Alzheimer's disease(AD),a neurodegenerative disorder,manifests pathological changes in the brain even during the asymptomatic stage.As the pathological burden intensifies,patients experience functional decline in multiple cognitive domains,including memory,language,spatial perception,executive function,and calculation,and may also exhibit emotional abnormalities.Once AD progresses,treatment becomes extremely chal-lenging.Therefore,early diagnosis and accurate prediction of disease conversion are core tasks in the prevention and treatment of AD,and they are also urgent scientific research challenges to be overcome.Deep learning(DL)models demonstrate considerable advantages in the diagnosis,prediction,classification,and feature extraction of AD,offering new hope for solving this challenging problem.This research commences with a concise introduction to the outcomes of AD and the fundamental knowledge of deep learning.Subsequently,it offers an overview of the imaging studies on the utilization of deep learning for predicting disease transformation from two perspectives.Firstly,it systematically summarizes the existing DL models that have demonstrated innovation in the classification and prediction performance of AD.Secondly,it provides a comprehensive outline of the DL fusion models applied to the diagnosis,classification,and prediction of AD.Finally,this paper expounds upon the impending challenges in the research of this domain.This article demonstrates that deep learning models is cutting-edge trends in the ex-ploration of AD research.

Alzheimer's disease(AD),a neurodegenerative disorder,manifests pathological changes in the brain even during the asymptomatic stage.As the pathological burden intensifies,patients experience functional decline in multiple cognitive domains,including memory,language,spatial perception,executive function,and calculation,and may also exhibit emotional abnormalities.Once AD progresses,treatment becomes extremely chal-lenging.Therefore,early diagnosis and accurate prediction of disease conversion are core tasks in the prevention and treatment of AD,and they are also urgent scientific research challenges to be overcome.Deep learning(DL)models demonstrate considerable advantages in the diagnosis,prediction,classification,and feature extraction of AD,offering new hope for solving this challenging problem.This research commences with a concise introduction to the outcomes of AD and the fundamental knowledge of deep learning.Subsequently,it offers an overview of the imaging studies on the utilization of deep learning for predicting disease transformation from two perspectives.Firstly,it systematically summarizes the existing DL models that have demonstrated innovation in the classification and prediction performance of AD.Secondly,it provides a comprehensive outline of the DL fusion models applied to the diagnosis,classification,and prediction of AD.Finally,this paper expounds upon the impending challenges in the research of this domain.This article demonstrates that deep learning models is cutting-edge trends in the ex-ploration of AD research.

Severe insulin resistance syndrome associated with mutations in the insulin receptor(INSR) gene is rare in clinical practice. We report a 13-year-old female patient with insulin resistance, acanthosis nigricans, and Class Ⅱ malocclusion, whose family history included hyperinsulinemia in both her mother and grandmother. Whole-exome sequencing and PCR-Sanger validation identified a novel INSR mutation, c. 637delA(p.S213Vfs*69), resulting in a pathogenic variant that substitutes serine at position 213 with valine. This case highlights a clinical phenotype that is challenging to differentiate between Rabson-Mendenhall syndrome and A-type insulin resistance syndrome. Long-term follow-up is crucial to assess disease progression and prognosis.

Severe insulin resistance syndrome associated with mutations in the insulin receptor(INSR) gene is rare in clinical practice. We report a 13-year-old female patient with insulin resistance, acanthosis nigricans, and Class Ⅱ malocclusion, whose family history included hyperinsulinemia in both her mother and grandmother. Whole-exome sequencing and PCR-Sanger validation identified a novel INSR mutation, c. 637delA(p.S213Vfs*69), resulting in a pathogenic variant that substitutes serine at position 213 with valine. This case highlights a clinical phenotype that is challenging to differentiate between Rabson-Mendenhall syndrome and A-type insulin resistance syndrome. Long-term follow-up is crucial to assess disease progression and prognosis.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To analyze the distribution characteristics of special types of diabetes in China, in order to provide a theoretical basis for the diagnosis and treatment of special types of diabetes.Methods:Pubmed, CNKI, and WanFang Data were searched for the case reports and clinical studies of special types of diabetes in China from 2011 to 2021. After independent literature screening by 2 researchers according to the inclusion and exclusion criteria, diseases and the number of corresponding cases included were extracted for statistics. The etiological composition and disease characteristics of three subtypes of special type diabetes were analyzed.Results:A total of 613 articles(7 377 patients)were included and roughly divided into eight subtypes of special type diabetes according to etiological classification for disease composition analysis. The results by ratio in descending order were as follows: mono-genetic gene defects in islet β-cell function, pancreatogenic diabetes, diabetes induced by drugs or chemicals, endocrine disease, mono-genetic gene defects in insulin action, other genetic syndromes associated with diabetes, infection, and uncommon immune-mediated diabetes. The disease composition of the three subtypes of special types of diabetes that we focused on were mono-genetic gene defects in islet β-cell function(50.21%), pancreatogenic diabetes(35.65%), and mono-genetic gene defects in insulin action(1.56%). The composition analysis of the special types of diabetes in each subtype showed that neonatal diabetes mellitus(NDM, n=1 749, 23.71%)and maturity onset diabetes in young(MODY, n=1 554, 21.07%)accounted for the largest proportions. According to the composition analysis of each subtype of MODY patients, the top three subtypes were MODY2(50.89%), MODY3(16.03%), and MODYX(8.91%). In addition, taking MODY as an example, patients with de novo mutations(DNMs)and(or)new mutation sites were summarized and analyzed. The results revealed 31 MODY patients with DNMs(1.99%) and 339 MODY patients with new mutation sites(21.81%). Conclusions:According to the literature analysis, NDM and MODY represent the largest proportion of patients with special type diabetes in China. MODY2 patients make up the largest proportion of MODY patients. In addition, diabetic patients carrying DNMs and(or)new mutation sites should be taken seriously.

Conclusion:Patients with OlimHSPC who are not sensitive to traditional CAB treatment, ADT combined with abiraterone acetate neoadjuvant therapy and postoperative adjuvant therapy can be attempted.

Congenital generalized lipodystrophy type 1 (CGL1) is an autosomal recessive genetic disease caused by mutations in AGPAT2 gene. The main clinical mainifestations include body subcutaneous fat loss, muscle hypertrophy, obvious subcutaneous veins, pseudoacromegaly, hirsutism, and acanthosis nigricans. What′s more, CGL1 is always accompanied by metabolic diseases. Therefore, it is easily misdiagnosed as metabolic syndrome, type 2 diabetes, polycystic ovary syndrome, acromegaly, or Cushing′s syndrome. Meanwhile, it is difficult to distinguish it from partial lipoatrophy syndrome. In this article, we present clinical and molecular characteristics of a patient with CGL1 and review mutations reported in literature to replenish current knowledge about this orphan disease.

Objective:To investigate the effectiveness and safety of soothing moisturizing repair cream on acne depressed scar exfoliative fractional laser wound repair.Methods:From October 2018 to June 2020, the Department of Dermatology, Qingdao Haici Hospital Affiliated to Qingdao University took 33 patients with acne depressed scars as the research object, including 8 males and 25 females, aged from 20 to 36 years (29.6±8.6) years. The left and right face comparison method was adopted. After laser operation, the trial side was given a soothing moisturizing repair cream, and the control side was given a placebo. By collecting the patient's facial pictures and objective skin data before and after the laser operation, 1 h, 1 d, 3 d, 7 d, 21 d, and combined with the researcher's semi-subjective evaluation and patient's subjective evaluation the wound skin reaction and wound healing were observed.Results:At 1, 3, 7, 21 days after laser operation, the skin water content of the test side was higher than that of the control side ( P<0.05), and the skin water loss was lower than the control side ( P<0.05); at 3, 7, 21 days, the skin pigment of the test side was lower than the control side ( P<0.05); at 3, 7 d, the test side skin erythema index was lower than the control side ( P<0.05); at 1, 3, 7 d, the test side wound skin erythema, edema, dryness and tightness, etc. were better than the control side ( P<0.05). The duration of pain, crusting time, scab removal time, and complete healing time of the wound on the test side were shorter than those on the control side ( P<0.05). The patient's satisfaction with the moisturization and comfort of the nursing products on the trial side was better than that on the control side ( P<0.05). Conclusions:There is no adverse reaction to the soothing moisturizing repair cream after laser surgery, which can better inhibit skin inflammation, reduce post-inflammatory pigmentation, promote skin healing, and help repair the wound after laser surgery.

Objective:To explore the selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection.Methods:From January 2011 to February 2017, 31 patients with vulvar tumor who were admitted to Hunan Cancer Hospital underwent repair of wound after tumor resection with various flaps/myocutaneous flaps. The patients were composed of 5 males and 26 females, aged 39-76 years, with 27 vulvar cancer and 4 Paget′s disease in primary diseases. The size of defects after vulvar tumor radical resection ranged from 8.0 cm×4.5 cm to 27.5 cm×24.0 cm. According to the theory of perforasome, the defects were repaired by the external pudendal artery perforator flap, deep inferior epigastric artery perforator flap, rectus abdominis myocutaneous flap, anterolateral thigh flap, internal pudendal artery perforator flap, gracilis myocutaneous flap, and profunda artery perforator flap based on the specific size and location of perineum and groin where the defect was located. According to the blood supply zone of flap, totally 17 local translocation flaps, 18 axial flaps/myocutaneous flaps, and 7 V-Y advancement flaps were resected, with an area of 7.0 cm×4.0 cm to 21.0 cm×13.0 cm. All the flaps/myocutaneous flaps were transferred in pedicled fashion, and the donor sites were closed without tension. The number of flaps/myocutaneous flaps, wound closure, flaps/myocutaneous flaps survival, and follow-up were observed and recorded.Results:Altogether 42 flaps/myocutaneous flaps were harvested in 31 patients. Two flaps/myocutaneous flaps were used in 11 cases for large circular defect repair. All the defects achieved tension-free primary closure. The blood supply of 32 flaps/myocutaneous flaps was good, while insufficient blood supply was noted in the other 10 flaps/myocutaneous flaps. Seventeen flaps/myocutaneous flaps survived smoothly. Wound dehiscence occurred in 5 flaps/myocutaneous flaps 8 to 14 days postoperatively, which was healed with dressing change. Temporary congestion was noted in 7 flaps/myocutaneous flaps 2 to 5 days postoperatively, which recovered without special treatment. Three flaps/myocutaneous flaps had infection 7 to 15 days postoperatively, two of which recovered after dressing change, while the other one had partial necrosis and received debridement and direct closure. Two flaps/myocutaneous flaps were totally necrotic 8 to 15 days postoperatively, which were repaired with pedicled rectus abdominis myocutaneous flap after debridement. Seven flaps/myocutaneous flaps had partial necrosis 7 to 20 days postoperatively and were healed after dressing change. Twenty-four patients were followed up for 9-38 months. The color of flaps/myocutaneous flaps was similar to that of the surrounding skin, the shape of vulva was natural, the movement of hip joint was not limited, the function of micturition and defecation was not affected, and tumor recurrence was noted in 3 patients.Conclusions:For the complicated large defect after perineum tumor resection, the flexible application of different forms of flaps/myocutaneous flaps to repair according to different areas regains the appearance and function. However, there are many complications, so it is necessary to further strengthen the postoperative care.