Medicine
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A systematic retrospective analysis of patients with lumbar disc herniation treated with percutaneous endoscopic discectomy was performed to identify key risk factors for postoperative recurrence, and a Nomogram prediction model was constructed based on them. The data of patients with lumbar disc herniation who were treated in our hospital between January 2021 and December 2023 were included in this study. Statistical tools, including univariate and multivariate logistic regression analyses, were used to accurately screen independent risk factors significantly associated with postoperative recurrence. ⋯ The model performance was evaluated by plotting the receiver operating characteristic curve and calculating the area under the curve, supplemented by calibration curve and decision curve analysis, to ensure the predictive accuracy and clinical practicability of the model. 286 patients with lumbar disc herniation were included in the study, and 29 patients had a postoperative recurrence, with a recurrence rate of 10.14%. After univariate and multivariate logistic regression analyses, a total of 5 variables were identified as independent risk factors for postoperative recurrence of lumbar disc herniation: age > 60 years (OR = 2.831; 95% CI = 1.089-5.430), body mass index (BMI) > 24 kg/m2 (OR = 4.632; 95% CI = 1.183-14.337), The type of lumbar disc herniation was herniation (OR = 5.064; 95% CI = 1.198-15.364), degeneration grade III-IV (OR = 5.916; 95% CI = 1.357-16.776), and postoperative high-intensity activity (OR = 4.731; 95% CI = 1.341-14.024). The nomogram constructed in this study for postoperative recurrence of lumbar disc herniation by percutaneous endoscopic discectomy has good predictive accuracy, and this tool can effectively assist orthopedic surgeons in identifying high-risk patients with recurrence after percutaneous endoscopic discectomy, providing a scientific basis for early intervention and individualized management strategies, thus optimizing patient prognosis.
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Observational Study
fMRI used to observe the acute craniocerebral response of esophageal cancer related depressive patients treated by rTMS: Initial experience.
To observe the immediate craniocerebral response, changes of spontaneous nerve activity and functional connection after repeated transcranial magnetic stimulation (rTMS) in esophageal cancer patients with depression (ECPD) by functional magnetic resonance imaging (fMRI), and to explore the therapeutic effect, neuroactivity response and mechanism. Eleven patients with ECPD were enrolled to treated with single rTMS. The patients were examined by fMRI before and after the treatment. ⋯ Compared with those before rTMS treatment, the Hamilton Depression Rating Scale (HAMD) score decreased significantly after rTMS treatment (t = -7.63, P = .0001). The ALFF of bilateral putamen, left thalamus, left posterior cingulate gyrus and right middle temporal gyrus decreased significantly (P = .02). In addition, the functional connection between the cortex-limbic system-striatum-thalamus nerve loop increased in patients after rTMS treatment. rTMS may achieve the effect of rehabilitation treatment by improving the spontaneous neural activity and regulating the neural connection network of cortical-limbic systems-triatum-thalamus loop in ECPD.
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Despite significant advancements in the treatment of non-small cell lung cancer (NSCLC) through immunotherapy, many patients still exhibit resistance to this approach. This study aims to identify the characteristics of individuals who can benefit from immunotherapy, especially immune checkpoint inhibitors (ICIs), and to investigate optimal strategies for patients who experience resistance to it. Data on gene expression patterns and clinical information from NSCLC patients who underwent immunotherapy were obtained from the Gene Expression Omnibus databases. ⋯ The risk signature has demonstrated its effectiveness in forecasting the prognosis of NSCLC treated with ICIs, enabling better patient stratification and more accurate prediction of immunotherapy response. Moreover, MNX1 and HOXD1 have been identified as key molecules related to immunotherapy resistance. Inhibition of these molecules, combined with current ICIs, offers novel strategies for the management of NSCLC patients.
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Endometrial cancer (EC) is the most common gynecologic malignancy with increasing incidence and mortality. The tumor immune microenvironment significantly impacts cancer prognosis. Weighted Gene Co-Expression Network Analysis (WGCNA) is a systems biology approach that analyzes gene expression data to uncover gene co-expression networks and functional modules. ⋯ Basic leucine zipper activating transcription factor-like transcription factor(BATF) expression in EC tissues positively correlated with CD8+ T cell infiltration, suggesting BATF's crucial role in EC development and antitumor immunity. The prognostic model comprising ARPC1B, BATF, CCL2, and COTL1 can effectively identify high-risk EC patients and predict their response to immunotherapy, demonstrating significant clinical potential. These genes are implicated in EC development and immune infiltration, with BATF emerging as a potential therapeutic target for EC.
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Scoliosis, marked by abnormal spinal curvature, is common in adolescents and can lead to chronic pain and reduced quality of life. The relationship between physical activity and scoliosis is debated. In this study, we aim to investigate the causal relationship between physical activity levels and idiopathic scoliosis risk using the Mendelian randomization (MR) approach. ⋯ Total physical activity emerges as an idiopathic scoliosis risk factor, warranting mechanistic exploration. LIPA and MVPA do not causally link to scoliosis. Idiopathic scoliosis does not influence activity levels.