简介：AbstractPreeclampsia is a progressive, multi-system disorder of pregnancy associated with morbidity and mortality on both the mother and the fetus. Currently, research is directed at identifying early biomarkers of preeclampsia in order to predict its occurrence. This is important because it helps understand the pathophysiology of the disease, and thus, promises new treatment modalities. Although a clear understanding of the pathogenesis of PE remains elusive, the currently most accepted theory suggests a two-stage process. The first stage results in inadequate remodeling of the spiral arteries and leads to the second stage, whereby the clinical features of the syndrome are featured. In this review, we summarize the modalities that have been studies so far to predict preeclampsia. The use of uterine artery Doppler and several other biomarkers such as vitamin D, soluble fms-like tyrosine kinase 1/placental growth factor (sFLT1/PlGF) ratio, soluble endoglin, and a subset of T-lymphocytes has shown promising results. We are still at early stages in this advance, and no clear recommendations have been made about their clinical use to date. Further studies are still needed to improve screening strategies and evaluate the cost-effectiveness of any intervention.

简介：Earlydiagnosisandtreatmentisthekeytoimprovingtheprognosisofgastriccancer.Thepastdecadeshavewitnessedtherapidadvancesinthediagnosisandmanagementofearlygastriccancer(EGC):endoscopyhasplayedanincreasinglyimportantrole,whereaslaparoscopictechniqueshavealsobeenintroducedforEGCtreatment.InChina,the

简介：Objective:Toevaluatetheeffectofosteoporosisonfracturehealingthroughobservingthehistomorphologicalchanges,bonemineraldensityofcallusandexpressionanddistributionoftransforminggrowthfactorbeta1(TGF-β1),basicfibroblastgrowthfactor(bFGF)andbonemorphogeneticprotein-2(BMP-2)inovariectomizedrats.Methods:SixtyfemaleSprague-Dawleyrats(aged12weeksandweighing235gonaverage)wererandomlydividedintoanovariectomized(OVX)group(n=30)andasham-operated(SO)group(n=30).OvariectomywasperformedintheOVXratsandsameincisionwasmadeintheSOrats.Threemonthslater,fractureoffemoralshaftwasmadeonalltherats.Thentheywerekilledatdifferenttimepoints.Callusformationwasobservedwithhistologicalandimmunohistochemicalmethods.Results:AreductionincallusandbonemineraldensityinthehealingfemurandadecreaseofosteoblastsexpressingTGF-β1nearthebonetrabeculawereobservedintheOVXrats3-4weeksafterfracture.HistomorphologicalanalysisrevealedahighercontentofsoftcallusintheOVXratsthanthatintheSOrats.ImmunohistochemistryresultsshowedthatnoremarkabledifferenceinexpressionanddistributionofBMP-2andbFGFbetweentheOVXandSOgroupswasfound.Conclusions:Osteoporosisinfluencesthequantityandqualityofcallusduringtheearlyperiodoffracturehealing.TheeffectofosteoporosisonfracturehealinghasnorelationshipwiththeexpressionofBMP-2orbFGF.ThedecreasedexpressionofTGF-β1inosteoblastsmaycauseadecreaseinqualityoffacturehealingafterosteoporosis.

简介：精子是导出把父亲的单倍体染色体送到卵母细胞的一种高度专业化的房间类型。渐成说，或基因规章，精子的性质和机制在父亲的染色体的准备帮助贡献胚胎开始和接合子的染色体。许多最近的研究在精子处理了改变的渐成说过程的问题。这评论评估DNA损坏，染色体非整倍性，减少的端粒长度，中心体的畸形性，印错误的genomic，改变的mRNA侧面，并且在胚胎开始上的在授精和观察效果以前的在精子的反常原子包装的当前的理解。注意也被给了在人与改变的渐成说机制理解精子的内在的病原学。

简介：Traumaticinjuriestothecentralnervoussystem(CNS),includingtraumaticbraininjury(TBI)andspinalcordinjury(SCI),ofteninvolveanimmediatemechanicaldamagetoplasmamembranethatsurroundsneuronalsomataandaxons.Thisinitialdisruptionofplasmamembranefollowinginjurieshasbeenconvincinglydemonstratedbyincreasedmembrane

简介：AbstractChronic obstructive pulmonary disease (COPD) is a respiratory disease with a high incidence, mortality, and disability rate. Because there are few symptoms in the early stages of COPD, diagnosis and treatment are seriously insufficient. It is necessary to find effective clues for early COPD diagnosis and provide appropriate interventions. Several studies suggest that small airway disease is the earliest stage of COPD because it is correlated with subsequent development of airflow obstruction. However, there are currently no globally accepted criteria for defining early COPD. This study mainly introduced risk factors, definition, diagnosis, and treatment of early COPD from a new perspective.

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简介：Thecurrentulcerativecolitis(UC)treatmentalgorithminvolvesastep-uptherapeuticstrategy,mainlyaimingatinducingandmaintainingitsclinicalremission.Althoughthistherapeuticstrategymayseemtobecost-efficientandreducetheriskofsideeffects,recenttrialsandcasereportshaveshownthattop-downtherapyusingin·iximabinducesarapidclinicalresponse,enhancespatientqualityoflife,promotesmucosalhealing,reducessurgeriesandindirectcostoftreatmentforpatientswithsevereUC.Moreover,sincelong-termtreatmentwithin·iximabissafeandwelltolerated,earlyaggressivetop-downtherapeuticstrategymaybeamoreeffectiveapproach,atleastinasubgroupofsevereextensiveUCpatients.

简介：Earlyrepolarizationisawell-described,commonelectrocardiographicvariant.Itwasinitiallyfelttobebenign,butinthelasttwentyyearsasuggestedalinkbetweenspecifictypesofearlyrepolarizationandsuddencardiacdeathhasemerged.ThisassociationwashasbeentermedtheJwavesyndromeandincludesboththehighriskearlyrepolarizationandBrugadaECGpatterns.Theoddsofearlyrepolarizationchangebeingassociatedwithpooroutcomesarestillexceedinglysmall.Nevertheless,theassociationofafairlyubiquitousECGfindingwithfatalornearfatalclinicaloutcomeshasraisedconcern.Howcanweidentifythetrulyhigh-riskpatients?IfapatienthasasignificantclinicaleventwithaconcerningECGrepolarizationpattern,whatshouldbedonenext?TheauthorsofthisreviewpresentcurrentinformationregardingtheEarlyRepolarizationandBrugadaSyndromesandhowtoproceedwithdiagnosis,management,andriskstratificationwhenearlyrepolarizationchangeisobservedonECG.

简介：Heartratevariaty(HRV)of85caseswithAMIwasobservedintheearlyphaseafteronsetandrehabilitationphaseatfirstmonthandsixthmonth,andwascontrastedwithsixtimethresholdindicesof111caseswithcoronaryheartdiseaseandthatof35normalcontrol.WefoundtheHRVofAMIwasapperantlylowerintheacutephasethanthatofcoronaryheartdiseaseandnormalcontrols.HRVrecoveredgraduallywithincliningtobestableafterhalfayear,butitwasstilllowerthanthatofcontrols.LowHRVinearlyphaseofAMIsuggestedthepoorprognosis.

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简介：AbstractThe treatments for early-onset scoliosis (EOS) remain great challenges for spine surgeons. This study aimed to comprehensively review the treatments for EOS, especially the advancements made in the last decade. Current studies on EOS were retrieved through a search on PubMed, UpToDate, the Web of Science Core Collection and Scopus were reviewed. The most pertinent information related to the current treatments for EOS was collected. The foci of treatments for EOS have included creating a well-developed thoracic cavity, improving lung volume, and improving pulmonary function. Conservative treatments include bracing, casting, halo-gravity traction, and physiotherapy. Serial casting is the most effective conservative treatment for EOS. Surgical treatments mainly include growth-friendly techniques, which are generally classified into three types according to the amount of correction force applied: distraction-based, compression-based, and growth-guided. The distraction-based systems include traditional or conventional growing rods, magnetically controlled growing rods, and vertical expandable prosthesis titanium ribs. The compression-based systems include vertebral body stapling and tethering. The growth-guided systems include the Shilla system and modern Luque trolley. In addition, some newer techniques have emerged in recent years, such as posterior dynamic deformity correction (ApiFix). For EOS patients presenting with sharp deformities in a long, congenital spinal deformity, a hybrid technique, one-stage posterior osteotomy with short segmental fusion and dual growing rods, may be a good choice. Hemivertebra resection is the gold standard for congenital scoliosis caused by single hemivertebra. Although the patient’s growth potential is preserved in growth-friendly surgeries, a high complication rate should be expected, as well as a prolonged treatment duration and additional costs. Knowledge about EOS and its treatment options is rapidly expanding. Conservative treatments have specific limitations. For curves requiring a surgical intervention, surgical techniques may vary depending on the patients’ characteristics, the surgeon’s experience, and the actual state of the country.

简介：ObjectivesItisnotfullyclarifiedhowdiabetesmellitusinducedcardiacdysfunctionandmyocardialultrastructuralchangesintheearlystate.Inthepresentstudy,weprovidedanintegratedapproachtoinvestigateearlychangesinmyocardialfunctionofdiabeticrabbitsandassessedthestructuralalteration.MethodsandResultsDiabeteswasinducedbyalloxaninjection.After30days,echocardio-graphyandleftventricularcannulationwereperformedindia-betic(D,n=8)andcontrolrabbits(C,n=10).Aftercatheterization,animalswerekilledforhistologicalstudies.Hema-toxylin-eosinandMasson’sTrichromestainingoftheheartwereanalyzed.Theultrastructureofleftventriclewasalsoexaminedwithelectronmicroscopy.EchocardiographyrevealedthatearlydiabeticcardiomyopathyhadimpairedLVdiastolicfunctionexpressedbydiminishedE-waves,increasedAwaves,E/AratioreversionandincreasedE-wavedecelerationtime(EDT).Concurrently,LVend-diastolicpressure(LVEDP)anddiastolictimeconstant(T)wereincreased,minimumdP/dt(LV-dp/dt)wasreduced,obtainedthroughcardiaccatheterization.TherewerenosignificantdifferencesinLVejectionfraction(EF),LVpeaksystolicpressure(LVSP),ormaximumdP/dt(LV+dp/dt).Qualitativelightmicroscopyrevealednohistologicchangesinmyocardiumfromdiabeticrabbits.Themostevidentultrastructuralchangewasspottedmyofibrillardamage,whileinterstitialfibrosiswasslight.ConclusionsTheseresultssuggestthatearlydiabeticcardiomyopathyinanimalmodelischaracterizedbyleftventriculardiastolicdysfunction,bothimpairedactiverelaxationandincreasedpassivechamberstiffness.Whereas,leftventricularsystolicfunctioncanremainnormal.Itmightpartlycontributetomyofibrillardamage,butnotmyocardialfibrosis.

简介：ObjectiveTodetectearlysignsofnoise-inducedhearingloss(NIHL)inmilitarypilotswithouthearingcomplaints.MethodsPuretoneaudiometryandacousticreflexthresholdsweretestedin36militarypilots(72ears)withnoiseexposurehistorybutnocomplaintsofhearingloss.Conventionaltestfrequencies(0.25-8kHz)andextendedhighfrequencies(EHF,10and12.5kHz)wereincludedinaudiometry.Whitenoiseandpuretonesat0.5,1,2,and4kHzwereusedforacousticreflextests.Twentynormalhearingsubjects(40ears)withnoexposuretooccupationalnoisewereusedascontrols.ResultsPuretonethresholdsatallconventionalfrequenciesandatEHFswereelevatedinthepilots,withthemaximumshiftat4kHz,comparedwithcontrols(p<0.01).ThepilotsalsoshowedelevatedARTtowhitenoiseanddecreaseddifferentialsbetweenwhitenoiseandpuretoneARTs(p<0.01).ConclusionEarlysignsofNIHLarepresentinsomesymptom-freemilitarypilots.Highfrequencyhearingthresholdshift,elevatedwhitenoiseARTanddecreaseddifferentialbetweenwhitenoiseandpuretoneARTsmaybeobjectiveindicatorsofearlyNIHL.

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简介：AbstractBackground:Functional mitral regurgitation (FMR) is common in critically ill patients and may cause left atrial (LA) pressure elevation. This study aims to explore the prognostic impact of synergistic LA pressure elevation and FMR in patients with shock.Methods:We retrospectively screened 130 consecutive patients of 175 patients with shock from April 2016 to June 2017. The incidence and impact of FMR and early diastolic transmitral velocity to early mitral annulus diastolic velocity ratio (E/e’) ≥ 4 within 6 h of shock on the prognosis of patients were evaluated. Finally, the synergistic effect of FMR and E/e’ were assessed by combination, grouping, and trend analyses.Results:Forty-four patients (33.8%) had FMR, and 15 patients (11.5%) had E/e’ elevation. A multivariate analysis revealed FMR and E/e’ as independent correlated factors for 28-day mortality (P = 0.043 and 0.028, respectively). The Kaplan-Meier survival analysis revealed a significant difference in survival between patients with and without FMR (χ2 = 7.672, P = 0.006) and between the E/e’ ≥ 14 and E/e’ < 14 groups (χ2 = 19.351, P < 0.010). Twenty-eight-day mortality was significantly different among the four groups (χ2 = 30.141, P < 0.010). The risk of 28-day mortality was significantly higher in group 4 (E/e’ ≥ 14 with FMR) compared with groups 1 (E/e’ < 14 without FMR) and 2 (E/e’ < 14 with FMR) (P = 0.001 and 0.046, respectively).Conclusions:Patients with shock can be identified by the presence of FMR. FMR and E/e’ are independent risk factors for a poor prognosis in these patients, and prognosis is worst when FMR and E/e’ ≥ 14 are present. It may be possible to improve prognosis by reducing LA pressure and E/e’.Trial Registration:ClinicalTrials.gov, NCT03082326.

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简介：EpidemiologicalstudiesshowedtheincidencemortalityratesofcancerwereincreasinginrecentdecadesinChinesepopulation.Nationalandregionalpreventiveprogramsaimtoreducethehealthhazardsofcancerandfocusethepopulationathighrisksforspecificcancer,particularlyinruralareasandtooffertheaccesstoearlydetectionformultlplecancersinurbanareas.Theearlyscreening,earlydetectionandtreatmenthavebeenputintooperationforthepopulationatrisksinruralareasatfirst,andintheurbanareasinrecentyears.Tounderstandtheepidemicpatternsandtrendsofcancer,andtheexperiencesinapplyingearlydetectionstrategiesinChina,selectedliteratureswerereviewedforbriefsummary.