原发性肝癌是常见的严重威胁人类健康的恶性肿瘤之一,老年人群中发病率逐渐上升,但老年患者存在着治疗不足的风险。随着科学技术的不断进步,临床上原发性肝癌的治疗方法发展迅速,FUAS作为唯一的体外的非侵入性的肿瘤局部治疗方式,现广泛应用于早期肝癌、中晚期肝癌、困难部位的肝癌等方面。现就FUAS在老年原发性肝癌患者中的治疗机制、临床应用及研究进展方面进行综述。Primary liver cancer is a common and aggressive malignancy that significantly impacts human health, with its incidence steadily increasing among the elderly population. However, elderly patients are often at risk of receiving suboptimal treatment. With ongoing advancements in medical science and technology, the clinical management of primary liver cancer has seen rapid progress. Focused ultrasound ablation surgery (FUAS) stands out as the only extracorporeal, non-invasive, and localized tumor treatment, and has become widely adopted for early-stage hepatocellular carcinoma, as well as for intermediate- and advanced-stage cases, and tumors located in challenging anatomical sites. This article provides an overview of the therapeutic mechanisms, clinical applications, and research advancements of FUAS in elderly patients with primary liver cancer.
妊娠期生理性胰岛素抵抗(IR)是维持胎儿营养供给的重要适应性改变,然而病理性IR已成为影响母婴健康的关键病理基础。近年研究表明,IR不仅与复发性流产、妊娠期糖尿病(GDM)、妊娠期高血压疾病(HDP)等常见产科并发症密切相关,更会通过表观遗传机制对子代远期代谢功能产生跨代影响。本文系统阐述IR导致妊娠并发症的分子机制,重点解析IR通过影响卵母细胞质量、子宫内膜容受性、血管内皮功能等途径引发不良妊娠结局的作用通路,并对当前干预策略的临床证据进行循证评价。Physiological Insulin Resistance (IR) during pregnancy is an important adaptive change to maintain fetal nutrition supply. However, pathological IR has become a key pathological basis affecting the health of both the mother and the fetus. Recent studies have shown that IR is not only closely related to common obstetric complications such as recurrent miscarriage, Gestational Diabetes Mellitus (GDM), and Hypertensive Disorders of Pregnancy (HDP), but also has a trans-generational impact on the long-term metabolic function of offspring through epigenetic mechanisms. This article systematically expounds on the molecular mechanisms by which IR leads to pregnancy complications, focuses on analyzing the pathways through which IR causes adverse pregnancy outcomes by affecting oocyte quality, endometrial receptivity, vascular endothelial function, etc., and conducts an evidence-based evaluation of the clinical evidence of current intervention strategies.
背景:建立基于白蛋白衍生指标的急性高脂血症型胰腺炎(HLAP)重症化的机器学习预测模型。方法:回顾性收集HLAP患者临床数据,按7:3分为训练集和验证集。训练集中通过Lasso回归筛选出与入住ICU显著相关的特征变量,多种机器学习算法构建预测模型,并在验证集中通过ROC曲线评估模型性能。结果:最终筛选的特征变量包括APACHE II评分、是否发热、直接胆红素(DB)、是否胰周液体积聚及C反应蛋白/白蛋白(CAR)。逻辑回归模型表现最佳,验证集中ROC曲线下面积(AUC)为0.757。结论:基于CAR的预测模型能较准确地评估HLAP患者入住ICU的风险,为早期识别HLAP患者重症化提供了一种简便实用的工具。Background: Establish a machine learning prediction model for the severity of acute hyperlipidemic pancreatitis (HLAP) based on albumin-derived indicators. Method: Retrospective collection of clinical data from HLAP patients, divided into a training set and a validation set in a 7:3 ratio. In the training set, Lasso regression was used to screen out feature variables significantly correlated with ICU admission. Multiple machine learning algorithms were used to construct predictive models, and the model performance was evaluated in the validation set using ROC curves. Result: The final selected feature variables include APACHE II score, presence of fever, direct bilirubin (DB), presence of peripancreatic fluid accumulation, and C-reactive protein/albumin (CAR). The logistic regression model performed the best, with an area under the ROC curve (AUC) of 0.757 in the validation set. Conclusion: The CAR-based prediction model can accurately assess the risk of HLAP patients being admitted to the ICU, providing a simple and practical tool for the early identification of severe HLAP patients.
本文综述了有限元分析在骨盆生物力学中的应用,包括基础研究、疾病诊断、损伤机制以及手术模拟等方面。尽管有限元分析在骨盆力学研究中取得了显著进展,但在建模精确度、力学数据准确性及模拟验证等领域仍然存在挑战。随着技术的发展,未来有限元分析在骨盆生物力学中的应用将更为广泛,尤其是在个性化治疗和手术规划中具有重要意义。This paper reviews the applications of Finite Element Analysis in pelvic biomechanics, covering basic research, disease diagnosis, injury mechanisms, and surgical simulation. Despite significant progress in pelvic biomechanics research through FEA, challenges still exist in modeling accuracy, the precision of mechanical data, and simulation validation. With ongoing technological advancements, the application of FEA in pelvic biomechanics will become more extensive, particularly in personalized treatment and surgical planning, offering significant clinical relevance.
本文系统综述了ChatGPT在骨科领域的研究进展与应用,重点涵盖其在骨科医学教育、围手术期管理以及疾病诊断中的关键作用。ChatGPT通过自然语言处理和深度学习技术,在提升医疗效率和为医生及患者提供支持方面展现了显著潜力。与此同时,其应用仍面临逻辑推理能力不足、知识更新滞后以及伦理和隐私问题等挑战。本文总结了现有研究成果,分析了其优势与局限性,并提出了优化策略,旨在为ChatGPT在骨科领域的持续发展和临床应用提供指导和参考。This paper systematically reviews the research progress and applications of ChatGPT in the field of orthopedics, focusing on its key roles in orthopedic medical education, perioperative management, and disease diagnosis. Through natural language processing and deep learning technologies, ChatGPT has demonstrated significant potential in improving medical efficiency and providing support to both physicians and patients. However, its application still faces challenges, including limitations in logical reasoning, delays in knowledge updates, and concerns related to ethics and privacy. This paper summarizes existing research findings, analyzes its advantages and limitations, and proposes optimization strategies, aiming to provide guidance and reference for the continued development and clinical application of ChatGPT in orthopedics.
血脂代谢异常是肾移植术后常见的并发症,可导致心血管疾病,严重影响患者及移植物存活。肾移植术后免疫抑制剂的使用可能是导致血脂异常的主要原因。降脂的目标为低密度脂蛋白胆固醇,他汀类药物为一线降脂药物,其次是与依折麦布联合使用。然而,应考虑他汀类药物与免疫抑制剂之间的药物相互作用。一些新型降脂药物,如PCSK9抑制剂、血管生成素样蛋白3 (ANGPTL3)和载脂蛋白C3 (apoC3)抑制剂,可有效降低低密度脂蛋白胆固醇和心血管疾病风险,并可能成为对他汀类药物耐药或不耐受的肾移植受者有前景的降脂方案。本文就肾移植术后血脂紊乱的危险因素、当前及未来治疗进展作一综述。Dyslipidemia is a common complication after kidney transplantation, which can lead to cardiovascular disease and seriously affect patient and graft survival. The use of immunosuppressive drugs after kidney transplantation may be the main cause of dyslipidemia. The target for lipid lowering is LDL cholesterol, and statins are first-line lipid-lowering agents, followed by combination with ezetimibe. However, drug interactions between statins and immunosuppressants should be considered. Some novel lipid-lowering agents, such as PCSK9 inhibitors, angiopoietin-like protein 3 (ANGPTL3) and apolipoprotein C3 (apoC3) inhibitors, are effective in lowering LDL cholesterol and cardiovascular disease risk and may be promising lipid-lowering regimens for kidney transplant recipients who are resistant or intolerant to statins. This article provides a review of risk factors, current and future therapeutic advances in dyslipidemia after kidney transplantation.
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