Clinical application

临床应用
  • 文章类型: Journal Article
    2022年,胆道闭锁及相关疾病(BARD)社区就肝肠造口术(HPE)后胆道闭锁(BA)患者的可疑和确诊胆管炎的定义达成共识。本研究回顾性评估了新的标准化BARD定义,多中心队列研究。
    我们纳入了2010年至2020年在汉诺威医学院和日内瓦大学医院/瑞士小儿肝脏中心管理的BA病例。标准化的BARD胆管炎定义评估了四个临床项目和四个成像/实验室项目来定义胆管炎。该定义回顾性适用于所有已提交的BA病例,根据他们的医生,HPE后第一年内的胆管炎。将由标准化BARD定义定义的诊断与医生做出的最终临床诊断进行比较。Spearman相关系数用于检验标准化诊断与临床评估之间的相关性。
    在185名连续的BA患者中,59(32%)在HPE后的第一年内至少发生过一次胆管炎。临床医生的印象和标准化的BARD定义之间的相关性非常强(r=0.8)。胆管炎的定义与临床医生的印象一致(2.5[±0.7]/4临床项目,2.6[±0.5]/4成像/实验室项目)。疑似胆管炎,在标准化的BARD定义中,诊断阈值较低(1.1[±0.3]/4临床项目,2.2[±0.8]/4个实验室/成像项目)。
    标准化BARD胆管炎定义的首次回顾性应用揭示了与标准化前医师评估的非常强的相关性。需要进行前瞻性研究以进一步完善BA患者胆管炎的标准化定义。
    UNASSIGNED: In 2022, the Biliary Atresia and Related Diseases (BARD) community reached a consensus for the definition of suspected and confirmed cholangitis for biliary atresia (BA) patients after hepatoportoenterostomy (HPE). This study assessed the new standardized BARD definition in a retrospective, multicenter cohort study.
    UNASSIGNED: We included BA cases managed between 2010 and 2020 at the Hannover Medical School and Geneva University Hospitals\' Swiss Pediatric Liver Center. The standardized BARD cholangitis definition assesses four clinical items and four imaging/laboratory items to define cholangitis. The definition was retrospectively applied to all BA cases having presented, according to their physician, cholangitis within the first year after the HPE. The diagnosis defined by the standardized BARD definition was compared with the final clinical diagnosis made by physicians. The Spearman\'s correlation coefficient was used to test for correlation between diagnoses made by standardized and clinical appreciation.
    UNASSIGNED: Of 185 consecutive BA patients, 59 (32%) had at least one episode of cholangitis within the first year after HPE. The correlation between the clinician\'s impression and the standardized BARD definition was very strong (r = 0.8). Confirmed cholangitis definition coincided with the clinician\'s impression (2.5 [±0.7]/4 clinical items, 2.6 [±0.5]/4 imaging/laboratory items). For suspected cholangitis, the threshold for diagnosis was lower within the standardized BARD definition (1.1 [±0.3]/4 clinical items, 2.2 [±0.8]/4 laboratory/imaging items).
    UNASSIGNED: This first retrospective application of the standardized BARD cholangitis definition reveals a very strong correlation with the physician\'s assessment before standardization. A prospective study is needed to further refine the standardized definition for cholangitis in BA patients.
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  • 文章类型: Journal Article
    癌症基因组学已经发现了许多癌基因和抑癌基因,它们在癌症的发生和发展中起着关键作用。癌基因促进细胞生长和增殖,而肿瘤抑制基因抑制细胞生长和分裂。这些基因的失调可导致癌症的发展。最近的研究集中在非编码RNA(ncRNAs),包括环状RNA(circularRNA),长链非编码RNA(lncRNA),和microRNA(miRNA),作为癌症的治疗靶点。在这篇文章中,我们讨论了与不同类型癌症相关的ncRNAs的癌基因和抑癌基因及其作为治疗靶点的潜力。这里,我们重点介绍了这些基因的作用机制及其在癌症治疗中的临床应用。了解癌症发展的分子机制和确定特定的治疗靶标是发展有效癌症治疗的重要步骤。
    Cancer genomics has led to the discovery of numerous oncogenes and tumor suppressor genes that play critical roles in cancer development and progression. Oncogenes promote cell growth and proliferation, whereas tumor suppressor genes inhibit cell growth and division. The dysregulation of these genes can lead to the development of cancer. Recent studies have focused on non-coding RNAs (ncRNAs), including circular RNA (circRNA), long non-coding RNA (lncRNA), and microRNA (miRNA), as therapeutic targets for cancer. In this article, we discuss the oncogenes and tumor suppressor genes of ncRNAs associated with different types of cancer and their potential as therapeutic targets. Here, we highlight the mechanisms of action of these genes and their clinical applications in cancer treatment. Understanding the molecular mechanisms underlying cancer development and identifying specific therapeutic targets are essential steps towards the development of effective cancer treatments.
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  • 文章类型: Journal Article
    肥大细胞(MC)是广泛分布在人体组织中的骨髓来源的造血细胞。激活时,它们会释放类胰蛋白酶,组胺和其他在各种疾病/紊乱中起主要作用的介质,包括过敏,炎症,心血管疾病,自身免疫性疾病,癌症,甚至死亡。MC的多种病理效应使其稳定剂成为治疗相关疾病的研究热点。迄今为止,临床上可用的MC稳定剂有限.考虑到MC相关疾病的发病率迅速增加和广泛流行,临床医生或研究人员需要一个全面的参考来识别和选择有效的MC稳定剂。这篇综述分析了MC激活的机制,并总结了迄今为止在MC稳定剂开发方面取得的进展。MC稳定剂按作用机理分类,包括作用于细胞表面受体,干扰信号转导途径和干扰胞吐系统。特别强调MC稳定剂的临床应用和未来发展方向。
    Mast cells (MCs) are bone-marrow-derived haematopoietic cells that are widely distributed in human tissues. When activated, they will release tryptase, histamine and other mediators that play major roles in a diverse array of diseases/disorders, including allergies, inflammation, cardiovascular diseases, autoimmune diseases, cancers and even death. The multiple pathological effects of MCs have made their stabilizers a research hotspot for the treatment of related diseases. To date, the clinically available MC stabilizers are limited. Considering the rapidly increasing incidence rate and widespread prevalence of MC-related diseases, a comprehensive reference is needed for the clinicians or researchers to identify and choose efficacious MC stabilizers. This review analyzes the mechanism of MC activation, and summarizes the progress made so far in the development of MC stabilizers. MC stabilizers are classified by the action mechanism here, including acting on cell surface receptors, disturbing signal transduction pathways and interfering exocytosis systems. Particular emphasis is placed on the clinical applications and the future development direction of MC stabilizers.
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  • 文章类型: Journal Article
    贝母(FRU)属于百合科贝母属。它是中药材“川北木”的原始植物之一,也是中国青藏高原的生物资源。FRU的干球茎用于中药。已分离和鉴定的FRU的化学成分包括生物碱,固醇,有机酸及其酯,核苷和挥发油。FRU有镇咳,祛痰药,抗哮喘,抗炎,抗菌,减少急性肺损伤,抗纤维化,抗肿瘤,和其他药理作用。这种珍贵的植物具有极高的市场需求,多年来,由于过度开发,FRU现在已被列为关键物种,在中国作为传统中草药几乎没有种植。然而,对FRU的研究很少,及其有效成分,资源控制,和作用机制需要进一步研究。这篇综述系统地讨论了中草药的特点,资源分配,化学成分,生物合成,药理作用,临床应用,和FRU的育种技术,希望为FRU的进一步研究和使用提供参考。
    Fritillaria unibracteata (FRU) belongs to the genus Fritillaria of the Liliaceae family. It is one of the original plants of the Chinese medicinal material \"Chuanbeimu\" and also a biological resource featured in the Tibetan Plateau of China. The dried bulbs of FRU are used in traditional Chinese medicine. The chemical constituents of FRU that have been isolated and identified include alkaloids, sterols, organic acids and their esters, nucleosides and volatile oils. FRU has antitussive, expectorant, anti-asthmatic, anti-inflammatory, antibacterial, acute lung injury-reducing, antifibrosis, antitumor, and other pharmacological effects. This valuable plant has an extremely high market demand, and over the years, due to over-exploitation, FRU has now been listed as a key species that is endangered and scarcely cultivated in China as a traditional Chinese medicinal herb. However, research on FRU is rare, and its effective components, resource control, and mechanisms of action need further study. This review systematically discusses the herbal characteristics, resource distribution, chemical composition, biosynthesis, pharmacological effects, clinical application, and breeding techniques of FRU, hoping to provide a reference for further research and the use of FRU.
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  • 文章类型: Journal Article
    该评论整合了过去5-7年报道的一些黄芪(Fabaceae)物种的成分组成和生物活性的信息。34种黄芪的地上和地下部分含有三萜皂苷,黄酮类化合物,多糖类,单宁,游离有机酸,高级脂肪酸,维生素,微量元素,和其他选民。在黄芪物种中,A.膜质(费希。)Bunge在成分组成和生物活性方面进行了最好的研究。抗炎,免疫调节,抗氧化剂,抗癌,心脏保护,并且在总生物活性物质中已经通过实验检测到了血液保护活性,分数,以及从各种膜虫和膜虫中提取的单个化合物。Mongholicus在体外和体内。其他黄芪属物种的组成和生物学效应仍然知之甚少。本文综述了近年来从黄芪中提取的新化合物及其生物学活性的研究进展。
    The review integrates information on the component composition and biological activity of some Astragalus L. (Fabaceae) species from studies reported over the past 5-7 years. The aerial and underground parts of 34 Astragalus species contain triterpene saponins, flavonoids, polisaccharides, tannins, free organic acids, higher fatty acids, vitamins, trace elements, and other constituents. Among the Astragalus species, A. membranaceus (Fisch.) Bunge is the best studied in terms of component composition and biological activity. Anti-inflammatory, immunomodulatory, antioxidant, anticancer, cardioprotective, and hepathoprotective activities have been experimentally detected in total bioactive substances, fractions, and individual compounds extracted from various parsts of A. membranaceus and A. membranaceus var. mongholicus in vitro and in vivo. The composition and biological effects of other Astragalus species are still poorly understood. The review summarizes the recent advances in studying new compounds extracted from Astragalus species and their biological activities.
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  • 文章类型: Journal Article
    多年生草本植物乌头草Nakai(毛茸茸科)在中国已被用作传统的东方药物多年。A.sinomontanum的主要药理成分,高乌甲素(LA),表现出镇痛药,抗炎,抗肿瘤,抗心律失常,和抗癫痫活性。由于其强大的功效和非成瘾性质,LA广泛用于治疗癌症疼痛和术后镇痛。这篇综述涵盖了与LA有关的研究进展,包括提取方法,分离技术,药理学性质,化学修饰,和临床应用。此外,它提供了与LA相关的潜在应用和当前挑战的见解,以促进未来的研究工作。
    The perennial herb Aconitum sinomontanum Nakai (Ranunculaceae) has been utilized as a traditional oriental medicine in China for numerous years. The principal pharmacological constituent of A. sinomontanum, lappaconitine (LA), exhibits analgesic, anti-inflammatory, anti-tumor, anti-arrhythmic, and anti-epileptic activities. Due to its potent efficacy and non-addictive nature, LA is widely utilized in the management of cancer pain and postoperative analgesia. This review encompasses the research advancements pertaining to LA including extraction methods, separation techniques, pharmacological properties, chemical modifications, and clinical applications. Additionally, it offers insights into the potential applications and current challenges associated with LA to facilitate future research endeavors.
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  • 文章类型: Journal Article
    最近,来自间充质干细胞(MSC)的细胞外囊泡(EV)的治疗潜力已在人类和兽医学中得到广泛研究。EV是包含通常在其他生物材料中发现的生物组分的纳米尺寸的颗粒。出于这个原因,电动汽车的隔离和表征对于在调查期间得出准确的结论至关重要。兽医领域的电动汽车研究仍处于早期阶段,然而,近年来发表了许多论文。用于衍生MSC的常规成人组织包括脂肪组织和骨髓。尽管如此,替代来源,如滑液,子宫内膜,牙龈,和牛奶也被间歇性地使用。胎儿附件是羊膜/液体,脐带和沃顿的果冻。来自胎儿附件的细胞表现出胚胎和成体细胞之间的中间状态,与成年组织细胞相比,具有更高的增殖和分化潜能和更长的端粒。这里总结了主要的和最近的临床前和临床研究在家畜如马,牛,狗和猫尽量减少抗生素的使用,并解决作为公共卫生问题的抗生素耐药性这一严重问题,毫无疑问,它们将来也将用于治疗家畜的感染。一些担忧,包括电动汽车分离和表征技术标准化的大规模生产,必须解决临床应用。
    Recently, the therapeutic potential of extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) has been extensively studied in both human and veterinary medicine. EVs are nano-sized particles containing biological components commonly found in other biological materials. For that reason, EV isolation and characterization are critical to draw precise conclusions during their investigation. Research on EVs within veterinary medicine is still considered in its early phases, yet numerous papers were published in recent years. The conventional adult tissues for deriving MSCs include adipose tissue and bone marrow. Nonetheless, alternative sources such as synovial fluid, endometrium, gingiva, and milk have also been intermittently used. Fetal adnexa are amniotic membrane/fluid, umbilical cord and Wharton\'s jelly. Cells derived from fetal adnexa exhibit an intermediate state between embryonic and adult cells, demonstrating higher proliferative and differentiative potential and longer telomeres compared to cells from adult tissues. Summarized here are the principal and recent preclinical and clinical studies performed in domestic animals such as horse, cattle, dog and cat. To minimize the use of antibiotics and address the serious issue of antibiotic resistance as a public health concern, they will undoubtedly also be utilized in the future to treat infections in domestic animals. A number of concerns, including large-scale production with standardization of EV separation and characterization techniques, must be resolved for clinical application.
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  • 文章类型: Journal Article
    探讨3D切片器重建和3D打印定位联合经颅神经内镜在脑深部微小海绵状血管瘤手术治疗中的优缺点。方法回顾性分析我院2022年6月至2023年2月采用3D切片器重建和3D打印定位技术联合经颅内镜手术治疗的脑深部微海绵状血管瘤患者的临床资料。共收集5例资料完整,包括2名男性和3名女性,9-59岁。5例患者均为深幕上海绵状血管瘤,直径小于1.5cm,有头痛或癫痫等临床症状,并通过CT或MRI诊断。脑深部小海绵状血管瘤反复出血可导致临床症状,如反复发作的头痛和癫痫,需要手术治疗。然而,海绵状血管瘤通常有较小的病变,很难在深部定位。没有神经导航,手术可能变得极其困难。我们的团队新开发的3D切片器重建和3D打印定位技术,可以为小型海绵状血管瘤或其他脑深部小病变的手术治疗提供新的选择。但其准确性和安全性仍需进一步的临床研究验证。
    To explore the advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization combined with transcranial neuroendoscope in the surgical treatment of deep cerebral micro cavernous hemangiomas. Method The clinical data of patients with deep cerebral micro cavernous hemangiomas treated by our hospital from June 2022 to February 2023 using 3D Slicer reconstruction and 3D printing localization technology combined with transcranial endoscopic surgery were retrospectively analyzed. A total of 5 cases with complete data were collected, including 2 males and 3 females, aged 9-59 years. All 5 patients had deep supratentorial cavernous hemangiomas with a diameter of less than 1.5 cm, and had clinical symptoms such as headache or epilepsy, and had been diagnosed by CT or MRI. Repeated bleeding from small cavernous hemangiomas in the deep brain can lead to clinical symptoms such as recurrent headache and epilepsy, and is required surgical treatment. However, cavernous hemangiomas often have smaller lesions and are difficult to locate in the deep part. Without neuronavigation, surgery can become extremely difficult. Our team\'s newly developed 3D Slicer reconstruction and 3D printing localization technology which could provide new options for surgical treatment of small cavernous hemangiomas or other small lesions in the deep brain, but its accuracy and safety still need to be verified by further clinical research.
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  • 文章类型: Journal Article
    脊髓损伤(SCI)表示脊髓的结构和功能受损,主要表现为神经传递途径中断引起的感觉和运动缺陷,有可能导致不可逆转的瘫痪.其病理生理过程复杂,许多分子和信号通路错综复杂。值得注意的是,SCI后Wnt信号通路的显著上调有望实现神经再生和修复。Wnt通路的激活在神经元分化中起着至关重要的作用,轴突再生,局部神经炎症反应,和细胞凋亡,强调其作为治疗SCI的治疗靶点的潜力。然而,Wnt通路的过度激活也会导致负面影响,强调需要进一步研究其在SCI中的适用性和意义。本文综述了Wnt信号通路在SCI中的最新研究进展,总结了Wnt信号通路相关治疗策略的最新进展,并分析了其优缺点。此外,我们提供了Wnt信号通路在SCI中的临床应用,以及未来研究方向的前瞻性途径。
    Spinal cord injury (SCI) denotes damage to both the structure and function of the spinal cord, primarily manifesting as sensory and motor deficits caused by disruptions in neural transmission pathways, potentially culminating in irreversible paralysis. Its pathophysiological processes are complex, with numerous molecules and signaling pathways intricately involved. Notably, the pronounced upregulation of the Wnt signaling pathway post-SCI holds promise for neural regeneration and repair. Activation of the Wnt pathway plays a crucial role in neuronal differentiation, axonal regeneration, local neuroinflammatory responses, and cell apoptosis, highlighting its potential as a therapeutic target for treating SCI. However, excessive activation of the Wnt pathway can also lead to negative effects, highlighting the need for further investigation into its applicability and significance in SCI. This paper provides an overview of the latest research advancements in the Wnt signaling pathway in SCI, summarizing the recent progress in treatment strategies associated with the Wnt pathway and analyzing their advantages and disadvantages. Additionally, we offer insights into the clinical application of the Wnt signaling pathway in SCI, along with prospective avenues for future research direction.
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  • 文章类型: Journal Article
    蓝细菌是唯一能够在地球上进行含氧光合作用的原核生物。除了他们作为初级生产者的传统角色之外,蓝藻还合成丰富的次级代谢产物,包括类胡萝卜素,生物碱,肽,据报道具有药用潜力。更重要的是,合成生物学技术的进步进一步扩大了其潜在的生物医学应用,特别是使用活/工程蓝细菌,为未来的疾病治疗提供有希望和有吸引力的策略。为了增进了解并促进将来的应用,本文旨在讨论基于蓝藻的生物医学工程的现状和未来前景。首先,总结了蓝藻与生物活性化合物的天然产物和重金属吸附等生物医学应用相关的特定性质。随后,基于蓝细菌的这些特性,我们讨论了它们在各种疾病模型中的应用进展,如缺氧微环境缓解,伤口愈合,药物输送,等等。最后,未来的前景包括蓝藻次生代谢产物的进一步探索,将蓝藻原位合成的生物活性化合物与医学诊断和治疗相结合,并对体内应用的优化进行了批判性的阐述。该综述将促进蓝藻生物医学工程的相关研究及其在临床试验中的实际应用。
    Cyanobacteria are the only prokaryotes capable of performing oxygenic photosynthesis on Earth. Besides their traditional roles serving as primary producers, cyanobacteria also synthesize abundant secondary metabolites including carotenoids, alkaloids, peptides, which have been reported to possess medicinal potentials. More importantly, the advancement of synthetic biology technology has further expanded their potential biomedical applications especially using living/engineered cyanobacteria, providing promising and attractive strategies for future disease treatments. To improve the understanding and to facilitate future applications, this review aims to discuss the current status and future prospects of cyanobacterial-based biomedical engineering. Firstly, specific properties of cyanobacteria related with biomedical applications like their natural products of bioactive compounds and heavy metal adsorption were concluded. Subsequently, based on these properties of cyanobacteria, we discussed the progress of their applications in various disease models like hypoxia microenvironment alleviation, wound healing, drug delivery, and so on. Finally, the future prospects including further exploration of cyanobacteria secondary metabolites, the integration of bioactive compounds synthesized by cyanobacteria in situ with medical diagnosis and treatment, and the optimization of in vivo application were critically presented. The review will promote the studies related with cyanobacteria-based biomedical engineering and its practical application in clinical trials in the future.
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