at a single institution between December 2014 and December 2022 was conducted. Five assessors with a range of experience, including orthopaedic surgeons and radiologists, independently classified injuries using the WCS across three image methods: plain radiograph, 2D CT, and 2D and 3D CT reconstruction images, on two occasions with an eight-week interval. Interobserver and intraobserver reliability were evaluated using kappa statistics and the Landis and Koch criteria. A total of 73 patients were included in the study. Interobserver reliability was moderate, with mean kappa values of 0.518 (95% CI 0.499 to 0.537), 0.557 (95% CI 0.537 to 0.577), and 0.582 (95% CI 0.562 to 0.601), for radiographs, 2D CT, and 2D and 3D CT reconstructions, respectively. Intraobserver agreement was substantial (mean kappa 0.695 (SE 0.067), 0.729 (SE 0.071), and 0.777 (SE 0.070) for radiographs, 2D CT, and 3D CT reconstructions, respectively). The WCS is a reliable and valuable tool for characterizing elbow fracture-dislocations and guiding surgical interventions. This study found moderate reliability in using the WCS, with higher reliability with combined 2D and 3D CT imaging. Further refinement within the WCS in differentiating between coronoid avulsions, basal, anteromedial, and/or anterolateral facet injuries may help improve reliability and reproducibility.

Developing the EPA Guidance of Pharmacological Treatment of Schizophrenia - Results of a Delphi process.

Developing the EPA Guidance of Pharmacological Treatment of Schizophrenia - Results of a Delphi process.

Transforming Rheumatoid Arthritis Care with ChatGPT: A New Digital Companion

Objective: This study examines the role of ChatGPT, an AI-based conversational model, in managing rheumatoid arthritis (RA), focusing on patient education, symptom management, and personalized support. Method: ChatGPT’s responses to common RA-related inquiries were analyzed for accuracy, relevance, and usability. Key areas assessed included disease education, treatment guidance, lifestyle recommendations, and symptom tracking. A literature review was conducted to contextualize its capabilities against other AI tools in healthcare. Results: ChatGPT effectively provided clear, accessible information about RA, including symptoms, treatment options, and self-care strategies. It excelled in delivering lifestyle recommendations, such as anti-inflammatory diets and low-impact exercises. However, it cannot replace professional medical advice or provide tailored medical recommendations. Ethical concerns, including misinformation risks and patient privacy, were also noted. Conclusion: ChatGPT shows promise as a supplementary tool in RA management by enhancing patient education and promoting self-management. While it has limitations, its potential to assist healthcare providers and patients highlights the need for further development and ethical integration. Future advancements may enable more personalized and interactive support for chronic disease management.

P-1630. Retrospective Evaluation of Urinalysis to Urine Culture Reflex Frequency and Criteria

Abstract Background Patients with asymptomatic bacteriuria (ASB) often receive inappropriate treatment despite IDSA guidelines recommendation against antimicrobial treatment of ASB in the majority of adults. Emphasis on laboratory results rather than symptoms often triggers ASB treatment. At our institution, a urinalysis (UA) positive for ≥ 1 criteria ( &amp;gt; 10 WBC / HPF, leukocyte esterase (LE), or nitrites) results in a reflex to urine culture (UC). The objective of this study was to assess the frequency of UC reflex orders and the specific criteria driving reflex to identify opportunities for diagnostic stewardship and treatment guidance. Methods Retrospective data were provided by the Best Practices Integrated Informatics Core for hospitalized adults with an ICD-10 diagnosis of urinary tract infection (UTI) or related condition and a UA +/- UC order within 72 hours between 11/1/2022 and 4/30/2023 at a large academic medical center. Number and frequency of UA to UC reflex and UA criteria driving UC reflex were assessed. LE results were considered positive if “moderate” or “large” and negative if “small”, “trace”, or “negative”. RStudio (version 2023.06.0) was utilized to perform logistic regression analyses with univariable and multivariable models to calculate odds ratios for reflex to UC. Results This cohort comprised 2007 unique patients with a total of 3193 UA orders. Of 3193 UA orders, 1016 (31.8%) reflexed to UC. The highest frequency of UC reflex was with 2 of 3 UA criteria positive (43.2%), followed by 1 of 3 criteria positive (39.0%), then 3 of 3 criteria positive (9.5%), and lastly, the remaining 8.3% of patients had UC reflexed for unknown reasons that need to be further investigated (Table 1). All 3 criteria when positive had increased odds for triggering UC reflex (Table 2). In the multivariable model, LE had the highest odds of triggering UC reflex (OR 1.73, 95% CI: 1.68-1.78). Conclusion Despite frequent UA orders, only 31.8% reflexed to UC. Following these results, retrospective chart review will be completed to characterize patients with symptomatic UTI vs. ASB based on review of progress notes. These data will identify whether certain UA criteria are more highly correlated with symptomatic UTI and will help inform the need for revised UA and UC diagnostics. Disclosures Elizabeth B. Hirsch, PharmD, FCCP, FIDSA, GSK: Advisor/Consultant|GSK: Honoraria

AI model for automatic 3D reconstruction of ossicular chain and bony labyrinth from High-Resolution CT

Abstract Background Three-dimensional (3D) reconstruction of ossicular chain and bony labyrinth based on temporal bone high resolution computed tomography (HRCT) is useful for diagnosis and treatment guidance of middle and inner ear diseases. However, these structures are small and irregular, making manual reconstruction time-consuming. Purpose To develop and validate an artificial intelligence (AI) model based on semi-supervised learning for automated 3D reconstruction of ossicular chain and bony labyrinth on HRCT images. Methods HRCT images from 304 ears of consecutive 152 patients retrospectively collected from a single center were randomly divided into training (246 ears), validation (28 ears) and internal test (30 ears) cohorts for model development. A novel semi-supervised ear bone segmentation framework was used to train the AI model, and its performance was evaluated by Dice similarity coefficients. The trained algorithm was applied to a temporally independent test dataset of 30 ears of 15 patients from the same center for comparison with manual 3D reconstruction for processing time, target volume and visual assessment of segmentation. Results The AI model demonstrated a Dice score of 0.948 (95% CI: 0.940, 0.955) for the internal and 0.979 (95% CI: 0.973, 0.986) for the temporally independent test sets. In the latter dataset, the AI model required 2% or less processing time of manual 3D reconstruction for each ear (17.7 seconds ± 10.1 vs 1080.5 seconds ± 149.8; P ＜ .001), and had an accuracy comparable to human experts in the volume and visual assessment of segmentation targets (P = .237-1.000). In a subgroup analysis, the model achieved accurate segmentation (Dice scores of 0.98-0.99) across various diseases (e.g. otitis media, mastoiditis, otosclerosis, middle and inner ear malformations, and Ménière’s disease). Conclusion The AI model enables robust, efficient and accurate 3D reconstruction for the small structures such as ossicular chain and bony labyrinth on HRCT images.

Longitudinal MRI evaluation of the efficacy of non-enhanced lung cancer brain metastases

Brain metastases (BM) are the most prevalent intracranial malignancies. Approximately 30–40% of cancer patients develop BM at some stage of their illness, presenting with a high incidence and poor prognosis. Our clinical findings indicate a significant disparity in the efficacy between non-enhanced and enhanced lung cancer BM. Therefore, the aim of this study is to conduct a longitudinal MRI evaluation of the therapeutic effect of non-enhanced lung cancer BM, thereby enabling improved efficacy prediction and more personalized treatment plans. We conducted a retrospective analysis of clinical and imaging data from 72 patients with lung cancer BM. Exclusion criteria included participants with a history of primary brain tumors, other malignancies, or neurological symptoms. We performed a longitudinal MRI evaluation of 8 patients with non-enhanced BM who met the eligibility criteria. The response to systemic therapy was locally assessed using the Neuro-Oncology response assessment criteria (RANO 2.0). A total of 8 patients were included in this study, comprising 4 cases of non-enhanced BM and 4 cases featuring both enhanced and non-enhanced BM. The median follow-up time for non-enhanced BM was 19 months, with a disease control rate of 50%. In contrast, the median progression-free follow-up time for enhanced BM was 35.5 months, yielding a disease control rate of 100%. After standardized treatment in accordance with clinical guidelines, patients with enhanced BM exhibited significantly better therapeutic outcomes than those with non-enhanced BM. Cases 1–4 demonstrated non-enhanced or mildly circular-enhanced lung cancer BM, with the sizes of all 4 lesions increasing by over 60% within approximately one year, indicating disease progression. In cases 5–8, each patient presented with two lesions: enhanced (Foci 1) and non-enhanced (Foci 2) BM. Comparative analysis of Foci 1 and Foci 2 revealed significantly weaker treatment responses in non-enhanced lesions (Patients 7–8), with Patient 5 exhibiting disease progression without any response. This study demonstrates that, following standardized treatment protocols aligned with clinical guidelines, the therapeutic effect of non-enhanced lung cancer BM is inferior to that of enhanced BM. Evaluating the enhancement type of lung cancer BM is essential for efficacy prediction and holds important implications for treatment guidance.

Using artificial intelligence to optimize anti-seizure treatment and EEG-guided decisions in severe brain injury.

Electroencephalography (EEG) is invaluable in the management of acute neurological emergencies. Characteristic EEG changes have been identified in diverse neurologic conditions including stroke, trauma, and anoxia, and the increased utilization of continuous EEG (cEEG) has identified potentially harmful activity even in patients without overt clinical signs or neurologic diagnoses. Manual annotation by expert neurophysiologists is a major resource limitation in investigating the prognostic and therapeutic implications of these EEG patterns and in expanding EEG use to a broader set of patients who are likely to benefit. Artificial intelligence (AI) has already demonstrated clinical success in guiding cEEG allocation for patients at risk for seizures, and its potential uses in neurocritical care are expanding alongside improvements in AI itself. We review both current clinical uses of AI for EEG-guided management as well as ongoing research directions in automated seizure and ischemia detection, neurologic prognostication, and guidance of medical and surgical treatment.

Dual-Locked Enzyme-Activatable Fluorescence Probes for Precise Bioimaging.

Real-time visualization of endogenous enzymes not only helps reveal the underlying biological principles but also provides pathological information for cancer/disease diagnosis and even treatment guidance. To this end, enzyme-activatable fluorescence probes are frequently fabricated that turn their fluorescence signals "on" exclusively at the enzyme-rich region, thus enabling noninvasive and real-time imaging of enzymes of interest at the molecular level with superior sensitivity and selectivity. However, in a complex biological context, commonly used single enzyme-activatable (i.e., single-locked) probes may suffer from "false positive" signals at healthy tissues and be insufficient to accurately indicate the occurrence of certain diseases. Therefore, dual-locked fluorescence probes have been promoted to address these issues. Using dual enzymes (or an enzyme with another stimulus) as "keys", they permit simultaneous detection of distinct biomarkers, offering significantly enhanced imaging precision toward certain biological events. Considering that recent reviews on these probes remain scarce, we thus provide this review. We summarize the recent progress, particularly highlighting the breakthroughs in the last three years, and discuss the challenges in this field.

Engineered alginate-polyethyleneimine and sludge-aluminosilicate biochar composites for greywater treatment: Performance evaluation and models for designing pilot-scale systems.

Greywater, originating from kitchen sinks and toilets, constitutes 75-80 % of the domestic wastewater produced in homes and can be reclaimed for non-potable uses. This study synthesized novel sludge-derived aluminosilicates and alginate-polyethyleneimine (PEI) biochar composites. The aluminosilicates offer a sustainable approach to sludge management, while alginate-polyethyleneimine presents a green biochar modification approach. Their performance in fixed bed columns for treating greywater was compared with zinc chloride, calcium alginate, and PEI-biochar composites. The CatBoost machine learning algorithm also predicted contaminant removal efficiency and breakthrough parameters. The morphological and chemical analyses showed that the modification techniques improved the physiochemical properties of the biochar, which in turn influenced contaminant removal efficiency. With its enhanced surface area and pore structure, zinc chloride-biochar demonstrated notable effectiveness in removing organic matter (highest COD removal efficiency 96.1 %). PEI-biochar exhibited a high removal efficiency for nitrates (highest value of 95.5 %), attributed to the positive amine groups. Aluminosilicate-biochar was the most effective at removing ammonium due to its high cation exchange capacity. The CatBoost algorithm successfully stimulated E. coli, total nitrogen, COD removal efficiencies, and breakthrough parameters from greywater using biochar (R2 > 0.7). Future research should conduct a pilot-scale study for this technology, explore the use of modified biochar arranged in multilayers for treating greywater, use of biochar for removing emerging contaminants in greywater, and optimize predictive models for greywater treatment. The insights from our study provide valuable guidance for effective and sustainable greywater treatment.

The role of a «short-term» preoperative endocrine therapy for adjuvant therapy guidance in early HR+ HER2-negative breast cancer

In the absence of widespread access to genomic tests there is an urgent need for additional methods that influence the choice of adjuvant therapy in patients with early luminal Her2-negative subtype of breast cancer (BC). The IMPACT and POETIC trials have shown that Ki67 level decrease up to ≤10% after a “short-term” (2–4 weeks) preoperative endocrine therapy (ET) is a favorable prognostic factor. This test allows some patients to avoid adjuvant chemotherapy associated with immediate and delayed adverse events.Aims of the study. To evaluate the impact of “short-term” preoperative endocrine therapy for guidance of further treatment for patients with primary operable luminal Her2-negative breast cancer stages T1–3 N0–1 M0.Results. The study included 123 patients, 76 (60.8%) received tamoxifen and 47 (37.6%) – aromatase inhibitors (AI). Most patients – 69 (55.2%) were &gt;50 years old, premenopausal – 58 (46.4%), menopausal – 67 (53.6%). The average age was 52 years (30–82). With the initial Ki67 level&gt;10% (N= 107), Ki67 decreased in 24 (22.4%) up to ≤10% after “short-term” ET, and remained &gt;10% in 83 (77.6%). According to the PREDICT calculator, the benefit of adjuvant chemotherapy (AChT) was assessed as high in 35 (28.5%) patients, and 10 of them (27.8%) were able to avoid Ch T. In 86 patients with a relatively low estimated AChT benefit (&lt;5% at 10 years) there was no response to “short-term” ET, which led to the AChT prescription in 13 cases (15.1%).Conclusions. “Short-term” course of preoperative endocrine therapy is a simple, accessible and reproducible method for personalizing of adjuvant therapy in patients with luminal HER2-negative breast cancer.

Trends in Mycoplasma pneumoniae infections in pediatric patient preceding, during, and following the COVID-19 pandemic: a comprehensive longitudinal analysis.

The resemblance between the transmission pathways of M. pneumoniae and those of COVID-19 suggests that non-pharmaceutical interventions may have comparable effects on both. This study aimed to analyze the epidemiological characteristics of children with M. pneumoniae infections in Shaoxing, China, from 2018 to 2023. This study explored how the COVID-19 pandemic has influenced the prevalence of M. pneumoniae and provided guidance for disease treatment and infection prevention.

Advances of immunosensors based on noble metal composite materials for detecting procalcitonin.

Procalcitonin (PCT) is a reliable biomarker for diagnosing and monitoring bacterial infections and sepsis. PCT exhibits good stability both in vivo and in vitro, and its levels drastically increase in response to bacterial infection or inflammatory reactions in the human body, making it a dependable indicator for sepsis diagnosis and monitoring with significant implications for clinical diagnosis and treatment guidance. Currently, immunosensors are widely utilized in PCT detection due to their high sensitivity and low detection limits. Noble metals, because of their excellent electronic conductivity, biocompatibility, and superior physicochemical properties, are extensively combined with other materials to play a pivotal role in the construction of PCT immunosensors. This review summarizes the research progress on PCT antigen immunosensors based on noble metal composite materials, encompassing the classification and principles of immunosensors. Starting from noble metals, which are widely used as electrode materials in sensors, the review categorizes and discusses the carbon materials, metal oxides, metal sulfides, and other composites with noble metals. The reviewalso elaborates on the influence of sensitive materials on the performance of immunosensors. Finally, the review discusses and anticipates the challenges and future opportunities for the research on PCT antigen immunosensors using noble metal-composite nanomaterials, providing new insights and directions for their application in the treatment and clinical management of sepsis and other diseases.

A IMPORTÂNCIA DO FARMACÊUTICO NA ORIENTAÇÃO E ADESÃO FARMACOLÓGICA EM PORTADORES DO TRANSTORNO DO ESPECTRO AUTISTA

Introduction: Autism Spectrum Disorder (ASD) is configured as a complex neurobiological disorder that affects communication and social behavior. Since there is no cure for autism, various medications can be used to help control specific symptoms, such as anxiety, hyperactivity, and sleep disturbances. Pharmacological interventions in autism are challenging due to etiological and clinical heterogeneity. Although there is no cure or adequate management, including pharmaceutical care, it is crucial to promote the quality of life of individuals with ASD. Objective: to understand the importance of pharmaceutical assistance exercised by pharmacists in the orientation and administration of medication treatments by two patients with autism spectrum disorder. Methodology: This study was carried out based on a bibliographic survey of articles in the last 5 years, regarding the proposed topic, in order to emphasize the relevance of pharmaceutical assistance in the social sphere. Results and discussion: from the searches carried out in the databases of electronic data Scielo, Google Academic and BVS, a qualitative analysis was carried out, where 6 foramed articles were selected and described according to the title and conclusion of each study. Conclusion: it can be affirmed that the presence of a pharmacist not accompanying two ASD carriers is of great importance, not that it says respect for the treatment and specific guidance and management regarding the proposed drug therapies: side effects and adverse effects, drug interactions, dosages and other relevant aspects, mitigating low adesão and possible failures in treatment.

Predictive value of preoperative circulating tumor cells combined with hematological indexes for liver metastasis after radical resection of colorectal cancer.

Colorectal cancer is one of the most common malignant tumors in the world, and about 50% of its advanced patients will have liver metastasis. Preoperative assessment of the risk of liver metastasis in patients with colorectal cancer is of great significance for making individualized treatment plans. Traditional imaging examinations and tumor markers have some limitations in predicting the risk of liver metastasis. Therefore, it is of great clinical value to explore more sensitive and specific predictive indicators for improving early detection and treatment effect. In recent years, circulating tumor cells (CTCs), as a new biomarker, have attracted much attention because of their close relationship with tumor metastasis and prognosis. The purpose of this study is to collect and analyze the data of colorectal cancer patients treated in our hospital, so as to determine the predictive value of circulating tumor cells before operation and related hematological indexes for liver metastasis after radical resection of colorectal cancer, and to establish the corresponding prediction model to provide gastrointestinal surgeons with more accurate identification of high-risk patients and guidance for treatment. A total of 88 patients were included in this study, and 26 of whom developed liver metastasis after colorectal cancer surgery. The possible related factors are included in the single factor logistic regression, and the results are obtained after analysis. Body mass index, carcinoembryonic antigen (CEA), carbohydrate antigen 19-9, tumor marker CA72-4 (CA72-4), cytokeratin-7 (CK-7), CTC count, and neutrophil-to-lymphocyte ratio (P < .2) are risk factors for liver metastasis after radical resection of colorectal cancer. Furthermore, the data obtained were included in multivariate regression analysis, and CEA, CA72-4, CK-7, and CTC counts were independent risk factors for liver metastasis after radical resection of colorectal cancer (P < .05). This study confirmed that CEA, CA72-4, CK-7, and CTC counts are independent risk factors for liver metastasis after radical resection of colorectal cancer. In addition, the prediction model of this study can help gastrointestinal surgeons accurately identify patients who are prone to liver metastasis after colorectal cancer surgery.