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Objective To evaluate the clinical application value of three methods, Xpert (MTB/RIF), culture, and smear, in the detection of Mycobacterium tuberculosis and rifampicin resistance. Methods A total of 529 sputum samples were collected from pulmonary tuberculosis patients in the tuberculosis outpatient and inpatient departments of Guangzhou Liwan Central Hospital from October 2021 to September 2022. Three methods, Xpert, culture, and smear, were used to detect Mycobacterium tuberculosis and rifampicin resistance, and the results were statistically analyzed. Results The sensitivity of Xpert, culture, and smear was 40.64% (215/529), 35.35% (187/529), and 15.31% (81/529), respectively. There was no significant difference in sensitivity between Xpert and culture (χ²=1.23, P＞0.05), but there was a significant difference between Xpert and smear (χ²=67.21, P＜0.05). In the detection of rifampicin resistance, the detection rate of rifampicin resistance in Mycobacterium tuberculosis strains by Xpert was 22.46% (42/187), and the sensitivity and specificity of Xpert were 95.12% (39/41) and 97.95% (143/146), respectively. There was no significant difference compared to culture (χ²=0.167, P＞0.05). Conclusion Among the three detection methods; Xpert MTB/RIF system showes the highest sensitivity and specificity in detecting Mycobacterium tuberculosis and rifampicin resistance. It also provides rapid results and has the highest clinical application value; making it worthy of promotion and use. [ABSTRACT FROM AUTHOR]

The Mongolian medicine Wulan—13 (WL—13) decoction was first recorded in the “Tongwagajid”, and then included in the 1998 edition of the “Drug Standards of the Ministry of Health of the People’s Republic of China” (Mongolian Medicine Volume). It is composed of Gardeniae fructus, Chebulae fructus, Toosendan fructus, Inula helenium, Kaempferia galanga, Rubus sachajinensis, Sophora flavescens, Rubia cordifolia, Arnebia guttata bunge, Eriobotrya japonica leaf, Trollius chinensis bumge, Trollius chinensis and Acorn. WL—13 decoction has the efficacy for abatement of fever, and is mainly used to treat Xuere, headache, conjunctival hyperemia, hypertension, fever, cold, white-pulse disease, pneumonia, epistaxis, skin rash, heatstroke, rheumatism, rheumatoid arthritis and other diseases, and have potential research value. This review explores the historical history, prescription explanation, clinical application and experimental research progress of WL—13, with a view to providing theoretical support for the modernization research of WL—13. [ABSTRACT FROM AUTHOR]

Background: Acute cerebral infarction (ACI) is a common neurological disease that is associated with high morbidity, disability and mortality rates. At present, antiplatelet therapy is a necessary treatment for ACI. The present study aimed to investigate the effects of omentin-1 on the intravenous thrombolysis of ACI. Objective: The present study aimed to investigate the effects of omentin-1 on the intravenous thrombolysis of ACI. Material and Methods: The mouse model of ACI was induced using male C57BL/6 mice through middle cerebral artery occlusion (MCAO). Meanwhile, the murine BV2 microglial cells were pretreated with 0.1 mg/ml of lipopolysaccharide (LPS), and then induced with 2 mM of adenosine triphosphate (ATP). Results: The omentin-1 mRNA expression in patients receiving intravenous thrombolysis for ACI was down-regulated compared with the normal group. Additionally, the serum level of omentin-1 was negatively correlated with National Institute of Health Stroke Scale (NIHSS) score or serum level of IL-1ß or MMP-2 in patients receiving intravenous thrombolysis for ACI. Meanwhile, the serum mRNA expression of omentin-1 was positively correlated with Barthel index or high-sensitivity C-reactive protein (hs-CRP) in patients undergoing intravenous thrombolysis for ACI. As observed from the in vitro model, Omentin-1 reduced inflammation, promoted cell growth, alleviated ROS-induced oxidative stress, and enhanced AMPK activity through activating NLRP3 ubiquitination. Omentin-1 presented ACI in the mouse model of ACI. Regulating AMPK activity contributed to controlling the effects of Omentin-1 on the in vitro model. Conclusions: Omentin-1 reduced neuroinflammation and ROS-induced oxidative stress in the mouse model of ACI, which was achieved by inhibiting NLRP3 ubiquitination through regulating AMPK activity. Therefore, omentin-1 may serve as a treatment factor for the intravenous thrombolysis of ACI in further clinical application. [ABSTRACT FROM AUTHOR]

Introduction: For liver stereotactic body radiation therapy (SBRT), the placement of fiducial markers or retained ethiodized oil by transarterial chemoembolisation (TACE) provides a landmark for consistent target localisation. TACE and fiducial markers are invasive procedures that harbour additional risks. We hypothesise that liver SBRT can be accurately delivered without the use of these invasive surrogate markers. Methods: We retrospectively identified 50 consecutive patients who underwent liver SBRT with respiratory motion management to a single lesion which exhibited retained ethiodized oil per prior TACE delivery. For each SBRT fraction, two manual rigid image registrations were performed by the treating physician. One using the liver contour as a surrogate for the target and second aligning only to the radio‐opaque retained ethiodized oil of the treated lesion. The magnitude of the displacement vector between the two registration methods was used to assess the accuracy of target localisation if ethiodized oil was not present. Results: For the 50 patients, a total of 244 analysable cone‐beam CTs (CBCTs) were included (six CBCTs excluded due to poor ethiodized oil visualisation). Respiratory motion management techniques consisted of active breathing control for 13 and abdominal compression for 37 patients. Forty‐two patients had peripheral lesions and eight had central lesions (<2 cm from left and right portal veins). The average target localisation offset between the two registration methods (i.e. liver contour vs. retained ethiodized oil alignment) for patients with a single peripheral or central liver lesion was 5.8 and 5.3 mm, respectively. Conclusions: Across all patients, the average change in target position exceeded 5 mm for image registration methods based on the liver contour alone versus the retained ethiodized oil region. This suggests that margins greater than 5 mm may be required for respiratory motion‐managed liver SBRT treatments in patients who do not undergo prior TACE or fiducial placement. [ABSTRACT FROM AUTHOR]

Robots are widely used in surgeries worldwide. To improve robotic surgical treatments, we established a database of clinical applications and research on surgical robots. Robotics-related literature included in the China national knowledge infrastructure (CNKI), Wanfang, Vipshop, Chinese science citation database (CSCD), Web of Science, EMBASE, PubMed, and Cochrane databases up to September 2022 was searched and entered into the database. Information on all patients who had undergone robotic surgery at our hospital since 2016 was also included. Literature and case information was classified and evaluated according to standard guidelines and statements. The Gansu Provincial Hospital was the first to use evidence-based medical research methods to successfully establish a database of clinical applications and research on surgical robots. This database comprised literature search, upload, quality evaluation, risk of bias assessment, case information entry, and access functions. Based on the database, we conducted related studies in general surgery, gynecology, urology, thoracic surgery, and cardiovascular surgery, and published 16 meta-analyses and 15 clinical studies. Establishing this database removes language, retrieval, and evaluation barriers in clinicians' use of clinical evidence and lays the foundation for the efficient and accurate use of clinical data for future research. Further, it facilitates evidence-based evaluation of the effectiveness of robotic therapy, which may guide future medical practice. This typical case of interdisciplinary research aims to build a platform to disseminate knowledge and technology in robotic surgery. [ABSTRACT FROM AUTHOR]

Purpose of Review: This abstract aims to examine the advancements in the utilization, indications, and implementation of ultrasound enhancing agents (UEAs) and their potential to enhance cost-effective diagnostics. Recent Findings: The review highlights significant progress in the application of UEAs, particularly in improving the delineation of endocardial borders, enhancing interpretation of wall motion, and increasing diagnostic accuracy. Moreover, UEAs contribute to streamlining workflows and help avoid more expensive procedures, especially in cases with technically challenging or suboptimal studies. Summary: UEAs have shown great promise in various medical scenarios, such as enhancing the visualization of the cardiac blood pool and enabling better assessment of ventricular borders, ventricular function, masses, and other intracavitary or myocardial abnormalities. This abstract presents an overview of the recent findings that underscore the potential benefits of UEAs in optimizing cardiac diagnostics while considering cost-effectiveness. [ABSTRACT FROM AUTHOR]

Astragali Radix (A. Radix) is the dried root of Astragalus membranaceus var. mongholicus (Bge) Hsiao or Astragalus membranaceus (Fisch.) Bge., belonging to the family Leguminosae, which is mainly distributed in China. A. Radix has been consumed as a tonic in China for more than 2000 years because of its medicinal effects of invigorating the spleen and replenishing qi. Currently, more than 400 natural compounds have been isolated and identified from A. Radix, mainly including saponins, flavonoids, phenylpropanoids, alkaloids, and others. Modern pharmacological studies have shown that A. Radix has anti-tumor, anti-inflammatory, immunomodulatory, anti-atherosclerotic, cardioprotective, anti-hypertensive, and anti-aging effects. It has been clinically used in the treatment of tumors, cardiovascular diseases, and cerebrovascular complications associated with diabetes with few side effects and high safety. This paper reviewed the progress of research on its chemical constituents, pharmacological effects, clinical applications, developing applications, and toxicology, which provides a basis for the better development and utilization of A. Radix. [ABSTRACT FROM AUTHOR]

This review examines advances in the metabolites, pharmacological research, and therapeutic applications of the medicinal fruit of Brucea javanica (L.) Merr. Brucea javanica (BJ) is derived from the fruit of the Brucea javanica (L.) Merr. There are nearly 200 metabolites present in BJ, and due to the diversity of its metabolites, BJ has a wide range of pharmacological effects. The traditional pharmacological effects of BJ include anti-dysentery, anti-malaria, etc. The research investigating the contemporary pharmacological impacts of BJ mainly focuses on its anti-tumor properties. In the article, the strong monomeric metabolites among these pharmacological effects were preliminarily screened. Regarding the pharmacological mechanism of action, current research has initially explored BJ's pharmacological agent and molecular signaling pathways. However, a comprehensive system has yet to be established. BJ preparations have been utilized in clinical settings and have demonstrated effectiveness. Nevertheless, clinical research is primarily limited to observational studies, and there is a need for higher-quality research evidence to support its clinical application. There are still many difficulties and obstacles in studying BJ. However, it is indisputable that BJ is a botanical drugs with significant potential for application, and it is expected to have broader global usage. [ABSTRACT FROM AUTHOR]

Background: Recent technological advances have led to a surge in the use of wearable devices for personal health and fitness monitoring; however, clinical uptake of wearable devices for remote or 'free-living' measurement of daily health-related behavior has lagged. To advance the field, there is need for valid and reliable outcomes across multiple health domains specific to the cohorts or patients of interest and centralized tools to build capacity for use of these data. The NiMBaLWear pipeline provides a flexible and integrated approach to wearables analytics applied to raw sensor data that considers multiple, inter-related physiological and behavioral signals to provide a holistic view of health status. Results & discussion: NiMBaLWear is a modular, open-source, wearable sensor analytic pipeline that quantifies physical activity, mobility, and sleep from raw single- or multi-sensor free-living data collected over multiple days. Data captured from any device, in different possible formats, are standardized prior to processing. Data preparation includes accelerometer autocalibration, cross-device synchronization, and non-wear detection. Validated, domain-specific algorithms detect events, generate outcome measures, and output standardized tabular data and user-friendly summary collection reports. NiMBaLWear was developed in Python using an iterative and incremental software development process, which included a combination of semi-automated inspection and expert review of data collected from 286 participants across two remote-measurement studies. A comparative analysis revealed a paucity of open-source packages capable of deriving and sharing health-related behavioral outcomes across multiple domains from multi-sensor wearables data. Forthcoming improvements to the pipeline will leverage sensor fusion techniques to add new, and refine existing, domain- and disease-specific analytics, and optimize pipeline accessibility and reporting. Conclusion: The NiMBaLWear pipeline transforms raw multi-sensor wearables data into accurate and relevant outcomes across multiple health domains to objectively characterize and measure an individual's daily health-related behavior. NiMBaLWear's focus on high-quality, clinically relevant outcomes, as well as end-user optimization, provides a foundation for innovation to improve the utility of wearables for clinical care and self-management of health. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disease and a major health burden worldwide. Extracellular vesicles (EVs) are nanosized vesicles which possess a lipid bilayer structure that are secreted by various cells. They contain a variety of bioactive substances, which can regulate various physiological and pathological processes and are closely related to the development of diseases. Recently, EVs have emerged as a novel tool for intercellular crosstalk, which plays an essential role in COPD development. This paper reviews the role of EVs in the development of COPD and their potential clinical value, in order to provide a reference for further research on COPD. [ABSTRACT FROM AUTHOR]

The knee is the most complex joint in the human body, including bony structures like the femur, tibia, fibula, and patella, and soft tissues like menisci, ligaments, muscles, and tendons. Complex anatomical structures of the knee joint make it difficult to conduct precise biomechanical research and explore the mechanism of movement and injury. The finite element model (FEM), as an important engineering analysis technique, has been widely used in many fields of bioengineering research. The FEM has advantages in the biomechanical analysis of objects with complex structures. Researchers can use this technology to construct a human knee joint model and perform biomechanical analysis on it. At the same time, finite element analysis can effectively evaluate variables such as stress, strain, displacement, and rotation, helping to predict injury mechanisms and optimize surgical techniques, which make up for the shortcomings of traditional biomechanics experimental research. However, few papers introduce what material properties should be selected for each anatomic structure of knee FEM to meet different research purposes. Based on previous finite element studies of the knee joint, this paper summarizes various modeling strategies and applications, serving as a reference for constructing knee joint models and research design. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the clinical application and efficacy of a super-low-positioned intestinal decompression tube in the treatment of intestinal obstruction. Methods: A total of 130 patients with postoperative small bowel obstruction were included in this study. The patients were divided into a super-low-positioned intestinal decompression group and a conventional intestinal decompression group. The clinical data, treatment outcomes, and complications were compared between the two groups. Results: The technical success rate of placing the super-low-positioned intestinal decompression tube was 100%, with no intraoperative complications. The patients in the super-low-positioned intestinal decompression group had a significantly shorter hospital stay (8.3 ± 5.2 vs 17.7 ± 13.3, P < 0.001) and a higher non-operative treatment success rate (83.6% vs 57.9%, P = 0.001) compared to the conventional intestinal decompression group. Multivariate logistic regression analysis showed that the placement of a super-low-positioned intestinal decompression tube was an independent protective factor for treatment outcomes (P = 0.001). The hospital stay was significantly shorter in the super-low-positioned intestinal decompression group compared to the conventional group in both successful non-operative treatment patients (6.9 ± 3.0 vs 11.2 ± 7.5, P < 0.001) and failed non-operative treatment patients (16.2 ± 7.4 vs 26.6 ± 14.4, P < 0.001). The super-low-positioned intestinal decompression tube effectively relieved the "Self-strangulation" phenomenon in patients with intestinal obstruction. Conclusion: The super-low-positioned intestinal decompression tube is a safe and effective method for the treatment of intestinal obstruction, with better treatment outcomes and shorter hospital stays compared to conventional intestinal decompression. Further prospective studies are needed to validate these findings. [ABSTRACT FROM AUTHOR]

Histamine receptor antagonists, which can bind to specific histamine receptors on target cells, exhibit substantial therapeutic efficacy in managing a variety of histamine-mediated disorders. Notably, histamine H1 and H2 receptor antagonists have been extensively investigated and universally acknowledged as recommended treatment agents for numerous allergic diseases and acid-related disorders, respectively. Historically, the combination of H1 and H2 receptor antagonists has been considered a classic treatment strategy, demonstrating relatively superior efficacy compared with single-drug therapies in the treatment of diverse histamine-mediated diseases. The latest emerging studies have additionally suggested the underlying roles of histamine and H1R and H2R in the development of anxiety disorders, arthritic diseases, and postexercise hypotension. Nevertheless, there is still a lack of systematic reviews on the clinical efficacy of combination therapy, greatly limiting our understanding of its clinical application. Here, we present a comprehensive overview of the current knowledge and perspectives regarding the combination of H1 and H2 histamine receptor antagonists in various histamine-mediated disorders. Furthermore, we critically analyze the adverse effects and limitations associated with combination therapy while suggesting potential solutions. Our review can offer a systematic summary and promising insights into the in-depth and effective application of the combination of H1 and H2 receptor antagonists. [ABSTRACT FROM AUTHOR]

Nowadays, hepatocellular carcinoma (HCC) is still a major threat to human health globally, with a disappointing prognosis. Regular monitoring of patients at high risk, utilizing abdominal ultrasonography combined with alpha‐fetoprotein (AFP) serum analysis, enables the early detection of potentially treatable tumors. However, the approach has limitations due to its lack of sensitivity. Meanwhile, the current standard procedure for obtaining a tumor biopsy in cases of HCC is invasive and lacks the ability to assess the dynamic progression of cancer or account for tumor heterogeneity. Hence, there is a pressing need to develop non‐invasive, highly sensitive biomarkers for HCC which can improve the accuracy of early diagnosis, assess treatment response and accurately predict the prognosis. In contrast to the conventional method of tissue biopsy, liquid biopsy offers a non‐invasive approach that can be readily repeated. As a liquid biopsy approach, the analysis of cell‐free DNA (cfDNA) offers real‐time insights that can accurately portray the tumor burden and provide a comprehensive depiction of the genetic profile associated with HCC. In this review, we present a comprehensive summary of the recent research findings pertaining to the significance and potential practicality of cfDNA analysis in the early detection and effective management of HCC. [ABSTRACT FROM AUTHOR]

Lemongrass is a medicinal plant that produces essential oil with a variety of therapeutic properties. Although lemongrass essential oil (LGEO) is promising in clinical applications, the existing knowledge on the efficacy and safety of LGEO remains limited. This scoping review aimed to identify, summarize, and synthesize existing literature related to the clinical applications of LGEO to provide an overview of its potential therapeutic benefits for patients. Three databases (PubMed, Web of Science, Scopus) were used following the PRISMA-ScR guidelines to find articles published between 1 January 2013, and 1 November 2022. A total of 671 records were identified and 8 articles were included in this scoping review. The majority of patients received oromucosal and topical treatment. The results of the studies suggest that LGEO might be a useful tool in the treatment of periodontitis, gingivitis and oral malodour, with similar efficacy to chlorhexidine (anti-gingivitis effect) and doxycycline (periodontitis). Additionally, LGEO has the potential for treating pityriasis versicolor and preventing skin aging and may have anti-dandruff effects. These findings not only underscore the diverse clinical potential of LGEO but also emphasize its comparable efficacy to established treatments. Further research is imperative to comprehensively evaluate LGEO's effectiveness, safety, mechanisms of action, potential interactions with other medications, and its long-term tolerability across diverse populations. [ABSTRACT FROM AUTHOR]

Objective：To describe the preparation process of domestic carrier ⁃free lutetium［177Lu］and the method for labeling of 177Lu with 1, 4, 7, 10⁃tetraazacyclododecane⁃1u⁃, 4, 7, 10⁃tetraacetic acid conjugated Tyr3⁃octreotide（DOTA⁃TOC), and to explore the safety and efficacy of the preliminary clinical application of domestically produced 177Lu⁃DOTA⁃TOC. Methods：Domestic carrier⁃free lutetium［177Lu］was prepared by multistage sequential isolation and purification, and fully automated modular labeling was used to synthesize 177Lu ⁃DOTA ⁃TOC. The data of 4 patients with neuroendocrine neoplasms（NEN) in Naning Hospital Affiliated to Nanjing Medical University who only received domestic carrier⁃free lutetium［177Lu］labeled DOTA⁃TOC peptide receptor radionuclide therapy (PRRT) were retrospectively analyzed. Results：The domestic carrier⁃free lutetium［177Lu］had good quality control, with copper（Cu) <0.01, zinc（Zn) <0.01, iron（Fe) <0.01, lead（Pb) <0.15, and thulium（Yb) undetectable, radiochemical purity >99%, and bacterial endotoxin <2 EU/mL. The yield of domestic automated labeling of 177Lu⁃DOTA⁃TOC was（98.85±0.97) %, and the specific activity of the product was（80.96 ± 7.47) GBq/μmol. Sterility and endotoxin tests of the labeled product met the specified standards, and the ethanol content in the labeled product was 0, with a radiochemical purity greater than 99%. Among the 4 patients who received only domestic 177Lu⁃DOTA⁃TOC only, 1 patient showed almost complete disappearance of the primary and metastatic lesions after only one treatment, while another patient experienced grade 3 bone marrow toxicity one month after treatment, which recovered to normal after three months. None of the patients showed renal toxicity. Conclusion; Domestic carrier⁃free lutetium［177Lu］labeled DOTA⁃TOC meets quality control standards, has a high yield, good safety, and tolerability, and has good therapeutic efficacy for patients with inoperable NEN. The domestication and large⁃scale production of carrier⁃free lutetium［177Lu］will promote the integrated development of nuclear medicine diagnosis and treatment in China. [ABSTRACT FROM AUTHOR]

Armeniacae semen amarum-seeds of Prunus armeniaca L. (Rosaceae) (ASA), also known as Kuxingren in Chinese, is a traditional Chinese herbal drug commonly used for lung disease and intestinal disorders. It has long been used to treat coughs and asthma, as well as to lubricate the colon and reduce constipation. ASA refers to the dried ripe seed of diverse species of Rosaceae and contains a variety of phytochemical components, including glycosides, organic acids, amino acids, flavonoids, terpenes, phytosterols, phenylpropanoids, and other components. Extensive data shows that ASA exhibits various pharmacological activities, such as anticancer activity, anti-oxidation, antimicrobial activity, anti-inflammation, protection of cardiovascular, neural, respiratory and digestive systems, antidiabetic effects, and protection of the liver and kidney, and other activities. In clinical practice, ASA can be used as a single drug or in combination with other traditional Chinese medicines, forming ASA-containing formulas, to treat various afflictions. However, it is important to consider the potential adverse reactions and pharmacokinetic properties of ASA during its clinical use. Overall, with various bioactive components, diversified pharmacological actions and potent efficacies, ASA is a promising drug that merits in-depth study on its functional mechanisms to facilitate its clinical application. [ABSTRACT FROM AUTHOR]

Purpose of Review: Intestinal ultrasound (IUS) is a non-invasive, accurate, and well-tolerated tool that provides real-time assessment of inflammatory bowel disease (IBD) activity and is therefore an ideal monitoring tool. This review describes the evolving role of IUS in each phase of clinical management of IBD. Recent Findings: Accumulating evidence has demonstrated that IUS is an excellent tool for the assessment of suspected IBD, with a very high negative predictive value. It accurately assesses disease activity, disease complications, and in the pre-treatment phase, provides a benchmark for subsequent follow-up. IUS can detect early therapeutic response and correlates well with other established monitoring modalities with arguably superior predictive capabilities and ability to assess a deeper degree of remission, transmural healing (TH). Summary: IUS has a crucial role in the management of IBD and has ushered in a new era of monitoring with more rapid evaluation and the opportunity for early optimization, deeper therapeutic targets, and improved outcomes. [ABSTRACT FROM AUTHOR]

Finite element (FE) modeling is widely used to study the biomechanical effect of material properties, surgical procedures, and loading and boundary conditions on the lumbar spine. Since several studies have presented FE analyses of the lumbar spine in relation to spine biomechanics, soft tissue modeling, intervertebral discs, facet joints, load-sharing behaviors of lumbar motion segments, and FE modeling methods, detailed analyses of disc degeneration or muscle force prediction have been little considered. This study focused on recent developments in FE modeling of the lumbar spine, including disc degeneration, muscle force prediction, and clinical applications. Modeling and analysis from the bone to soft tissue and muscle forces, as well as the validation and application of these models were provided and discussed with material properties, element types, loading and boundaries, geometric parameters, and muscle force modeling. Experimental data was summarized for validation of the FE model. Application studies were briefly reviewed, in which the majority of FE models focused on spinal degeneration diseases and surgical instrumentation techniques. Although muscle force prediction and optimization are challenging with FE modeling due to their complexity and redundancy, several studies have predicted muscle activation and spinal forces for injury prevention assessments and treatment strategies. The level of modeling prediction and representation can be improved with subject-specific data, and integration of FE and musculoskeletal models could generate a comprehensive analysis of the lumbar spine in clinical applications. [ABSTRACT FROM AUTHOR]

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Cancer genomics has led to the discovery of numerous oncogenes and tumor suppressor genes that play critical roles in cancer development and progression. Oncogenes promote cell growth and proliferation, whereas tumor suppressor genes inhibit cell growth and division. The dysregulation of these genes can lead to the development of cancer. Recent studies have focused on non-coding RNAs (ncRNAs), including circular RNA (circRNA), long non-coding RNA (lncRNA), and microRNA (miRNA), as therapeutic targets for cancer. In this article, we discuss the oncogenes and tumor suppressor genes of ncRNAs associated with different types of cancer and their potential as therapeutic targets. Here, we highlight the mechanisms of action of these genes and their clinical applications in cancer treatment. Understanding the molecular mechanisms underlying cancer development and identifying specific therapeutic targets are essential steps towards the development of effective cancer treatments.

Neovascular age-related macular degeneration (nARMD) is an important cause of visual impairment and blindness in the elderly, with choroidal neovascularization in the macula as the main pathological feature. The onset of nARMD is closely related to factors including age, oxidative stress, and lipid metabolism. Vascular endothelial growth factor (VEGF) is an important factor contributing to nARMD as well as choroidal neovascularization and retinal leakage formation. At present, anti-VEGF therapy is the only treatment that improves vision and halts disease progression in most patients, making anti-VEGF drugs a landmark development for nARMD treatment. Although intravitreal injection of anti-VEGF drugs has become the first-line treatment for nARMD, this treatment has many shortcomings including repeated injections, poor or no response in some patients, and complications such as retinal fibrosis. As a result, several new anti-VEGF drugs are being developed. This review provides a discussion of these new anti-VEGF drugs for the treatment of nARMD.

Abstract The etiology of gastrointestinal (GI) diseases is intricate and multifactorial, encompassing complex interactions between genetic predisposition and gut microbiota. The cell fate change, immune function regulation, and microenvironment composition in diseased tissues are governed by microorganisms and mutated genes either independently or through synergistic interactions. A comprehensive understanding of GI disease etiology is imperative for developing precise prevention and treatment strategies. However, the existing models used for studying the microenvironment in GI diseases—whether cancer cell lines or mouse models—exhibit significant limitations, which leads to the prosperity of organoids models. This review first describes the development history of organoids models, followed by a detailed demonstration of organoids application from bench to clinic. As for bench utilization, we present a layer‐by‐layer elucidation of organoid simulation on host–microbial interactions, as well as the application in molecular mechanism analysis. As for clinical adhibition, we provide a generalized interpretation of organoid application in GI disease simulation from inflammatory disorders to malignancy diseases, as well as in GI disease treatment including drug screening, immunotherapy, and microbial‐targeting and screening treatment. This review draws a comprehensive and systematical depiction of organoids models, providing a novel insight into the utilization of organoids models from bench to clinic.

Lung cancer is the leading cause of death among malignant tumors in the world. High lung cancer mortality rate is due to most of patients diagnosed at advanced stage. The Liquid biopsy of lung cancer have received recent interest for early diagnosis. One of the components of liquid biopsy is the exosome. The exosome cargos non-coding-RNAs, especially long non-coding RNAs (lncRNAs), circular RNAs (circRNAs), and microRNAs (miRNAs). The lung cancer derived exosomal non-coding RNAs play the pivotal roles of lung cancer in carcinogenesis, diagnosis, therapy, drug resistance and prognosis of lung cancer. Given ceRNA (competitive endogenous RNA) mechanism, lncRNA or circRNA can act as ceRNA to compete to bind miRNAs and alter the expression of the targeted mRNA, contributing to the development and progression of lung cancer. The current research progress of the roles of the exosomal non-coding-RNAs and the interplay of ceRNAs and miRNAs in mediated lung cancer is illustrated in this article. Hence, we presented an experimentally validated lung cancer derived exosomal non-coding RNAs-regulated target gene axis from already existed evidence in lung cancer. Then LncRNA/circRNA-miRNA-mRNA axis may be a potential target for lung cancer treatment and has great potential in the diagnosis and prognosis of lung cancer.

Huaier, derived from the fungus on Sophora japonica trees, is a fruiting body belonging to Polyporaceae family. Traditionally, it has been utilized for treating hemorrhoids and rectal bleeding. As a medicine food homology herb, its remarkable immune-regulating properties have led to widespread adoption in digestive system tumors in recent years. Currently, over 502 compounds, excluding polysaccharides, have been isolated from Huaier exhibiting diverse biological activities and medicinal value. Clinically, Huaier has demonstrated effectiveness against digestive system tumors. Mechanistic studies suggested that Huaier may exert its antitumor effects by bolstering immunity, inducing tumor cell death, inhibiting tumor proliferation, migration, invasion, metastasis, and dampening inflammatory cancer transformation. The abundance of active ingredients underscores Huaier's potential as an anticancer agent. Both its clinical application and mechanistic investigations highlight its significant promise in addressing digestive system tumors.

Gastric cancer (GC) is the leading cause of cancer-related death worldwide, and it is associated with a combination of genetic, environmental, and microbial risk factors. Helicobacter pylori (H. pylori) is classified as a type I carcinogen, however, the exact regulatory mechanisms underlying H. pylori-induced GC are incompletely defined. MicroRNAs (miRNAs), one of small non-coding RNAs, negatively regulate gene expression through binding to their target genes. Dysregulation of miRNAs is crucial in human cancer. A noteworthy quantity of aberrant miRNAs induced by H. pylori through complex regulatory networks have been identified. These miRNAs substantially affect genetic instability, cell proliferation, apoptosis, invasion, metastasis, autophagy, chemoresistance, and the tumor microenvironment, leading to GC development and progression. Importantly, some H. pylori-associated miRNAs hold promise as therapeutic tools and biomarkers for GC prevention, diagnosis, and prognosis. Nonetheless, clinical application of miRNAs remains in its infancy with multiple issues, including sensitivity and specificity, stability, reliable delivery systems, and off-target effects. Additional research on the specific molecular mechanisms and more clinical data are still required. This review investigated the biogenesis, regulatory mechanisms, and functions of miRNAs in H. pylori-induced GC, offering novel insights into the potential clinical applications of miRNA-based therapeutics and biomarkers.

Abstract Background Molecular diagnostic technology is the foundation of precision medicine, which has the advantages of good specificity, high sensitivity, strong targeting, rapiddiagnosis, etc. It has a wide range of applications in the field of pediatrics. However, molecular diagnostic technology is characterized by complicated experimental operation, high difficulty in data analysis and interpretation, in consistent standards among laboratories, and difficult standardization of technical processes. Enhancing the application value of molecular diagnostic technology in pediatrics and promoting the high‐quality development of the discipline requires careful consideration by relevant management and professionals. Methods This study firstly outlines the development history of molecular diagnostic technology. Then, it analyzes the application of molecular diagnostic technology in the field of pediatrics. Finally, it explores the countermeasures for the management of molecular diagnostic laboratories. Results This study highlights the importance of molecular diagnostic technology in providing information and decision‐making basis for disease prevention, prediction,diagnosis, treatment and regression. It has a wide range of applications in the molecular diagnosis of pediatric hereditary diseases, malignant tumors and infectious diseases. In addition, the countermeasures for the management of molecular diagnostic laboratories are proposed from the five aspects of laboratory, personnel team construction, standardized management,multidisciplinary cross‐discipline, research and translation, safety managementand ethical supervision, and management upgrading and modernization. Conclusions Molecular diagnostic technology, as the basis of precision medicine, has become one of the important frontier fields in the development of contemporary pediatric medicine. Enhanced laboratory capacity in molecular diagnostic techniques can improve outcomes in the prevention, prediction, diagnosis, treatment, prognosis and research of pediatricdiseases, and lay the groundwork for child healthcare.

Objectives: To evaluate the diagnostic performance of different brands of immunochromatographic test (ICT) reagents for Chlamydia trachomatis using homogenized samples to provide a reference for reagent quality control. Methods: Eight commercially available ICT reagents were evaluated, of which three used the latex method and five used the colloidal gold method. Analytical performance evaluation using a pure culture broth of C. trachomatis, as well as clinical application validation using cervical epithelial cell samples acquired from the research subjects, were conducted. The concentration of C. trachomatis was quantified using a nucleic acid amplification test. Results: The limit of detection (LOD) of different ICT reagents in the analytical performance evaluation varied from 9.5 × 103 to 1 × 105 IFU/mL, and only one reagent met the LOD specified in the manufacturer's instructions. Likewise, only one reagent in the clinical application validation achieved the analytical LOD, four reagents were 2.1–4.2-fold of the analytical LODs, and three reagents failed to detect positive results in clinical samples. Conclusions: The diagnostic performance of different methods and different brands of ICT reagents in clinical practice was different from the manufacturer's instructions and the results of laboratory evaluation. The diagnostic performance of reagents should be evaluated before they are actually used in clinical practice.

Background: The incidence of pulmonary nodules is increasing because of the promotion and popularisation of low-dose computed tomography (LDCT) screening for populations with suspected lung cancer. However, a high rate of false positives and concerns regarding the radiation-related cancer risk of repeated CT scanning remain major obstacles to its wide application. This study aimed to investigate the clinical value of seven tumour-associated autoantibodies (7-TAAbs) in the differentiation of malignant pulmonary tumours from benign ones and the early detection of lung cancer in routine clinical practice. Methods: We included 377 patients who underwent both the 7-TAAbs panel test and LDCT screening, and were diagnosed with pulmonary nodules using LDCT. An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels antibodies for P53, PGP9.5, SOX2, GAGE7, GBU4-5, CAGE, and MAGE-A1. The relationships between the positive rates of the 7-TAAbs and the patient sex, and age, and the number, size, and composition of pulmonary nodules were analysed. We then statistically evaluated the clinical application value. Results: The positive rates of the 7-TAAbs did not correlate with sex, age, number, size, or composition of pulmonary nodules. The serum antibody level of GBU4-5 in patients with pulmonary nodules tended to increase with age; the serum antibody level of SOX2 tended to increase with nodule size and was the highest among patients with mixed ground-glass opacity (mGGO) nodules. The antibody positive rate for CAGE in female patients with pulmonary nodules was significantly higher than that in male patients (P

Abstract RNA modification, especially RNA methylation, is a critical posttranscriptional process influencing cellular functions and disease progression, accounting for over 60% of all RNA modifications. It plays a significant role in RNA metabolism, affecting RNA processing, stability, and translation, thereby modulating gene expression and cell functions essential for proliferation, survival, and metastasis. Increasing studies have revealed the disruption in RNA metabolism mediated by RNA methylation has been implicated in various aspects of cancer progression, particularly in metabolic reprogramming and immunity. This disruption of RNA methylation has profound implications for tumor growth, metastasis, and therapy response. Herein, we elucidate the fundamental characteristics of RNA methylation and their impact on RNA metabolism and gene expression. We highlight the intricate relationship between RNA methylation, cancer metabolic reprogramming, and immunity, using the well‐characterized phenomenon of cancer metabolic reprogramming as a framework to discuss RNA methylation's specific roles and mechanisms in cancer progression. Furthermore, we explore the potential of targeting RNA methylation regulators as a novel approach for cancer therapy. By underscoring the complex mechanisms by which RNA methylation contributes to cancer progression, this review provides a foundation for developing new prognostic markers and therapeutic strategies aimed at modulating RNA methylation in cancer treatment.

The field of biomedical radar has witnessed significant advancements in recent years, paving the way for innovative and transformative applications in clinical settings. Most medical instruments invented to measure human activities rely on contact electrodes, causing discomfort. Thanks to its non-invasive nature, biomedical radar is particularly valuable for clinical applications. A significant portion of the review discusses improvements in radar hardware, with a focus on miniaturization, increased resolution, and enhanced sensitivity. Then, this paper also delves into the signal processing and machine learning techniques tailored for radar data. This review will explore the recent breakthroughs and applications of biomedical radar technology, shedding light on its transformative potential in shaping the future of clinical diagnostics, patient and elderly care, and healthcare innovation.

Spinal cord injury (SCI) is a devastating injury that causes permanent neurological dysfunction. To develop a new treatment strategy for SCI, a clinical trial of transplantation of human-induced pluripotent stem cell-derived neural precursor cells (NPCs) in patients in the subacute phase of SCI was recently initiated. The formation of synaptic connections with host neural tissues is one of the therapeutic mechanisms of cell transplantation, and this beneficial efficacy has been directly demonstrated using a chemogenetic tool. This research focuses on the establishment of cell therapy for chronic SCI, which is more challenging owing to cavity and scar formation. Thus, neurogenic NPC transplantation is more effective in forming functional synapses with the host neurons. Furthermore, combinatory rehabilitation therapy is useful to enhance the efficacy of this strategy, and a valid rehabilitative training program has been established for SCI animal models that received NPC transplantation in the chronic phase. Therefore, the use of regenerative medicine for chronic SCI is expected to increase.

Abstract Background Accurate clinical structural variant (SV) calling is essential for cancer target identification and diagnosis but has been historically challenging due to the lack of ground truth for clinical specimens. Meanwhile, reduced clinical-testing cost is the key to the widespread clinical utility. Methods We analyzed massive data from tumor samples of 476 patients and developed a computational framework for accurate and cost-effective detection of clinically-relevant SVs. In addition, standard materials and classical experiments including immunohistochemistry and/or fluorescence in situ hybridization were used to validate the developed computational framework. Results We systematically evaluated the common algorithms for SV detection and established an expert-reviewed SV call set of 1,303 tumor-specific SVs with high-evidence levels. Moreover, we developed a random-forest-based decision model to improve the true positive of SVs. To independently validate the tailored ‘two-step’ strategy, we utilized standard materials and classical experiments. The accuracy of the model was over 90% (92–99.78%) for all types of data. Conclusion Our study provides a valuable resource and an actionable guide to improve cancer-specific SV detection accuracy and clinical applicability.

Walking is one of the most common daily movements of the human body. Therefore, quantitative evaluation of human walking has been commonly used to assist doctors in grasping the disease degree and rehabilitation process of patients in the clinic. Compared with the kinematic characteristics, the ground reaction force (GRF) during walking can directly reflect the dynamic characteristics of human walking. It can further help doctors understand the degree of muscle recovery and joint coordination of patients. This paper proposes a GRF estimation method based on the elastic elements and Newton-Euler equation hybrid driving GRF estimation method. Compared with the existing research, the innovations are as follows. 1) The hardware system consists of only two inertial measurement units (IMUs) placed on shanks. The acquisition of the overall motion characteristics of human walking is realized through the simplified four-link walking model and the thigh prediction method. 2) The method was validated not only on 10 healthy subjects but also on 11 Parkinson’s patients and 10 stroke patients with normalized mean absolute errors (NMAEs) of 5.95%±1.32%, 6.09%±2.00%, 5.87%±1.59%. 3) This paper proposes a dynamic balance assessment method based on the acquired motion data and the estimated GRF. It evaluates the overall balance ability and fall risk at four key time points for all subjects recruited. Because of the low-cost system, ease of use, low motion interference and environmental constraints, and high estimation accuracy, the proposed GRF estimation method and walking balance automatic assessment have broad clinical value.

Keratoconus is a progressive blinding eye disease that characterized by corneal thinning and protrusion, which accompanied with irregular astigmatism and impaired visual acuity.The irregular astigmatism of early keratoconus can be corrected by spectacles. For the irregular astigmatism of moderate to severe keratoconus, spectacles are no longer suitable, and contact lenses are the best choice for patients to restore vision. There are various types of contact lenses, making the selection very difficult. In addition, trying on lenses for a long time will increase the discomfort and overall feeling of patients, and greatly increase the workload of doctors. Thus, the article aims to summarize and discuss the classification of contact lenses, the application of contact lenses in different types of keratoconus, the complications of contact lens, and the current status and prospect of contact lenses, with a view to understanding the management and clinical application of contact lenses in keratoconus patients and to further improving the application value of contact lenses in keratoconus.

With the development of artificial intelligence and the further deepening of medical-engineering integration, spine surgical robot-assisted (RA) technique has made significant progress and its applicability in clinical practice is constantly expanding in recent years. In this review, we have systematically summarized the majority of literature related to spine surgical robots in the past decade, and not only classified robots accordingly, but also summarized the latest research progress in RA technique for screw placement such as cervical, thoracic, and lumbar pedicle screws, cortical bone trajectory screws, cervical lateral mass screws, and S2 sacroiliac screws; guiding targeted puncture and placement of endoscope via the intervertebral foramen; complete resection of spinal tumor tissue; and decompressive laminectomy. In addition, this report also provides a detailed evaluation of RA technique’s advantages and disadvantages, and clarifies the accuracy, safety, and practicality of RA technique. We consider that this review can help clinical physicians further understand and familiarize the current clinical application status of spine surgical robots, thereby promoting the continuous improvement and popularization of RA technique, and ultimately benefiting numerous patients.

Jiaqi Tian,1,&ast; Zhengpu Han,1,2,&ast; Dandan Song,1 Yanjie Peng,1 Min Xiong,3 Zhen Chen,2 Shuyin Duan,4 Lin Zhang1,5 1Clinical Medical Research Center for Women and Children Diseases, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, People’s Republic of China; 2School of Public Health, Weifang Medical University, Weifang, People’s Republic of China; 3School of Public Health, North China University of Science and Technology, Tangshan, People’s Republic of China; 4School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, People’s Republic of China; 5Key Laboratory of Birth Defect Prevention and Genetic Medicine of Shandong Health Commission, Jinan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lin Zhang, Clinical Medical Research Center for Women and Children Diseases, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, 250001, People’s Republic of China, Tel +86-531-68795046, Email zhanglin8901@163.com Shuyin Duan, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250001, People’s Republic of China, Tel +86-13419581411, Email shuyinduan@126.comAbstract: Exosomes are nano-sized membrane vesicles that transfer bioactive molecules between cells and modulate various biological processes under physiological and pathological conditions. By applying bioengineering technologies, exosomes can be modified to express specific markers or carry therapeutic cargo and emerge as novel platforms for the treatment of cancer, neurological, cardiovascular, immune, and infectious diseases. However, there are many challenges and uncertainties in the clinical translation of exosomes. This review aims to provide an overview of the recent advances and challenges in the translation of engineered exosomes, with a special focus on the methods and strategies for loading drugs into exosomes, the pros and cons of different loading methods, and the optimization of exosome production based on the drugs to be encapsulated. Moreover, we also summarize the current clinical applications and prospects of engineered exosomes, as well as the potential risks and limitations that need to be addressed in exosome engineering, including the standardization of exosome preparation and engineering protocols, the quality and quantity of exosomes, the control of drug release, and the immunogenicity and cytotoxicity of exosomes. Overall, engineered exosomes represent an exciting frontier in nanomedicine, but they still face challenges in large-scale production, the maintenance of storage stability, and clinical translation. With continuous advances in this field, exosome-based drug formulation could offer great promise for the targeted treatment of human diseases.Keywords: engineered exosomes, drug delivery, clinical application, preparation strategy

Abstract Flavonoids are phytochemicals that widely exist in plants, fruits, and vegetables and have a variety of activities. However, due to their complex structure, it is often rarely absorbed into the blood. Intestinal bacteria regarded as the third kind of human organ have attracted extensive attention in recent years. Complex structural flavonoids can be catabolized into low molecular weight phenolic acids under the action of intestinal bacteria and then absorbed into the blood, showing several protective effects on the body. In addition, the intake of flavonoids can also regulate the composition and function of intestinal flora. This paper comprehensively summarizes the interaction between flavonoids and intestinal flora, as well as the impact on human health, in order to provide some insights on how to combine intestinal microorganisms to select and ingest dietary polyphenols for future applications in medicine.

Abstract Background Recent research has suggested that artemisinin and its derivatives may have therapeutic effects on parasites, viruses, tumors, inflammation and skin diseases. This study aimed to review clinical research on artemisinin and its derivatives except anti-malaria and explore possible priority areas for future development. Methods Relevant articles in English and Chinese published before 28 October 2021 were reviewed. All articles were retrieved and obtained from databases including WanFang, PubMed/MEDLINE, the Cochrane Library, China National Knowledge International, Embase, OpenGrey, the Grey Literature Report, Grey Horizon, and ClinicalTrials.gov. Studies were selected for final inclusion based on predefined criteria. Information was then extracted and analyzed by region, disease, outcome, and time to identify relevant knowledge gaps. Results Seventy-seven studies on anti-parasitic (35), anti-tumor (16), anti-inflammatory (12), anti-viral (8), and dermatological treatments (7) focused on the safety and efficacy of artemisinin and its derivatives. The anti-parasitic clinical research developed rapidly, with a large number of trials, rapid clinical progress, and multiple research topics. In contrast, anti-viral research was limited and mainly stayed in phase I clinical trials (37.50%). Most of the studies were conducted in Asia (60%), followed by Africa (27%), Europe (8%), and the Americas (5%). Anti-parasite and anti-inflammatory research were mainly distributed in less developed continents such as Asia and Africa, while cutting-edge research such as anti-tumor has attracted more attention in Europe and the United States. At the safety level, 58 articles mentioned the adverse reactions of artemisinin and its derivatives, with only one study showing a Grade 3 adverse event, while the other studies did not show any related adverse reactions or required discontinuation. Most studies have discovered therapeutic effects of artemisinin or its derivatives on anti-parasitic (27), anti-tumor (9), anti-inflammatory (9) and dermatological treatment (6). However, the efficacy of artemisinin-based combination therapies (ACTs) for parasitic diseases (non-malaria) is still controversial. Conclusions Recent clinical studies suggest that artemisinin and its derivatives may be safe and effective candidates for anti-tumor, anti-parasitic, anti-inflammatory and dermatological drugs. More phase II/III clinical trials of artemisinin and its derivatives on antiviral effects are needed. Graphical Abstract

The increasing interest in postbiotics, a term gaining recognition alongside probiotics and prebiotics, aligns with a growing number of clinical trials demonstrating positive outcomes for specific conditions. Postbiotics present several advantages, including safety, extended shelf life, ease of administration, absence of risk, and patentability, making them more appealing than probiotics alone. This review covers various aspects, starting with an introduction, terminology, classification of postbiotics, and brief mechanisms of action. It emphasizes microbial metabolomics as the initial step in discovering novel postbiotics. Commonly employed techniques such as NMR, GC-MS, and LC-MS are briefly outlined, along with their application principles and limitations in microbial metabolomics. The review also examines existing research where these techniques were used to identify, isolate, and characterize postbiotics derived from different microbial sources. The discovery section concludes by highlighting challenges and future directions to enhance postbiotic discovery. In the second half of the review, we delve deeper into numerous published postbiotic clinical trials to date. We provide brief overviews of system-specific trial applications, their objectives, the postbiotics tested, and their outcomes. The review concludes by highlighting ongoing applications of postbiotics in extended clinical trials, offering a comprehensive overview of the current landscape in this evolving field.

With the increasing global incidence and mortality rates of cancer, the development of novel anti-tumor drugs has become particularly urgent. Scutellaria barbata D. Don, a perennial herb belonging to the genus Scutellaria in the family Lamiaceae, has aroused extensive attention for its medicinal value in recent years. This article presents an exhaustive review of the flavonoid, diterpene, and other chemical constituents harbored within Scutellaria barbata, delving into the intricate mechanisms by which these compounds orchestrate their anti-tumor effects via diverse biological pathways. Remarkably, these compounds distinguish themselves through their capability to regulate cellular signaling, inhibit cancer cell proliferation, trigger apoptosis, disrupt angiogenesis, and bolster immune responses. These anti-tumor effects are achieved through strategic modulation of pivotal signaling cascades, particularly the PI3K/Akt/mTOR, MAPK, and NFκB pathways. In addition, this article also summarizes the clinical applications of Scutellaria barbata in tumor treatment, especially its potential in alleviating the side effects of radiotherapy and chemotherapy and improving patients’ quality of life. In conclusion, this review comprehensively summarizes and analyzes the chemical constituents, anti-tumor mechanisms, and clinical applications of Scutellaria barbata, with the aim of systematically reviewing the existing research results and exploring potential future research directions.

Nanotechnology plays a pivotal role in the biomedical field, especially in the synthesis and regulation of drug particle size. Reducing drug particles to the micron or nanometer scale can enhance bioavailability. Supercritical fluid technology, as a green drug development strategy, is expected to resolve the challenges of thermal degradation, uneven particle size, and organic solvent residue faced by traditional methods such as milling and crystallization. This paper provides an insight into the application of super-stable homogeneous intermix formulating technology (SHIFT) and super-table pure-nanomedicine formulation technology (SPFT) developed based on supercritical fluids for drug dispersion and micronization. These technologies significantly enhance the solubility and permeability of hydrophobic drugs by controlling the particle size and morphology, and the modified drugs show excellent therapeutic efficacy in the treatment of hepatocellular carcinoma, pathological scarring, and corneal neovascularization, and their performance and efficacy are highlighted when administered through multiple routes of administration. Overall, supercritical fluids have opened a green and efficient pathway for clinical drug development, which is expected to reduce side effects and enhance therapeutic efficacy.