Prognosis Of Life Research Articles

MiR-107 Targets NSG1 to Regulate Hypopharyngeal Squamous Cell Carcinoma Progression through ERK Pathway.

Hypopharyngeal squamous cell carcinoma (HSCC) is a kind of malignant tumor with a poor prognosis and low quality of life in the otolaryngology department. It has been found that microRNA (miRNA) plays an important role in the occurrence and development of various tumors. This study found that the expression level of miRNA-107 (miR-107) in HSCC was significantly reduced. Subsequently, we screened out the downstream direct target gene Neuronal Vesicle Trafficking Associated 1 (NSG1) related to miR-107 through bioinformatics analysis and found that the expression of NSG1 was increased in HSCC tissues. Following the overexpression of miR-107 in HSCC cells, it was observed that miR-107 directly suppressed NSG1 expression, leading to increased apoptosis, decreased proliferation, and reduced invasion capabilities of HSCC cells. Subsequent experiments involving the overexpression and knockdown of NSG1 in HSCC cells demonstrated that elevated NSG1 levels enhanced cell proliferation, migration, and invasion, while the opposite effect was observed upon NSG1 knockdown. Further investigations revealed that changes in NSG1 levels in the HSCC cells were accompanied by alterations in ERK signaling pathway proteins, suggesting a potential regulatory role of NSG1 in HSCC cell proliferation, migration, and invasion through the ERK pathway. These findings highlight the significance of miR-107 and NSG1 in hypopharyngeal cancer metastasis, offering promising targets for therapeutic interventions and prognostic evaluations for HSCC.

Exploring trends and developments in cholesteatoma research: a bibliometric analysis.

Examination of the scientific literature on cholesteatoma from past to present using bibliometric methods. A total of 2353 articles on cholesteatoma between 1980 and 2023 were obtained from the Web of Science database and statistically analysed using bibliometric techniques. The journals with the highest number of contributions to the literature were Otology & Neurotology (n = 192), Acta Oto-Laryngologica (156) and Laryngoscope (149). The most impactful journals based on h-index and total citation (TC) counts were Laryngoscope (h:36, TC: 4241), Otology & Neurotology (29, 3141), and American Journal of Otology (26, 2071) respectively. The most prolific author was Kojima H. (n = 49). According to the findings of the Reference Publication Year Spectroscopy (RPYS) analysis, there has been a significant increase in academic interest in Cholesteatoma since its first description in 1959, particularly following the expansion of its definition in 1977. Subsequently, the trend of increased interest has risen rapidly in later years, with notable peaks in research intensity observed in 1989, 2006, and 2011. The highest academic trend occurred in 2006. In recent years, trending topics have included innovative approaches such as diagnostic and imaging methods particularly alongside technological developments, endoscopic surgery, recurrence and complications, prognosis and quality of life, artificial intelligence, and obliteration. In conclusion, the evolution of cholesteatoma and its research priorities reveal temporal shifts and emerging areas of interest over time. Primarily, diagnosis, treatment, and surgical approaches remain central. Additionally, research has expanded to encompass developments in surgical techniques, imaging modalities, cellular biology, pathology, and molecular mechanisms.

Oropharyngeal cancer and human papillomavirus: a visualization based on bibliometric analysis and topic modeling.

The incidence of oropharyngeal cancer (OPC) is increasing. This study used bibliometric analysis and topic modeling to explore the research trends and advancements in this disease over the past 10 years, providing valuable insights to guide future investigations. 7,355 English articles from 2013 to 2022 were retrieved from the Web of Science Core Collection for bibliometric analysis. Topic modeling was applied to 1,681 articles from high-impact journals, followed by an assessment of topic significance ranking (TSR). Medical Subject Headings (MeSH) terms were extracted using R and Python, followed by an analysis of the terms associated with each topic and on an annual basis. Additionally, genes were extracted and the number of genes appearing each year and the newly emerged genes were counted. The bibliometric analysis suggested that the United States and several European countries hold pivotal positions in research. Current research is focused on refining treatments, staging and stratification. Topic modeling revealed 12 topics, emphasizing human papillomavirus (HPV) and side effect reduction. MeSH analysis revealed a growing emphasis on prognosis and quality of life. No new MeSH terms emerged after 2018, suggesting that the existing terms have covered most of the core concepts within the field of oropharyngeal cancers. Gene analysis identified TP53 and EGFR as the most extensively studied genes, with no novel genes discovered after 2019. However, CD69 and CXCL9 emerged as new genes of interest in 2019, reflecting recent research trends and directions. HPV-positive oropharyngeal cancer research, particularly treatment de-escalation, has gained significant attention. However, there are still challenges in diagnosis and treatment that need to be addressed. In the future, more research will focus on this issue, indicating that this field still holds potential as a research hotspot.

Comparative assessment of long-term survival of patients after primary and recurrent myocardial infarction: a data from the RIMIS registry

Aim. To compare the long-term prognosis of life of patients after primary and recurrent acute myocardial infarction (MI).Material and methods. The study was based on the RIMIS registry, which included all patients after transmural MI in 2017 in one of the Moscow vascular centers. The prospective part included 191 patients who survived the acute stage of MI, of which 145 suffered a primary acute MI, 46 — a recurrent acute MI. Long-term follow-up data were collected 71 (53;75) months after discharge from the hospital. The primary endpoint was any-cause death.Results. During the follow-up period, 35 (25,2%) patients with a primary MI and 25 (64,1%) patients with a recurrent MI died (p<0,001). It was not possible to establish the fate of 13 (6,81%) patients, of which 7 (4,83%) were people with primary MI and 6 (13,04%) people with recurrent MI. The death risk was significantly higher in patients who had a recurrent MI compared to patients who had a primary MI: hazard ratio (HR)=3,52 (2,09;5,96), p<0,001). An unfavorable prognosis was determined not by the fact of a recurrent MI, but by the complications that resulted from a previous MI, primarily heart failure, as well as age, sex, smoking status, and hospitalizations for cardiovascular diseases in the year before the reference MI, history of angina and following comorbidities: a prior stroke, major bleeding (life-threatening gastrointestinal bleeding requiring complex surgical intervention). Patients who had a recurrent MI were significantly more adherent to follow-up and prescribed therapy.Conclusion. Despite the modern strategy for treating MI both in the acute stage and in the long-term period, the prognosis after recurrent MI remains unfavorable. Signs negatively affecting the prognosis were sex, age, a history of heart failure and angina pectoris, and hospitalizations for cardiovascular diseases one year prior to reference MI.

Prognostic Features of Sarcopenia in Older Hospitalized Patients: A 6-Month Follow-Up Study.

Background: Sarcopenia is associated with adverse health outcomes. Understanding the association between sarcopenia, multidimensional frailty, and prognosis is essential for improving patient care. The aim of this study was to assess the prevalence and prognostic signature of sarcopenia in an acute hospital setting co-led by internists and geriatricians. Methods: Sarcopenia was assessed by applying the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm, including the SARC-F score, handgrip strength, bioelectrical impedance analysis (BIA), and Timed Up and Go (TUG) test, to 97 older multimorbid inpatients (76.5 ± 6.8 years, 55% women). The patients underwent a Comprehensive Geriatric Assessment (CGA) including an evaluation of Geriatric Syndromes (GSs) and Resources (GR) and prognosis calculation using the CGA-based Multidimensional Prognostic Index (MPI), European Quality of life-5 Dimensions (EQ-5D-5L) scale, Rosenberg Self-Esteem Scale (RSES), and Geriatric Depression Scale (GDS). Information on survival and rehospitalizations was collected 1, 3, and 6 months after discharge. Results: Sarcopenia was present in 63% (95% CI: 54-72%) of patients and categorized as probable (31%), confirmed (13%), and severe sarcopenia (18%). Sarcopenic patients showed significantly higher median MPI-values (p < 0.001), more GSs (p = 0.033), fewer GR (p = 0.003), lower EQ-5D-5L scores (p < 0.001), and lower RSES scores (p = 0.025) than non-sarcopenic patients. Six months after discharge, being sarcopenic at baseline was predictive of falls (p = 0.027) and quality of life (p = 0.043), independent of age, gender, and MPI. Conclusions: Sarcopenia is highly prevalent in older hospitalized multimorbid patients and is associated with poorer prognosis, mood, and quality of life up to 6 months after discharge, independent of age, sex, and MPI as surrogate markers of biological age.

Oxytocin attenuates hypothalamic injury-induced cognitive dysfunction by inhibiting hippocampal ERK signaling and Aβ deposition

In clinical settings, tumor compression, trauma, surgical injury, and other types of injury can cause hypothalamic damage, resulting in various types of hypothalamic dysfunction. Impaired release of oxytocin can lead to cognitive impairment and affect prognosis and long-term quality of life after hypothalamic injury. Hypothalamic injury-induced cognitive dysfunction was detected in male animals. Behavioral parameters were measured to assess the characteristics of cognitive dysfunction induced by hypothalamic–pituitary stalk lesions. Brains were collected for high-throughput RNA sequencing and immunostaining to identify pathophysiological changes in hippocampal regions highly associated with cognitive function after injury to corresponding hypothalamic areas. Through transcriptomic analysis, we confirmed the loss of oxytocin neurons after hypothalamic injury and the reversal of hypothalamic-induced cognitive dysfunction after oxytocin supplementation. Furthermore, overactivation of the ERK signaling pathway and β-amyloid deposition in the hippocampal region after hypothalamic injury were observed, and cognitive function was restored after inhibition of ERK signaling pathway overactivation. Our findings suggest that cognitive dysfunction after hypothalamic injury may be caused by ERK hyperphosphorylation in the hippocampal region resulting from a decrease in the number of oxytocin neurons, which in turn causes β-amyloid deposition.

In silico identification and targeting of key genes involved in renal cell carcinoma metastasis

Metastasis is a challenge in the management of renal cell carcinoma (RCC). The clinical implications of RCC metastasis are significant, with patients experiencing a poorer response to treatment and a reduced life expectancy. Currently, there is no curative treatment for RCC metastasis, and systemic chemotherapy and immunotherapy remain mainstay therapies. However, emerging evidence suggests that targeted therapies may provide promising treatment options for improving the prognosis and quality of life of patients with metastatic RCC. The current study aimed to investigate the underlying molecular mechanisms of RCC metastasis and identify key therapeutic targets using computational approaches. Also, a library of FDA approved drugs was screened against the target genes to obtain potential inhibitors that can be used in therapies. Differential gene expression analysis followed by functional enrichment and protein-protein interaction analyses led to the identification of CCND2 and MMP9 as key genes involved in multiple process in the metastatic tumors in case of both clear cell and papillary cell renal carcinoma. Docking studies revealed good binding of drugs mysoline and ethisterone with CCND2 and canrenone and evodiamine with MMP9. Molecular Dynamics simulations showed stable and strong binding of these drugs with CCND2, but the identified drugs failed to have stable interactions with MMP9. Hence, our study reveals mysoline and ethisterone to be potential inhibitors that target CCND2 to control metastasis of RCC.

Factors associated with risk analysis for asymptomatic left ventricular diastolic dysfunction in nondialysis patients with chronic kidney disease

Heart failure (HF) constitutes a major determinant of outcome in chronic kidney disease (CKD) patients. The main pattern of HF in CKD patients is preserved ejection fraction (HFpEF), and left ventricular diastolic dysfunction (LVDD) is a frequent pathophysiological mechanism and specific preclinical manifestation of HFpEF. Therefore, exploring and intervention of the factors associated with risk for LVDD is of great importance in reducing the morbidity and mortality of cardiovascular disease (CVD) complications in CKD patients. We designed this retrospective cross-sectional study to collect clinical and echocardiographic data from 339 nondialysis CKD patients without obvious symptoms of HF to analyze the proportion of asymptomatic left ventricular diastolic dysfunction (ALVDD) and its related factors associated with risk by multivariate logistic regression analysis. Among the 339 nondialysis CKD patients, 92.04% had ALVDD. With the progression of CKD stage, the proportion of ALVDD gradually increased. The multivariate logistic regression analysis revealed that increased age (OR 1.237; 95% confidence interval (CI) 1.108–1.381, per year), diabetic nephropathy (DN) and hypertensive nephropathy (HTN) (OR 25.000; 95% CI 1.355–48.645, DN and HTN vs chronic interstitial nephritis), progression of CKD stage (OR 2.785; 95% CI 1.228–6.315, per stage), increased mean arterial pressure (OR 1.154; 95% CI 1.051–1.268, per mmHg), increased urinary protein (OR 2.825; 95% CI 1.484–5.405, per g/24 h), and low blood calcium (OR 0.072; 95% CI 0.006–0.859, per mmol/L) were factors associated with risk for ALVDD in nondialysis CKD patients after adjusting for other confounding factors. Therefore, dynamic monitoring of these factors associated with risk, timely diagnosis and treatment of ALVDD can delay the progression to symptomatic HF, which is of great importance for reducing CVD mortality, and improving the prognosis and quality of life in CKD patients.

Reduced heart failure hospitalizations and improved quality of life in cardiac amyloidosis patients undergoing atrial fibrillation ablation

Abstract Background Cardiac amyloidosis (CA) has been associated with an increased risk of atrial arrhythmias and development and worsening of heart failure due to infiltration of the amyloid protein in the atrial wall. Few data exist regarding prognosis, symptoms, and quality of life after catheter ablation of atrial fibrillation in this category of patients. Objective The study evaluates the outcome of hospitalization for heart failure and quality of life in cardiac amyloidosis patients with atrial fibrillation after catheter ablation. Methods This is a study including 102 consecutive patients from two different centers with an established diagnosis of amyloidosis ATTR that underwent their first AF catheter ablation for persistent AF. They underwent pulmonary vein (PV) isolation + isolation of left atrial posterior wall and superior vena cava. Additionally, extrapulmonary triggers were identified and ablated. Post procedure, patients were followed up routinely with ECG during office visits, 7-day Holter monitor and event recorders during the first year followed by biannual checkups during the remaining part of the follow-up period. Quality of life (QoL) was measured using The Minnesota Living Heart Failure Questionnaire (MLHFQ) before Catheter ablation and after 18 months follow up; QoL was compared with T-test. Results 102 patients (mean age 72 ± 6) were included in the study. After 18 months follow up, 72 patients (70.6%) remained arrhythmia-free without antiarrhythmic drugs (Group 1), whereas 30 patients (29.4%) experienced recurrence (Group 2). In Group 1, 9 patients were hospitalized for heart failure, in contrast to 18 patients in Group 2, indicating a higher rate of heart failure hospitalizations associated with arrhythmia recurrence (p=0.02). The Quality of life in group 1 was 62 ±12 points before ablation and 63±16 points at 18 months follow up (p=0.17) while in group 2 was 68±16 points before ablation and 86±12 points at 18 months follow up (p&amp;lt;0.001). Conclusion Catheter ablation for AF in patients with cardiac amyloidosis is associated with reduced hospitalizations for heart failure, along with improvement in QoL.

#1231 Atypical uremic hemolytic syndrome diagnosis, therapeutic management, control and follow-up in pregnancy: about a case

Abstract Background and Aims Atypical hemolytic uremic syndrome (aHUS) is a clinical entity characterized by non immune hemolytic anemia, thrombopenia, and renal failure in which the lesions are mediated by a process of thrombotic microangiopathy, mutations in its genes that lead to uncontrolled activation. of C5 and formation of the membrane attack complex. Its correct diagnosis allows prescribing treatment based on eculizumab, a C5 inhibitor. The clinical case of a patient with aHUS is presented, who three months after diagnosis, becomes pregnant. The objective is to highlight the importance of early differential diagnosis for the early establishment of effective treatment of this pathology, as well as management during pregnancy, childbirth and the postpartum period. The pathophysiology, diagnosis and genetic study are updated, as well as the therapeutic management of aHUS. Case Reports 27 year old women with no personal or family history of interest. She went to the emergency room in the full pandemic by SARSCov2 due to choluric urine along with fever of 38, myalgias and generalized arthralgias. At that time, PCR positive SARSCov2, deterioration of renal function was noted with Creatinine of 1.8 mg/dl (previous normal), LDH 1954 u/l, Platelets 21000, Hemoglobin 14.4 g/dl without schistocytes in smear, albumin/creatinine ratios 8700 and intense hematuria. It was interpreted as thrombotic thrombocytopenic purpura receiving corticosteroids, rituximab and plasmapheresis. After 48 hours, thrombopenia persists, schistocytes appear in smears and renal function deteriorates creatinine to 2.8 mg/dl. ADAMS 13 is received at normal values, considering at this time a diagnosis of aHUS, the previous treatment is interrupted and a dose of eculizumab 900 mg is received, doses of 900 per week are scheduled for 4 weeks in the fifth week 1200 mg and from Then on biweekly dose 1200 mg of eculizumab. At the third week of treatment, renal function has already normalized, hemolysis data have disappeared, Htcro and platelets have returned to normal. Proteinuria and hematuria disappears which has been maintained up to now. Good tolerance to treatment without any incidence, presenting a positive pregnancy test at three months. During pregnancy treatment with eculizumab is maintained. We continued with the biweekly regimen with 1200 mg of eculizumab until delivery. Labor is induced at week 37 receiving a extra dose of 1200 mg in the first 24 hours of delivery and continuing with 4 doses of 1200 mg once a week. Afterwards the dose is changed to a biweekly dose without modifying it throughout lactation until it ends. The reason is to avoid complement deregulation in the context of pregnancy and therefore ensure blockade. Subsequently it is done Switch to ravulizumab when breastfeeding begins as follows: A loading dose of 2700 mg (according to the interval of patient's weight) 15 days after the last dose of eculizumab. The maintenance dose is 3300 mg every 8 weeks starting 2 weeks after the loading dose. Normal kidney function has been maintained. She presented on debut positive serology for parvovirus B19, receiving treatment with Immunoglobulins and PCR SARSCov2 was positive prescribing treatment with remdesivir. Vitus (CMV, HBV, HCV and HIV) serology was negative and autoimmune study as well as study of complement and proteinogram were negative or within normal limits. No data suggestive of a neoplastic process. Genetic study has been detected a pathogenic variant associated with aHUS. Conclusion We found a heterozygous carrier patient in genetic study, who developed aHUS during a Sars-cov2 infection, which could have been a trigger for its clinical expression. The clinical course of this case highlights how crucial it is to identify atypical hemolytic uremic syndrome. The early initiation of eculizumab improves the prognosis and quality of life, with pregnancy becoming increasingly more likely and therapy with eculizumab does not have safety problems in this regard, although pregnant patients with aHUS should be closely monitored close during pregnancy and postpartum.

Exploring digital biomarkers using smartphones for fatigue assessment in patients with multiple sclerosis

AbstractObjectivesThe treatment goals for multiple sclerosis (MS) are shifting from relapse inhibition to the improvement of long‐term prognosis and quality of life (QoL). Fatigue reduces QoL in patients with MS. The methods for assessing and treating fatigue, particularly those that are easily applicable in clinical settings remain unestablished. This study aimed to explore and identify digital biomarkers related to fatigue using smartphones.MethodsThe patients with MS attending the Department of Neurology at St. Marianna University School of Medicine (Kanagawa, Japan) were surveyed via mail and responses were obtained online. The survey items included patient background such as age and sex, Fatigue Assessment Scale (FAS), which is one of the patient‐reported outcomes (PROs) and serves as a questionnaire method for assessing fatigue, as well as self‐assessments of depression, sleep, and pain. Additionally, the number of steps recorded on smartphones was collected as personal health records (PHRs) along with the time spent using smartphones.ResultsOverall, 27 (18 female) participants responded (response rate: 46.6%). The mean age was 41.0 ± 14.6 y and the majority (12 participants) had a disease duration of &lt;5 y. According to self‐assessments, moderate or higher symptoms of depression, sleep disturbances, and pain were observed in 13 participants, 10 participants, and 6 participants, respectively. The daily number of steps ranged from 805 to 15 263 (median of 4514 steps). The number of steps was negatively correlated with FAS (r = −0.47, P = .02), and in cases with any physical disability, the number of steps was negatively correlated with FAS (r = −0.69, n = 0.01).ConclusionThe number of steps automatically measured by smartphones could be a digital biomarker reflecting fatigue in MS patients.

A nomogram of anastomotic stricture after rectal cancer: a retrospective cohort analysis.

Anastomotic stricture significantly impacts patients' quality of life and long-term prognosis. However, current clinical practice lacks accurate tools for predicting anastomotic stricture. This study aimed to develop a nomogram to predict anastomotic stricture in patients with rectal cancer who have undergone anterior resection. A total of 1542 eligible patients were recruited for the study. Least absolute shrinkage selection operator (Lasso) analysis was used to preliminarily select predictors. A prediction model was constructed using multivariate logistic regression and presented as a nomogram. The performance of the nomogram was evaluated using receiver operating characteristic (ROC) curves, calibration diagrams, and decision curve analysis (DCA). Internal validation was conducted by assessing the model's performance on a validation cohort. 72 (4.7%) patients were diagnosed with anastomotic stricture. Participants were randomly divided into training (n = 1079) and validation (n = 463) sets. Predictors included in this nomogram were radiotherapy, diverting stoma, anastomotic leakage, and anastomotic distance. The area under the ROC curve (AUC) for the training set was 0.889 [95% confidence interval (CI) 0.840-0.937] and for the validation set, it was 0.930 (95%CI 0.879-0.981). The calibration curve demonstrated a strong correlation between predicted and observed outcomes. DCA results showed that the nomogram had clinical value in predicting anastomotic stricture in patients after anterior resection of rectal cancer. We developed a predictive model for anastomotic stricture following anterior resection of rectal cancer. This nomogram could assist clinicians in predicting the risk of anastomotic stricture, thus improving patients' quality of life and long-term prognosis.

Relationship among muscle strength, muscle endurance, and skeletal muscle oxygenation dynamics during ramp incremental cycle exercise.

Peak oxygen uptake (VO2), evaluated as exercise tolerance, is a strong predictor of life prognosis regardless of health condition. Several previous studies have reported that peak VO2 is higher in those with a greater decrease in muscle oxygen saturation (SmO2) in the active muscles during incremental exercise. However, the skeletal muscle characteristics of individuals exhibiting a greater decrease in SmO2 during active muscle engagement in incremental exercise remain unclear. This study aimed to clarify the relationship among muscle strength, muscle endurance, and skeletal muscle oxygenation dynamics in active leg muscles during incremental exercise. Twenty-four healthy young men were included and categorized into the non-moderate-to-high muscular strength and endurance group (those with low leg muscle strength, endurance, or both; n = 11) and the moderate-to-high muscular strength and endurance group (those with both moderate-to-high leg muscle strength and endurance; n = 13). All participants underwent cardiopulmonary exercise testing combined with near-infrared spectroscopy to assess whole-body peak VO2 and the change in SmO2 at the lateral vastus lateralis from rest to each exercise stage as skeletal muscle oxygenation dynamics. A linear mixed-effects model, with the change in SmO2 from rest to each stage as the dependent variable, individual participants as random effects, and group and exercise load as fixed effects, revealed significant main effects for both group (P = 0.001) and exercise load (P < 0.001) as well as a significant interaction between the two factors (P < 0.001). Furthermore, multiple-comparison test results showed that the change in SmO2 from rest to 40%-100% peak VO2 was significantly higher in the moderate-to-high muscular strength and endurance group than in the non-moderate-to-high muscular strength and endurance group. Maintaining both muscle strength and endurance at moderate or higher levels contributes to high skeletal muscle oxygenation dynamics (i.e., greater decrease in SmO2) during moderate- or high-intensity exercise.

Four Patients with Neonatal Diabetes Mellitus and their Outcomes: A Case Series

Background: Neonatal diabetes mellitus (NDM) is a severe type of glucose metabolism disorder that appears in the first months of life and mostly presents with symptoms such as dehydration, inability to gain weight, and in extreme cases, ketoacidosis and coma. Strong evidence shows the benefits of early molecular tests that investigate variability in kATP channels such as KCNJ11, ABCC8, INS gene mutations, and 6q24 abnormalities. In the presence of these genomics changes, switching from Insulin treatment toward high-dose oral sulfonylurea can enhance the course of treatment, prognosis, and quality of life. Case Report: In this study, we report four cases of neonatal diabetes with different symptoms who were referred to Shahid Sadoughi Medical Center in Yazd, Iran. Conclusion: The diagnosis and treatment of NDM is a good model for implementing patient-centered and personalized medicine. For all patients with diabetes diagnosed before the 6th month of their age (even the 12th month), genetic testing should be considered.

Current Situation and Future Direction of Multidisciplinary Diagnosis and Treatment of Lung Cancer

Although multidisciplinary team (MDT) diagnosis and treatment model can improve the quality of life and survival prognosis of the patients, why does it not reach the expected goal of the MDT diagnosis and treatment model? The main reason is that the diagnosis and treatment mode of MDT in lung cancer lags behind the progress of various treatment methods. By analyzing the latest research results of MDT diagnosis and treatment of lung cancer at home and abroad, combined with the experience of MDT diagnosis and treatment of lung cancer in the Lung Cancer Center of West China Hospital of Sichuan University, this article will discuss and summarize the progress and future direction of MDT in lung cancer from the following aspects: (1) The connotation and extension of MDT diagnosis and treatment mode of lung cancer need to be changed and adapted to new methods of diagnosis and treatment; (2) The clinical decision making in the diagnosis and treatment of MDT in lung cancer should be transformed from "multidisciplinary consultation (MDC)" to "MDT"; (3) The diagnosis and treatment process of MDT in lung cancer should shift from "fire brigade mode" to "firewall mode", and finally implement "individualized whole-process management mode"; (4) The path of MDT diagnosis and treatment of lung cancer should be changed from "temporary convening mode" to "single disease center system mode of lung cancer". .

Radiologically guided interventional therapies for the treatment of neuroendocrine tumors

The majority of patients with neuroendocrine tumors (NET) develop liver metastases during the course of the disease, significantly impacting prognosis and quality of life. Radiologically guided interventional therapies, such as thermal ablation, transarterial embolization (TAE)/chemoembolization (TACE), and selective internal radiotherapy (TARE), can play acrucial role in the treatment of metastatic NET. Due to the rarity of the disease, the majority of evidence is based on retrospective studies. For thermal ablation, the complete response rates ranging from 31.6to 95.3% depending on the study. No significant differences in outcomes were found between TAE, TACE, and TARE. In several studies, all intra-arterial procedures led to areduction of tumor-related symptoms and achieved disease control. Thermal ablation can be used as acurative therapy in oligometastatic patients with nonresectable liver metastases from NETs. In cases of disseminated liver metastases, intra-arterial therapy using TAE, TACE, or TARE can be employed.

Influence of malnutrition according to the glim criteria on the chemotherapy toxicities in patients with advanced lung cancer.

Cancer-associated malnutrition is highly prevalent in advanced lung cancer, and 50% of global cancer-related deaths are attributed to cancer-associated malnutrition. Platinum-containing chemotherapy is the standard treatment for advanced lung cancer. Unfortunately, it can cause exacerbated toxicities, which can also have a negative impact on patient's prognosis and quality of life. The Global Leadership Initiative on Malnutrition (GLIM) criteria have been proposed as the world's first accepted diagnostic criteria for malnutrition. However, the effectiveness of GLIM criteria in predicting chemotherapy toxicities in patients with advanced lung cancer is unclear. The aim of this study was to apply the GLIM criteria to assess the prevalence of pre-treatment diagnosis of malnutrition in patients with advanced non-small cell lung cancer (NSCLC) and to determine the impact of nutritional status on patient's chemotherapy toxicity. We conducted a study of hospitalized patients with pathologically and clinically diagnosed advanced NSCLC who presented to our hospital from May 2021 to January 2022. Initially, the Nutritional Risk Screening-2002 (NRS-2002) was used for nutritional risk screening, and nutritional status was assessed using the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and GLIM criteria. Chemotherapy toxicity was assessed and graded according to CTCAE5.0, and chemotherapy efficacy was assessed according to RECIST1.1. Kappa test was used to analyze the agreement between PG-SGA and GLIM criteria. Univariate and multivariate logistic regression analyses were used to determine the relationship between malnutrition and chemotherapy toxicity. A total of 215 patients with advanced NSCLC were evaluated for nutritional status. Most of the patients had normal BMI (61.86%) before the start of treatment, 40% were well-nourished as assessed by the PG-SGA tool, and 51.17% were well-nourished as assessed by GLIM criteria. Consistency analysis showed moderate agreement (Kappa = 0.463, P < 0.001) and their correlation was also moderate (Spearman, rs = 0.475, P < 0.001). The objective response rate (ORR) (P = 0.040) and disease control rate (DCR) (P < 0.001) were significantly lower in malnourished patients diagnosed according to GLIM criteria than in well-nourished patients. Multivariate analysis showed that malnutrition (OR = 1.531,95%CI 0.757-3.009; OR = 6.623,95%CI 1.390-31.567, P = 0.046) diagnosed by GLIM criteria was an independent predictor of chemotherapy toxicity. Conclusions Malnutrition diagnosed by GLIM criteria better predicts toxicity during chemotherapy, determines the degree of clinical benefit of chemotherapy, and may affect patient prognosis.

Influence of Blood Insulin Levels on The Daily Life and Health of Patients with COPD

The study examines hyperinsulinemia in patients with COPD and its impact on their lives. Clinical data and biochemical indicators were analyzed, including blood insulin levels and CAT questionnaire outcomes. A high frequency of hyperinsulinemia was identified, which has clinical significance for treatment and improving prognosis and quality of life for patients

A meta-analysis of randomized controlled trials comparing breast-conserving surgery and mastectomy in terms of patient survival rate and quality of life in breast cancer.

The study aimed to assess the effects of breast-conserving surgery (BCS) versus mastectomy on survival and quality of life in Stages I, II, and III breast cancer, providing solid evidence for clinical decisions. We conducted a meta-analysis of randomized controlled trials on breast cancer treatments, searching databases such as PubMed and the Cochrane Library to compare BCS, and mastectomy's effects on survival and quality of life. A combined total of 16 734 patients in the control group and 17 435 patients in the experimental group were included in this analysis. This meta-analysis used RevMan 5.3 (Cochrane Collaboration, Copenhagen, Denmark) software for analysis. Our meta-analysis of 34 169 patients from 11 studies showed that BCS significantly reduced the overall recurrence rate at a median follow-up of 29 months, with a mean difference of 1.27 and a 95% confidence interval of 1.19-1.36, strongly supporting its effectiveness (P < .00001). Furthermore, our analysis found no significant increase in 5-year local recurrence rates for BCS versus mastectomy, indicating its long-term effectiveness with a mean difference of 1.13 (95% confidence interval: [1.03, 1.24], P = .01). Additionally, there was a notable decrease in tissue ischaemic necrosis among patients who had received BCS, with a mean difference of 0.37 (95% confidence interval: [0.33, 0.42], P < .00001), underscoring its benefits and long-term viability. BCS resulted in fewer cases of tissue ischaemic necrosis and higher body image scores compared with mastectomy, suggesting that it is a preferable option for better cosmetic outcomes and potentially favourable effects on prognosis and quality of life.

Advancements in neuroregenerative and neuroprotective therapies for traumatic spinal cord injury.

Traumatic spinal cord injuries (SCIs) continue to be a major healthcare concern, with a rising prevalence worldwide. In response to this growing medical challenge, considerable scientific attention has been devoted to developing neuroprotective and neuroregenerative strategies aimed at improving the prognosis and quality of life for individuals with SCIs. This comprehensive review aims to provide an up-to-date and thorough overview of the latest neuroregenerative and neuroprotective therapies currently under investigation. These strategies encompass a multifaceted approach that include neuropharmacological interventions, cell-based therapies, and other promising strategies such as biomaterial scaffolds and neuro-modulation therapies. In addition, the review discusses the importance of acute clinical management, including the role of hemodynamic management as well as timing and technical aspects of surgery as key factors mitigating the secondary injury following SCI. In conclusion, this review underscores the ongoing scientific efforts to enhance patient outcomes and quality of life, focusing on upcoming strategies for the management of traumatic SCI. Each section provides a working knowledge of the fundamental preclinical and patient trials relevant to clinicians while underscoring the pathophysiologic rationale for the therapies.