Treatment Strategies Research Articles

Intracoronary thrombolysis combined with drug balloon angioplasty in a young ST-segment elevation myocardial infarction patient: A case report

BACKGROUND The combination of acute ST-segment elevation myocardial infarction (STEMI) and gastric ulcers poses a challenge to primary percutaneous coronary intervention (PPCI), particularly for young patients. The role of drug-coated balloons (DCBs) in the treatment of de novo coronary artery lesions in large vessels remains unclear, especially for patients with STEMI. Our strategy is to implement drug balloon angioplasty following the intracoronary administration of low-dose prourokinase and adequate pre-expansion. CASE SUMMARY A 54-year-old male patient presented to the emergency department due to chest pain on June 24, 2019. Within the first 3 minutes of the initial assessment in the emergency room, the electrocardiogram (ECG) showed significant changes. There was atrial fibrillation with ST-segment elevation. Subsequently, atrial fibrillation terminated spontaneously and reverted to sinus rhythm. Soon after, the patient experienced syncope. The ECG revealed torsades de pointes ventricular tachycardia. A few seconds later, it returned to sinus rhythm. High-sensitivity tropon in I was normal. The diagnosis was acute STEMI. Emergency coronary angiography revealed subtotal occlusion with thrombus formation in the proximal segment of the left anterior descending artery. Considering the patient's age and history of peptic ulcer disease, after the intracoronary injection of prourokinase, percutaneous transluminal coronary angioplasty and cutting balloon angioplasty were conducted for thorough preconditioning, and paclitaxel drug-eluting balloon angioplasty was performed without any stents, achieving favorable outcomes. CONCLUSION A PPCI without stents may be a viable treatment strategy for select patients with STEMI, and further research is warranted.

CSF α-Synuclein Seed Amplification Assay in Patients With Atypical Parkinsonian Disorders.

There is no disease-modifying treatment of corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP), 2 disorders characterized by their striking phenotypic, and, in CBS, pathologic heterogeneity. Seed amplification assays (SAAs) could enable the detection of neuropathologic processes, such as α-synuclein (αSyn) copathology, that affect the success of future disease-modifying treatment strategies. The primary objective was to assess possible αSyn copathology in CBS and PSP, as detected in CSF using an αSyn SAA (αSyn-SAA). Secondary objectives were to evaluate the association of αSyn-SAA positivity with other biomarkers including of Alzheimer disease (AD), and with clinical presentation. We hypothesized that αSyn-SAA positivity would be detectable in CBS and PSP and that it would be associated with AD biomarker positivity and β-amyloid (Aβ) 42 levels, neurodegeneration as assessed by neurofilament light chain (NfL) levels, and symptoms associated with synucleinopathies. This cross-sectional observational study included patients clinically diagnosed with CBS and PSP who underwent a lumbar puncture between 2012 and 2021 (Toronto Western Hospital, Canada). CSF was tested for αSyn-SAA positivity, AD biomarkers, and NfL levels. Clinical data were derived from medical records. We tested the CSF of 40 patients with CBS (19 female patients, 65.9 ± 8.6 years) and 28 with PSP (13 female patients, 72.5 ± 8.7 years old), mostly White (n = 50) or Asian (n = 14). αSyn-SAA positivity was observed in 35.9% patients with CBS and 28.6% with PSP. In young-onset, but not late-onset patients, αSyn-SAA positivity and AD positivity were associated (odds ratio [OR] 8.8, 95% CI 1.2-82.6, p < 0.05). A multivariable linear regression analysis showed a significant interaction of αSyn-SAA status by age at onset on CSF Aβ42 levels (β = 0.3 ± 0.1, p < 0.05). Indeed, age at onset was positively related to Aβ42 levels only in αSyn-SAA-positive patients, as shown by slope comparison. A logistic regression analysis also suggested that REM sleep behavior disorder was associated with αSyn-SAA positivity (OR 60.2, 95% CI 5.2-1,965.8; p < 0.01). We detected a frequency of αSyn-SAA positivity in CBS and PSP in line with pathologic studies, highlighting the usefulness of SAAs for in vivo detection of otherwise undetectable neuropathologic processes. Our results also suggest that AD status (specifically low Aβ42) and older age at onset may contribute to αSyn-SAA positivity. This opens new perspectives for the stratification of patients in clinical trials.

Abstract B159: Could cultural adaptation of nutrition education improve survivorship outcomes among African American/black women with reproductive cancers?

Abstract Background/Significance: Cancer epidemiological data suggest African American/Black women experience the lowest relative survival rate for reproductive cancers compared to other racial/ethnic groups, despite these cancers being most prevalent among White women. Findings from recent studies suggest contributors to these adverse outcomes include socio-cultural and lifestyle factors, including diet, physical activity, and smoking. As an intervention strategy, it has been recommended dietary changes may enhance overall health and survival among AA/B women with reproductive cancers. However, inequalities in access to nutritious foods and culturally and linguistically appropriate nutrition information may serve as an impediment to making healthy food choices. Methods: An environmental scan was conducted by reviewing peer reviewed literature and online nutrition information sources to identify available, easily accessible, culturally adapted nutrition education for AA/B reproductive cancer survivors. Focus groups with breast and endometrial cancer survivors will ensure to inform the development of culturally targeted nutritional programs for cancer survivors. Results: Our literature review reveals a growing body of evidence indicating the potential benefits of culturally adapted dietary modifications post-diagnosis for African American/Black women with reproductive cancers, suggesting improved outcomes. Notably, the review underscores the critical role of culturally relevant nutrition information, disseminated by culturally affiliated individuals, with technology playing a pivotal role in accessibility facilitation. This research study aims to clarify the barriers and facilitators encountered by African American/Black women in accessing culturally and linguistically appropriate information, thereby enhancing understanding of factors influencing cancer survivorship outcomes. Conclusion and Implications/Discussion: Seeking to improve the survivorship of reproductive cancers in AA/B women through enhanced dietary patterns, this study merges insights from a systematic literature review and an environmental scan. Offering a comprehensive understanding of available nutritional information for AA/B women. Recognizing both strengths and gaps in existing resources, our research serves as a foundation for developing or adapting culturally specific nutritional programs to improve survivorship outcomes for reproductive cancers. Anticipating that our findings will contribute to understanding barriers and facilitators in accessing culturally and linguistically appropriate information, we aim to enhance cancer survivorship outcomes for AA/B women. Acknowledgement of Funding: The project described was supported by Award Number CHERC-MSI-21-166-01-CHERC-MSI. from the American Cancer Society (ACS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the ACS. Citation Format: Desiree Rivers, Zakirah L Abdul-Hameed. Could cultural adaptation of nutrition education improve survivorship outcomes among African American/black women with reproductive cancers? [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B159.

Factors of Bullying Victimization Among Students on the Autism Spectrum: A Systematic Review

AbstractStudies have increasingly suggested that autistic students face a heightened risk of bullying. Understanding the underlying factors for high rates of bullying victimization among autistic students is crucial for intervention, but the complexity of bullying and the heterogeneity of ASD (autism spectrum disorder) traits have made it challenging to explain these factors. Hence, this study systematically reviewed and summarized findings in this area, providing recommendations for intervention. It synthesized 34 studies investigating the predictive variable of bullying victimization among autistic students. Our review observed the role of schools, parents, and peers and of individual variables with respect to autistic traits and behavioral difficulties. We then proposed prevention and intervention strategies against bullying victimization toward autistic students.

Cancer Detection and Treatment Using Explainable AI

Cancer detection and treatment is one of the most difficult tasks in modern medicine, hence it has become a priority for researchers to study and develop specific and targeted procedures to patient outcomes. Just recently, the most promising direction is the humanization of explainable AI (XAI) which is a crucial tool for enhancing AI-based decision making in terms of transparency, and understandability. This paper starts out by describing conventional AI techniques for cancer detection and pointing out the informational gaps then delves into XAI's foundations. It explores the role of XAI in cancer detection and treatment by looking at its potential impact on this topic. It first presents the diagnosis of medical imaging data, then a discussion how patients' data will be interpreted by a XAI system and how treatment strategies that are tailored to the individual patient will be developed by optimizing the therapeutic interventions. This paper also presents comprehensive study of the changing side cancer treatment rendered by XAI and explain why further research and cooperation are getting to be of paramount importance in order for it to be fully exploited. Implementation of XAI in screening and treatment techniques for cancer comes to the conclusion of not only revolutionizing precision medicine, but also aiding in the improvement of patient care and will determine oncology practice in future.

Advances in understanding and managing celiac disease: Pathophysiology and treatment strategies

Advances in understanding and managing celiac disease: Pathophysiology and treatment strategies

Evaluation of Tracheobronchial Invasion as a Determinant of Treatment Strategy and Resectability in Locally Advanced Esophageal Cancer

Evaluation of Tracheobronchial Invasion as a Determinant of Treatment Strategy and Resectability in Locally Advanced Esophageal Cancer

The Analysis Study of Comparison of Effectiveness and Safety of Inhalers in Mild-to Moderate Asthma in Adults: A Comprehensive Systematic Review

Background: Asthma, a prevalent and potentially debilitating chronic disease, is traditionally managed using reliever medications such as short-acting β2-agonists (SABA) or low-dose inhaled corticosteroids (ICS). Recent evidence, however, indicates that a combination of as-needed ICS and a rapid-acting long-acting β2-agonist (LABA) provides superior outcomes compared to SABA alone. Furthermore, this combination therapy is at least as effective as regular ICS in mitigating the risk of exacerbations. This emerging evidence highlights a significant shift in treatment strategies for mild asthma, underscoring the potential for enhanced management and improved patient outcomes with the new therapeutic approach. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2014 and 2024. Result: The study conducted a comprehensive review of over 400 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Folowing an initial screening, eight publications were identified as warranting more in-depth analysis. Conclusion: The study found that as-needed ICS/LABA is effective in preventing exacerbations in mild-to-moderate asthma patients, but less effective than regular ICS in improving FEV1 and ACQ scores. Combining ICS/LABA with SMART regimen was highest for severe exacerbations prevention.

An outbreak of Galerina sulciceps-like (Galerina cf. sulciceps) mushroom poisoning

Objective Amatoxin-containing mushroom poisoning is a significant threat to public health worldwide. We report a mass poisoning of Galerina sulciceps-like mushrooms (Galerina cf. sulciceps) in Luzhou, Sichuan Province, China, aiming to offer insights for future prevention and treatment strategies. Methods We performed a retrospective survey of mass mushroom poisoning patients admitted to our hospital. The demographic data, clinical presentations, laboratory findings, therapeutic measures and prognostic information were collected and analyzed. We used the 2020 Chinese consensus on the clinical diagnosis and treatment of amatoxin-containing mushroom poisoning to assess the severity of poisoning. Mushrooms were examined through morphological analysis, molecular biology identification, and toxin detection. Results Our patient cohort consisted of nine males and six females, with mean (±SD) age of 34.9 ± 13.0 years. Gastrointestinal symptoms were the first to manifest, with mean (±SD) latency period of 13.4 ± 3.9 h. The majority of patients (86.7%) experienced nausea, vomiting, and diarrhea. Liver dysfunction was noted in 66.7% of patients, and thrombocytopenia was present in 26.7% of patients. In terms of the severity of poisoning, there were 10 mild cases and 5 severe cases. The mushrooms were provisionally labeled as Galerina cf. sulciceps, containing the toxins α-amanitin, β-amanitin, and γ-amanitin. All patients eventually recovered. Discussion We report what appears to be a new type of mushroom that is morphologically and phylogenetically similar to the known Galerina sulciceps, but further study is required to determine if it represents a distinct species. Conclusion This poisoning event was caused by unintentional ingestion of Galerina cf. sulciceps, an amatoxin-containing mushroom. Early symptoms are primarily gastrointestinal, with acute liver damage and coagulopathy being the main toxic effects. Thrombocytopenia is also prominent, particularly in severe cases. Accurate assessment and prompt, individualized, and intensive treatment are crucial for managing patients with acute Galerina cf. sulciceps poisoning effectively.

Lipid-Conjugated Reduced Haloperidol in Association with Glucose-Based Nanospheres: A Strategy for Glioma Treatment

Lipid-Conjugated Reduced Haloperidol in Association with Glucose-Based Nanospheres: A Strategy for Glioma Treatment

Uncovering relationships between formal and informal learning: unveiling the mediating role of basic need satisfaction and challenge-seeking behavior

Purpose Most of the current literature investigates workplace-based formal and informal learning separately; thus, the relationship between these two types of learning remains unclear. This study aims to fill this research gap, drawing on self-determination theory to bridge teachers’ formal and informal learning and uncover the relationship between the two. Design/methodology/approach The participants of the study are 1,886 primary and secondary in-service teachers in China. Structural equation modeling and bootstrapping are used to test the proposed model. Findings The study reveals complicated influencing mechanisms of formal learning on different types of informal learning among in-service teachers. Teachers’ basic psychological needs, satisfaction and challenge-seeking behavior are found to play crucial mediating roles in this process. Practical implications First, this study suggests that different configurations of intervention strategies should be formulated depending on the foci for improving teachers’ learning. Second, this study indicates that only highlighting the importance of reflection, which is the approach currently used, is not sufficient to improve teachers’ daily reflective practice. Third, there is an urgent need to design training programs to improve teachers’ abilities to purposefully expand their job boundaries, which could not only benefit teachers’ performance but also contribute to school improvement. For policymakers and school principals, we suggest that more attention be given to the satisfaction of teachers’ basic needs. Originality/value This study contributes to the literature on workplace learning by connecting formal and informal learning and elucidating how teachers’ reported formal learning influences their informal learning activities via varied paths. The findings have implications for continuous professional development policy and training programs in the workplace.

A Multimodal Interventional Strategy To Increase Hand Hygiene Compliance In Intensive Care Unit Of A Tertiary Care Hospital In South India

A Multimodal Interventional Strategy To Increase Hand Hygiene Compliance In Intensive Care Unit Of A Tertiary Care Hospital In South India

Cardiovascular Effectiveness and Safety of Antidiabetic Drugs in Patients with Type 2 Diabetes and Peripheral Artery Disease: Systematic Review

Peripheral artery disease (PAD) is an atherosclerotic condition commonly complicating type 2 diabetes (T2D), leading to poor quality of life and increased risk of major adverse lower-limb (MALE) and cardiovascular (CV) events (MACE). Therapeutic management of PAD in T2D patients is much more arduous, often due to bilateral, multi-vessel, and distal vascular involvement, in addition to increased systemic polyvascular atherosclerotic burden. On the other hand, the pathophysiological link between PAD and T2D is very complex, involving mechanisms such as endothelial dysfunction and increased subclinical inflammation in addition to chronic hyperglycemia. Therefore, the clinical approach should not ignore vascular protection with the aim of reducing limb and overall CV events besides a mere glucose-lowering effect. However, the choice of the best medications in this setting is challenging due to low-grade evidence or lacking targeted studies in PAD patients. The present review highlighted the strong relationship between T2D and PAD, focusing on the best treatment strategy to reduce CV risk and prevent PAD occurrence and worsening in patients with T2D. The Medline databases were searched for studies including T2D and PAD up to June 2024 and reporting the CV effectiveness and safety of the most used glucose-lowering agents, with no restriction on PAD definition, study design, or country. The main outcomes considered were MACE—including nonfatal acute myocardial infarction, nonfatal stroke, and CV death—and MALE—defined as lower-limb complications, amputations, or need for revascularization. To the best of our current knowledge, GLP-1 receptor agonists and SGLT2 inhibitors represent the best choice to reduce CV risk in T2D and PAD settings, but a personalized approach should be considered. GLP-1 receptor agonists should be preferred in subjects with prevalent atherosclerotic burden and a history of previous MALE, while SGLT2 inhibitors should be used in those with heart failure if overall CV benefits outweigh the risk of lower-limb complications.

The current understanding of the phenotypic and functional properties of human regulatory B cells (bregs)

Abstract B cells can have a wide range of pro- and anti- inflammatory functions. A subset of B cells called regulatory B cells (Bregs) can potently suppress immune responses. Bregs have been shown to maintain immune homeostasis and modulate inflammatory responses. Bregs are an exciting cellular target across a range of diseases, including Breg induction in autoimmunity, allergy and transplantation, and Breg suppression in cancers and infection. Bregs exhibit a remarkable phenotypic heterogeneity, rendering their unequivocal identification a challenging task. The lack of a universally accepted and exclusive surface marker set for Bregs across various studies contributes to inconsistencies in their categorisation. This review paper presents a comprehensive overview of the current understanding of the phenotypic and functional properties of human Bregs while addressing the persisting ambiguities and discrepancies in their characterisation. Finally, the paper examines the promising therapeutic opportunities presented by Bregs as their immunomodulatory capacities have gained attention in the context of autoimmune diseases, allergic conditions, and cancer. We explore the exciting potential in harnessing Bregs as potential therapeutic agents and the avenues that remain open for the development of Breg-based treatment strategies.

SARS-CoV-2 infection induces hyaluronan production in vitro and hyaluronan levels in COVID-19 patients relate to morbidity and long-term lung impairment: a prospective cohort study

ABSTRACT We previously demonstrated that the lungs of deceased COVID-19 patients were filled with a clear hydrogel consisting of hyaluronan (HA). In this translational study, we investigated the role of HA at all stages of COVID-19 disease to map the consequences of elevated HA on morbidity and identify the mechanism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced HA production. A reduced alveolar surface area was observed in the lungs of deceased COVID-19 patients compared to healthy controls, as visualized by a 3D rendering of lung morphology using light-sheet fluorescence microscopy. We confirmed the presence of HA in lung biopsies and found large quantities of proinflammatory fragmented HA. The association of systemic HA in blood plasma and disease severity was assessed in patients with mild (WHO Clinical Progression Scale, WHO-CPS, 1–5) and severe COVID-19 (WHO-CPS, 6–9) during the acute and convalescent phases and related to lung function. We found that systemic levels of HA were high during acute COVID-19 disease, remained elevated during convalescence, and were associated with a reduced diffusion capacity. In vitro 3D-lung models, differentiated from primary human bronchial epithelial cells, were used to study the effects of SARS-CoV-2 infection on HA metabolism, and transcriptomic analyses revealed a dysregulation of HA synthases and hyaluronidases, both contributing to increased HA in apical secretions. Furthermore, corticosteroid treatment reduced the inflammation and downregulated HA synthases. Our findings demonstrate that HA plays a role in COVID-19 morbidity and that sustained elevated HA concentrations may contribute to long-term respiratory impairment. IMPORTANCE This study provides insights into the role of hyaluronan (HA) in the severity and long-term impact of COVID-19 on lung function. Through extensive morphological examination of lung tissues and a multicenter study, we identified that HA levels are significantly elevated in COVID-19 patients, correlating with a reduced lung diffusion capacity during convalescence. Using a 3D-lung model, we further uncovered how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection causes a dysregulated HA metabolism, leading to increased HA production. Our findings provide valuable insights into the pathogenesis of SARS-CoV-2 and suggest that targeting HA metabolism could offer new therapeutic avenues for managing COVID-19, particularly to prevent long-term lung impairment. Additionally, HA holds potential as a biomarker for predicting disease severity, which could guide personalized treatment strategies.

Targeting IGF1/IGF1r signaling relieve pain and autophagic dysfunction in NTG-induced chronic migraine model of mice

BackgroundChronic migraine is a severe and common neurological disorder, yet its precise physiological mechanisms remain unclear. The IGF1/IGF1r signaling pathway plays a crucial role in pain modulation. Studies have shown that IGF1, by binding to its receptor IGF1r, activates a series of downstream signaling cascades involved in neuronal survival, proliferation, autophagy and functional regulation. The activation of these pathways can influence nociceptive transmission. Furthermore, alterations in IGF1/IGF1r signaling are closely associated with the development of various chronic pain conditions. Therefore, understanding the specific mechanisms by which this pathway contributes to pain is of significant importance for the development of novel pain treatment strategies. In this study, we investigated the role of IGF1/IGF1r and its potential mechanisms in a mouse model of chronic migraine.MethodsChronic migraine was induced in mice by repeated intraperitoneal injections of nitroglycerin. Mechanical and thermal hypersensitivity responses were assessed using Von Frey filaments and radiant heat, respectively. To determine the role of IGF1/IGF1r in chronic migraine (CM), we examined the effects of the IGF1 receptor antagonist ppp (Picropodophyllin) on pain behaviors and the expression of calcitonin gene-related peptide (CGRP) and c-Fos.ResultIn the nitroglycerin-induced chronic migraine model in mice, neuronal secretion of IGF1 is elevated within the trigeminal nucleus caudalis (TNC). Increased phosphorylation of the IGF1 receptor occurs, predominantly co-localizing with neurons. Treatment with ppp alleviated basal mechanical hypersensitivity and acute mechanical allodynia. Furthermore, ppp ameliorated autophagic dysfunction and reduced the expression of CGRP and c-Fos.ConclusionOur findings demonstrate that in the chronic migraine (CM) model in mice, there is a significant increase in IGF1 expression in the TNC region. This upregulation of IGF1 leads to enhanced phosphorylation of IGF1 receptors on neurons. Targeting and inhibiting this signaling pathway may offer potential preventive strategies for mitigating the progression of chronic migraine.

Comparative Efficacy of 21 Treatment Strategies for Resectable Pancreatic Cancer: A Network Meta-Analysis

The primary treatment for operable pancreatic cancer (PC) involves surgery followed by adjuvant therapy. Nevertheless, perioperative or neoadjuvant chemotherapy (CT) may be used to mitigate the likelihood of recurrence and mortality. This network meta-analysis (NMA) assesses the comparative efficacy of various treatment approaches for resectable PC. A thorough search was carried out on January 31, 2023, encompassing PubMed/MEDLINE, Cochrane Library, and Embase databases. We incorporated randomized clinical trials (RCTs) that compared surgical interventions with or without (neo)adjuvant or perioperative therapies for operable PC. We conducted a fixed-effects Bayesian NMA. We presented the effect sizes in terms of hazard ratios (HRs) for overall survival (OS) along with 95% credible intervals (95% CrIs). The treatment was deemed statistically superior when the 95% credible interval (CrI) did not encompass a null value (hazard ratio &lt; 1). Treatment rankings were established based on the surface under the cumulative ranking curve (SUCRA). A total of 24 studies were incorporated, comparing 21 treatments with surgery in isolation. Eleven treatments showed superior efficacy compared to surgery alone, with HRs ranging from 0.38 for perioperative treatments to 0.73 for adjuvant 5-fluorouracil. After the exclusion of studies conducted in Asia, it was found that the perioperative regimen of gemcitabine combined with nab-paclitaxel was the most effective regimen (SUCRA, p = 0.99). The findings endorse the utilization of perioperative CT, especially multi-agent CT, as the favored intervention for operable PC in Western nations.

Study on the role of peripheral immune cells in cerebral ischemia

Stroke, primarily resulting from the sudden interruption of blood supply to the brain, remains a leading cause of morbidity and mortality worldwide. Following an ischemic stroke, the peripheral immune system significantly contributes to brain damage. Damage-associated molecular patterns (DAMPs) released from ischemic cells activate peripheral immune cells, resulting in increased inflammation and disruption of the blood-brain barrier (BBB). This review highlights the critical immune cells of the peripheral immune system activated after cerebral ischemia, with an emphasis on the roles of T cells, B cells, macrophages, and neutrophils. We discuss the pathophysiological mechanisms of cerebral ischemia, which include reduced blood flow, energy metabolism disorders, neuronal injury and death, and BBB disruption and cerebral edema. The interplay between the peripheral immune system and cerebral ischemia is explored, offering insights into the inflammatory and immunosuppressive responses following ischemic events. Meanwhile, current research advances and future research directions are presented, focusing on potential therapeutic targets within the peripheral immune system to improve outcomes in ischemic brain injury. In summary, this review underscores the necessity of understanding the peripheral immune system's role in cerebral ischemia to develop effective treatment strategies and enhance patient recovery.

MRD in Acute Leukemias: Lessons Learned from Acute Promyelocytic Leukemia

Introduction: Advances in molecular biology, polymerase chain reaction (PCR), and next-generation sequencing (NGS) have transformed the concept of minimal residual disease (MRD) from a philosophical idea into a measurable reality. Current Treatment Paradigms and Lessons Learned from APL: Acute promyelocytic leukemia (APL) leads the way in this transformation, initially using PCR to detect MRD in patients in remission, and more recently, aiming to eliminate it entirely with modern treatment strategies. Along the way, we have gained valuable insights that, when applied to other forms of acute leukemia, hold the potential to significantly improve the outcomes of these challenging diseases. Does the BM Microenvironment Play a Role in MRD?: In this review, we explore the current use of MRD in the management of acute leukemia and delve into the biological processes that contribute to MRD persistence, including its overlap with leukemia stem cells and the role of the bone marrow microenvironment.

Molecular Therapeutics for Diabetic Kidney Disease: An Update

Diabetic kidney disease (DKD) is a common microvascular complication of diabetes mellitus (DM). With the increasing prevalence of DM worldwide, the incidence of DKD remains high. If DKD is not well controlled, it can develop into chronic kidney disease or end-stage renal disease (ESRD), which places considerable economic pressure on society. Traditional therapies, including glycemic control, blood pressure control, blood lipid control, the use of renin–angiotensin system blockers and novel drugs, such as sodium–glucose cotransporter 2 inhibitors, mineralocorticoid receptor inhibitors and glucagon-like peptide-1 receptor agonists, have been used in DKD patients. Although the above treatment strategies can delay the progression of DKD, most DKD patients still ultimately progress to ESRD. Therefore, new and multimodal treatment methods need to be explored. In recent years, researchers have continuously developed new treatment methods and targets to delay the progression of DKD, including miRNA therapy, stem cell therapy, gene therapy, gut microbiota-targeted therapy and lifestyle intervention. These new molecular therapy methods constitute opportunities to better understand and treat DKD. In this review, we summarize the progress of molecular therapeutics for DKD, leading to new treatment strategies.