Mitochondria, as the guardians of cells, have complex physiological functions in living organisms. Mitochondrial autophagy, as a selective autophagy method, plays a crucial role in clearing damaged mitochondria, maintaining the quantity and function of mitochondria, and so on. After myocardial infarction, myocardial cells undergo ischemia and reperfusion injury, accompanied by abnormal mitochondrial function and an increase in the number, leading to the formation of myocardial fibrosis. The activation of mitochondrial autophagy has potential therapeutic value for im-proving myocardial injury and fibrosis. This article will summarize the specific pathways through which mitochondrial autophagy improves myocardial fibrosis after myocardial infarction, and comprehensively elaborate on the research progress of traditional Chinese medicine intervention in mitochondrial autophagy, in order to provide more effective strategies for the clinical treatment of myocardial fibrosis after myocardial infarction
Calcium sensing receptor (CaSR) is a G-protein-coupled receptor that induces highly diffused messengers to activate various cellular responses. Recently, it has been suggested that CaSR mediates signal communication among endoplasmic reticulum, mitochondria, and nucleus, and this process is associated with myocardial injury. Cardiomyocytes are permanent cells and do not regenerate. Therefore, this paper will focus on the relevant regulatory mechanisms of CaSR in myocardial injury, comb out the complex intracellular signal transduction network mediated by CASR, and provide ideas for finding new therapeutic targets for myocardial injury.
Internet medical care has great potential for development, and the scientific research carried out under the background of internet medical care needs to be explored. This study starts from the application scenarios of internet medical care, and explores the selection of clinical scientific research topics under different application scenarios. Analyze the challenges faced by the application of internet medical care in clinical scientific research, and provide rational suggestions for the development of internet medical application in clinical scientific research. The results show that internet medical care has been applied in clinical diagnosis and treatment, pharmaceutical services, scientific research process management, rehabilitation care, health science popularization, etc. in clinical scientific research, highlighting the characteristics of convenience and accuracy, innovating diagnosis and treatment models, and improving service efficiency. The study specifically explores the challenges faced by clinical scientific research in the context of internet medical care in five aspects of scientific research elements, including the transformation of clinical evidence, the exchange and sharing of medical and health information, the development of clinical research methodologies, the training and supervision of scientific researchers, and internet traditional Chinese medicine. The development ideas of clinical scientific research and other aspects provide suggestions for the application of internet medical care in clinical scientific research, with a view to providing theoretical reference for the development of clinical scientific research related to internet medical care.
In children, autism spectrum disorder (ASD) is primarily characterized by social (communication) impairments and repetitive, stereotyped behaviors and restricted interests, affecting children's social interaction, communication abilities, and behavioral patterns. In recent years, with technological advancements, digital therapeutics has played a significant role in managing ASD. For instance, multimodal data integration and machine learning algorithms have been used for the early identification of ASD, while virtual reality, augmented reality, and gamified learning platforms have been widely applied to enhance the social skills and cognitive functions of children with ASD. Although digital therapy has shown great potential and benefits in the field of autism, it also faces challenges, including individual differences in treatment response, uncertainty of long-term effectiveness, and data privacy protection. Overall, digital therapeutics has opened up a new path for the management of autism, and also points out important directions for future research and applications.
Diet plays a critical role in the development, progression and prognosis of inflammatory bowel disease (IBD) . Given that specific nutritional guidelines are limited, nutritional management for patients with IBD remains challenging and fraught with uncertainty. Although previous studies have demonstrated that artificial intelligence (AI) shows promising applications in the nutritional management of patients with chronic diseases, research specifically focused on its application in the nutritional management of patients with IBD remains limited.
To conduct a scoping review of studies on AI in nutrition management of patients with IBD.
Following the methodology of scoping reviews, the databases of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, IEEE Xplore, Association for Computing Machinery Digital Library, SinoMed, CNKI, Wanfang Data, and VIP were systematically searched from inception to March 2024 for studies on the application of AI in the nutritional management of patients with IBD. According to the established inclusion and exclusion criteria, two investigators independently screened the literature, and the basic characteristics of the selected studies were extracted.
A total of 15 studies were included. The applications of AI in this field include exploring the relationship between diet and IBD, assisting in nutritional assessment, and aiding nutritional interventions. The majority of utilization AI technologies in the included studies are machine learning, with some also employing additional techniques such as natural language processing and deep neural networks.
AI is beneficial for exploring healthy dietary patterns for patients with IBD and providing personalized nutritional guidance. However, its application in the field of nutritional management in patients with IBD is still in its infancy. Future efforts should focus on strengthening multidisciplinary collaboration, emphasizing the integration of clinical guidelines, and assessing the effectiveness of AI applications in clinical settings to enhance the rigor and accuracy of the results.
Ischemic cardiomyopathy (ICM) is an important cause of heart failure with reduced ejection fraction. Despite the improvement of treatment methods, it still has a high mortality. Coronary revascularization is an important treatment for ICM patients, due to the fact that ICM patients are elderly, have multiple diseases and severe coronary artery lesions, the risk of revascularization is relatively high. Currently, there is still controversy over whether and how to revascularization in ICM patients. Myocardial viability has predictive value for the prognosis of ICM patients and provides reference for selecting treatment strategies, but its guiding value for revascularization in ICM patients still needs further verification. This article provides a review of the current treatment of ICM patients, commonly used methods for myocardial viability assessment, and the clinical application of myocardial viability to guide revascularization, so as to provide reference for clinical work.
Deubiquitination, mediated by deubiquitinating enzymes (DUBs), represents a crucial class of post-translational protein modifications. Its primary mechanism involves in the interaction of DUBs with ubiquitinated target proteins, whereby the DUBs cleave or remove ubiquitin chains from these targets, subsequently restoring their expression levels and functional activities. This article systematically reviews the latest research progress on deubiquitination in age-related diseases, covering the types of DUBs, their roles in cellular aging, and the regulatory mechanisms in age-related diseases through different pathways. It also summarizes the research progress in the development of small-molecule drugs targeting DUBs and related mechanisms. This review demonstrates that as the body ages, factors such as decreased protein renewal function and oxidative damage lead to the accumulation of ubiquitinated proteins, resulting in cellular dysfunction. DUBs play an important and complex regulatory role in age-related diseases by modulating mechanisms such as protein homeostasis, mitochondrial function, and cell cycle in aging cells.
Diabetic foot ulcer (DFU) is usually accompanied by varying degrees of peripheral neuropathy and vasculopathy. It is a difficult-to-heal wound. The delayed healing process is mainly due to new blood vessel regeneration disorder, persistent wound inflammation, wound re-epithelialization disorder and abnormal fibroblast proliferation. Exosomal miRNA, as an important medium for intercellular communication, is involved in a variety of biological processes and can regulate the transcription and translation of various target genes affecting DFU healing. This paper aims to briefly review the role of exosomal miRNAs in the regulation of neointimal regeneration, inflammatory response, wound re-epithelialization function, and fibroblast proliferation function in the repair of DFU, to provide new ideas for the treatment of DFU.
Family hypercholesterolemia (FH) is a common genetic metabolic disease, characterized by an abnormal increase in low-density lipoprotein cholesterol (LDL-C), which may manifest as corneal arcus and xanthomas. Long-term high levels of LDL-C can increase the risk of atherosclerotic cardiovascular disease (ASCVD). FH patients have a higher risk of early-onset ASCVD, with homozygous FH being more severe. Global prevalence of FH has gradually gained attention, but diagnosis and treatment still face challenges. Leveraging the release of the 2023 Chinese Lipid Management Guidelines, this article primarily compares domestic and foreign screening and diagnostic approaches to emphasize the importance of screening for lipid profiles and recommend early identification of FH patients. Additionally, genetic testing is also recommended, including not only a few key genes but also other related genes or whole-genome detection. Furthermore, this article compares different guidelines on LDL-C control management levels and ASCVD risk factors for different LDL-C subgroups. It highlights the differences in dietary recommendations, lifestyle advice, and medication control between domestic and foreign guidelines, pointing out that statins are the primary cholesterol-lowering agents universally recognized as important, with combination therapy being particularly crucial. However, for patients who failed to achieve LDL-C control after maximally tolerated therapy, international lipid management guidelines have made updates. Meanwhile, for Homozygous familial hypercholesterolemia (HoFH) patients, high-intensity statin combination therapy with other medications is the preferred approach, and early treatment is crucial; timely consideration of lipoprotein apheresis and Recombinant proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can help reduce the incidence and mortality rate of ASCVD.
Neonatal hypoxic-ischemic brain damage (HIBD) is one of the common causes of neurological injuries in the neonatal period, which is prone to lead to high disability and mortality in newborns, and its pathogenesis is complex and there is no specific treatment in the clinic. Ferroptosis, as a newly discovered type of non-apoptotic cell death in recent years, has received widespread attention and has gradually become a research hotspot. Research on ferroptosis and neonatal HIBD has been increasing year by year, and a large number of studies have shown that ferroptosis is closely related to the occurrence and development of neonatal HIBD. Moreover, it has been pointed out that vitamin K2, especially MK-4, can exert its neuroprotective effect by inhibiting ferroptosis. In this paper, we briefly review the mechanism of ferroptosis in neonatal HIBD and microglia, and look forward to the possibility that vitamin K2, especially MK-4, can improve the prognosis of neonatal HIBD by inhibiting ferroptosis, with the aim of providing a more economical, safer, and more targeted treatment.
Schizophrenia could affect the social and occupational functions of patients in the long term. Community-based mental health services and management models promote mental health by improving accessibility, acceptability, affordability, practicality and scalability. In the community management model, long-acting injectable antipsychotic agents are one of the main strategies for the treatment of schizophrenia, but there is a lack of relevant evidence. This paper systematically and comprehensively discussed the benefits of long-acting injectable antipsychotic agents in patients with schizophrenia, including effectiveness and safety, compliance, attitude to use, social function recovery and community rehabilitation. The results of this study showed that long-acting injectable antipsychotic agents can exert superior efficacy than oral drugs in the community rehabilitation of schizophrenia patients under different community management modes, not only reflected in the disease recurrence rate and readmission rate, but also in the recovery of social functioning and the reduction of accident rate and other aspects of excellent performance. However, the overall prescription rate of long-acting injectable antipsychotic agents is still low in China. The main reasons include insufficient information sharing between medical institutions and communities in primary level, low community medical services and treatment rate, low follow-up rate of patients, and less community psychiatric rehabilitation. This study can provide some references for the community treatment of schizophrenia patients in China, explore more community treatment programs, and improve the treatment effect and quality of life of schizophrenia patients in China.
Food intake disorders are costly to treat, with an increasing prevalence over the years, and a higher risk of mortality compared to other psychiatric disorders. Avoidant/restrictive food intake disorder (ARFID) , as a relatively new type of food intake disorder, is more prevalent in children and adolescents than in other age groups, affecting their normal growth and development, as well as psychosocial functioning. Currently, there are more foreign studies, while domestic studies are still in the initial stage. Therefore, this paper reviews assessment tools, influencing factors and treatment approaches for ARFID in children and adolescents, with the aim of providing a reference for related research in China.
There is growing evidence that pre-hospital use of metformin reduces mortality in patients with diabetes and sepsis; however, the effect of metformin on clinical outcomes in patients with diabetes and sepsis remains controversial. Therefore, there is a need for a systematic review and Meta-analysis of existing studies to further evaluate whether metformin can improve mortality and other clinical outcomes in patients with diabetes and sepsis.
To systematically evaluate the effects of pre-hospital metformin use on mortality, initial plasma lactate level and organ dysfunction in patients with diabetes and sepsis.
PubMed, Embase, Cochrane Library, Web of Science, Scopus, China Biomedical Literature Service System, Wanfang Data, CNKI and other databases were searched by computer for Chinese and English literature on the effects of pre-hospital metformin use on clinical outcomes in patients with sepsis and diabetes from inception to March 15, 2023. The test group (MET group) involved adult patients with diabetes and sepsis received pre-hospital metformin use, and the control group (NM group) involved adult patients with diabetes and sepsis who did not receive pre-hospital metformin use. After screening, data extraction and literature quality evaluation were conducted by two researchers, Meta-analysis was performed using RevMan 5.3 software.
A total of 12 papers were included in this study, involving 12 320 patients with diabetes and sepsis, with Newcastle-Ottawa Scale (NOS) scores of 7-8. The results of Meta-analysis showed that the mortality rate (OR=0.61, 95%CI=0.46 to 0.80, P<0.001) and the use rate of vasopressors (OR=0.83, 95%CI=0.69 to 0.98, P=0.03) in MET group were lower than those in NM group; there was no significant difference in initial plasma lactate level (MD=0.31, 95%CI=-0.12 to 0.75, P=0.16) , serum creatinine level (MD=-0.81, 95%CI=-0.48 to 0.13, P=0.25) , initial blood glucose level (MD=32.94, 95%CI=-10.12 to 76.01, P=0.13) and mechanical ventilation (OR=0.90, 95%CI=0.77 to 1.06, P=0.23) between the MET group and NM group.
The pre-hospital use of metformin can reduce the mortality of patients with diabetes and sepsis, and reduce the use rate of vasoppressors in corresponding patients, providing updated evidence that metformin can reduce the mortality of patients with diabetes and sepsis. However, whether it can reduce the sepsis severity score and reduce the maximum dose of norepinephrine in patients with diabetes and sepsis remains to be further studied.
