Int J Med Sci
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Randomized Controlled Trial
Multiclassifier Radiomics Analysis of Ultrasound for Prediction of Extrathyroidal Extension in Papillary Thyroid Carcinoma in Children.
Objective: To explore extrathyroidal extension (ETE) in children and adolescents with papillary thyroid carcinoma using a multiclassifier ultrasound radiomic model. Methods: In this study, data from 164 pediatric patients with papillary thyroid cancer (PTC) were retrospectively analyzed and patients were randomly divided into a training cohort (115) and a validation cohort (49) in a 7:3 ratio. To extract radiomics features from ultrasound images of the thyroid, areas of interest (ROIs) were delineated layer by layer along the edge of the tumor contour. ⋯ Generally, the LightGBM model performed well in both the training and validation cohorts. From the SHAP results, original_shape_MinorAxisLength,original_shape_Maximum2DDiameterColumn, and wavelet-HHH_glszm_SmallAreaLowGrayLevelEmphasis have the most significant effect on the model. Conclusions: Our combined model based on machine learning and ultrasonic radiomics demonstrate the excellent predictive ability for extrathyroidal extension (ETE) in pediatric PTC.
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Background: This study compares treatment failure for patients who received oral beta-lactams (BLs) and fluoroquinolones (FQs) for stepdown treatment of Enterobacterales bloodstream infections (BSIs). Methods: We conducted a single-center, retrospective, age- and sex-matched, cohort study, at a Veterans Affairs (VA) hospital in South Texas. Eligible patients were at least 18 years of age with a monomicrobial BSI treated with a single oral BL or FQ antibiotic. ⋯ One patient in the FQ group experienced Clostridioides difficile infection. Conclusion: This study suggests that BLs may be as effective as FQs for oral stepdown treatment of Enterobacterales BSI without the potential associated risks. Furthermore, in the setting of FQ-resistant Enterobacterales BSI secondary to urinary source, third generation oral cephalosporins (i.e., cefpodoxime) may be reasonable alternatives.
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Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally, and it can proceed to cirrhosis and hepatocellular carcinoma, as well as cardiovascular disease, chronic renal disease, and other complications, resulting in a massive economic burden. At the moment, nicotinamide adenine dinucleotide (NAD+) is thought to be a possible treatment target for NAFLD, besides Cluster of differentiation 38(CD38) is the primary NAD+ degrading enzyme in mammals and may play a role in the pathophysiology of NAFLD. ⋯ CD38 inhibitors enhance glucose intolerance and insulin resistance in mice and lipid accumulation in the liver is greatly decreased in CD38-deficient mice. This review describes the role of CD38 in the development of NAFLD in terms of Macrophage-1, insulin resistance, and abnormal lipid accumulation in order to offer recommendations for future NAFLD pharmacological trials.
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Review
Regulatory mechanisms and clinical applications of tumor-driven exosomal circRNAs in cancers.
Malignant tumors seriously affect people's survival and prognosis. Exosomes, as vesicle structures widely existing in human tissues and body fluids, are involved in cell-to-cell transmission. ⋯ Tumor-driven exosomal circRNAs are often involved in tumorigenesis and development including the proliferation, invasion, migration and chemo-or-radiotherapy sensitivity of tumor cell by multiple regulatory mechanisms. In this review, we will elaborate the roles and functions of tumor-driven exosomal circRNAs in cancers which may be used as potential cancer biomarkers and novel therapeutic targets.
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Diabetes mellitus and its complications pose a major threat to global health and affect the quality of life and life expectancy of patients. Currently, the application of traditional therapeutic drugs for diabetes mellitus has great limitations and can only temporarily control blood glucose but not fundamentally cure it. ⋯ Recently, human umbilical cord mesenchymal stem cells have been widely used in basic and clinical research on diabetes mellitus and its complications because of their abundance, low ethical controversy, low risk of infection, and high proliferation and differentiation ability. This paper reviews the therapeutic role and mechanism of human umbilical cord mesenchymal stem cells in diabetes mellitus and its complications and highlights the challenges faced by the clinical application of human umbilical cord mesenchymal stem cells to provide a more theoretical basis for the application of human umbilical cord mesenchymal stem cells in diabetes mellitus patients.