简介：ThistalkwillexplorethethesisthatresearchinacupunctureandotherraodalitiesofTraditionalEastAsianMedicine(TEAM)shouldbedesignedtobetterreflectingitsownprinciplesandpractice.Itmaybepossible,forexample,todevelopreliable,quantitativeTEAM-basedoutcomemeasuresbasedonpulseandtonguediagnoses,andonelectrodermalpropertiesofacupoints.Similarly,inclusioncriteriaandtreatmentplansshouldbeinformedbyTEAM-basedsyndromedifferentiations.

简介：AbstractElectrocochleography (ECochG) is an electrophysiological technique that records electrical potentials generated by different components of the inner ear and peripheral cochlear nerve in response to acoustic stimulation. ECochG responses can be analyzed into (1) cochlear microphonics (CM), (2) auditory nerve neurophonics, (3) summating potential, and (4) compound action potential. Over the past few decades, there have been ongoing refinements in technique and updates in the understanding of recorded potentials. Historically, ECochG found its main application in the diagnostic evaluation of Meniere’s disease (MD). However, in the last decade, the focus has shifted towards cochlear implantation (CI). In patients with residual hearing after CI, combined electric and acoustic stimulation has resulted in improved hearing and speech outcomes. Despite efforts to mitigate trauma during electrode insertion, hearing preservation rates vary after surgery. During implantation, real-time ECochG offers an opportunity to measure frequency specific CMs elicited from a localized region in the cochlea as the surgeon inserts the electrode array. In extracochlear ECochG recordings, the recording electrode can be placed on the promontory, the stapes, or the tympanic membrane. Intracochlear ECochG can be performed by inserting a recording electrode into the cochlea or by using one of the CI electrodes as the recording electrode. The loss of intraoperative ECochG signal may indicate cochlear trauma from electrode insertion, but the association between intraoperative ECochG changes and cochlear trauma remains controversial. The ability to monitor cochlear trauma during CI electrode placement holds promise to improve hearing preservation outcomes, modify surgical techniques, and change electrode design. The goal of this review is to provide a comprehensive overview of the electrophysiology and history of ECochG, discuss its recent applications in CI, and explore the ongoing research in this expanding field.

简介：AbstractDiffuse intrinsic pontine glioma (DIPG) is a lethal pediatric brain tumor and the leading cause of brain tumor-related death in children. As several clinical trials over the past few decades have led to no significant improvements in outcome, the current standard of care remains fractionated focal radiation. Due to the recent increase in stereotactic biopsies, tumor tissue availabilities have enabled our advancement of the genomic and molecular characterization of this lethal cancer. Several groups have identified key histone gene mutations, genetic drivers, and methylation changes in DIPG, providing us with new insights into DIPG tumorigenesis. Subsequently, there has been increased development of in vitro and in vivo models of DIPG which have the capacity to unveil novel therapies and strategies for drug delivery. This review outlines the clinical characteristics, genetic landscape, models, and current treatments and hopes to shed light on novel therapeutic avenues and challenges that remain.

简介：AbstractChronic hepatitis B virus (HBV) infection due to vertical transmission remains a critical concern with regards to eliminating HBV infection. Implementation of hepatitis B vaccine, the foundation to prevent perinatal and horizontal transmission, has reduced the prevalence of HBV by >80%. In countries where the hepatitis B immune globulin (HBIG) is available, such as China and the United States, the administration of HBIG and hepatitis B vaccine to the infants of mothers who are positive for hepatitis B surface antigen has become a standard practice and is effective in preventing vertical transmission. Accumulating evidence on the efficacy and safety of antiviral prophylaxis during pregnancy indicates the probability of attaining the goal of the World Health Organization to eliminate hepatitis by 2030. In this review, we discuss the transmission routes, diagnostic criteria, and preventive strategies for vertical transmission. A preventive program that includes screening before pregnancy, antiviral prophylaxis during pregnancy, and postpartum immunoprophylaxis provides "perfect strategies" to eliminate vertical transmission. However, there is still a notable gap between "perfect strategies" and real-world application, including insufficient coverage of timely birth dose vaccine and the efficacy and necessity of HBIG, especially in mothers who are negative for hepatitis B envelope antigen. In particular, there is a clear need for a comprehensive long-term safety profile of antiviral prophylaxis. Therefore, feasible and cost-effective preventive strategies need to be determined across regions. Access also needs to be scaled up to meet the demands for prophylaxis and prevalence targets.

简介：AbstractDiffuse intrinsic pontine glioma (DIPG) is a lethal pediatric brain tumor and the leading cause of brain tumor-related death in children. As several clinical trials over the past few decades have led to no significant improvements in outcome, the current standard of care remains fractionated focal radiation. Due to the recent increase in stereotactic biopsies, tumor tissue availabilities have enabled our advancement of the genomic and molecular characterization of this lethal cancer. Several groups have identified key histone gene mutations, genetic drivers, and methylation changes in DIPG, providing us with new insights into DIPG tumorigenesis. Subsequently, there has been increased development of in vitro and in vivo models of DIPG which have the capacity to unveil novel therapies and strategies for drug delivery. This review outlines the clinical characteristics, genetic landscape, models, and current treatments and hopes to shed light on novel therapeutic avenues and challenges that remain.

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简介：钝肾的损伤的管理一直在演变。过去的管理主要基于分级系统的损伤(AAST)的外科的美国协会，即要求了计算断层摄影术(CT)扫描。尽管CT扫描使用正在增加并且变得调查的标准化模式，分级的AAST不再在外科的干预的决定起唯一的作用。保守方法成功地管理的钝肾的损伤的二份案例报告被介绍。当与一顶头盔和完整的保护的设备在20km/h骑一辆机器脚踏车时，大小写一是有下降的1820岁的男孩。他被他的左胁腹打到岩石上。对比揭示的腹的CT4厘米，等级III脾的眼泪和等级IV与大perirenalhaematoma离开了肾损害。他的国际严厉分数(ISS)是34。他与床休息和监视的经常的浆液血色素保存地被管理。有推迟的对比的随后的CT与与等级IV肾的损害一致的尿溢出揭示了稳定的perirenalhaematoma。当他意指时，大小写二是在一条跑道上有一个马达自行车事故的4020岁的男性80～100km/h，穿一顶头盔。他失去了控制并且撞击了到跑道的sidewall上。对比揭示的腹的CT有大尿溢出的等级IV左肾的损害。他的肾的损害与间隔保存地被管理腹部的推迟的阶段CT。腹部上的重复CT被执行在没揭示剩余urinoma的起始的损害以后的五个月。在这学习，而且，到钝肾的损伤的管理的文学的评论被进行表明增加如此的损伤的保守管理的趋势。额外的放射学的参数可以指导未来决策。然而，数据的适用性可以被限制直到使随机化的试用是可得到的。

简介：Invasivefractionalflowreserve(FFR)measurementiscurrentlythegoldstandardforcoronaryintervention.FFRmeasurementbycoronarycomputedtomographyangiography(FFRCT)isanovelandpromisingimagingtechnologythatpermitsnoninvasiveassessmentofphysiologicallysignificantcoronarylesions.FFRCTiscapableofcombiningtheanatomicinformationprovidedbycoronarycomputedtomographyangiographywithcomputationalfluiddynamicstocomputeFFR.Todate,severalstudieshavereportedthediagnosticperformanceofFFRCTcomparedwithinvasiveFFRmeasurementasthereferencestandard.FurtherstudiesarenowbeingimplementedtodeterminetheclinicalfeasibilityandeconomicimplicationsofFFRCTtechniques.ThisarticleprovidesanoverviewanddiscussestheavailableevidenceaswellaspotentialfuturedirectionsofFFRCT.

简介：Theabilitytomodulatethefutureliverremnant(FLR)isakeycomponentofmodernoncologichepatobiliarysurgerypracticeandhasextendedsurgicalcandidacyforpatientswhomayhavebeenpreviouslythoughtunabletosurviveliverresection.MultipletechniqueshavebeendevelopedtoaugmenttheFLRincludingportalveinembolization(PVE),associatingliverpartitionandportalveinligation(ALPPS),andtherecentlyreportedtranshepaticlivervenousdeprivation(LVD).PVEisawell-establishedmeanstoimprovethesafetyofliverresectionbyredirectingbloodflowtotheFLRinanefforttoselectivelyhypertrophyandultimatelyimprovefunctionalreserveoftheFLR.ThisarticlediscussesthecurrentpracticeofPVEwithfocusonsummarizingthelargenumberofpublishedreportsfromwhichoutcomesbasedpracticeshavebeendeveloped.BothtechnicalaspectsofPVEincludingvolumetry,approaches,andembolizationagents;andclinicalaspectsofPVEincludingdatasupportingindications,anditsroleinconjunctionwithchemotherapyandtransarterialembolizationwillbehighlighted.PVEremainsanimportantaspectofoncologiccare;inlargepartduetothesubstantialfoundationofinformationavailabledemonstratingitsclearclinicalbenefitforhepaticresectioncandidateswithsmallanticipatedFLRs.

简介：摘要：冠心病位于人类死亡原因之首，虽然药物治疗、冠状动脉经皮介入治疗和冠状动脉旁路移植等血运重建治疗有了飞速的发展，但仍有一部分患者并不能通过这些治疗理想的控制病情。这些患者症状得不到有效控制、生活质量降低，传统药物治疗效果不理想，且因患者自身血管解剖学和非解剖学原因不能从PCI或CABG获益，属于难治性冠心病，成为了现代医学的难题。因此多种替代治疗方法应用于本病的治疗，如激光心肌血运重建、原位冠状静脉动脉化、增强型体外反搏、基因和细胞技术、脊髓刺激法等，但这些方法可行性和安全性上尚未得到肯定，且有些方法还不成熟，需要进一步改良或形成新的技术，并转换以往的视角，开拓现代植物药学、运动心脏康复等尚未普及的领域。本文拟阐述对难治性冠心病的认识，总结定义和特点，对现有的治疗方法进行总结并思考本病的治疗方向。