Objective Wearable devices refer to a class of monitoring devices that can be tightly integrated with the human body and are designed to continuously monitor individual's activity without impeding or restricting the user's normal activities in the process. With the rapid advancement of chips, sensors, and artificial intelligence technologies, such devices have been widely used for patients with cardiovascular diseases who require continuous health monitoring. These patients require continuous monitoring of a number of physiological indicators to assess disease progression, treatment efficacy, and recovery in the early stages of the disease, during the treatment, and in the recovery period. Traditional monitoring methods require patients to see a doctor on a regular basis with the help of fixed devices and analysis by doctors, which not only increases the financial burden of patients, but also consumes medical resources and time. However, wearable devices can collect data in real time and transmit it directly to doctors via the network, thus providing an efficient and cost-effective monitoring solution for patients. In this paper, we will review the applications, advantages and challenges of wearable devices in the treatment of cardiovascular diseases, as well as the outlook for their future applications.

Mild cognitive impairment (MCI) is the transitional stage between healthy aging and dementia, enjoying high risk of progression to Alzheimer's disease (AD). Therefore, MCI stage becomes the most important node for early identification, diagnosis and prevention of AD. At present, MCI clinical diagnosis lacks neuroimaging markers with non-invasive, timely and economic advantages. Recent studies suggest that microstructural and/or functional changes may occur in brain regions such as the hippocampus, amygdala, cingulate gyrus, thalamus, putamen, caudate nucleus and corpus callosum during MCI stage, and imaging features of these abnormal changes may serve as neuroimaging markers for early diagnosis of MCI. This article reviews the research progress on the abnormal changes of MCI related brain regions in neuroimaging.

The liver's remarkable regenerative capacity is crucial to restore its function, which can be compromised in cases of severe or chronic liver injury. Thus, the search of new methods to promote liver regeneration is of great clinical importance. In recent years, the gut microbiota is an emerging field of research that attracts the scientific community. The gut microbiota not only affects the integrity of digestive system but also exerts a significant impact on liver function via the so-called " gut-liver axis". Increasing evidence suggests that an imbalance in gut microbiota is associated with the development of various liver diseases, and modulation of gut microbiota might be a potential cure for liver diseases. Research into the role of gut microbiota in liver regeneration not only help us understand the pathogenesis of liver diseases but also facilitate the development of new therapeutic strategies.

Objective:To investigate the correlation between serum albumin and hypoalbuminemia (HA) and the outcome after endovascular mechanical thrombectomy (EMT) in patients with stroke caused by acute anterior circulation large vessel occlusion.Methods:Stroke patients caused by acute anterior circulation large vessel occlusion received EMT treatment at the Department of Emergency Stroke, the Affiliated Hospital of Jining Medical University from June 2020 to August 2022 were retrospectively included. The demographic information, baseline clinical data, endovascular treatment parameters, and clinical outcomes of the patients were collected. HA was defined as serum albumin <35 g/L within 24 h of admission, and poor outcome was defined as the modified Rankin Scale score >2 at 90 d after onset. Multivariate logistic regression analysis was used to identify the independent influencing factors for poor outcomes. Results:A total of 177 patients were included, with a median age of 66 years, and 126 (71.19%) were males. Thirty-nine patients (22.03%) had HA, and 119 (67.23%) had poor outcomes. The proportion of pulmonary infection in the HA group was significantly higher than that in the non-HA group ( P<0.05). Multivariate logistic regression analysis showed that lower serum albumin (odds ratio [ OR] 4.102, 95% confidence interval [ CI] 1.316-16.451; P=0.028), postprocedural neurological deterioration ( OR 6.326, 95% CI 1.263-48.318; P=0.042) and pulmonary infection ( OR 5.873, 95% CI 1.028-24.452; P=0.018) were significantly independently associated with the poor outcomes. Conclusions:The HA group has a higher incidence of postprocedural pulmonary infection. Lower serum albumin, postprocedural neurological deterioration and pulmonary infection are the independent risk factors for the poor outcomes in patients with anterior circulation ischemic stroke who had successful recanalization after EMT.

The liver is a highly proliferative organ. As the liver injured, the hepatocytes can quickly enter the cell cycle to restore the volume and function of liver. Liver regeneration involves complex processes that depend on the interaction of many different cell types. As limited by the average cell change level in tissues, traditional sequencing methods can only acquire the average genetic information reflecting dominant cell subpopulations, but ignore the secondary cell subpopu-lations, which leads to the loss of cellular heterogeneity information. Single-cell sequencing tech-nology can analyze the biological behavior of single cell, which helps to better understand the distri-bution, interaction and cell heterogeneity of different cells during liver regeneration. The authors review the application of single cell sequencing technology in liver regeneration.

Compared with conventional cardiopulmonary resuscitation (CCPR), extracorporeal cardiopulmonary resuscitation (ECPR) can improve the survival rate of patients with cardiac arrest, and reduce the risk of reperfusion injury. However, it is still difficult to avoid the risk of secondary brain damage. Low temperature management has good neuroprotective potential for ECPR patients, which minimizes brain damage. However, unlike CCPR, ECPR has no clear prognostic indicator. The relationship between ECPR combined with hypothermia management-related treatment measure and neurological prognosis is not clear. This article reviews the effect of ECPR combined with different therapeutic hypothermia on brain protection and provides a reference for the prevention and treatment of neurological injury in patients with ECPR.
Humans ; Brain ; Cardiopulmonary Resuscitation ; Brain Injuries ; Hypothermia, Induced ; Heart Arrest

Objective:To analyze the clinical characteristics and prognostic value of prostate-specific antigen (PSA) dynamic features in patients with metastatic castration resistant prostate cancer (mCRPC) received abiraterone acetate (AA) therapy.Methods:The data of 89 patients with mCRPC who received AA therapy from January 2017 to June 2021 in Shanghai Tongji Hospital were retrospectively reviewed. The age of patients was (75.7 ± 8.3) years old, median PSA before AA was 56.88 (19.31, 143.75) ng/ml. The PSA dynamic features included PSA nadir (PSAN) and PSAN time. PSAN was defined as the lowest value of PSA after treatment, and PSAN time was defined as time to PSAN after AA treatment. PSAN was divided into 3 groups: PSAN1 (<0.1 ng/ml), PSAN2 (0.1- 4.0 ng/ml) and PSAN3 (>4.0 ng/ml) groups. PSA response was defined as a maximum PSA decline rate ≥50%, and no PSA decline after treatment was defined as primary resistance. Cox regressions adjusted to clinical factors were performed to evaluate the influence of PSA dynamic features on patients' radiographic progression-free survival (rPFS) and overall survival (OS). Log-rank test was used to evaluate the survival time of patients in different PSAN groups. Receiver operator characteristic (ROC) curve and area under the curve (AUC) were performed to analyze the predictive value of PSA dynamic features on survival outcomes of patients.Results:The follow-up time was 17 (12, 23) months, and 75 (84.3%) patients showed PSA responses. The median PSAN was 1.82 (0.01, 11.70) ng/ml, median PSAN time was 5.0(3.0, 9.5)months. Multivariate Cox regression indicated that PSAN was an independent risk factor for rPFS ( PSAN2: HR=5.308, P=0.017; PSAN3: HR=13.209, P<0.001), and PSAN time ≥ 5 months( HR=0.309, P<0.001)was an independent protective factor for rPFS. Also, the PSAN3 was an independent risk factor for OS( HR=9.459, P=0.048). Log-rank test indicated that the rPFS of PSAN1 group (median not reached) was significantly longer than PSAN2 [median 13.0(95% CI 8.2-17.8) months, P=0.001] and PSAN3 [8.0 (95% CI 4.1-11.9) months, P<0.001] groups. ROC curve and AUC showed that PSAN had a higher predictive value in rPFS outcomes compared with T stage, metastatic disease volume, and Eastern Cooperative Oncology Group (ECOG) score (0.82 vs. 0.69, 0.68, 0.53, P<0.05). PSAN had a higher predictive value in OS outcomes than metastatic disease volume and ECOG(0.83 vs. 0.63, 0.58, P<0.05). Conclusions:Lower PSAN needs longer PSAN time. PSAN is an independent risk factor for rPFS and OS, and PSAN time is an independent protective factor for rPFS.

Objective:To investigate the risk factors of hypoalbuminemia (HA) in patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) after endovascular mechanical thromboectomy (EMT) and impact on outcomes.Methods:Patients first diagnosed with anterior circulation LVO-AIS and underwent emergency EMT at the Department of Acute Stroke, the Affiliated Hospital of Jining Medical University from June 1, 2020 to April 31, 2023 were retrospectively included. According to the first follow-up serum albumin examination after procedure (6-8 d), the patients were divided into HA group (<35 g/L) and non-HA group (≥35 g/L). According to the modified Rankin Scale score at 90 d after EMT, the patients were divided into a good outcome group (0-2) and a poor outcome group (3-6). Univariate and multivariate logistic analysis was used to determine independent risk factors for HA after EMT and their impact on outcomes. Results:A total of 144 patients were enrolled, including 107 males (74.30%) with a median age of 64 years (interquartile range, 56-71 years). There were 50 patients (34.72%) in the HA group and 94 (65.28%) in the non-HA group; 60 (41.67%) in the good outcome group, and 84 (58.33%) in the poor outcome group. Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.061, 95% confidence interval [ CI] 1.014-1.111; P=0.011) and pulmonary infection ( OR 5.136, 95% CI 1.917-13.760; P=0.001) were independent risk factors for HA; HA ( OR 4.345, 95% CI 1.367-13.814; P=0.013), pneumonia ( OR 5.113, 95% CI 1.217-12.528; P=0.026), and onset to reperfusion time ( OR 5.473, 95% CI 1.090-16.05; P=0.038) were independent risk factors for poor outcomes. Conclusions:Age and pulmonary infection are independent risk factors for HA in LVO-ASI patients after EMT, and HA is the independent risk factor for poor outcomes of the patients.

Objective:To investigate the clinical characters and prognostic value of PSA flare and bone flare in metastatic castration resistant prostate cancer(mCRPC) patients received Abiterone acetate(AA) therapy.Methods:A retrospective study was conducted for 93 mCRPC patients treated with AA from Jul.2016 to Dec.2020. Mean age was (75.4±8.9)years, median PSA was 58.2 (16.4, 148.6)ng/ml. Patients received at least 6 months of AA treatment. PSA flare was defined as an increase of PSA after AA therapy followed by a decrease. Bone flare was defined as disease progression after 3 months of therapy, typically based on increased lesion intensity or number, and reevaluation 6-9 months later showed improvement in the scan. The clinical characters and prognostic value of the flare phenomenon was evaluated and analyzed respectively.Results:The median follow up time was 16 months(6, 54 months), fourteen patients showed PSA flare at first month after AA treatment, and median time of duration was 2 months(1, 7 months). The serum alkaline phosphatase (ALP) had a similar rising trend along with PSA flare[115.5(98.0, 198.5)U/L vs. 119.0(97.0, 288.8)U/L, P=0.016]. Seven patients showed bone flare and 3 cases co-existed with PSA flare. Multivariate Cox regression analysis indicated bone flare was an independent protective factor for progression free survival(PFS)( HR=0.117, 95% CI 0.015-0.895, P=0.039), PSA flare had no significant influence on PFS ( HR=1.314, 95% CI 0.554-3.121, P=0.536)and overall survival(OS)( HR=1.348, 95% CI 0.393-4.263, P=0.635). Log-rank test showed patients with bone flare had a longer PFS( P=0.016) and OS( P=0.047) compared with patients without bone flare. Conclusions:PSA flare always faded away after 2 months AA therapy and had no influence on PFS and OS. Bone flare maybe an indication for better prognosis.

Prostate cancer with metastasis to the kidney is rare. Here, we report a case of prostate cancer metastasizing to renal cell carcinoma. A 67-year-old male presented with low back pain for 3 months, aggravated with persistent fever for 2 weeks in June 2018.Histopathological diagnosis of prostate adenocarcinoma was established. Meanwhile, contrasted CT of the abdomen showed a 3.0 cm×2.5 cm×2.5 cm enhanced solid mass on the lower pole of the right kidney. Nephron-sparing surgery was performed for the renal mass. Histopathology revealed a Grade 2 renal clear cell carcinoma with focal prostate carcinoma metastasis to the tumor. Then the patient received abiraterone acetate (AA) therapy. The patient did not encounter tumor recurrence in right kidney 18 months after surgery. However, PSA progression occurred 6 months later after AA therapy, then docetaxel chemotherapy and Sr 89 therapy were performed with limited efficacy. The patient died after 30 months.