Objective To explore the research hotspots and development trends in the field of cancer treatment in the past decade. Methods The CNKI and Web of Science Core Collection databases were searched for Chinese and English articles related to cancer treatment published over the last 10 years. Bibliometric research methods were employed, including keyword cluster analysis of published literature. Results A total of 45 455 Chinese articles and 866 958 English articles were retrieved. Combining the visualization analysis results and the current research dilemma of tumor treatment revealed that the current research hotspots of tumor treatment domestically and internationally can primarily focus on four key areas. In the realm of targeted therapy, efforts are directed towards the discovery of new drug targets, overcoming resistance to targeted therapy, and the development of monoclonal antibodies and antibody–drug conjugates. In the field of immunotherapy, the emphasis lies in enhancing the response rate to immune checkpoint inhibitors, determining the mechanisms behind resistance to immunotherapy, and improving the safety of treatment. The research in traditional Chinese medicine (TCM) covers evidence-based evaluation studies on TCM treatment, the identification of populations that can gain the most benefit from TCM, and strategies for improving the quality of life. In the area of novel drug development, cutting-edge technologies, such as organoid-based screening for anticancer drugs, synthetic biology, and artificial intelligence, are under investigation. Conclusion New targeted drugs, immune efficacy improvement, multidisciplinary integration, nano-delivery, and TCM innovation are the key research directions in the field of tumor therapy in the future.

Objective:To explore the biological process of liver tissue-derived extracellular vesicle (LT-EV) in promoting osteogenic differentiation of mesenchymal stem cells and healing of jaw defects to provide a feasible treatment method for the clinical treatment of jaw bone defects.Methods:Enzymatic hydrolysis and differential centrifugation were used to extract LT-EV, scanning electron microscopy, Western blotting, and nanoparticle tracking analyzers were used to identify and characterize LT-EV, and further to explore the biological functions of LT-EV through proteomics and Kyoto Encyclopedia of Genes and Genomes. Flow cytometry was used to detect LT-EV plasma concentration and to calculate the plasma half-life of LT-EV. Small animal in vivo imaging system was used to detect the biological distribution of LT-EV 24 hours after injection. Six C57BL/6 mice were divided into control group and LT-EV group (3 mice in each group) by simple random sampling method. All mice underwent jaw bone defect surgery and tail vein injection every 7 days (the control group was injected with phosphoric buffer saline, LT-EV group was injected with LT-EV), micro-CT was used to evaluate the degree of mouse jaw bone healing 28 days after surgery, HE staining was used to analyze the multi-organ biosafety of LT-EV, and immunofluorescence staining was used to detect the jaw bone expression of osteogenic marker proteins in the defect area. Human jaw bone mesenchymal stem cells (hJBMSC) induced by osteogenic differentiation were treated with LT-EV (obtained from orthognathic surgery patients provided by the Department of Traumatology and Orthognathic Surgery of School of Stomatology of The Fourth Military Medical University resected normal jaw bone fragments), and the difference in osteogenic differentiation ability between the hJBMSC group and the control group (phosphate buffer saline treatment) was compared, and the in vitro bone differentiation promoting effect of LT-EV was verified through alkaline phosphatase (ALP) staining and real-time fluorescence quantitative PCR. Results:The yield of LT-EV was high, and proteomics and Kyoto Encyclopedia of Genes and Genomes showed that LT-EV contained a series of proteins that regulated cell biological functions. LT-EV injected into the tail vein could reach the mouse jaw bone defect area and promote the regeneration and repair of the jaw bone defect [the bone volume fractions of the LT-EV group and the control group were (36.06±4.20)% and (18.58±5.61)%, respectively; t=4.32, P=0.013], and had good biosafety. LT-EV could promote osteogenic differentiation of hJBMSC in vitro. Compared to the control group, ALP staining and osteogenic gene expression levels were significantly enhanced after osteogenic differentiation of hJBMSC ( P<0.05). Conclusions:LT-EV exhibits a high yield, ease of acquisition, high biological safety, and excellent bone-promoting effects. It holds promise as a novel cell-free therapy strategy for regenerating craniofacial bone defects.

Background Chronic intermittent hypobaric hypoxia (CIHH) can effectively alleviate type 2 diabetes mellitus (T2DM). In this process, the underlying mechanism in its association with the epigenetic regulation of DNA methylation in the promoter regions of glucose metabolism key enzyme genes remains unclear yet. Objective To investigate the effects of CIHH on expression and promoter region methylation of key enzyme genes related to glucose metabolism in diabetes mice, and to explore the underlying mechanism by which CIHH regulates glucose metabolism. Methods Forty C57BL/6J male mice were divided randomly into a normobaric normoxic control (NN/CON) group, a chronic intermittent hypobaric hypoxia intervention control (CIHH/CON) group, a normobaric normoxic diabetic model (NN/DM) group, and a chronic intermittent hypobaric hypoxia intervention diabetic model (CIHH/DM) group. The mice in the NN/DM and the CIHH/DM groups were fed for 7 weeks with high-fat and high-sugar diet. Subsequently, these mice were intraperitoneally injected consecutively with 50 mmol·L⁻¹ streptozotocin (STZ) for 5 d at a dose of 40 mg·kg⁻¹ (body weight) per day to create T2DM model mice. The mice in the CIHH/DM and the CIHH/CON groups were intervened by simulating hypobaric hypoxia at 5000 m altitude for 6 h per day, while the mice in the NN/DM and the NN/CON groups were always placed in a normobaric normoxic environment. All mice were continuously treated for 4 weeks, and blood glucose were monitored during this period. After the CIHH intervention experiment, the glucose tolerance and insulin sensitivity of mice were evaluated. A set of indicators involved in key glycolytic enzymes glucokinase (GK) and pyruvate kinase (PK), as well as key gluconeogenic enzymes phosphoenolpyruvate carboxyl kinase (PEPCK) and glucose-6-phosphatase (G6P) were measured in the liver of mice, including enzyme activity, relative mRNA expression level, and DNA methylation level in the gene promoter regions. Results Compared with the mice in the NN/DM group, the blood glucose levels of the mice in the CIHH/DM group decreased after the 25^th day of the CIHH intervention (P<0.05). Regarding the diabetic glucose tolerance curves, the area under the curve (AUC) of the mice in the CIHH/DM group was lower than that of the NN/DM group (P<0.05). Compared with the mice in the NN/DM group, the mice in the CIHH/DM group showed that the serum insulin content and HOMA of insulin resistance index (HOMA-IRI) decreased (P<0.05), the enzyme activities of GK and PK increased and the relative mRNA expression levels of their genes were up-regulated (P<0.05), while the enzyme activities of PEPCK and G6P decreased and the relative mRNA expression levels of their genes were down-regulated (P<0.05) in liver. The average DNA methylation levels in the promoter regions of GK, PK, PEPCK, and G6P genes in liver of mice in each group were not significantly different (P>0.05), and their correlations with mRNA expression levels were also not statistically significant (P>0.05). Conclusion CIHH intervention may reduce blood glucose level, improve glucose tolerance, alleviate insulin resistance, and regulate the key enzyme activities of glucose metabolism and the relative mRNA expression of their corresponding genes in T2DM mice, but the above phenomena are not related to the DNA methylation levels in the promoter regions of these key enzymes.

Objective:To analyze the effect of individualized respiratory function training combined with swallowing function training on lung function, dyspnea symptoms, and incidence of aspiration pneumonia in patients with stroke complicated by dysphagia.Methods:A total of 120 patients with stroke complicated by dysphagia who received treatment at Bao Ji People's Hospital from January 2022 to March 2023 were included in this study. These patients were assigned to a control group and a study group, with 60 patients in each group, using simple randomization. The control group received conventional swallowing function training, while the study group underwent individualized respiratory function training combined with swallowing function training. Both groups were treated for 8 weeks. Rehabilitation outcomes, repetitive saliva swallowing times, quality of oral intake (the Functional Oral Intake Scale score), and lung function parameters (peak expiratory flow rate, forced vital capacity, and forced expiratory volume in 1 second, dyspnea symptoms (the Modified Medical Research Council Dyspnea Scale score), respiratory muscle strength (maximum expiratory pressure percentage and maximum inspiratory pressure percentage), quality of life [the Swallowing Quality of Life questionnaire score], psychological status (the Depression, Anxiety and Stress Scale-21 Items score), incidence of aspiration pneumonia, and severity of aspiration (the Rosenbek scale score) were compared between the two groups.Results:The total response rate in the study group was 95.0% (57/60), which was significantly higher than that in the control group [81.7% (49/60), χ2 = 5.18, P = 0.023]. After 4 and 8 weeks of training, repetitive saliva swallowing times [(3.86 ± 0.25) times, (4.35 ± 0.30) times] and Functional Oral Intake Scale scores [(5.29 ± 0.61) points, (5.94 ± 0.50) points] in the study group were significantly higher compared with the control group [(3.45 ± 0.28) times, (3.81 ± 0.32) times, (4.73 ± 0.58) points, (5.18 ± 0.54) points, t = 8.46, 9.54, 5.15, 8.00, all P < 0.05]. The values for forced vital capacity, forced expiratory volume in 1 second, and peak expiratory flow rate in the study group were significantly higher than those in the control group, and the Modified Medical Research Council Dyspnea Scale score in the study group was significantly lower than that in the control group ( t = 4.88, 6.05, 7.34, 7.35, 3.82, 4.32, 4.63, 9.23, all P < 0.05). The maximum expiratory pressure percentage and maximum inspiratory pressure percentage in the study group were significantly higher than those in the control group ( t = 3.84, 3.82, 0.65, 3.69, all P < 0.05). The Swallowing Quality of Life questionnaire scores in the study group [(179.26 ± 20.17) points, (189.54 ± 21.06) points] were significantly higher than those in the control group [(162.75 ± 18.43) points, (170.61 ± 20.35) points, t = 4.68, 5.01, both P < 0.05]. The scores for the Depression, Anxiety and Stress Scale-21 Items in the study group [(28.03 ± 2.74) points, (25.71 ± 2.68) points] were significantly lower than those in the control group [(30.15 ± 2.96) points, (28.20 ± 3.17) points, t = 4.07, 4.65, both P < 0.05]. During the training period, the incidence of aspiration pneumonia in the study group was significantly lower than that in the control group [3.3% (2/60) vs. 15.0% (9/60), χ2 = 4.90, P = 0.027]. After 8 weeks of training, the severity of aspiration in the study group was milder than that in the control group ( Z = 2.54, P = 0.011). Conclusion:Individualized respiratory function training combined with swallowing function training can effectively improve lung function, reduce dyspnea symptoms, and decrease the incidence of aspiration pneumonia in patients with stroke who are experiencing dyspnea.

Reversible cerebral vasoconstriction syndrome(RCVS)is a clinical condition characterized by reversible segmental and multifocal vasoconstriction of cerebral arteries,making early diagnosis challenging.This paper presents two case reports of RCVS triggered by different causes and explores the clinical manifestations and imaging changes of the syndrome,aiming to assist clinicians in the early identification and management of RCVS.

Objective To describe the diagnosis,treatment,and clinical course of a patient with severe acute organophosphorus pesticide poisoning(AOPP)complicated by recurrent respiratory failure,intermediate syndrome(IMS),multiple organ dysfunction syndrome(MODS)and sepsis.Methods On May 8,2021,a patient who self-administered the pesticide Dimethoate AOPP was admitted to the department of internal medicine intensive care unit(MICU)of the First People's Hospital of Yunnan Province.After 29 days of treatment,the patient was successfully cured and discharged.The clinical diagnosis and treatment process was introduced.Results The 78-year-old male patient suffered from severe AOPP due to self-ingestion of the pesticide leptophos.Upon admission,he rapidly developed respiratory failure requiring urgent endotracheal intubation and mechanical ventilation support.A series of targeted treatments were administered,including the use of reactivators such as pralidoxime iodide,anticholinergic agents like atropine and scopolamine,as well as antibiotic therapy and management of water-electrolyte balance and acid-base equilibrium.Throughout his treatment,the patient experienced multiple complications,including episodes of sepsis,fluctuating cholinesterase levels,infections from multidrug-resistant bacteria,and recurrent respiratory failures.After 29 days of meticulous care,the patient was successfully weaned off the ventilator,regained normal organ function,and was discharged.Conclusion The analysis of this case highlights the importance of closely monitoring and managing drug dosage adjustments,preventing and treating infections,addressing septic shock,paying attention to the prevention and control of ventilator-associated pneumonia(VAP),conducting timely psychological evaluations,and providing interventions during the treatment process for AOPP.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective:To compare single-cell transcriptome sequencing data from skin samples of patients with atopic dermatitis (AD) and those from skin samples of healthy controls, and to investigate immunometabolic characteristics of inflammatory dendritic epidermal cells (IDECs) in skin lesions of patients with AD.Methods:An in-depth analysis was carried out on previously published single-cell sequencing data from 8 AD patients and 7 healthy controls in the Gene Expression Omnibus database (GSE 153760). Marker genes were used to screen out IDECs, and differentially expressed genes in IDECs between the two groups were analyzed. Kyoto Encyclopedia of Genes and Genomes enrichment analysis was performed on these differentially expressed genes, the "AddModuleScore" function in the Seurat package was used to evaluate the IDEC-involved inflammatory and metabolic pathways in the two groups, and Mann-Whitney rank sum test was used for statistical analysis; correlations between the IDEC-involved metabolic and inflammatory pathways were evaluated using the above scores and the "cor" and "cor.test" functions in R packages.Results:A large number of IDECs infiltrating the skin lesions of AD patients highly expressed Th2 chemokines (CCL17), antigen presentation-related genes (CD1B), endothelial growth-related genes (TYMP, AREG), inflammation-related genes (S100A8, S100A10, LGALS1), stromal fibrosis-related genes (MMP12, ADAM19), metabolism-related genes (LDHA, LIPA, GLUL), and danger signaling-related genes (HSPA1B, HSP90AA1, HSPB1, HSPH1). The activities of glucose energy metabolism, glycolytic metabolism, nucleotide metabolism, glutamate and glutamine metabolism, and amino acid metabolism were significantly upregulated in IDECs in AD patients, and were positively correlated with Th2 inflammation levels; the activities of oxidative phosphorylation and lipid metabolism were significantly downregulated in IDECs in AD patients, and the lipid metabolism level was negatively correlated with Th2 inflammation levels. Glutamine metabolism and glucose energy metabolism activities were positively correlated with Th22 inflammation levels; Th1 and Th17 inflammation levels were negatively correlated with the activities of pentose phosphate metabolism, nucleotide metabolism, glycolytic metabolism, and amino acid metabolism pathways.Conclusion:The inflammation- and metabolism-related genes were abnormally expressed in IDECs in skin lesions of AD patients, and activities of multiple metabolic pathways were markedly upregulated in IDECs, among which the glycolysis metabolism activity was mostly correlated with Th2 inflammation levels.

Humans ; Waldenstrom Macroglobulinemia/genetics* ; East Asian People ; Chromosome Aberrations ; Lymphoma

Humans ; Ulcer/pathology* ; Herpesvirus 4, Human ; Epstein-Barr Virus Infections ; Skin Diseases