Hot Spot In Clinical Research Research Articles

Isolation and whole genomic analysis of mesophilic bacterium Pseudoglutamicibacter cumminsii in epithelial mesothelioma

The relationship between bacteria and tumors has been the hot spot of clinical research in recent years. Pseudoglutamicibacter cumminsii is an aerobic Gram-positive bacterium commonly found in soil. Recent studies have identified P. cumminsii in patients with cutaneous and urinary tract infections. However, little is known on its pathogenesis as well as involvement in other clinical symptoms. In this study, we first report the isolation of P. cumminsii in blood of an epithelial mesothelioma patient. The clinical and laboratory characteristics of P. cumminsii were first described and evaluated. The pure colony of P. cumminsii was then identified using automated microorganism identification system and mass spectrum. The whole genome of the newly identified strain was sequenced with third generation sequencing (TGS). The assembled genome was further annotated and analyzed. Whole genomic and comparative genomic analysis revealed that the isolated P. cumminsii strain in this study had a genome size of 2,179,930 bp and had considerable unique genes compared with strains reported in previous findings. Further phylogenetic analysis showed that this strain had divergent phylogenetic relationship with other P. cumminsii strains. Based on these results, the newly found P. cumminsii strain was named P. cumminsii XJ001 (PC1). Virulence analysis identified a total of 71 pathogenic genes with potential roles in adherence, immune modulation, nutrition/metabolism, and regulation in PC1. Functional analysis demonstrated that the annotated genes in PC1 were mainly clustered into amino acid metabolism (168 genes), carbohydrate metabolism (107 genes), cofactor and vitamin metabolisms (98 genes), and energy metabolism (68 genes). Specifically, six genes including yodJ, idh, katA, pyk, sodA, and glsA were identified within cancer pathways, and their corresponding homologous genes have been documented with precise roles in human cancer. Collectively, the above results first identified P. cumminsii in the blood of tumor patients and further provide whole genomic landscape of the newly identified PC1 strain, shedding light on future studies of bacteria in tumorigenesis.

Accelerated partial breast irradiation: Current evidence and future developments.

Whole breast irradiation after breast-conserving surgery for early breast cancer has become one of the standard treatment modes for breast cancer and yields the same effect as radical surgery. Accelerated partial breast irradiation (APBI) as a substitute for whole breast irradiation for patients with early breast cancer is a hot spot in clinical research. APBI is characterised by simple high-dose local irradiation of the tumour bed in a short time, thus improving convenience for patients and saving costs. The implementation methods of APBI mainly include brachytherapy, external beam radiation therapy, and intraoperative radiotherapy. This review provides an overview of the clinical effects and adverse reactions of the main technologies of APBI and discusses the prospects for the future development of APBI.

Current Concepts in Clinical Treatment of Osteochondral Lesions of the Talus

Osteochondral lesions of the talus (OLTs) are common reason for the deep ankle pain and seriously affect patient’s sports and the daily life. Managements of the OLTs including conservative treatment, cartilage repair surgery, cartilage replacement surgery and cartilage regeneration surgery. For asymptomatic, serendipitous, or acute OLTs with no displaced fragments, conservative treating is suitable to execute, including mainly including affected ankle immobilization with or without physical therapy, bone stimulation, or drugs used. For small OLTs, cartilage repair strategy like bone marrow stimulation technique (BMS) was recommended, and microfracture is the most commonly used surgical procedure. For larger OLTs, both cartilage replacement and cartilage regeneration could be considered including. Although there are many treatment options, each treatment option may have certain limitations and may not be applicable. With the continuous development of science and technology, the development of biological adjuvants and tissue engineering technology has been accelerated and promoted. The combined application of surgery and biological adjuvants and tissue engineering technology has gradually become a hot spot in clinical research. This work briefly introduced present strategies and advance in treatment of OLTs and discussed the potential application problems aiming to provide reference for the future treatment selection and research of OLTs.

Research progress of effect of Tai Chi on cognitive function in the elderly based on neuroelectrophysiological techniques and brain imaging techniques

With the increasing prominence of population aging, the cognitive decline of the elderly has gradually become a hotspot of clinical research. As a traditional rehabilitation exercise, Tai Chi has been proved to have a positive effect on improving cognitive function and delaying cognitive decline in the elderly. However, the related brain function mechanism is still unclear. In this paper, we collected studies which observed the changes of Tai Chi on brain regions related to cognitive function in the elderly using magnetic resonance imaging (MRI), electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS). We summarized relevant studies from perspective of structural and functional changes in the brain. The results showed that Tai Chi may delay and improve cognitive decline in the elderly by reshaping the structure and function of brain regions related to cognitive function such as memory, attention and execution. The effect of Tai Chi for cognitive function may be associated with positive regulation of cardiovascular function, emotion and meditation level of the elderly. In addition, the improvement of cognitive function further enhances the balance of the elderly. We also found that practice time, frequency and intensity of Tai Chi could be factors influencing the improvement of cognitive function and brain function in the elderly.

Research Progress of Central Insulin Resistance and Cognitive Impairment

With the acceleration of the aging of the world's population, the number of patients with cognitive dysfunction has increased significantly, resulting in more and more serious social problems, economic problems, family problems and public health problems, how to better prevention and treatment of cognitive dysfunction is also a hot spot of clinical research. Studies have shown that insulin resistance and compensatory hyperinsulinemia (HI) exist in many patients with cognitive dysfunction, which also provides new ideas for the prevention and treatment of dysfunction. At present, more attention has been paid to peripheral insulin resistance, but there is little discussion on cognitive dysfunction caused by central insulin resistance. Insulin receptors (InsRs) are widely distributed in the brain region, especially in the hippocampus. Insulin can be through the blood - brain barrier to enter the central nervous system, adjust the structure of cerebral glucose metabolism and brain plasticity, protect nerve cells, improve memory, in order to protect the nervous system and cognitive function, while type 2 diabetes mellitus (T2DM) patients with insulin resistance, in turn, cause central insulin resistance can cause cognitive dysfunction [1]. Therefore, the effects of central insulin resistance on cognitive function and related mechanisms have gradually become a research hotspot. This paper summarizes the current research situation.

Application and progress of artificial intelligence in endoscopic diagnosis of superficial esophageal cancer

China is a country with high incidence of esophageal cancer. Advanced esophageal cancer not only brings serious threat to the health of patients, but also brings heavy economic burden to their families and society. Early diagnosis and treatment of esophageal cancer are always the hot spot in clinical research, and gastroscopy screening is the key point. The development of artificial intelligence is expected to provide new mean for early diagnosis and treatment of esophageal cancer in the aspects of endoscopy procedure and quality control.Through a brief overview of the concept and development of artificial intelligence in endoscopic diagnosis of superficial esophageal cancer, this study summarizes and reviews the research progress of artificial intelligence in the diagnosis of superficial esophageal carcinoma, and illustrates the importance of its application. This study also discusses the main problems and difficulties of artificial intelligence in the endoscopic diagnosis of esophageal carcinoma. It prospects the application of artificial intelligence in endoscopic esophageal diagnosis in the future.

Clinical application and accuracy analysis of 3D printing guide plate based on polylactic acid in mandible reconstruction with fibula flap

BackgroundDue to the special anatomy morphology and physiological function of the mandible, it has always become a challenge to accurately reconstruct the mandibular defect in maxillofacial surgery. Digital three dimensions (3D) printing surgical guide, as the effective method for individual and accurate surgery, is a hotspot of clinical research at present. In this study, 3D printing PLA surgical guide plate was applied to reconstruct the mandibular defect with fibula flap, its clinical effect and accuracy were evaluated, which aimed to improve the accurate reconstruction of mandibular defects.MethodsAfter sterilization, the dimension deformation of the PLA standard specimen were measured. Eighteen patients diagnose with mandibular tumor were collected as observation objects. Then partial mandible resection and simultaneous mandible reconstruction with fibula graft were implemented according to the computer-aided design plan. The clinical effects of 3D printing PLA guide plates application were evaluated by facial contours, occlusal stability and chewing function. Through registering the postoperative computed images reconstruction with preoperative designed shape, the reconstruction accuracy was evaluated by detecting the maximum difference including the distance between lateral convex point of the condyles, the distance between medial convex point of the condyles and the horizontal contained angle between long axis of the condyles.ResultsAfter high temperature steam sterilization, the curvature of the PLA specimen with 100% filling rate and 4.8 mm thickness were the smallest and their dimension deformation had no statistical significance (P>0.05). The minimally deformed 3D printing PLA guide plate were smoothly placed in the right place during the operation. After surgery, the face was symmetrical, the occlusal relationship was restored well and no deviation of the mandibular movement were found. The spiral computed tomography (SCT) scanning showed that the distance between lateral/medial convex points of the condyle and the horizontal contained angle were 128.34±8.68 mm, 88.69±6.75 mm and 145.87°±12.01°. Compared with preoperative design, the maximum deviation of the actual postoperative registration was 1.67±0.63, and the difference was not statistically significant (P>0.05).ConclusionsThe application of 3D printing PLA guide plate in the segmental section and reconstruction of the mandible can effectively simplify the operation, and better reconstruct the continuity of the mandible. The surgical accuracy can fully meet clinical needs with relatively low prices.

Clinical Study of Autologous Cartilage Transplantation Based on Nano-Hydroxyapatite in the Treatment of Talar Osteochondral Injury.

Talus osteochondral damage is one of the common symptoms of chronic ankle pain in people's lives. The cartilage regeneration and self-repair ability are extremely limited, the joint cartilage lesions are often accompanied by the lesions of the subchondral bone, and the subchondral bone lesions can affect the metabolism of the cartilage above it, which brings certain difficulties to clinical treatment. Traditional methods of treating cartilage damage include microfractures and drilling. Due to large trauma, inconsistent clinical efficacy reports, poor tissue repair results, and limited donor sources, etc., the application of traditional treatment methods in the clinic has been largely limited. Therefore, finding an ideal treatment method for bone injury has been a hot spot in clinical research in orthopedics. Studies have shown that autologous cartilage transplantation via nano-hydroxyapatite has become a new treatment model, providing new ideas for clinical treatment of talar osteochondral damage. Nano-hydroxyapatite and its composites have good histocompatibility, biological activity, and bone conductivity. They are an ideal bone defect repair material, and have been initially applied in clinical practice. The preparation of nano-hydroxyapatite, its biological characteristics and the repairing effect on the composite defect of osteochondral bone were studied experimentally, and its feasibility for repairing osteochondral damage was discussed. In this paper, the unique structure and properties of natural cartilage layers are studied. In combination with bionics theory and methods, nano-hydroxyapatite micro-particle composite samples are prepared by the gel method, and the bone-forming properties of nano-composites are measured by in vitro drug release experiments. To establish a model of infectious bone injury in New Zealand white rabbits, and nano-hydroxyapatite composites were implanted into local lesions of New Zealand white rabbit models by autologous cartilage transplantation, and evaluated by imaging, blood biochemistry, histology, infection control and bone repair. The experimental results show that using the unique physical and chemical and biological properties of nano-hydroxyapatite materials. It is innovatively introduced into the treatment of talar osteochondral defects caused by open fractures. It has been proven in vitro and in vivo experiments that nano-hydroxyapatite materials can be used. As an ideal tissue engineering scaffold for the treatment of talar osteochondral defects, this provides a new way to solve clinical orthopedic problems using new nanomaterials.

Clinical research hotspots on adenocarcinoma of esophagogastric junction

Despite increasing incidence of adenocar-cinoma of esophagogastric junction (AEG) in developed countries, the optimal therapeutic approach for locally advanced disease remains controversial. Surgery is still the primary treatment for resectable AEG, surgical strategies of AEG are selected according to Siewert classification, but outcomes are dismal with surgery alone. Although multidisciplinary therapy can improve the survival of patients, there is a significant difference in the specific practices among the different regions. Perioperative chemotherapy is the standard method in most European countries, whereas preoperative chemoradiotherapy is favored in the United States. Further studies focusing on AEG are needed to determine the optimal therapeutic strategy and the ideal sequence of chemotherapy and radiation with respect to surgery, and to clarify the role of emerging targeted therapies in resectable AEG. Key words: Esophagogastric junction neoplasms, adenocarcinoma; Siewert classification; Surgical strategies; Multidisciplinary therapy

Current status and future prospect of internal medicine treatment for advanced esophageal cancer

Esophageal cancer (EC) is one of common malignant tumors, and the incidence and mortality of EC in China rank the first place in the world. Because of the occult onset, the early atypical symptoms, and the lack of effective early diagnostic methods, most of patients are diagnosed at an advanced stage of the disease and lost the chance of surgery. Comprehensive treatment including palliative medical treatment, molecular targeted therapy, immunotherapy and so on is appropriate for these patients. How to choose the chemotherapy regimen and formulate reasonable treatment plan has become a hot spot in clinical research. Molecular targeted drugs have become a new developmental direction in cancer treatment because of their high specificity and antitumor activity, but the effects on esophageal cancer remain controversial. With the development of immune check point blockade treatment, breakthrough has been made in tumor immunotherapy, which has become an important means in cancer comprehensive treatment and shown a good prospect of treatment.