Fano enhancement of SERS for rapid early diagnosis of colorectal cancer.

Patients benefit greatly from early detection of colorectal cancer, but present diagnostic procedures have high costs, low sensitivity, and low specificity. However, it is still difficult to develop a strategy that can effectively detect cancer early using high-throughput blood analysis. Fano resonance-boosted SERS platform label-free serum creates an effective diagnostic system at the point of care. We obtained 220 high-quality SERS serum spectral datasets from 88 healthy volunteers and 132 patients with colorectal cancer. The biomarker detected in serum was further evaluated using 100 colorectal cancer tissues and adjacent normal intestinal tissues collected from West China Biobanks, West China Hospital, Sichuan University. The results showed that in 97 out of 100 paired samples, the biomarkers were successfully detected using the SERS platform. This demonstrates that Fano resonance-based SERS is highly effective for diagnosing colorectal cancer.

Effect of Atorvastatin combined with Irbesartan in the treatment of early diabetic nephropathy.

Objective: To explore the effect of Atorvastatin combined with Irbesartan in the treatment of early diabetic nephropathy (DN). Methods: Clinical data from 153 patients with early DN, admitted to Huzhou Central Hospital from January 2020 to December 2022, was retrospectively selected. Patients were divided into two groups based on the treatment they received: patients received Irbesartan treatment alone were assigned to Irbesartan group (n=74); patients received Irbesartan combined with Atorvastatin were assigned to combined group (n=79). Levels of renal function indicators, renal fibrosis indicators, micro inflammatory status indicators, and incidence of adverse reactions were compared between the two groups before and after the treatment. Results: After the treatment, indicators of renal function, renal fibrosis and micro-inflammation in both groups significantly decreased compared to pretreatment levels (P<0.05), and were significantly lower in the combined group compared to Irbesartan group (P<0.05). There was no significant difference in the incidence of adverse reactions between the groups (P>0.05). Conclusions: Compared with Irbesartan alone, Atorvastatin combined with Irbesartan is more effective in the treatment of early DN. Combined treatment regimen is able to effectively reduces the micro-inflammatory state, improve renal function and fibrosis, and is not associated with the increased risk of adverse reactions.

Cpne1 deficiency preserves sperm motility under Ca2+ channel blockade.

Calcium ions (Ca2+) play crucial roles in sperm motility and fertilization. The copine (CPNE) family comprises several Ca2+-dependent phospholipid-binding proteins. Of these, CPNE1 is extensively expressed in mammalian tissues; however, its precise role in testicular development and spermatogenesis is yet to be fully characterized. In this study, we used proteomics to analyze testicular biopsies and found that levels of CPNE1 were significantly reduced in patients with non-obstructive azoospermia (defective spermatogenesis) compared to those in patients with obstructive azoospermia (physiological spermatogenesis). In mice, CPNE1 is expressed at various stages of germ cell development and is associated with the Golgi apparatus. Ultimately, CPNE1 is expressed in the flagella of mature sperms. To further examine the role of CPNE1, we developed a Cpne1 knockout mouse model. Analysis showed that the loss of Cpne1 did not impair testicular development, spermatogenesis, or sperm morphology and motility in physiological conditions. When treated with gadolinium (III) chloride or 2-aminoethoxydiphenyl borate, known inhibitors of store-operated Ca2+ entry, Ca2+ signals and sperm motility were significantly compromised in wild-type mice; however, both mechanisms were conserved in KO mice. These results suggested that CPNE1 is dispensable for testicular development, spermatogenesis or sperm motility in physiological conditions. In addition, CPNE1 may represent a target of Ca2+ channel inhibitors and may therefore be implicated in the regulation of Ca2+ signaling and sperm motility.

Death Caused by Disseminated Herpes Zoster in a Patient with Multiple Myeloma: A Case Report and Literature Review.

We report a fatal case of disseminated herpes zoster in a patient with multiple myeloma, illustrating the severe risks immunocompromised individuals face from viral infections. By combining a detailed case report with an extensive literature review, the paper seeks to shed light on the underlying susceptibility factors for varicella-zoster virus infection in multiple myeloma patients. We further evaluate effective prophylactic protocols for herpes zoster, aiming to equip clinicians with improved therapeutic strategies. The case underscores the critical need for vigilant clinical assessments and tailored patient management to mitigate infection risks and enhance patient outcomes.

A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy.

PURPOSE: To compare the effectiveness of 577nm subthreshold micropulse laser (SML) with half-dose photodynamic therapy (Hd-PDT) for acute central serous chorioretinopathy (CSC). METHOD: A non-inferiority clinical trial was performed with a non-inferiority margin of eight letters. Sixty-eight eyes of 68 patients with acute CSC were randomized to the Hd-PDT group or 577 nm SML group. Best-corrected visual acuity (BCVA ), the subretinal fluid (SRF), and the central foveal thickness (CFT) were evaluated at 6 months. RESULTS: The visual acuity significantly improved from 70.38 ± 10.37 at baseline to 83.24 ± 3.03 at 6 months after treatment in the SML group (P < 0.001), from 71.09 ± 10.50 to 84.35 ± 2.09 in the PDT group (P < 0.001). SML was non-inferior to the PDT (mean difference: -0.41, 95% CI: -5.51 - 4.68, P = 0.0021). At the endpoint, CFT was significantly reduced in the two groups, but no statistical difference (P = 0.7694). The complete resolution of SRF reached 82.35% (28/34) in the SML group and 91.18% (31/34) in the PDT group, respectively,but no statistical difference (P = 0.3724). CONCLUSIONS: SML was non-inferiority to half-dose PDT in improving the visual acuity for CSC, and it is a viable alternative, especially when the verteporfin in PDT is unavailable.

Association between hearing loss and physical performance in patients on maintenance hemodialysis.

BACKGROUND: The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. METHODS: This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. RESULTS: Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = -0.356, p < 0.001 and r = -0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73-1.81), 1.69 (1.07-2.70), and 2.87 (1.69-4.88) (p for trend = 0.005). CONCLUSION: Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.

Successful Treatment of Recurrent Adult-Onset Still's Disease with Tocilizumab: A Case Report and Literature Review.

Adult-onset Still's disease (AOSD) is considered a rare autoimmune inflammatory disorder with an unclear etiology and pathogenesis.The main clinical manifestations of this disease are high fever, joint pain, and transient skin lesions. Physical examination may reveal hepatomegaly, splenomegaly, and lymphadenopathy, while laboratory tests show abnormalities such as elevated white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum ferritin (SF). The lack of specific diagnostic markers contributes to a relatively high rate of clinical misdiagnosis and missed diagnoses.In terms of treatment, glucocorticoids have always been the cornerstone medication, but some patients exhibit suboptimal responses to conventional drug therapy, making disease control challenging. However, as our understanding of the pathogenesis continues to grow, novel therapeutic approaches targeting various cytokines have been gradually identified. In this report, we present a case of successful treatment of recurrent AOSD with tocilizumab (TCZ), along with a concise review of innovative treatment strategies for AOSD based on literature retrieval.

Efficacy and safety of laser-related therapy for melasma: A systematic review and network meta-analysis.

BACKGROUND: Melasma is a prevalent, persistent hyperpigmentation disorder that negatively affects the psychological health of patients. However, the treatment outcome remains unsatisfactory due to the complexity of pathogenesis, recurrence characteristics, and relatively high morbidity. OBJECTIVES: To compare the performance of laser-related therapies in improving the melasma area severity index (MASI) score of melasma and the occurrence of adverse effects by network meta-analysis (NMA). METHODS: From the inception to November 2022, eligible randomized controlled trials were identified. Two investigators independently searched relevant studies from PUBMED, EMBASE, and the Cochrane Library database. RESULTS: A total of 39 clinical studies with 1394 participants were eligible for enrollment. For efficacy, the NMA demonstrated that Q-switched Nd: YAG laser + topical medications (QSND+TM) was superior to Q-switched Nd:YAG laser (QSND) [MD = -4.21 (-6.80, -1.63)], Er: YAG laser + topical medications (ERYL+TM) [MD = -3.52 (-6.84, -0.19)], and picosecond laser + topical medications (PICO+TM) [MD = -4.80 (-9.33, -0.27)]. The microneedling + topical medications (MN+TM) was superior to picosecond laser (PICO) [MD = -5.26 (-10.44, -0.08)] and topical medications (TM) [MD = -5.22 (-9.20, -1.23)]. The top five of the surface under the cumulative ranking curve value (SUCRA) are Q-switched Nd:YAG laser + topical medications (QSND+TM 85.9%), oral tranexamic acid (oTA 80.1%), microneedling + topical medications (MN+TM 79.7%), Q-switched Nd:YAG laser + intense pulse light (QSND+IPL 78.9%), and fractional carbon dioxide laser + topical medications (FCDL+TM 70.5%). CONCLUSIONS: In conclusion, the Qs-Nd:YAG laser with topical medications is the first choice for treating melasma according to the SUCRA value. Among the three treatment modalities, namely MN + TM, PICO, and TM, our recommendation favors MN+TM as the superior choice for enhancing the curative efficacy in melasma. However, the actual clinical choice should also take into account the adverse effects, the skin type of the patient, the duration of the disease, and other relevant factors.

Artificial intelligence-assisted dermatology diagnosis: From unimodal to multimodal.

Artificial Intelligence (AI) is progressively permeating medicine, notably in the realm of assisted diagnosis. However, the traditional unimodal AI models, reliant on large volumes of accurately labeled data and single data type usage, prove insufficient to assist dermatological diagnosis. Augmenting these models with text data from patient narratives, laboratory reports, and image data from skin lesions, dermoscopy, and pathologies could significantly enhance their diagnostic capacity. Large-scale pre-training multimodal models offer a promising solution, exploiting the burgeoning reservoir of clinical data and amalgamating various data types. This paper delves into unimodal models' methodologies, applications, and shortcomings while exploring how multimodal models can enhance accuracy and reliability. Furthermore, integrating cutting-edge technologies like federated learning and multi-party privacy computing with AI can substantially mitigate patient privacy concerns in dermatological datasets and further fosters a move towards high-precision self-diagnosis. Diagnostic systems underpinned by large-scale pre-training multimodal models can facilitate dermatology physicians in formulating effective diagnostic and treatment strategies and herald a transformative era in healthcare.

Stochastic Stabilization of Dual-Layer Rumor Propagation Model with Multiple Channels and Rumor-Detection Mechanism.

With the development of information technology, individuals are able to receive rumor information through various channels and subsequently act based on their own perceptions. The significance of the disparity between media and individual cognition in the propagation of rumors cannot be underestimated. In this paper, we establish a dual-layer rumor propagation model considering the differences in individual cognition to study the propagation behavior of rumors in multiple channels. Firstly, we obtain the threshold for rumor disappearance or persistence by solving the equilibrium points and their stability. The threshold is related to the number of media outlets and the number of rumor debunkers. Moreover, we have innovatively designed a class of non-periodic intermittent noise stabilization methods to suppress rumor propagation. This method can effectively control rumor propagation based on a flexible control scheme, and we provide specific expressions for the control intensity. Finally, we have validated the accuracy of the theoretical proofs through experimental simulations.

Non responsible vascular area hyperperfusion syndrome after mechanical thrombectomy for vertebral artery occlusion: A case report.

Introduction: There are currently no published reports of hyperperfusion syndrome in the non responsible vascular area after mechanical thrombectomy for acute cerebral infarction with large vessel occlusion. Here, we report a case of hyperperfusion syndrome in the blood supply area of the right middle cerebral artery after mechanical thrombectomy for acute cerebral infarction after vertebral artery occlusion. Patient concerns: A 21-year-old woman developed left vertebral artery occlusion, for which she received mechanical thrombectomy and successful recanalization of her occluded cerebral vessel. Subsequently, the patient became extremely agitated, with high blood pressure and headache. Diagnosis: Two hours after the operation, bedside transcranial Doppler ultrasound examination found that the cerebral blood flow velocity of the M1 segment of the right middle cerebral artery was more than twice that of the left middle cerebral artery. Combined with the symptoms, signs and examination results of the patient, hyperperfusion syndrome in the blood supply area of the right middle cerebral artery was considered. Interventions: The patient was administered sedation, and her pressure and ventricular rate were strictly controlled. She was no longer agitated, and her headache was significantly relieved at 36 hours after the operation. Outcomes: On the 5th day after the operation, the blood flow velocity of her right middle cerebral artery decreased to normal level, and the patient recovered well. Conclusion: In this case, after mechanical thrombectomy, such patients with acute posterior circulation cerebral infarction can experience hyperperfusion syndrome in the non responsible vascular area of the anterior circulation. Bedside transcranial Doppler cerebral blood flow examination can identify the hyperperfusion state of cerebral vessels in a timely manner and effectively guide treatment.

Twenty-year outcome in neovascular age-related macular degeneration treated with photodynamic therapy and intravitreal bevacizumab/ranibizumab injections: A case report.

A 64-year-old female presented with acute painless vision loss in the left eye was diagnosed with neovascular age-related macular degeneration. During the 20-year follow-up, the patient experienced subretinal fluid, subretinal hemorrhage, pigmentary epithelium detachment, intraretinal fluid, subretinal scar formation and macular atrophy. A total of 3 PDT treatments, 3 intravitreal bevacizumab and 16 ranibizumab injections were performed in the left eye. At the last visit, she remained best-corrected visual acuity of 20/200 with foveal macular atrophy and subfoveal fibrotic scar.

Investigating the Effects of Anatomical Structures on the Induced Electric Field in the Brain in Transcranial Magnetic Stimulation.

Transcranial magnetic stimulation (TMS) is capable of stimulating neurons in the brain non-invasively and provides numerous possibilities for the treatment of various neurological disorders such as major depressive disorder, Parkinson's disease, obsessive compulsive disorder. TMS coils can affect the distribution of induced electric fields significantly, thus the design of TMS coils is always a popular topic in TMS studies. Yet the importance of the role of anatomical structures in the induced electric field has not been thoroughly investigated. Therefore, this work has compared the strength of electric fields induced from fifty realistic head models with twelve commercial or novel TMS coils to explore how anatomical structures affect the electric field. It has been found that the electric field strengths among the fifty head models showed highly correlated patterns. The coils were placed at two positions, where all the twelve coils were placed at the vertex and eight of them were placed at the dorsolateral prefrontal cortex of the head due to the coil geometry. Notably, fifty heterogeneous head models that are derived from MRI data were used in the simulations for examining the difference on the performance of TMS coils caused by different anatomical structures. A total of one thousand simulations have been conducted, providing a large amount of data for analysis. Clinical Relevance- This provides a basis to make treatment protocols or predictions in TMS clinical trials considering the different anatomical structures among subjects.

The immunoregulatory effects of natural products on psoriasis via its action on Th17 cells versus regulatory T cells balance.

Psoriasis is an incurable, chronic inflammatory disease, which brings a substantial burden on individuals and society. Currently, the treatment of psoriasis has entered the era of biologics, but its highly targeting of inflammatory mediators may enable the immune response to circumvent the blockade, leading to disease recurrence, or other clinical and immunological characteristics. Therefore, the discovery of new therapies that have the ability of multidirectional regulation on immunity and maintain the dynamic balance of immunity in psoriasis, may be the key to the treatment of the disease. Natural products extracted from herbal medicines have synergistic effects to alleviate psoriasis and its comorbidities because of their structural diversity and multiple active mechanisms. To date, the characteristics of natural products regulating T helper 17 (Th17) cells/regulatory T (Treg) cells balance in the treatment of psoriasis have attracted more and more attention from basic and clinical studies. In this review, we systematically introduced the natural products regulating the balance of Th17/Treg and their specific mechanism of action, finding Datura metel L, Grape seed proanthocyanidin extract (GSPE), Thymol, Kaempferol, Aloperine, Abietic acid (AA), Isogarcinol, Luteolin reduced the frequency and function of Th17 cells and simultaneously increased that of Treg cells. It is expected that our work can provide a reference for clinicians in drug use.

Association of thyroid function abnormality and prognosis in non-small-cell lung cancer patients treated with PD-1 inhibitors.

Background: Thyroid function abnormality (TFA) is one of the most common toxicities in non-small-cell lung cancer (NSCLC) patients receiving immune checkpoint inhibitors. However, the risk factors related to TFA and the relationship between TFA and prognosis in NSCLC are not fully clarified. Methods: We conducted a retrospective study of patients with advanced NSCLC who were treated with PD-1 inhibitors in Huzhou Central Hospital. Thyroid function test was carried out using electrochemiluminescent bridging immunoassay. The association between TFA and clinical outcome was investigated. Results: A total of 273 patients were included in this study. Patients who experienced TFA had longer progression-free survival (21.9 vs 6.4 months; p < 0.001) and overall survival (44.6 vs 24.1 months; p = 0.02) than patients without TFA. After multivariate analysis, TFA was an independent prognostic factor for progression-free and overall survival (p < 0.05). Conclusion: TFA is associated with better outcome in NSCLC patients who receive immunotherapy.

Many patients with non-small-cell lung cancer are treated with immunotherapy, a type of treatment that uses the body's natural immune system to fight diseases. We conducted a retrospective study of advanced non-small-cell lung cancer patients who were treated with PD-1 inhibitors (a type of immunotherapy) in Huzhou Central Hospital. Thyroid function abnormality (TFA) is one of the common toxicities in patients receiving PD-1 inhibitors. Our study showed that patients who experienced TFA have longer survival times compared with patients without TFA (overall survival, 44.6 vs 24.1 months; p = 0.02). TFA could be an effective predictor of outcome in non-small-cell lung cancer cases being treated with immunotherapy.

Klotho/FGF23 and Wnt in SHPT associated with CKD via regulating miR-29a.

OBJECTIVE: Recently, the interaction between Klotho/fibroblast growth factor 23 (FGF-23) axis and Wnt signaling has been recognized to be responsible for chronic kidney disease (CKD)-associated comorbidities, including secondary hyperparathyroidism (SHPT). This study aimed to investigate the molecular mechanism of the interaction between Klotho/FGF23 axis and Wnt. METHODS: A SHPT model was successfully established with a high-phosphorus diet plus 5/6 nephrectomy. Cell counting Kit-8 (CCK-8) assay and calcium deposit experiment were applied to detect the proliferation and calcium levels. Quantitative real-time PCR (qRT-PCR), Western blotting and immunofluorescence (IF) were used to determine the expression or location of FGF23, calcification-related factors and ß-catenin after lentivirus-mediated Klotho overexpression. Luciferase reporter assay was performed to further validate the transcriptional regulation between microRNA-29a (miR-29a) and Dickkopf-1 (DDK1). RESULTS: We found increased serum biochemical factors including parathyroid hormone (PTH), phosphorus, calcium, enhanced parathyroid calcification, and decreased expressions of Klotho in a rat model of secondary hyperparathyroidism. Moreover, genetic-induced upregulation of Klotho inhibited the proliferation, reduced the calcification and the alkaline phosphatase (ALP) activity, and downregulated Wnt/ß-catenin signaling in parathyroid cells. CONCLUSIONS: Mechanistically, Klotho suppressed miR-29a expression, led to upregulated expression of Wnt/ß-catenin signaling inhibitor DKK1, and finally downregulated the activity of Wnt/ß-catenin signaling. These findings suggest a novel molecular mechanism in the pathogenesis of CKD-associated SHPT, which provides a potential therapeutic target in the future.

A Novel Epidemic Model Base on Pulse Charging in Wireless Rechargeable Sensor Networks.

As wireless rechargeable sensor networks (WRSNs) are gradually being widely accepted and recognized, the security issues of WRSNs have also become the focus of research discussion. In the existing WRSNs research, few people introduced the idea of pulse charging. Taking into account the utilization rate of nodes' energy, this paper proposes a novel pulse infectious disease model (SIALS-P), which is composed of susceptible, infected, anti-malware and low-energy susceptible states under pulse charging, to deal with the security issues of WRSNs. In each periodic pulse point, some parts of low energy states (LS nodes, LI nodes) will be converted into the normal energy states (S nodes, I nodes) to control the number of susceptible nodes and infected nodes. This paper first analyzes the local stability of the SIALS-P model by Floquet theory. Then, a suitable comparison system is given by comparing theorem to analyze the stability of malware-free T-period solution and the persistence of malware transmission. Additionally, the optimal control of the proposed model is analyzed. Finally, the comparative simulation analysis regarding the proposed model, the non-charging model and the continuous charging model is given, and the effects of parameters on the basic reproduction number of the three models are shown. Meanwhile, the sensitivity of each parameter and the optimal control theory is further verified.

Emergency thrombectomy for cerebrovascular occlusion in a patient with mirror-image dextrocardia: a case report.

Cases of patients complicated with dextrocardia who suffer from acute cerebral infarction with large vessel occlusion and receive emergency thrombectomy are particularly rare and have not been widely reported. This article aimed to increase the awareness and knowledge of these cases. We report the case of a patient with mirror-image dextrocardia who suffered from cerebral infarction with large vessel occlusion and received emergency thrombectomy. A male patient in his early 60s with dextrocardia had acute cerebral infarction with posterior circulation large vessel occlusion and underwent emergency thrombectomy. During the operation, the rapid confirmation of dextrocardia and use of flexible interventional instruments helped establish a pathway for blood flow. We used an intracranial thrombectomy stent and intracranial balloon dilation catheter to restore the cerebral blood supply. The Modified Rankin Scale score was 0 at 3 months after thrombectomy, indicating a good prognosis of the patient. Acute cerebral infarction with large vessel occlusion in patients with dextrocardia is extremely rare. Emergency thrombectomy is feasible to recanalize cerebral blood flow and give patients a chance to recover.