经食道心房调搏的放射性核素心血管造影

本文应用反符合电路剔除调搏脉冲干扰的方法,制成经食道心房调搏心电心音门电路触发装置,用于经食道心房调搏的核素心血管造影。参考Tzivoni标准,当逐级增加调搏心率至140次/min或亚极量心率后发现:冠心病人有调搏后EF降低;急性心肌梗塞病人EF减低更为明显,并呈室壁反向运动。因此,心房调搏核素心血管造影有助于冠心病,特别是心肌梗塞的诊断。     

中国大陆进口冷链食品关联新型冠状病毒疫情调查

目的 新型冠状病毒（SARS-CoV-2）全球大流行以来,中国大陆报道了多起SARS-CoV-2污染进口冷链食品引起的本土新冠疫情,分析此类疫情的特点和传播概况,可以为今后类似疫情防控提出相应建议。方法 收集SARS-CoV-2污染进口冷链食品引起本土新冠疫情文献、官方新闻报道等信息,整理和分析相应数据。结果 2020年6月至2022年11月,共检索到此类疫情20起,包含1 646例病例,涉及9个省（自治区、直辖市）。其中,2020年10起,2021年3起,2022年7起;病例数规模在200例及以上共3起。结论 新冠全球大流行以来中国大陆检索到的20起进口冷链食品相关本土新冠疫情均为冷链从业人员接触进口冷链食品或其外包装感染引起,且大部分（75%）引起了后续社区传播,但是在中国大陆集中监管仓建设等各种有力控制措施下,此类疫情数量和持续时间均呈下降趋势。     

Neurotoxicity Associated with Treatment of Acute Lymphoblastic Leukemia Chemotherapy and Immunotherapy

Immunotherapy is a milestone in the treatment of poor-prognosis pediatric acute lymphoblastic leukemia (ALL) and is expected to improve treatment outcomes and reduce doses of conventional chemotherapy without compromising the effectiveness of the therapy. However, both chemotherapy and immunotherapy cause side effects, including neurological ones. Acute neurological complications occur in 3.6–11% of children treated for ALL. The most neurotoxical chemotherapeutics are L-asparaginase (L-ASP), methotrexate (MTX), vincristine (VCR), and nelarabine (Ara-G). Neurotoxicity associated with methotrexate (MTX-NT) occurs in 3–7% of children treated for ALL and is characterized by seizures, stroke-like symptoms, speech disturbances, and encephalopathy. Recent studies indicate that specific polymorphisms in genes related to neurogenesis may have a predisposition to MTX toxicity. One of the most common complications associated with CAR T-cell therapy is immune effector cell-associated neurotoxicity syndrome (ICANS). Mechanisms of neurotoxicity in CAR T-cell therapy are still unknown and may be due to disruption of the blood–brain barrier and the effects of elevated cytokine levels on the central nervous system (CNS). In this review, we present an analysis of the current knowledge on the mechanisms of neurotoxicity of standard chemotherapy and the targeted therapy in children with ALL.     

Human Stem Cell and Organoid Models to Advance Acute Kidney Injury Diagnostics and Therapeutics

Acute kidney injury (AKI) is an increasingly common problem afflicting all ages, occurring in over 20% of non-critically ill hospitalized patients and >30% of children and >50% of adults in critical care units. AKI is associated with serious short-term and long-term consequences, and current therapeutic options are unsatisfactory. Large gaps remain in our understanding of human AKI pathobiology, which have hindered the discovery of novel diagnostics and therapeutics. Although animal models of AKI have been extensively studied, these differ significantly from human AKI in terms of molecular and cellular responses. In addition, animal models suffer from interspecies differences, high costs and ethical considerations. Static two-dimensional cell culture models of AKI also have limited utility since they have focused almost exclusively on hypoxic or cytotoxic injury to proximal tubules alone. An optimal AKI model would encompass several of the diverse specific cell types in the kidney that could be targets of injury. Second, it would resemble the human physiological milieu as closely as possible. Third, it would yield sensitive and measurable readouts that are directly applicable to the human condition. In this regard, the past two decades have seen a dramatic shift towards newer personalized human-based models to study human AKI. In this review, we provide recent developments using human stem cells, organoids, and in silico approaches to advance personalized AKI diagnostics and therapeutics.     

Genetics and Epigenetics of Spontaneous Intracerebral Hemorrhage

Intracerebral hemorrhage (ICH) is a complex and heterogeneous disease, and there is no effective treatment. Spontaneous ICH represents the final manifestation of different types of cerebral small vessel disease, usually categorized as: lobar (mostly related to cerebral amyloid angiopathy) and nonlobar (hypertension-related vasculopathy) ICH. Accurate phenotyping aims to reflect these biological differences in the underlying mechanisms and has been demonstrated to be crucial to the success of genetic studies in this field. This review summarizes how current knowledge on genetics and epigenetics of this devastating stroke subtype are contributing to improve the understanding of ICH pathophysiology and their potential role in developing therapeutic strategies.     

The Predictive Role of Plasma Biomarkers in the Evolution of Aortopathies Associated with Congenital Heart Malformations

Dilatation of the aorta is a constantly evolving condition that can lead to the ultimate life-threatening event, acute aortic dissection. Recent research has tried to identify quantifiable biomarkers, with both diagnostic and prognostic roles in different aortopathies. Most studies have focused on the bicuspid aortic valve, the most frequent congenital heart disease (CHD), and majorly evolved around matrix metalloproteinases (MMPs). Other candidate biomarkers, such as asymmetric dimethylarginine, soluble receptor for advanced glycation end-products or transforming growth factor beta have also gained a lot of attention recently. Most of the aortic anomalies and dilatation-related studies have reported expression variation of tissular biomarkers. The ultimate goal remains, though, the identification of biomarkers among the serum plasma, with the upregulation of circulating MMP-1, MMP-2, MMP-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), asymmetric dimethylarginine (ADMA), soluble receptor for advanced glycation end-products (sRAGE) and transforming growth factor beta (TGF-β) being reported in association to several aortopathies and related complications in recent research. These molecules are apparently quantifiable from the early ages and have been linked to several CHDs and hereditary aortopathies. Pediatric data on the matter is still limited, and further studies are warranted to elucidate the role of plasmatic biomarkers in the long term follow-up of potentially evolving congenital aortopathies.     

Mutated KIT Tyrosine Kinase as a Novel Molecular Target in Acute Myeloid Leukemia

KIT is a type-III receptor tyrosine kinase that contributes to cell signaling in various cells. Since KIT is activated by overexpression or mutation and plays an important role in the development of some cancers, such as gastrointestinal stromal tumors and mast cell disease, molecular therapies targeting KIT mutations are being developed. In acute myeloid leukemia (AML), genome profiling via next-generation sequencing has shown that several genes that are mutated in patients with AML impact patients’ prognosis. Moreover, it was suggested that precision-medicine-based treatment using genomic data will improve treatment outcomes for AML patients. This paper presents (1) previous studies regarding the role of KIT mutations in AML, (2) the data in AML with KIT mutations from the HM-SCREEN-Japan-01 study, a genome profiling study for patients newly diagnosed with AML who are unsuitable for the standard first-line treatment (unfit) or have relapsed/refractory AML, and (3) new therapies targeting KIT mutations, such as tyrosine kinase inhibitors and heat shock protein 90 inhibitors. In this era when genome profiling via next-generation sequencing is becoming more common, KIT mutations are attractive novel molecular targets in AML.     

A smartphone‐based U‐Healthcare system for real‐time monitoring of acute myocardial infarction

In recent years, medical service has been evolving from systems designed around centralized hospitals to Ubiquitous Healthcare (U‐Healthcare). U‐Healthcare system can facilitate real‐time monitoring of patient states, and can provide medical checkups and management whenever and wherever the medical staff deems necessary. U‐Healthcare services can provide chronic condition monitoring in the early stages of diseases and help execute decisive medical action in emergencies. However, thus far, the application of U‐Healthcare systems has been limited to diseases such as obesity, diabetes, etc. Acute myocardial infarction (AMI) is among the most critical chronic diseases and requires early detection and treatment. In this paper, we propose an AMI diagnostic software technique and protocol that can support real‐time communication between the patient and medical personnel. Our monitoring and diagnostic system has been developed using a protocol based on ISO/IEEE 11073. When data is transferred from the patient's smartphone to a server in hospital, the medical personnel consult the patient's biosensor data to determine the status of the relevant disease and provide appropriate medical service. The relevant information is sent back to the patient's smartphone through a wireless network, and patients can view their data in graphical format through their smartphone. Copyright © 2015 John Wiley & Sons, Ltd.     

Bioinspired Multiantioxidant-Cooperative Nanotheranostic Platform for Realizing Time-Sensitive Management of Acute Kidney Injury

Targeting the pivotal pathological processes of acute kidney injury (AKI) and parallelly monitoring the treatment process has emerged as an intriguing strategy for the timely tailored treatment of AKI, especially in the acute phase. Unfortunately, current clinical treatment approaches are restricted to supportive care, which shows limited efficiency. Herein, a multiantioxidant-cooperative polydopamine-based nanotheranostic platform (mc-PDATP) is reported to achieve imaging-assisted time-sensitive therapy of AKI. Benefiting from the decoration of atomic Cu, mc-PDATP comprehensively mimics the complicated antioxidant defense system as in natural environment, thus displaying improved catalytic activity to multiple toxic reactive oxygen species (ROS). Consequently, both in vitro and in vivo experiments confirm mc-PDATP can efficiently protect the kidney from ROS attack and rescue the kidney function via targeting the inflammatory network of AKI. In addition, the coordinated atomic Gd contributes to a desired magnetic resonance (MR) T1-weighted contrast effect of mc-PDATP, which can be used to construct the sensitive MR histogram imaging signatures for pinpointing treatment effects in a timely manner. The study represents an innovative strategy for anti-AKI therapy, which will facilitate the development of next-generation theranostic nano-antioxidants.     

Gelable and Adhesive Powder for Lethal Non-Compressible Hemorrhage Control

Hemostatic powders are widely used in clinical and emergency situations but often exhibit low wet adhesion, cytotoxicity concerns, and do not work well for lethal non-compressible hemorrhage. Here a new kind of gelable and adhesive powder (GAP) is developed, which integrates chitosan microspheres (CM), tetra-armed poly(ethylene glycol) amine (Tetra-PEG-NH₂), and tetra-armed poly(ethylene glycol) succinimidyl succinate (Tetra-PEG-SS). Upon application to the wound site, the macroporous CM can rapidly absorb the interfacial liquids, and meanwhile, the hydrated GAP turns into hydrogel (crosslinking between Tetra-PEG-SS and CM/Tetra-PEG-NH₂) with stable and robust adhesion to the wet tissue though covalent bonding. The in vitro and in vivo results suggest that the GAP with optimized formulation exhibits strong tissue adhesive, high burst pressure, and enhanced blood clotting ability, as well as excellent biocompatibility and on-demand removal properties. A significantly improved hemostatic efficacy is demonstrated in the rat liver, spleen, and femoral artery injury models compared to that of the CM, commercial fibrin glue, and Yunnan Baiyao (YB). The GAP can also halt the severe bleeding from pig visceral organs. Overall, the proposed GAP has many advantages including good biocompatibility, rapid and effective hemostasis, low cost, and ease of use, making it as a promising hemostat for lethal non-compressible hemorrhage control.