Esophageal cancer is one of the common malignant tumors with high incidence and poor prognosis. Angiogenesis-related pathways play an important role in the occurrence and development of esophageal cancer. Vascular endothelial growth factor (VEGF) is the main mediator of angiogenesis. In addition to promoting angiogenesis and maintaining the survival of neovascularization, VEGF can also directly act on esophageal cancer cells and promote the occurrence and development of tumors. This article reviews the biology of VEGF and its effect on blood vessels, the expression of VEGF in esophageal cancer cells and its influencing factors, the role of VEGF in esophageal cancer cells, the immunomodulatory activity of VEGF and the clinical study of VEGF inhibitors. The purpose of this study is to provide a basis for more rational use of VEGF inhibitors in the treatment of esophageal cancer.
ObjectiveIn this study, we aimed to investigate the medical postgraduates’ attitudes on scientific misconduct activities to provide support to scientific research integrity education.MethodsWe conducted a cross-sectional survey in 3 medical schools in Sichuan province in September 2020. Medical postgraduates were investigated to report the sociodemographic information and self-attitude on research activities.ResultsOf the 983 students completed, 73.14% were pursuing the master program and 27.9% had published SCI papers. For attitudes on scientific misconduct activities, 0.93% agreed to change negative results picture into positive by software and 5.08% consented to modify data when P value was above 0.05 slightly.ConclusionsThe results of this study show that a small portion of medical postgraduates are still not resolute on academic misconduct. We should further strengthen education and establish the bottom line thinking which cannot be touched by the academic misconduct of medical postgraduates.
Abstract: Objective To summarize the clinical experiences of onestage hybrid operation for treating typeB aortic dissection and aortic aneurysm involving distal aortic arch, explore the indication for this special technique and analyze shortterm followup results. Methods From October 2008 to May 2010, 16 consecutive patients received onestage hybrid operation in Fu Wai Hospital for aortic dissection or aortic aneurysm involving distal aortic arch. There were 12 males and 4 females. Their age ranged from 38.0 to 67.0 years (54.0±9.2 years). There were 14 patients of typeB aortic dissection, 1 patient of thoracic aortic aneurysm involving the aortic arch, and 1 patient of penetrating aortic ulcer. Among them, 10 were acute ones and 6 were chronic ones. Brachiocephalic artery bypass using neck incision with retrograde endovascular stent graft implantation was used. Four patients received bypass from the left common carotid artery to the left subclavian artery; 11 patients underwent bypass from the right common carotid artery to the left common carotid artery; and 1 patient had both of the bypasses. Intensive care unit(ICU) stay, hospital stay， and incidence of complications were closely monitored after operation. Computed tomography(CT) and general condition of the bypass grafts and its blood flow were followed up at three months and one year after operation. Results No death or severe complications occurred perioperatively. All onestage surgeries were technically successful with stent grafts implanted. Angiography during the operation showed 100% patency of all the bypass grafts and no obvious translocation or endoleakage of the stent grafts. One patient had mild paraplegia and recovered soon after treatment. Ventilation time of these patients was 2.010.0 hours (5.3±2.7 hours). The ICU stay was 0.0-2.0 days (1.1±0.4 days) and hospital stay was 4.0-7.0 days (5.3±0.8 days). The expenditure of blood products was 0.0-1 016.5 RMB (134.5±281.8 RMB). All patients were followed up with a followup period of 3.0 to 26.0 months (130±5.1 months). All patients recovered to normal social life. Enhanced CT scanning at three months and one year after operation showed no endoleakage or translocation of the stent grafts and 100% patency of the bypass grafts. There was no obvious change of the distal part of the dissection except some thrombosis formation in nine patients. Conclusion Onestage hybrid operation is safe and effective in shortening the duration of the operation and hospital stay, reducing the surgical trauma and sufferings of the patients, and lowering the risk of staged operations with satisfactory shortterm results. This special technique may expand the indications of simple endovascular repair. The mid and longterm results still need to be followed up.
Based on previous evidence-based researches and teaching experience, our team conducted literature and book review, and summarized 4 requirements, 1) effect measure calculation and conversion, 2) registration of evidence-based research, 3) evidence-based research database and 4) quality evaluation tools and reporting guidelines. We developed an online platform of evidence-based medicine research helper using the front-end and back-end technology, which can be accessed using www.ebm-helper.cn. Currently, the online tool has included 46 scenarios for effect measure calculation and conversion, introduction of 7 evidence-based research registration platforms, 26 commonly used databases for evidence-based research and 29 quality evaluation tools and reporting guidelines. This online tool can help researchers to solve specific problems encountered in different stages of evidence-based medicine research. Promoting the application of this platform in evidence-based medicine will help researchers to use the tool scientifically and improve research efficiency.
Objective To review the researches on the jointpreserving procedures for the treatment of the avascular necrosis (AVN) of the femoral head. Methods The latest original literatures about the joint-preserving procedures for the treatment of AVN of the femoral head were extensively reviewed. Results There were many surgical jointpreserving procedures to treat AVN of the femoral head, such as core decompression, bone grafting, and osteotomy. Most researchers achieved excellent clinical results by using the joint-preserving procedures to treat the early stages of AVN of the femoral head. Conclusion Treating AVN of the femoral head by the joint-preserving procedures, especially the free vascularized fibula grafting, can achieve an excellent longterm clinical outcome.
This is the sixth paper in the evidence-based medicine glossary series. In this paper, We mainly introduced the concept of research synthesis, systematic review and meta-analysis and review developing process of these glossary.
ObjectiveTo gain an in-depth understanding of the research status, hotspots, and development trends in the field of ocular toxocariasis (OT). MethodsThe literature related to OT included in the Web of Science Core Collection dataset from 1993 to 2024 was retrieved and screened. The bibliometric softwares, VOSviewer and CiteSpace were applied to visually analyze the annual publication volume, countries, institutions, core authors, journal distribution, co-cited references, and keyword clustering. ResultsA total of 279 articles were included. There was an overall fluctuating upward trend of annual publications from 1993 to 2024, with the highest number of publications in 2020 (24 articles, accounting for 8.60%). There was an increasing trend in the frequency of citations to relevant literature. Authors from the United States had the highest number of publications (50 articles, 17.92%). Among institutions, Tokyo Medical and Dental University had the most the most published articles (11 articles, 3.94%). Among authors, professor Ding Xiaoyan from Zhongshan Eye Center at Sun Yat-sen University is the author with the most published papers (6 articles, 2.15%). Among journals, Ocul Immunol Inflamm had the highest number of published articles (21 articles, 7.53%). Highly cited references showed a significant clustering tendency, which were epidemiology, clinical characteristics and treatment, and immunological diagnosis. Keyword co-occurrence analysis showed that clinical features, serological diagnosis, epidemiology, immunodiagnosis, granuloma and treatment were high-frequency keywords. Timeline view map showed that the 9 clusters could be divided into 3 categories: epidemiological investigation including risk factors and seroprevalence (#0), clinical research including clinical features and treatment modalities (#1, #2, #3, # 6, #7), immunological detection and laboratory examination (#3, #5, #8). The keywords bursts analysis showed that the trend of research hot topics of OT had shifted from the initial study of animal experiments and immunological detection to the subsequent study of risk factor, and then to clinical characteristics studies combined with multimodal imaging technology. ConclusionsOver the past three decades, the number of publications on OT research has shown an increasing trend and the research hotspots have mainly focused on epidemiology, immunological detection and clinical features. The multimodal imaging diagnosis technology based on clinical features and the treatment strategy based on pathogenesis remain crucial directions for future research.
Senile sarcopenia has become a prominent problem affecting the normal life and self-care ability of the elderly. More attention to the research on senile sarcopenia is conducive to its prevention and treatment. This article states information details about the epidemiology, influencing factors and mechanism, clinical manifestations and diagnostic criteria, evaluation methods and rehabilitation therapy, so as to provide reference for research on elderly sarcopenia.
Objective To review the progress in amputation technique of diabetic foot. Methods Recent l iterature concerning the amputation technique of diabetic foot was reviewed and analyzed. Results According to the different levels of the amputation, the diabetic foot’s amputation can be classified as major amputation and minor amputation, and differentkinds of methods can derive from these styles. Different factors should be considered when the style and method of amputation are chosen. Conclusion To the diabetic foot amputation, the general rule is to l imit the amputation level on the premise of the good cl inical effect. The health state, the region of the diabetic foot, the tissue perfusion, the susceptibil ity to infection in local tissue, and the abil ity of wound healing are important factors in selecting the styles and methods of diabetes-related amputations. Importance should be attached to the synthesis treatments of diabetes to prevent the higher level amputation.
Before transcatheter aortic valve replacement (TAVR), echocardiography is the first choice for preoperative screening of suitable patients, which can be used to observe the morphology of aortic valve, determine the cause of aortic stenosis, and evaluate the severity of aortic stenosis and other cardiac structure and function. During TAVR procedure, echocardiography is mainly used for real-time monitoring of complications and immediate postoperative evaluation. After TAVR, echocardiography can be used to evaluate the shape and function of the prosthesis valve and monitor long-term complications. This article reviews the research progress of echocardiography in TAVR for guiding clinical practice.