Cancer Patients with Venous Access Device Status and Influencing Factors of Path Analysis Decision Conflicts.

Objective: The study aims to investigate the status of decision-making and the influencing factors of venous access devices in cancer patients and to explore their action path. Methods: A retrospective analysis was conducted on the clinical data of 360 inpatients in the oncology department from July 2022 to October 2022 in Hebei, Shandong, and Shanxi provinces. The patients were assessed with a general information questionnaire, decision conflict scale, general self-efficacy scale, patient version of doctor-patient decision-making questionnaire, and medical version of social support scale. Further analysis was conducted on the influencing factors of decision conflict on cancer patients' status and access to venous access devices. Results: A total of 345 valid questionnaires were acquired, showing the total score of decision-making conflict regarding venous access devices in cancer patients to be 34.72 ± 12.13. A total of 245 patients exhibited decision-making conflict, with a high level in 119 patients. A negative correlation was found between the total score of decision-making conflict with that of self-efficacy, doctor-patient joint decision-making, and social support (r = 0.766, -0.816, -0.74, P < .001). The joint decision-making between doctor and patient directly negatively affected decision-making conflict (ß = -0.587, P < .001). Self-efficacy was found to exert a direct positive and negative predictive effect on the doctor-patient joint decision-making and decision-making conflict, respectively (ß = 0.415, 0.277, P < .001). Social support can contribute to decision-making conflict in a direct or indirect way through multiple modulations of self-efficacy and joint decision-making between doctors and patients (ß = -0.296, -0.237, -0.185, P < .001). Conclusion: Decisional conflicts are existing among cancer patients in intravenous access device selection, the degree of joint decisional involvement of doctors and patients makes a negative predictive effect on intravenous access device selection, and self-efficacy and social support exert direct or indirect effects. Accordingly, enhancing patients' self-efficacy and improving patients' social support from multiple perspectives could contribute to decision-making of intravenous access devices for cancer patients, which could be achieved by developing decision support programs to elevate decision quality, block related paths early, and reduce the level of patients' decision conflicts.

Diagnostic value of imaging modalities in primary squamous cell carcinoma of the liver.

Primary squamous cell carcinoma of the liver (PSCCL) is rare. PSCCL's lack of specific clinical manifestations and laboratory tests necessitate preoperative diagnosis via imaging examination. Conventional ultrasound (US) demonstrates a mass with mixed echogenicity, and contrast-enhanced US shows a circular pattern of "fast forward, fast backward or slow backward, high enhancement." Enhanced computed tomography (CT) showed enhancement in the center or edge of the lesion, and the density of the enhanced lesion was lower than that of the liver tissue in the same layer. Positron emission tomography-CT demonstrates an inhomogeneous low-density mass with increased 18F-FDG metabolism. Magnetic resonance imaging shows low signal intensity on T1-weighed images (T1WI) and high signal on T2-weighed images (T2WI). By summarizing the imaging characteristics of PSCCL, this review aims to improve clinicians' understanding of PSCCL and its diagnosis.

Long-term survival of patients with unoperated single ventricle heart defect: Four case reports and literature review.

A single ventricle (SV) heart defect is a rare complex congenital cardiac malformation, accounting for approximately 1%-2% of congenital heart diseases. Surgical intervention is the mainstay treatment for SV patients, although patients who do not receive surgical intervention may also survive. We followed up four adult patients who had SV since birth without surgical intervention and they had a good prognosis. The common characteristics of four long-term SV survivors were investigated by reviewing their medical records and the literature, and the current treatment methods for SV patients were also reviewed. The clinical presentation and long-term prognosis of SV patients without surgical intervention depend on the presence or absence of pulmonary blood flow obstruction, pulmonary vascular resistance, ventricular shape and function, aortic blood flow obstruction, and the atrioventricular valve shape and function. While the Fontan operation has become a common and effective method for SV treatment, long-term outcomes are fraught with morbidity and mortality. In our opinion, such patients with balanced hemodynamic condition could be followed and treated conservatively. Major cardiac surgery which leads to gross hemodynamic adjustments should be avoided. However, additional prospective study will be necessary to verify this assertion. This report aims to improve the prognosis as well as quality of life of SV patients.

Ultrasonographic Diagnosis of Intussusception in Children: A Systematic Review and Meta-Analysis.

Ultrasonography offers a unique advantage in the clinical diagnosis of intussusception. We aimed to evaluate the diagnostic accuracy of ultrasonography in pediatric intussusception. The PubMed, Embase, Web of Science, Cochrane Library databases, and African Journals Online database were searched for studies pertaining to ultrasonographic diagnosis of intussusception in children. Finally, 14 studies (combined n = 2367) were found eligible for inclusion. Pooled sensitivity and specificity were 0.94 (95% confidence interval: 0.91-0.96) and 0.96 (95% confidence interval: 0.93-0.98), respectively. In conclusion, ultrasonography has high sensitivity and specificity in the diagnosis of intussusception.

Conventional Ultrasound and Contrast-Enhanced Ultrasound in the Diagnosis of Splenic Diseases: A Systematic Review and Meta-analysis.

Accurate diagnosis of splenic diseases is important for timely and accurate treatment. The objective of this study was to compare the accuracy of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (US) in detecting splenic lesions. A systematic literature search was undertaken, and 8 studies met the inclusion criteria. The sensitivity and specificity of the consolidated results of CEUS were 0.95 (95% confidence interval [CI], 0.92-0.97) and 0.97 (95% CI, 0.90-0.99), respectively (I2 = 27.4%; area under the curve [AUC] from a summary receiver operating characteristic curve = 0.97). The sensitivity and specificity of the consolidated results of conventional US were 0.70 (95% CI, 0.56-0.80) and 0.96 (95% CI, 0.76-0.99; I2 = 83.4%; AUC = 0.84). In this systematic review and meta-analysis, the sensitivity and specificity of CEUS were higher than those of conventional US in diagnosing splenic lesions. Contrast-enhanced US is a promising method for accurately diagnosing splenic lesions.

Aortic sinus aneurysm rupture into the right atrium in a 29-year-old patient.

A 29-year-old man presented with chest tightness and shortness of breath. Physical examination showed jugular venous distention. Echocardiography showed a large saccular anechoic structure in the right atrium, swinging with the cardiac cycle. The operator initially mistook the lesion for a right atrial cystic tumor; however, color Doppler imaging showed abundant, high-velocity blood flow signals, leading to the diagnosis of giant aortic sinus rupture into the right atrium. Aortic sinus aneurysm is a rare and usually asymptomatic lesion. However, rupture leads to chest tightness and dyspnea, suggesting left or right heart failure. Surgery is the primary treatment.

[Effect of miR-873 on cardiomyocyte apoptosis induced by hypoxia reoxygenation and its mechanism].

OBJECTIVE: To explore the role of miR-873 in cardiomyocyte injury induces by hypoxia reoxygenation (H/R) and its related mechanisms.
 Methods: H/R model was established by culturing mouse cardiac H9c2 cells in vitro, and miR-873 mimic was transfected. The experiments were divided into a control group, a H/R group, a negative control group and a miR-873 mimic group. The expression of miR-873 was measured using real-time PCR. The protein expression levels of egl-9 family hypoxia inducible factor 3 (Egln3), B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) were evaluated by Western blotting. Cell apoptosis ELISA kit and cysteine-containing, aspartate-specific proteases-3 (caspase-3) activity kit was used to detect cell apoptosis and caspase-3 activity, respectively. The targeting effect of miR-873 on Egln3 were examined by the dual luciferase report gene assay, and the experiments were divided into a negative control group, a Egln3 3'-untranslated regions (3'-UTR) WT group (WT group) and a Egln3 3'-UTR MUT group (MUT group). In order to further detect the effects of Egln3 on miR-873 mimics, the Egln3 overexpressed cells were constructed, and the experiments were divided into a H/R group, a H/R+miR-873 mimic group, a H/R+pcDNA3-Egln3 (pcEgln3) group and a H/R+ miR-873 mimic+pcEgln3 group.
 Results: Compared with the control group, the expression level of miR-873 was significantly decreased in the H/R group (P<0.05). Compared with the H/R group, H9c2 cell apoptosis, caspase-3 activity and the ratio of Bax/Bcl-2 were significantly reduced in the miR-873 mimic group (all P<0.05). Compared with the negative control group, the luciferase activity was significantly down-regulated in the WT group (P<0.05), while the luciferase activity was not significantly changed in the MUT group (P>0.05). In the over-expression experiment, compared with the H/R group, the cell apoptosis and the ratio of Bax/Bcl-2 were significantly reduced in the miR-873 mimic group (both P<0.05). Compared with miR-873 mimic group, the cell apoptosis and the ratio of Bax/Bcl-2 were significantly up-regulated in the H/R+pcEgln3 group and the H/R+miR-873 mimic+pcEgln3 group (all P<0.05).
 Conclusion: MiR-873 can inhibit H/R- induced apoptosis of cardiomyocyte via targeting Egln3.

A network meta-analysis on the efficacy and prognosis of different interventional therapies for early-stage hepatocellular carcinoma.

PURPOSE: It is unclear which kind of interventional therapies is the best when treating early-stage hepatocellular carcinoma (HCC). We conducted Bayesian network meta-analyses to compare local tumor progression (LTP), total tumor recurrence and survival rates and to rank the best intervention arm. MATERIALS AND METHODS: A literature search of Pubmed, Embase, Cochrane library and Clinicaltrials.gov was conducted and randomized controlled trials (RCTs) comparing the outcomes of interventional therapies on early-stage HCC were enrolled. The quality assessment was conducted using Cochrane Collaboration's tool, while the outcome synthesis of the network meta-analysis was conducted using R-3.3.4 software. RESULTS: A total of 35 RCTs were enrolled for further analysis. Using network meta-analysis, it was demonstrated that radiofrequency ablation (RFA) plus adjuvant therapies achieved the best performance in decreasing the LTP rate in early-stage HCC, while hepatic resection ranked as the best arm among all the interventional techniques for LTP at 3 years. Meanwhile, hepatic resection and RFA plus adjuvant therapies were the top two best arms in decreasing total recurrence. Furthermore, RFA plus adjuvant therapeutics ranked the best in achieving overall survival outcome, followed by hepatic resection. For disease-free survival, hepatic resection was the best, while for LTP-free survival, the difference among the included treatments was not significant. CONCLUSIONS: Our network meta-analysis showed that RFA-based adjuvant therapies might be the most effective interventions in achieving the best outcomes, while hepatic resection exhibited the best performance in several situations in treating early-stage HCC. More RCTs are needed to draw more solid conclusions.

Protease-activated receptor 2 enhances renal cell carcinoma cell invasion and migration via PI3K/AKT signaling pathway.

Protease-activated receptor 2 (PAR-2) has been implicated in the regulation of several cellular functions in the progression of cancer. It is reported that PAR-2 expression is significantly increased in human renal cell carcinoma (RCC) tissue compared with the adjacent non-neoplastic kidney tissue. However, the function of PAR-2 in regulating cell invasion and migration of RCC remains elusive. In this study, we found that PAR-2 was overexpressed in RCC cells. Activation of PAR-2 with PAR-2AP (PAR-2 agonist) enhanced the invasion and migration of RCC cells, and increased the expressions of MMP-13 and urokinase plasminogen activator (uPA). However, knockdown of PAR-2 by siRNA could intervene in all regulating effects of PAR-2AP. Furthermore, activation of PAR-2 induced the activation of PI3K and AKT, and PI3K/AKT inhibitor LY294002 attenuated the invasion and migration of RCC cells stimulated by PAR-2 activation. Altogether, our study demonstrates that PAR-2 stimulates the activation of PI3K/AKT pathway, subsequently increasing the expressions of MMP-13 and uPA, and thereby promotes the invasion and migration of RCC cells.

A ternary nanocomposite electrode of polyoxometalate/carbon nanotubes/gold nanoparticles for electrochemical detection of hydrogen peroxide.

In this work, a nanocomposite film electrode containing polyoxometalate (POM) clusters K6P2W18O62 (P2W18), carbon nanotubes (CNTs) and Au nanoparticles (AuNPs) was fabricated by a smart combination of layer-by-layer (LbL) with the self-assembly technique. The synergistic effect of POM, CNTs and AuNPs on the electrocatalysis of H2O2 was investigated to improve the sensitivity of H2O2 detection. The response of (P2W18/CNTs/P2W18/AuNPs)4 electrodes to H2O2 was remarkably enhanced due to large active sites and good electron conducting ability. The sensor exhibited a quick response (less than 1 second) to H2O2 with a high sensitivity (596.1 µAm M(-1) cm(-2)), and a low detection limit (52 nM). Based on the respective advantages of POMs, CNTs and AuNPs, the nanocomposite multilayer POMs/CNTs/POMs/AuNPs will have special properties and high potential for application.

Neopterin concentrations in synovial fluid may reflect disease severity in patients with osteoarthritis.

We aimed to detect neopterin concentrations in serum and synovial fluid (SF) of knee osteoarthritis (OA) patients and to clarify their relationship with clinical severity of the disease. We cross-sectionally enrolled 176 knee OA patients and 63 age- and sex-matched controls. We measured neopterin concentrations by enzyme-linked immunosorbent assay (ELISA) and investigated the correlation between serum/SF neopterin concentrations and Kellgren-Lawrence (KL) grades as well as Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores in OA patients. Our results demonstrated that increased SF neopterin concentrations were independently correlated with greater symptomatic and radiographic severity in OA patients. These results suggested a crucial role of neopterin activation in the development and progression of knee OA. Assessment of neopterin levels in SF is a potential biomarker to evaluate disease severity in OA patients.

Recent advances in sonodynamic immunotherapy.

Tumor immunotherapy has become an important means of tumor therapy by enhancing the immune response and triggering the activation of immune cells. However, currently, only a small number of patients respond to immunotherapy alone, and patients may experience immune-related adverse events (irAEs) during the course of treatment. Sonodynamic therapy (SDT) can produce cytotoxic substances to tumor tissue, induce apoptosis and enhance immunity. SDT combined with immunotherapy is considered a promising strategy for cancer treatment. In this mini review, we summarize the role of SDT in immunotherapy in recent years, including the application of SDT-triggered immunotherapy and the combination of SDT and immunotherapy.

Endogenous H2O2 Self-Replenishment and Sustainable Cascades Enhance the Efficacy of Sonodynamic Therapy.

Purpose: Sonodynamic therapy (SDT), with its high tissue penetration and noninvasive advantages, represents an emerging approach to eradicating solid tumors. However, the outcomes of SDT are typically hampered by the low oxygen content and immunosuppression in the tumor microenvironment (TME). Accordingly, we constructed a cascade nanoplatform to regulate the TME and improve the anti-tumor efficiency of SDT. Methods: In this study, we rationally design cascade nanoplatform by incorporating immunostimulant hyaluronic acid (HA) and sonosensitizer chlorin e6 (Ce6) on the polydopamine nanocarrier that is pre-doped with platinum nanozymes (designated Ce6/Pt@PDA-HA, PPCH). Results: The cascade reactions of PPCH are evidenced by the results that HA exhibits reversing immunosuppressive that converts M2 macrophages into M1 macrophages in situ, while producing H2O2, and then platinum nanozymes further catalyze the H2O2 to produce O2, and O2 produces abundant singlet oxygen (1O2) under the action of Ce6 and low-intensity focused ultrasound (LIFU), resulting in a domino effect and further amplifying the efficacy of SDT. Due to its pH responsiveness and mitochondrial targeting, PPCH effectively accumulates in tumor cells. Under LIFU irradiation, PPCH effectively reverses immunosuppression, alleviates hypoxia in the TME, enhances reactive oxygen species (ROS) generation, and enhances SDT efficacy for eliminating tumor cells in vivo and in vitro. Meanwhile, an in vivo dual-modal imaging including fluorescence and photoacoustic imaging achieves precise tumor diagnosis. Conclusion: This cascade nanoplatform will provide a promising strategy for enhancing SDT eradication against tumors by modulating immunosuppression and relieving hypoxia.

A computational prognostic model of lncRNA signature for clear cell renal cell carcinoma with genome instability.

Long non-coding RNAs (lncRNAs) play a critical role in genomic instability and prognosis of cancer patients, but the methods to identify genomic instability-related lncRNAs have yet to be established. In the present study, to assess the prognostic value of lncRNAs associated with genomic instability in clear cell renal cell carcinoma (ccRCC).A computational framework was established based on the mutation hypothesis and combined lncRNA expression and somatic mutation profiles of the ccRCC genome. Furthermore, a prognostic model was developed using the genome instability-derived lncRNA signature GILncSig based on three lncRNA genes (LINC02471, LINC01234, and LINC00460) and verified using multiple independent patient cohorts.This study established an effective computational method to study the role of lncRNAs in genomic instability, with potential applications in identifying new genomic instability-related cancer biomarkers.

The diagnostic value of imaging techniques for keratoacanthoma: A review.

Keratoacanthoma (KA) is a fast-growing skin tumor with solitary KA being the most common type. KAs rarely metastasize and subside spontaneously. Although histopathology is the gold standard for the diagnosis of KA, its histopathological features are sometimes difficult to distinguish from those of other skin tumors. Imaging studies have certain advantages in the preoperative diagnosis of KA; they not only show the exact shape of the lesion but can also accurately determine the extent of the lesion. Combined with histopathological examination, these findings help establish a diagnosis. By summarizing the imaging features of KA, this article aimed to improve radiologists' understanding of the disease and help in the clinical and differential diagnosis of KA.

The complete chloroplast genome sequence of Sloanea leptocarpa (Elaeocarpaceae) from China.

Sloanea leptocarpa Diels, 1931 of the Elaeocarpaceae is an endemic plant from China distributed in subtropical evergreen broad-leaved forests and an excellent ornamental tree. The only available chloroplast genomic resource of the genus at present is that of S. sinensis (Hance) Hemsl., 1900 from eastern China. Here, we report the complete chloroplast genome sequence of S. leptocarpa which is less common than S. sinensis. The complete chloroplast genome of S. leptocarpa is 158,077 bp in length, and shows quadripartite organization including a pair of inverted repeat regions (IRs) (24,963 bp) that is divided by a large single-copy (LSC) region (88,519 bp) and a small single-copy (SSC) region (19,632 bp). The circular chloroplast genome of S. leptocarpa contains 119 unique genes, composed of 74 protein-coding genes, 37 tRNA genes, and eight rRNA genes. Phylogenetic analysis involving 52 species with complete chloroplast genomes supported that S. leptocarpa is closely related to S. sinensis. This finding is in agreement with previous studies in which Elaeocarpaceae belongs to Oxalidales instead of Malvales and provides additional evidence for the monophyly of the Sloanea, a sister clade of the Elaeocarpus.

Associations between tumor grade, contrast-enhanced ultrasound features, and microvascular density in patients with clear cell renal cell carcinoma: a retrospective study.

Background: Clear cell renal cell carcinoma (ccRCC) comprises 70% of all renal cell carcinomas (RCCs). Currently, the most important prognostic factor for this type of carcinoma is the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade. However, nonsurgical methods are rarely used to determine a tumor's WHO/ISUP grade, thus limiting the development of nonsurgical therapies. Due to variations in microvascular density (MVD) at different stages of tumor growth, contrast-enhanced ultrasound (CEUS) features may provide a noninvasive method for evaluating the WHO/ISUP grade of ccRCC. Methods: In this study, we analyzed confirmed cases of ccRCC using CEUS features. We also used CD34 and CD31 antibodies to determine MVD. The heterogeneity of CD34 and CD31 expressions were used to determine different degrees of angiogenesis. Results: When compared to WHO/ISUP grade I/II (G1/G2) tumors, grade III/IV (G3/G4) tumors had reduced peak intensity (PI) (P=0.006), time to peak (TTP) (P<0.001), and relative enhancement percentage index (∆PI%) (P<0.001). However, the frequency of incomplete pseudocapsule (P=0.049) and slow wash-in (P=0.001) was significantly higher in G3/G4 tumors. A cut-off value of ∆PI% <33.15% (P<0.001) allowed identification of G3/G4 tumors with an area under the curve (AUC) of 0.80 [95% confidence interval (CI): 0.70 to 0.91) and a sensitivity of 80%. The mean CD34+ MVD (P<0.001) and CD31+ MVD (P<0.001) were significantly lower in G3/G4 tumors. A positive correlation was revealed between ∆PI% and MVD. There was a statistically significant difference in the density of undifferentiated vessels between the slow wash-in and fast wash-in cases (P<0.001). Conclusions: The features of CEUS are effective for differentiating G3/G4 tumors from G1/G2. There was a positive correlation detected between ∆PI% and MVD, and the density of undifferentiated vessels showed a significant difference between slow wash-in and fast wash-in cases. These findings indicate that CEUS can enable the sonographic visualization of tumor angiogenesis and thus be considered an acceptable method for the nonsurgical assessment of tumor microvascular distribution and grade.

Ultrasonography findings for the diagnosis of renal oncocytoma.

Renal oncocytomas are rare benign epithelial tumors of the kidney. However, they are easily misdiagnosed as renal cancers, resulting in unnecessary radical nephrectomy. This review summarizes the use of ultrasound for the diagnosis of renal oncocytomas. On two-dimensional grayscale ultrasound, renal oncocytomas appear as solid, well-defined, round or oval, and relatively isoechoic or slightly hyperechoic masses. On color Doppler flow imaging, the "spoke-wheel" sign is evident. On power Doppler flow imaging, renal oncocytomas show mixed penetrating and peripheral patterns. Renal oncocytomas usually appear as highly enhanced on contrast-enhanced ultrasound images, and irregular nonenhanced areas in larger tumors. This review will help sonographers recognize renal oncocytomas.

Application of family-involved smart medication management system in rural-dwelling middle-aged and older adult participants with chronic diseases: Management of chronic diseases in rural areas.

Management of patients with chronic diseases in rural areas and the use of medications need to be urgently addressed. Therefore, this study aimed to evaluate the efficacy of a family-involved smart medication management system for rural patients with chronic diseases. Between June and August 2021, 82 patients with chronic diseases were selected using convenience sampling from 2 county towns in Hebei Province, China. They were randomly divided into control (41 participants) and experimental (41 participants) groups. The control group was managed using a routine medication management model for chronic diseases. The experimental group was managed using a family-involved smart medication management system, in addition to the control group interventions. The groups were graded using the 8-item Morisky Medication Adherence Scale (MMAS-8), the Self-efficacy for Appropriate Medication Use Scale (SEAMS), the Medication Knowledge Assessment Questionnaire, and the Family Support Scale before the intervention and at 8 and 24 weeks after the intervention. Pre-intervention group differences were not statistically significant. At 8 weeks after the intervention, the control group showed no statistically significant differences in the MMAS-8, SEAMS, and Medication Knowledge Assessment scores pre-and post-intervention. These scores were higher in the experimental group than in the control group, with the post-intervention scores being higher than the pre-intervention scores. The MMAS-8, SEAMS, and Medication Knowledge Assessment scores for the experimental group were higher at 24 weeks than at 8 weeks; these scores were higher in the experimental group than in the control group. The experimental group also had higher family support scores than the control group; these scores were higher pre-intervention than post-intervention. A family-involved smart medication management system can effectively improve medication adherence, self-efficacy for appropriate medication use, medication knowledge assessment scores, and family support for rural middle-aged and older adult patients with chronic diseases.

Solar water oxidation using TaON-BiVO4 photoanodes functionalized with WO3.

Efficient solar-powered water oxidation over BiVO4-based anodes requires coupling photoactive semiconductors to improve inferior activity and stability. Herein, we examine how functionalization with coated tungsten trioxide WO3 affects the photoelectrocatalytic performance of TaON-BiVO4 photoanodes prepared by the doctor-blade method. The effects of the formation of the particularly-porous microstructure and PEC performance of the resulting anodes are explored. Significant enhancements were achieved in water oxidation photocurrent densities at 1.23 V (vs. RHE) with the use of TaON-BiVO4/WO3 photoanodes compared to unmodified TaON-BiVO4. All the composites and photoanodes were studied via numerous characterization methods. Besides, the formation process and probable transfer mechanism of photoinduced carriers were also investigated in detail.