Successful Treatment Research Articles

Effects of levonorgestrel-releasing intrauterine system on recurrence and fertility outcomes during assisted reproduction after complete remission of early endometrioid endometrial cancer and precancerous lesions: A retrospective cohort study.

To investigate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) on recurrence and fertility outcomes during controlled ovarian stimulation (COS) in patients with early stage endometrioid endometrial carcinoma (EEC) and endometrial atypical hyperplasia (EAH) following successful fertility-preserving treatment. We reviewed the patients with Grade 1 presumed Stage IA EEC or EAH who underwent in vitro fertilization and embryo transfer after successful fertility-sparing treatment. A total of 176 women were enrolled in this study, undergoing 318 cycles of COS and 290 cycles of embryo transfer (ET). Twenty-one percent (37/176) patients have an LNG-IUS insertion during the initial ovarian stimulation, and the median follow-up time for this cohort was 61.3 months (interquartile range [IQR], 39.0-76.6 months), while it was 60.5 months for the other cohort (IQR, 44.9-80.3 months). Disease recurrence was experienced by 34.7% (61/176) of the patients. Compared to the non-LNG-IUS group, the LNG-IUS group had a lower recurrence rate 1 year after COS (5.4% (2/37) versus 20.9% (29/139), p = .034). The use of LNG-IUS was associated with a reduced recurrence rate 1 year after COS (hazard ratio = 0.203, 95% confidence interval [0.042-0.984], p = .048). The overall clinical pregnancy rate reached as high as 65.3% (115/176), while the cumulative live birth rates were up to 46.6% (85/176). We found that LNG-IUS during COS did not impact oocyte yield, ET, or pregnancy outcomes. The placement of LNG-IUS during COS in EEC/EAH patients is worth considering, as it is likely to reduce the recurrence of endometrial lesions without affecting fertility outcomes.

Pathway regulation of an on-surface stepwise reaction through a metal coordination template.

Herein, we have demonstrated a pathway regulation of a stepwise reaction on Cu(111), including both debrominative and dehydrogenative couplings, facilitated by a persistent template effect from the metal-organic coordination motif of Cu-N. Using scanning tunneling microscopy, in combination with density functional theory calculations, we revealed that the compound 2-bromo-1,8-naphthyridine on Cu(111) initially transformed into C-Cu organometallic dimeric intermediates via dehalogenation, and then into covalent tetramers and cyclic pentamers via dehydrogenation upon successive thermal annealing treatments. The cisoid species was predominant in all reaction steps, demonstrating the persistent template effect of Cu-N coordination. Our results present a new opportunity to precisely control stepwise on-surface reactions, potentially enabling the bottom-up engineering of functional organic nanostructures.

Proteomic analysis identifying proteins relevant for treatment success following experimental neonatal inflammation-sensitized hypoxia-ischemia.

Understanding the mechanisms of injury following neonatal hypoxic-ischemic encephalopathy (HIE) is a major goal in neonatal research. HIE can have severe effects on cognitive and motor development in newborns, including an increased risk of death. As the incidence is 10-20 times higher in low- and middle-income countries compared to developed countries, the interest in a therapy exists worldwide. Therapeutic hypothermia (HT) is the only effective treatment after HIE. However, TH is not universally effective, particularly in cases of inflammation-sensitized hypoxia-ischemia (HI); it provides limited benefit. To identify proteins that may contribute to the reduced efficacy of HT in the case of pre-HI inflammation sensitization, the proteomic profiles of animals subjected to HI and HT combined with lipopolysaccharide (LPS) were analyzed via liquid chromatography mass spectrometry (LC-MS/MS). We identified proteins that potentially support the efficacy of HT and those that prevent the success of the therapy in the neonatal rat model of inflammation-sensitized HI. This study represents a step forward in identifying proteins related to the efficacy of HT following inflammation-sensitized HI. Therapeutic hypothermia is the only available treatment for neonatal hypoxic-ischemic encephalopathy, but not effective in models of inflammation-sensitized hypoxic-ischemic brain injury. Using liquid chromatography mass spectrometry, we identified proteins possibly having an effect on the treatment success of therapeutic hypothermia following experimental inflammation-sensitized hypoxic-ischemic brain injury. This proteomic analysis reveals proteins as potential markers that could prevent or support the efficacy of therapeutic hypothermia in experimental neonatal inflammation-sensitized hypoxic-ischemic encephalopathy.

The Value of Three‐Dimensional Doppler Indices in the Prediction of Successful Medical Treatment for Missed Miscarriage

The Value of Three‐Dimensional Doppler Indices in the Prediction of Successful Medical Treatment for Missed Miscarriage

Bee and wasp venom allergies in children and adolescents

The diagnostic procedure to detect sensitization to bee or wasp venom should only be carried out if this results in atherapeutic consequence, i.e., allergen immunotherapy (AIT) against Hymenoptera venom (HG). The risk of amore severe reaction to another insect sting after asystemic allergic reaction is very low in children. Therefore, children who have only reacted with an intensified local reaction or generalized urticaria do not usually require AIT or an emergency kit. For children who show anaphylaxis that goes beyond urticaria, AIT and an emergency kit are indicated. The AIT for at least 3 years can significantly reduce the risk of another severe anaphylactic reaction. The chances of success of AIT are so good that in many cases the emergency kit can be dispensed with during the course of the reaction. Sting provocations for diagnostic purposes or to check the success of treatment are generally not indicated in children and adolescents.

Public Insurance Status is Associated With Lower Bracing Treatment Success in Infants With Developmental Dysplasia of the Hip.

Early diagnosis and initiation of bracing for developmental dysplasia of the hip (DDH) can result in disease resolution. Bracing failure or late presentation necessitates surgical intervention. Socioeconomic factors can contribute to delayed diagnosis requiring more invasive treatment. Our purpose was to evaluate whether measures of health disparities are associated with bracing outcomes and treatment progression in children with DDH. Patients screened for DDH in a pediatric orthopaedic clinic at a single academic children's hospital between January 2013 and December 2021 were retrospectively reviewed. Demographics, state Area Deprivation Index (ADI; decile from 1 to 10 with a higher number indicating greater socioeconomic disadvantage), distance from a primary residence to the clinic, insurance type, >1 no-show appointments, and treatment course were collected. Four hundred one patients received a diagnosis of DDH and were included in the analysis. The median age at presentation was 46 days and the median state ADI was 4. Two hundred ninety-six patients (73.8%) had resolution of DDH with bracing (Pavlik harness, abduction brace, or both), 77 (19.2%) underwent surgery, and 28 (7.0%) were lost to follow-up. Compared with patients with ADI 1 to 4, patients with ADI 5 to 10 were significantly more likely to have public insurance (P<0.001) and >1 no-show appointment (P<0.001). Higher socioeconomic disadvantage was associated with a greater proportion of patients requiring treatment progression (ie, failed bracing and need for surgery) or loss to follow-up (P<0.001). Regressions controlling for sex, race, state ADI, distance from residence to clinic, and insurance type revealed that public insurance was predictive of age >6 months at presentation (P<0.001), greater treatment progression (P<0.001), and higher need for surgery (P=0.001). Public insurance was a negative predictor of successful bracing treatment (P<0.001). Our study showed that children with DDH and public insurance were older at initial presentation and had a higher likelihood of bracing failure necessitating more invasive treatment. Public insurance may be the most significant measure of health disparities in assessing which DDH patients are at risk for conservative treatment failure and would benefit from early social work support. Level III-therapeutic.

Risk factors and nomogram model for recurrence of benign paroxysmal positional vertigo in postmenopausal women: a multicenter cross-sectional study

ObjectiveTo explore the risk factors for recurrent benign paroxysmal positional vertigo (BPPV) in postmenopausal women within 1 year of canalith repositioning procedure (CRP), and develops a risk model based on serum 25-hydroxyvitamin D (25(OH)D), estradiol, and calcium levels to provide early identification of high-risk groups and guide prevention and treatment strategies.MethodsData from postmenopausal women with BPPV, diagnosed and successfully treated with CRP at five hospitals in Sichuan Province between January 2019 and January 2024, were retrospectively analyzed. Participants were divided into BPPV validation and training sets in a 3:7 ratio. Clinical data were categorized into recurrence and non-recurrence subgroups based on whether BPPV recurred after treatment. LASSO regression identified factors influencing recurrence within 1 year after CRP, and multivariate logistic regression (MLR) analysis was used to develop a risk nomogram prediction model (NPM).ResultsA total of 490 patients were enrolled, with 147 in the validation set and 343 in the training sets. Among them, 151 patients (30.82%) experienced recurrenced, including 58 (30.61%) in the validation set and 106 (30.90%) in the training sets. LASSO and MLR analyses identified migraine (OR = 2.208, 95% CI = 1.278–3.817), serum calcium (OR = 0.601, 95% CI = 0.447–0.81), 25(OH)D (OR = 0.785, 95% CI = 0.713–0.864), and serum estradiol (OR = 0.820, 95% CI = 0.752–0.894) as significant factors influencing recurrence within 1 year after CRP treatment in postmenopausal women with BPPV.ConclusionThe recurrence rate of BPPV within 1 year after CRP treatment in postmenopausal women is high. Migraine, 25(OH)D, calcium, and estradiol are associated with recurrence. The risk prediction model, developed using these factors, demonstrates good discrimination and calibration. It effectively predicts the recurrence risk within 1 year after successful CRP treatment, offering practical clinical value.

CRISPR/Cas9 Screening Highlights PFKFB3 Gene as a Major Contributor to 5-Fluorouracil Resistance in Esophageal Cancer

Background: Esophageal cancer (EC) is the eighth most common cancer and the sixth most common cause of death worldwide. Esophageal squamous cell carcinoma (ESCC) comprises the majority of esophageal cancers globally, and 5-Fluorouraci (5-FU) is one of the commonly used chemotherapeutics for this type of cancer. Chemoresistance to drugs is a main obstacle in the successful treatment of this malignancy. Methods: In this study, we used the CRISPR/Cas9 screening method to determine the target gene related to 5-FU drug resistance in esophageal cancer. Results: Our research findings indicate that the loss of PFKFB3 can increase the resistance of different human esophageal squamous cell carcinoma cell lines to 5-FU through various pathways. Specifically, in KYSE-70 cells, loss of PFKFB3 can induce epithelial–mesenchymal transition (EMT) and prolong the S phase of the cell cycle, allowing cancer cells to evade the effects of 5-FU and develop resistance. In the KYSE-270 and KYSE-150 cell lines, loss of PFKFB3 can upregulate the expression of Slug and Mcl-1, indirectly regulate Chk1 and promote its autophosphorylation, which in turn inhibits apoptosis, thus counteracting the effects of 5-FU. Conclusions: Our research not only enriches our understanding of the biological characteristics of different ESCC cell lines but also provides new clinical insights for future personalized treatments. Assessing the status of PFKFB3 can help predict resistance to 5-FU in ESCC patients with different genetic backgrounds, allowing for more precise treatment planning. This personalized approach has the potential to improve treatment efficacy, reduce unnecessary drug use and side effects, and ultimately improve patient survival rates and quality of life.

Successful Treatment of Extragenital Lichen Sclerosus with Narrow-band UVB Phototherapy.

Successful Treatment of Extragenital Lichen Sclerosus with Narrow-band UVB Phototherapy.

Bilateral trochanteric hip fractures in a semi-supercentenarian treated with an orthogeriatric team: A rare case report

Rationale: Hip fractures are common injuries in the elderly, yet surgical cases in individuals over 105 years old are rarely reported. As a result, the clinical course and surgical outcomes in this age group remain unclear, leading to a lack of evidence to guide decision-making for super-elderly patients. We report a rare case of a 105-year-old woman who successfully underwent bilateral hip fracture surgeries at ages 105 and 106, with a 3-year follow-up. Patient concerns: A 105-year-old female fell at home and was diagnosed with a right trochanteric fracture and suffered a left trochanteric fracture at 106 years old. Diagnoses: Bilateral trochanteric fractures. Interventions: She underwent surgery using a short femoral nail under general anesthesia with early rehabilitation with the orthogeriatric team. One year later, at age 106, she suffered a left trochanteric fracture and underwent a similar procedure. Outcomes: She regained independent ambulation with a cane and maintained full cognitive function, as confirmed by Hasegawa Dementia Scale-Revised and Mini-Mental State Examination scores of 30/30 until her passing at 108 years old. The involvement of an orthogeriatric team and early mobilization may have contributed to preventing cognitive decline. Lessons: This case demonstrates that advanced age alone is not a contraindication for surgery if the patient’s overall condition is favorable. A multidisciplinary medical team, skilled surgical techniques, appropriate anesthesia, and early rehabilitation are crucial for successful treatment in super-elderly patients.

Safety of intravenous mesenchymal stem cell therapy: a meta-analysis of randomized controlled trials

Previous preclinical research and human trials have demonstrated that intravenous cell administration is a safe and successful treatment method for improving the quality of life in patients with a variety of illnesses. The purpose of this study was to evaluate the safety profile of mesenchymal stem cells administered intravenously. We explored PubMed, ScienceDirect, Web of Science, ClinicalTrials.gov, and the Cochrane Library for published research from their creation through December 2024, following PRISMA 2020 guidelines. Two researchers independently assessed the study’s inclusion and exclusion criteria, data extraction, and risk of bias assessment. Our meta-analysis includes 36 studies on mesenchymal stem cell therapy by intravenous method. The safety profile of mesenchymal stem cell therapy was evaluated across various adverse event categories using meta-analyses of randomized controlled trials. Twenty-two randomized controlled trials assessed general disorders and administration site conditions, showing no statistically significant increase in adverse event risk in the mesenchymal stem cell group compared to controls (log odds ratio [OR]: 0.29, 95% confidence interval [CI]: –0.15 to 0.73, P = 0.201). Similarly, analyses of musculoskeletal/connective tissue disorders (four randomized controlled trials, log OR: –0.26, 95% CI: –1.81 to 1.29, P = 0.742) and renal/urinary disorders (five randomized controlled trials, log OR: 0.30, 95% CI: –0.59 to 1.19, P = 0.511) revealed non-significant results. Conversely, a statistically significant increase in nervous system disorders was observed (thirteen randomized controlled trials, log OR: 0.54, 95% CI: –0.05 to 1.13, P = 0.072). Infection-related adverse events, evaluated in twenty randomized controlled trials, showed a slight but significant elevated risk in the mesenchymal stem cell group (log OR: –0.32, 95% CI: –0.61 to -0.02, P = 0.036). Gastrointestinal disorders (five randomized controlled trials, log OR: 0.00, 95% CI: –0.33 to 0.33, P = 0.988), respiratory/thoracic disorders (eight randomized controlled trials, log OR: –0.12, 95% CI: –0.67 to 0.42, P = 0.652), and immune system disorders (three randomized controlled trials, log OR: –0.97, 95% CI: –2.42 to 0.49, P = 0.193) did not show significant risk increases. Injury and procedural complications (five randomized controlled trials) also demonstrated a non-significant trend. Heterogeneity was minimal across all analyses, and no substantial publication bias or influential studies were identified. While most findings support the safety of mesenchymal stem cell therapies, significant results for nervous system and infection-related adverse events warrant further investigation. We conclude that intravenous delivery of mesenchymal stem cells is safe for many conditions. However, large-scale randomized controlled trials are required to confirm the findings.

Prevalence, progression, and treatment of asymptomatic tuberculosis: a prospective cohort study in Lanxi County, Zhejiang Province, China

Abstract Background Individuals with asymptomatic tuberculosis are considered a significant risk to the disease burden and transmission. However, the progression and treatment for asymptomatic tuberculosis remain incompletely described. Methods This prospective cohort study was embedded within a prevalence survey conducted in 2021 and 2022 in Lanxi County, China. All patients with pulmonary tuberculosis who consented to participant would be included in the study and were categorized as asymptomatic or symptomatic. For the primary analysis, asymptomatic tuberculosis was defined as the absence of current cough, fever, night sweats, weight loss, or hemoptysis. Patients were followed up until November 10, 2024. Results Among 109,345 individuals screened, 193 were included, of which 101 (52.3%) were symptomatic and 92 (47.7%) were asymptomatic. The proportion of asymptomatic tuberculosis varied from 32.5% to 62.7% depending on varying symptom negative threshold. Fewer asymptomatic patients were bacteriologically confirmed compared to symptomatic patients (71.7% [66/92] vs. 90.1% [91/101], p=0.001). The median time for asymptomatic patients at screening to develop symptoms was 102 days. Most patients in both groups received treatment for active tuberculosis (97.8% vs. 99.0%, p=0.606). The treatment success rate among asymptomatic patients was comparable to that of symptomatic patients (93.3% vs. 96.0%, p=0.521), but their treatment duration was significantly shorter (196 vs. 273 days, p&amp;lt;0.001). Conclusion In the community setting, a significant number of tuberculosis cases were asymptomatic and remained so for months. These cases demonstrated satisfactory treatment coverage and outcomes, with shorter durations compared to symptomatic tuberculosis, suggesting the potential for developing shorter regimens for asymptomatic tuberculosis.

The impact and cost of a new rapid diagnostic test for school-based prevalence mapping and monitoring and evaluation surveys of schistosomiasis: A modelling study.

In endemic communities where the prevalence of Schistosomiasis is ≥ 10%, annual preventive chemotherapy is recommended. Traditional sampling methods determine infection prevalence through district-level surveys in school-aged-children (SAC). Recently, an alternative sampling strategy-the Schistosomiasis Practical and Precision Assessment (SPPA) protocol-was developed to aid in targeting treatment to the sub-district level. A prototype circulating anodic antigen rapid diagnostic test (CAA RDT) could avoid the pitfalls associated with current microscopy techniques and therefore be better suited to support precision-mapping. We modelled the ability of a CAA RDT to correctly classify sub-district prevalence above or below the 10% threshold in simulated districts under alternative sampling strategies. Each district (10 sub-districts/district) had varying mean prevalence and prevalence distributions. Test sensitivity (60-100%) and specificity (95-100%) of the CAA RDT was varied. We then determined the associated survey costs for prevalence mapping or monitoring and evaluation for each sampling strategy using the CAA RDT compared to microscopy. The CAA RDT cost/SAC was US$12.14, which was similar to Kato-Katz (US$13.23/SAC) using traditional sampling. Sampling with the CAA RDT cost the least when conducting SPPA sampling or M&E, or when both Kato-Katz and urine filtration were required. High specificity of the CAA RDT was a key determinant of performance and a test with 100% specificity and 85% sensitivity correctly classified the most sub-districts (87%) under SPPA sampling. SPPA sampling generally led to less under- and overtreatment of sub-districts compared to traditional sampling. A CAA RDT with high specificity will lead to similar treatment success at lower costs, under either sampling strategy, as compared to Kato-Katz and urine filtration. The CAA RDT could be a valuable diagnostic tool for determining schistosomiasis prevalence and could better support precision mapping strategies through reduced costs, thereby improving mass drug administration and aiding programmes to eliminate schistosomiasis as a public health problem.

An integrated 3D model of water shutoff considering the gelation kinetics of nanosilica gel

The latest developments in nanosilica gel technology hold great promise for mitigating excessive water production in oil and gas wells. Nevertheless, to unlock the full potential of this technology, advanced modeling techniques are required to accurately predict and design optimal placement strategies, ensuring effective and efficient treatment outcomes. Numerical simulations play a vital role in the design and optimization of water shutoff treatments, but their potential is frequently compromised by two significant shortcomings: the oversimplification of gel behavior and the neglect of formation heterogeneity. These limitations can result in inaccurate predictions, suboptimal treatment designs, and reduced effectiveness, underscoring the need for more sophisticated and realistic simulation approaches that can accurately capture the intricate interactions between the gel, formation, and fluid properties. By addressing these limitations, advanced numerical simulations can provide a more comprehensive understanding of the complex processes involved, enabling the development of more effective and efficient water shutoff treatments that maximize well performance and minimize environmental impact. This study presents a groundbreaking 3D modeling approach that simulates water shutoff operations using Nanosilica gel, addressing the complexities of gel behavior and formation heterogeneity. By integrating experimental data, mathematical formulations, and computational simulations, the model reveals the intricate relationships between key factors such as injection rate, fluid temperature, treatment volume, activator concentration, and formation properties. The simulation results emphasize the need to strike a delicate balance between competing factors, including gel penetration, temperature cooldown, and gelation time, to achieve optimal treatment outcomes. Furthermore, the model demonstrates the significant impact of formation heterogeneity on gel distribution and performance, highlighting the importance of considering localized variations in permeability and porosity during the design phase. This innovative approach provides a powerful tool for optimizing treatment success, reducing water management costs, and improving overall efficiency in oil and gas fields.

Development of a DNA Aptamer-Based Approach to Noninvasively Image CAR-T Cells In Vivo and Traceless Enrichment In Vitro.

Chimeric antigen receptor (CAR) T cells offered a potential cure for malignancies, however, their outcomes and dynamics across different anatomical sites remained inadequately characterized. Monitoring the bio-distribution and tumor-homing of CAR-T cells in vivo is crucial, as it provides patient-specific data that might inform on treatment success, potential failure, and off-target toxicities. Herein, an Aptamer A3 by Cell-SELEX (systematic evolution of ligands by exponential enrichment) is generated, which can bind with CAR-T cells with nanomolar affinity. After CAR-T cells are injected into Nalm6 xenograft tumor model mice through tail vein, Cy5-labeled A3 is injected into mice for fluorescence time-delay imaging in vivo. The fluorescence signal produced by the Cy5-labeled A3 is accumulated in the tumor area and reached its maximum at day 14. Moreover, A3 could enrich CAR-T cells in mixed cell populations in a traceless way. A3 is screened for CAR-T cells imaging and CAR-T cells enrichment, which may provide assistance for the evaluation of CAR-T cells efficacy and the manufacture of CAR-T cells. Overall, this research shows that A3 enabled repeated, sensitive, and specific assessment of the infused CAR-T cells in vivo. The screened aptamer will have broad applications for tracking CAR-T cells in patients, providing insights into treatment success, potential failure, and off-target toxicities.

Artificial Intelligence: Basics and Recent Health Care Protocols in Dentistry

Abstract - Artificial Intelligence (AI) has revolutionized healthcare and dentistry by enabling accurate diagnosis, prediction, and personalized treatment. This review article provides an in-depth understanding of AI in healthcare and its impact on dentistry. AI technology has transformed various aspects of dental practice, including diagnosis, treatment, and patient care. AI-powered image processing systems have significantly assisted dental professionals in diagnosing and treating dental diseases. Additionally, AI technology has improved patient management and communication, enabling personalized care and enhancing the overall dental experience. In dentistry, AI has been applied in various areas, including restorative dentistry, endodontics, and regenerative dentistry. AI models have shown accuracy in detecting dental caries, vertical root fractures, and periapical lesions. In endodontics, AI has displayed accuracy in diagnostic and prognostic evaluations, enhancing treatment planning and success rates. Despite the benefits, AI technology faces challenges, including the need for large datasets, complex mechanisms, and high costs. However, the future of AI in healthcare and dentistry looks promising, with potential applications in precision and accuracy, research exploration, and repetitive task management. Recent advances in AI have opened up new possibilities, including deep learning models and integration with other technologies. As AI continues to evolve, it is expected to drive innovation, improve efficiency, and enhance human life. Further research is needed to test the dependability, relevance, and expenditure of AI models before integrating them into routine clinical work. Nevertheless, AI has the potential to transform dentistry, improving diagnostic accuracy, reducing costs, and enhancing patient outcomes. Key Words: Artificial Intelligence, Machine learning, Deep learning, Neural networks, Artificial Intelligence in healthcare, AI in restorative dentistry, AI in Endodontics, AI in regenerative endodontics

Mottled hyperpigmentation caused by mesotherapy: successful treatment with a picosecond 1064 nm Nd:YAG laser

ABSTRACT Post-inflammatory hyperpigmentation represents an acquired pigmentation anomaly frequently observed as a common sequela following acute or chronic skin inflammation, which often poses a challenge for treatment. We report a patient who developed persistent, mottled pigmentary macules all over her face subsequent to mesotherapy treatment. The patient was treated with a picosecond 1064 nm Nd:YAG laser in a two-step procedure way combined with a large- spot size, low-fluence mode and a fractional mode. After two treatment sessions, considerable improvement in her pigmentary lesions was observed, with no exacerbation or other complications.

Efficacy and Safety of rVIII-SingleChain in Surgical Prophylaxis.

RVIII-SingleChain is a B-domain-truncated factor VIII construct with a covalent bond between the factor VIII heavy and light chains. We report on the efficacy and safety of rVIII-SingleChain in subjects with severe haemophilia A undergoing surgery. Surgery, elective or emergent, was defined as all procedures requiring general, spinal, or regional anaesthesia. rVIII-SingleChain was administered as a bolus or continuous infusion during the perioperative period, dosed individually at the discretion of the investigator based upon the type of surgery and clinical status of the patient. The investigator rated haemostatic efficacy on a 4-point scale (excellent, good, moderate or poor/no response), where treatment success was defined as excellent or good. Overall, 36 subjects underwent 48 surgeries: 41 surgeries in 30 adult/adolescent (mean age 34 [range 12-64] years) and 7 in 6 paediatric subjects (mean age 8 [5-11] years). rVIII-SingleChain was administered during 24 orthopaedic and 17 non-orthopaedic surgeries in adults/adolescents and 7 non-orthopaedic surgeries in paediatrics. Haemostatic efficacy was rated as excellent (n = 36, 88%) or good (n = 5, 12%) in adult/adolescent surgeries and as excellent (n = 7, 100%) in paediatric surgeries. In adults/adolescents, mean (standard deviation [SD]) blood loss was lower than predicted (68.6 [99.9]mL vs. 196.7 [292.8] mL); values were comparable in paediatric subjects (2.1 [2.7] mL vs. 2.9 [2.7] mL). No serious or related adverse events (AEs) were reported during the perioperative period. Perioperative administration of rVIII-SingleChain effectively achieves and maintains haemostatic control in adult/adolescent and paediatric subjects with haemophilia A undergoing surgery.

Integrated prognostic assessment of apoptosis and chemotherapy related gene in bladder cancer: a prognostic signature

BackgroundBladder cancer (BC), characterized by epithelial heterogeneity, remains a challenging malignancy with limited tissue biomarkers for anticipating neoadjuvant chemotherapy efficacy. Tumor progression, orchestrated by cancer cells, intricately involves the modulation of apoptosis-related pathways. Given their pivotal role in this cascade, apoptosis-related genes emerge as potential determinants of tumor development. Concurrently, the formidable challenge of drug resistance significantly impedes the success of cancer treatments, where a patient's susceptibility to chemotherapy profoundly influences therapeutic outcomes. Consequently, our objective is to develop a prognostic risk model rooted in apoptosis and chemotherapy related gene. This comprehensive approach aims to enhance our ability to predict the prognosis of BC patients and optimize treatment strategies.MethodsWe extracted 412 BC patients and 19 healthy humans RNA-seq samples from the TCGA database and loaded 1416 apoptosis and chemotherapy related genes from the GeneCards website. Subsequently, we established four risk score models for apoptosis and chemotherapy related genes through single-factor, multi-factor, and LASSO regression analysis. Additionally, we conducted analyses on the risk model using methods such as Kaplan–Meier log-rank test, principal component analysis, time-dependent ROC curve analysis, uni-variate analysis, and multivariate Cox regression analysis. We discussed the relationship of this model with the immune status and its predictive capability for drug sensitivity. Finally, we validated the correlation of these four genes with BC drug resistance by establishing drug-resistant cell lines and conducting in vitro drug resistance-related experiments.ResultsThis study’s findings demonstrate that apoptosis and chemotherapy related genes can impact the progression of BC. We obtained a prognostic risk model composed of four apoptosis and chemotherapy related genes (FASN, GLI2, VHL, and PDGFRA). Among them, FASN, GLI2, and PDGFRA were identified as risk factors, with high expression in the high-risk group, while VHL exhibited high expression in the low-risk group. A nomogram was constructed based on these features to assess patient survival and prognosis. In addition, in vitro drug resistance experiments showed that FASN was associated with BC resistance.ConclusionThese four apoptosis-related genes may serve as valuable factors for predicting the prognosis of BC, providing insights into the pathogenic mechanisms of apoptosis-related genes in BC. It provides a new research path to overcome drug resistance in BC. They offer more precise references and guidance for the treatment of high-risk BC patients.

Laparoscopic Nissen Fundoplication Outcomes in Children with Gastroesophageal Reflux Disease and Hiatus Hernia: Retrospective Trial

Background Diagnosis and treatment of infant gastroesophageal reflux (GER) can be accomplished in a number of ways. Although the long-term effects on high-risk infants are unknown, laparoscopic surgery has led to an increase in the number of children needing antireflux surgery. This study aims to assess the outcome of laparoscopic nissen fundoplication in children younger than 18 years old. Methods Retrospective study of infants younger than 18 years' old who underwent laparoscopic Nissen fundoplication (Lap-NF) between 2020 and 2023 had their outcomes tracked until 2024. Results There were 44 cases, with a mean weight of 12.9 kg±3.5 and a median age of 3.32 year±1.9. An improved respiratory status following nasoduodenal feeding tube insertion was a typical rationale for surgical consultation.There were minimum postoperative problems. Median times for feeds were 1.61±0.72 days and for reaching the objective were 3.93±1.8 days. Hospital stay range from 3 : 7 days . During the postoperative phase, Three patient required readmission due to recurrence. Conclusion In children younger than 18 years old, Nissen fundoplication is a successful treatment for GER symptoms and hiatus hernia (HH). In this population, the procedure has a low rate of complications.