BACKGROUND Echinococcosis,caused by Echinococcus parasites,includes alveolar echinococcosis(AE),the most lethal form,primarily affecting the liver with a 90%mortality rate without prompt treatment.While radical surger...BACKGROUND Echinococcosis,caused by Echinococcus parasites,includes alveolar echinococcosis(AE),the most lethal form,primarily affecting the liver with a 90%mortality rate without prompt treatment.While radical surgery combined with antiparasitic therapy is ideal,many patients present late,missing hepatectomy opportunities.Ex vivo liver resection and autotransplantation(ELRA)offers hope for such patients.Traditional surgical decision-making,relying on clinical experience,is prone to bias.Machine learning can enhance decision-making by identifying key factors influencing surgical choices.This study innovatively employs multiple machine learning methods by integrating various feature selection techniques and SHapley Additive exPlanations(SHAP)interpretive analysis to deeply explore the key decision factors influencing surgical strategies.AIM To determine the key preoperative factors influencing surgical decision-making in hepatic AE(HAE)using machine learning.METHODS This was a retrospective cohort study at the First Affiliated Hospital of Xinjiang Medical University(July 2010 to August 2024).There were 710 HAE patients(545 hepatectomy and 165 ELRA)with complete clinical data.Data included demographics,laboratory indicators,imaging,and pathology.Feature selection was performed using recursive feature elimination,minimum redundancy maximum relevance,and least absolute shrinkage and selection operator regression,with the intersection of these methods yielding 10 critical features.Eleven machinelearning algorithms were compared,with eXtreme Gradient Boosting(XGBoost)optimized using Bayesian optimization.Model interpretability was assessed using SHAP analysis.RESULTS The XGBoost model achieved an area under the curve of 0.935 in the training set and 0.734 in the validation set.The optimal threshold(0.28)yielded sensitivity of 93.6%and specificity of 90.9%.SHAP analysis identified type of vascular invasion as the most important feature,followed by platelet count and prothrombin time.Lesions invading the hepatic vein,inferior vena cava,or multiple vessels significantly increased the likelihood of ELRA.Calibration curves showed good agreement between predicted and observed probabilities(0.2-0.7 range).The model demonstrated high net clinical benefit in Decision Curve Analysis,with accuracy of 0.837,recall of 0.745,and F1 score of 0.788.CONCLUSION Vascular invasion is the dominant factor influencing the choice of surgical approach in HAE.Machine-learning models,particularly XGBoost,can provide transparent and data-driven support for personalized decision-making.展开更多
Crotalaria ferruginea Graham ex Benth.is a commonly used herb among ethnic minorities.Its whole plant is used as medicine for conditions such as heatstroke,tinnitus,hearing loss,phlegm heat cough,gum swelling and pain...Crotalaria ferruginea Graham ex Benth.is a commonly used herb among ethnic minorities.Its whole plant is used as medicine for conditions such as heatstroke,tinnitus,hearing loss,phlegm heat cough,gum swelling and pain,lower back and knee pain,vaginal discharge and infantile malnutrition.Modern pharmaceutical research has found that Crotalaria ferruginea Graham ex Benth.mainly contains flavonoids,steroids,organic acids and terpenes,which have antibacterial,free radical scavenging,antiinflammatory and other effects.Quality control mainly focuses on characteristics,identification,content determination,etc.This article summarizes the recent research progress on the chemical composition,pharmacological effects,quality control and extraction process of Crotalaria ferruginea Graham ex Benth.on the basis of existing Crotalaria ferruginea Graham ex Benth.research reports.展开更多
Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been propo...Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.展开更多
The net primary productivity(NPP) is an important indicator for assessing the carbon sequestration capacities of different ecosystems and plays a crucial role in the global biosphere carbon cycle. However, in the cont...The net primary productivity(NPP) is an important indicator for assessing the carbon sequestration capacities of different ecosystems and plays a crucial role in the global biosphere carbon cycle. However, in the context of the increasing frequency, intensity, and duration of global extreme climate events, the impacts of extreme climate and vegetation phenology on NPP are still unclear, especially on the Qinghai-Xizang Plateau(QXP), China. In this study, we used a new data fusion method based on the MOD13A2 normalized difference vegetation index(NDVI) and the Global Inventory Modeling and Mapping Studies(GIMMS) NDVI_(3g) datasets to obtain a NDVI dataset(1982–2020) on the QXP. Then, we developed a NPP dataset across the QXP using the Carnegie-Ames-Stanford Approach(CASA) model and validated its applicability based on gauged NPP data. Subsequently, we calculated 18 extreme climate indices based on the CN05.1 dataset, and extracted the length of vegetation growing season using the threshold method and double logistic model based on the annual NDVI time series. Finally, we explored the spatiotemporal patterns of NPP on the QXP and the impact mechanisms of extreme climate and the length of vegetation growing season on NPP. The results indicated that the estimated NPP exhibited good applicability. Specifically, the correlation coefficient, relative bias, mean error, and root mean square error between the estimated NPP and gauged NPP were 0.76, 0.17, 52.89 g C/(m^(2)·a), and 217.52 g C/(m^(2)·a), respectively. The NPP of alpine meadow, alpine steppe, forest, and main ecosystem on the QXP mainly exhibited an increasing trend during 1982–2020, with rates of 0.35, 0.38, 1.40, and 0.48 g C/(m^(2)·a), respectively. Spatially, the NPP gradually decreased from southeast to northwest across the QXP. Extreme climate had greater impact on NPP than the length of vegetation growing season on the QXP. Specifically, the increase in extremely-wet-day precipitation(R99p), simple daily intensity index(SDII), and hottest day(TXx) increased the NPP in different ecosystems across the QXP, while the increases in the cold spell duration index(CSDI) and warm spell duration index(WSDI) decreased the NPP in these ecosystems. The results of this study provide a scientific basis for relevant departments to formulate future policies addressing the impact of extreme climate on vegetation in different ecosystems on the QXP.展开更多
Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in u...Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in urinary control and the change in demand force.Method:In this study,five sheep bladders were used to design and build a biomechanical evaluation system.The biomechanical system included the bladder,pressure gauge,pressure regulator system of the bladder,and force application system by the cuff.In this study,we increased the fluid pressure inside the bladder from 0 cmH_(2)O to 200 cmH_(2)O(1 cmH_(2)O=0.098 kPa),and at each point,the force applied by the cuff to prevent fluid leakage was measured and recorded.Results:The study revealed that a mean tensile force of 2.81(standard deviation 0.23)N for a single cuff and 1.63(standard deviation 0.16)N for double cuffs with symmetrical pressure effectively prevented bladder fluid leakage in the pressure range from 75 cmH_(2)O to 100 cmH_(2)O(p<0.001).However,there were no significant differences in results when comparing the applied tensile force required by double cuffs with asymmetric tensile force to that of the single cuff use.Furthermore,using three cuffs instead of two did not yield significantly different outcomes.Conclusion:Using double cuffs with symmetrical pressure had a greater effect compared with a single cuff with the same tensile force.Although multiple cuffs with varying tensile forces were not found to be useful in controlling urine leakage in this study,it is suggested that applying variable forces alternately and rotationally among several cuffs may reduce long-term risks such as atrophy and necrosis.Future in vivo studies are recommended to further evaluate efficiency.展开更多
The published article titled“Long Noncoding RNA GAS5 Suppresses Tumorigenesis by Inhibiting miR-23a Expression inNon-Small Cell Lung Cancer”has been retracted fromOncology Research,Vol.25,No.6,2017,pp.1027–1037.DOI...The published article titled“Long Noncoding RNA GAS5 Suppresses Tumorigenesis by Inhibiting miR-23a Expression inNon-Small Cell Lung Cancer”has been retracted fromOncology Research,Vol.25,No.6,2017,pp.1027–1037.DOI:10.3727/096504016X14822800040451 URL:https://www.techscience.com/or/v25n6/56885 Following the publication,concerns have been raised about a number of figures in this article.An unexpected area of similarity was identified in terms of the cellular data,where the results from differently performed experiments were intended to have been shown,although the areas immediately surrounding this area featured comparatively different distributions of cells.展开更多
Although Steen's solution plays a crucial role in maintaining vascular oncotic pressure and reducing pulmonary edema due to its high concentration of human serum albumin during ex vivo lung perfusion(EVLP),it incu...Although Steen's solution plays a crucial role in maintaining vascular oncotic pressure and reducing pulmonary edema due to its high concentration of human serum albumin during ex vivo lung perfusion(EVLP),it incurs high costs and potential immune responses in rat models.In our preliminary research,donor lungs perfused with Steen's solution exhibited significant lung injury post transplantation,likely due to a strong immune response elicited by the high concentration of xenogenic proteins upon reperfusion.This study explores a low-cost and efficient perfusate composition for use in rat EVLP and lung transplant models.The modified perfusate employed in this study uses artificial colloids as the primary component,with an albumin concentration of only 2%,demonstrating comparable physiological parameters,metabolic levels,and pathological changes to those of Steen's solution during EVLP.Moreover,the modified composition exhibited good biocompatibility in transplantation,with minimal lung injury.In summary,the proposed perfusate offers a safer and more economical alternative for establishing rat EVLP and lung transplant models,facilitating the advancement of related research.展开更多
BACKGROUND Traditional limitations of cold static storage(CSS)on ice at 4℃during lung transplantation have necessitated limiting cold ischemic time(CIT)to 4-6 hours.Ex vivo lung perfusion(EVLP)can extend this preserv...BACKGROUND Traditional limitations of cold static storage(CSS)on ice at 4℃during lung transplantation have necessitated limiting cold ischemic time(CIT)to 4-6 hours.Ex vivo lung perfusion(EVLP)can extend this preservation time through the suspension of CIT and normothermic perfusion.As we continue to further expand the donor pool in all aspects of lung transplantation,teams are frequently traveling further distances to procure organs.AIM To determine the effect of CSS or EVLP on donors with extended travel distance[>750 nautical miles(NM)]to recipient.METHODS Lung transplants,whose donor traveled greater than 750 NM,were identified from the United Network for Organ Sharing Database.Recipients were stratified into either:CSS or EVLP,based on preservation method.Groups were assessed with comparative statistics and survival was assessed by Kaplan-Meier methods.A 3:1 propensity match was then created,and same analysis was repeated.RESULTS Prior to matching,those in the EVLP group had significantly increased postoperative morbidity to include dialysis,ventilator use,acute rejection,and treated rejection in the first year(P<0.05 for all).However,there were no significant differences in midterm survival(P=0.18).Following matching,those in the EVLP group again had significantly increased post-operative morbidity to include dialysis,extracorporeal membrane oxygenation use,ventilator use,and treated rejection in the first year(P<0.05 for all).As before,there were no significant differences in midterm survival following matching(P=0.08).CONCLUSION While there was no significant difference in survival,EVLP patients had increased peri-operative morbidity.With the advent of changes in CSS with 10℃storage further analysis is necessary to evaluate the best methods for utilizing organs from increased distances.展开更多
AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA wer...AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.展开更多
CD34+ cells from human umbilical cord blood were purified by Dynal beads M-450 CD34 immunoselection system and cultured in the presence of various cytokines alone or in combination, including stem cell factor (SCF), i...CD34+ cells from human umbilical cord blood were purified by Dynal beads M-450 CD34 immunoselection system and cultured in the presence of various cytokines alone or in combination, including stem cell factor (SCF), interleukin-6 (IL-6) and erythropoietin (EPO). The results revealed that: (D In methylcellulose culture, the plating efficiencies of purified cord blood CD34+ cells were much different when stimulated by various cytokines. IL-6 alone had the lowest colo-ny yield, while the combination of SCF, IL-6 and EPO had the highest yield. ② In the suspension culture, IL-6 alone or IL-6 + EPO had little expanding effect on cord blood CD34+ celis, the other cytokine combinations could expand cord blood CD34+ celis at different Ievels. Among them, the combination of SCF, IL-6 and EPO had the maximal expanding effect on cord blood CD34+ celis, the number of progenitor celis peaked at day 21, about 29-fold increase and nucleated celis increased approximately 3676-fold at day 28. The expanding effect of展开更多
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01D17State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia,No.SKL-HIDCA-2024-2.
文摘BACKGROUND Echinococcosis,caused by Echinococcus parasites,includes alveolar echinococcosis(AE),the most lethal form,primarily affecting the liver with a 90%mortality rate without prompt treatment.While radical surgery combined with antiparasitic therapy is ideal,many patients present late,missing hepatectomy opportunities.Ex vivo liver resection and autotransplantation(ELRA)offers hope for such patients.Traditional surgical decision-making,relying on clinical experience,is prone to bias.Machine learning can enhance decision-making by identifying key factors influencing surgical choices.This study innovatively employs multiple machine learning methods by integrating various feature selection techniques and SHapley Additive exPlanations(SHAP)interpretive analysis to deeply explore the key decision factors influencing surgical strategies.AIM To determine the key preoperative factors influencing surgical decision-making in hepatic AE(HAE)using machine learning.METHODS This was a retrospective cohort study at the First Affiliated Hospital of Xinjiang Medical University(July 2010 to August 2024).There were 710 HAE patients(545 hepatectomy and 165 ELRA)with complete clinical data.Data included demographics,laboratory indicators,imaging,and pathology.Feature selection was performed using recursive feature elimination,minimum redundancy maximum relevance,and least absolute shrinkage and selection operator regression,with the intersection of these methods yielding 10 critical features.Eleven machinelearning algorithms were compared,with eXtreme Gradient Boosting(XGBoost)optimized using Bayesian optimization.Model interpretability was assessed using SHAP analysis.RESULTS The XGBoost model achieved an area under the curve of 0.935 in the training set and 0.734 in the validation set.The optimal threshold(0.28)yielded sensitivity of 93.6%and specificity of 90.9%.SHAP analysis identified type of vascular invasion as the most important feature,followed by platelet count and prothrombin time.Lesions invading the hepatic vein,inferior vena cava,or multiple vessels significantly increased the likelihood of ELRA.Calibration curves showed good agreement between predicted and observed probabilities(0.2-0.7 range).The model demonstrated high net clinical benefit in Decision Curve Analysis,with accuracy of 0.837,recall of 0.745,and F1 score of 0.788.CONCLUSION Vascular invasion is the dominant factor influencing the choice of surgical approach in HAE.Machine-learning models,particularly XGBoost,can provide transparent and data-driven support for personalized decision-making.
文摘Crotalaria ferruginea Graham ex Benth.is a commonly used herb among ethnic minorities.Its whole plant is used as medicine for conditions such as heatstroke,tinnitus,hearing loss,phlegm heat cough,gum swelling and pain,lower back and knee pain,vaginal discharge and infantile malnutrition.Modern pharmaceutical research has found that Crotalaria ferruginea Graham ex Benth.mainly contains flavonoids,steroids,organic acids and terpenes,which have antibacterial,free radical scavenging,antiinflammatory and other effects.Quality control mainly focuses on characteristics,identification,content determination,etc.This article summarizes the recent research progress on the chemical composition,pharmacological effects,quality control and extraction process of Crotalaria ferruginea Graham ex Benth.on the basis of existing Crotalaria ferruginea Graham ex Benth.research reports.
文摘Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.
基金supported by the National Natural Science Foundation of China (U2243227)。
文摘The net primary productivity(NPP) is an important indicator for assessing the carbon sequestration capacities of different ecosystems and plays a crucial role in the global biosphere carbon cycle. However, in the context of the increasing frequency, intensity, and duration of global extreme climate events, the impacts of extreme climate and vegetation phenology on NPP are still unclear, especially on the Qinghai-Xizang Plateau(QXP), China. In this study, we used a new data fusion method based on the MOD13A2 normalized difference vegetation index(NDVI) and the Global Inventory Modeling and Mapping Studies(GIMMS) NDVI_(3g) datasets to obtain a NDVI dataset(1982–2020) on the QXP. Then, we developed a NPP dataset across the QXP using the Carnegie-Ames-Stanford Approach(CASA) model and validated its applicability based on gauged NPP data. Subsequently, we calculated 18 extreme climate indices based on the CN05.1 dataset, and extracted the length of vegetation growing season using the threshold method and double logistic model based on the annual NDVI time series. Finally, we explored the spatiotemporal patterns of NPP on the QXP and the impact mechanisms of extreme climate and the length of vegetation growing season on NPP. The results indicated that the estimated NPP exhibited good applicability. Specifically, the correlation coefficient, relative bias, mean error, and root mean square error between the estimated NPP and gauged NPP were 0.76, 0.17, 52.89 g C/(m^(2)·a), and 217.52 g C/(m^(2)·a), respectively. The NPP of alpine meadow, alpine steppe, forest, and main ecosystem on the QXP mainly exhibited an increasing trend during 1982–2020, with rates of 0.35, 0.38, 1.40, and 0.48 g C/(m^(2)·a), respectively. Spatially, the NPP gradually decreased from southeast to northwest across the QXP. Extreme climate had greater impact on NPP than the length of vegetation growing season on the QXP. Specifically, the increase in extremely-wet-day precipitation(R99p), simple daily intensity index(SDII), and hottest day(TXx) increased the NPP in different ecosystems across the QXP, while the increases in the cold spell duration index(CSDI) and warm spell duration index(WSDI) decreased the NPP in these ecosystems. The results of this study provide a scientific basis for relevant departments to formulate future policies addressing the impact of extreme climate on vegetation in different ecosystems on the QXP.
文摘Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in urinary control and the change in demand force.Method:In this study,five sheep bladders were used to design and build a biomechanical evaluation system.The biomechanical system included the bladder,pressure gauge,pressure regulator system of the bladder,and force application system by the cuff.In this study,we increased the fluid pressure inside the bladder from 0 cmH_(2)O to 200 cmH_(2)O(1 cmH_(2)O=0.098 kPa),and at each point,the force applied by the cuff to prevent fluid leakage was measured and recorded.Results:The study revealed that a mean tensile force of 2.81(standard deviation 0.23)N for a single cuff and 1.63(standard deviation 0.16)N for double cuffs with symmetrical pressure effectively prevented bladder fluid leakage in the pressure range from 75 cmH_(2)O to 100 cmH_(2)O(p<0.001).However,there were no significant differences in results when comparing the applied tensile force required by double cuffs with asymmetric tensile force to that of the single cuff use.Furthermore,using three cuffs instead of two did not yield significantly different outcomes.Conclusion:Using double cuffs with symmetrical pressure had a greater effect compared with a single cuff with the same tensile force.Although multiple cuffs with varying tensile forces were not found to be useful in controlling urine leakage in this study,it is suggested that applying variable forces alternately and rotationally among several cuffs may reduce long-term risks such as atrophy and necrosis.Future in vivo studies are recommended to further evaluate efficiency.
文摘The published article titled“Long Noncoding RNA GAS5 Suppresses Tumorigenesis by Inhibiting miR-23a Expression inNon-Small Cell Lung Cancer”has been retracted fromOncology Research,Vol.25,No.6,2017,pp.1027–1037.DOI:10.3727/096504016X14822800040451 URL:https://www.techscience.com/or/v25n6/56885 Following the publication,concerns have been raised about a number of figures in this article.An unexpected area of similarity was identified in terms of the cellular data,where the results from differently performed experiments were intended to have been shown,although the areas immediately surrounding this area featured comparatively different distributions of cells.
文摘Although Steen's solution plays a crucial role in maintaining vascular oncotic pressure and reducing pulmonary edema due to its high concentration of human serum albumin during ex vivo lung perfusion(EVLP),it incurs high costs and potential immune responses in rat models.In our preliminary research,donor lungs perfused with Steen's solution exhibited significant lung injury post transplantation,likely due to a strong immune response elicited by the high concentration of xenogenic proteins upon reperfusion.This study explores a low-cost and efficient perfusate composition for use in rat EVLP and lung transplant models.The modified perfusate employed in this study uses artificial colloids as the primary component,with an albumin concentration of only 2%,demonstrating comparable physiological parameters,metabolic levels,and pathological changes to those of Steen's solution during EVLP.Moreover,the modified composition exhibited good biocompatibility in transplantation,with minimal lung injury.In summary,the proposed perfusate offers a safer and more economical alternative for establishing rat EVLP and lung transplant models,facilitating the advancement of related research.
基金Supported by The Jewel and Frank Benson Family Endowmentand The Jewel and Frank Benson Research Professorship.
文摘BACKGROUND Traditional limitations of cold static storage(CSS)on ice at 4℃during lung transplantation have necessitated limiting cold ischemic time(CIT)to 4-6 hours.Ex vivo lung perfusion(EVLP)can extend this preservation time through the suspension of CIT and normothermic perfusion.As we continue to further expand the donor pool in all aspects of lung transplantation,teams are frequently traveling further distances to procure organs.AIM To determine the effect of CSS or EVLP on donors with extended travel distance[>750 nautical miles(NM)]to recipient.METHODS Lung transplants,whose donor traveled greater than 750 NM,were identified from the United Network for Organ Sharing Database.Recipients were stratified into either:CSS or EVLP,based on preservation method.Groups were assessed with comparative statistics and survival was assessed by Kaplan-Meier methods.A 3:1 propensity match was then created,and same analysis was repeated.RESULTS Prior to matching,those in the EVLP group had significantly increased postoperative morbidity to include dialysis,ventilator use,acute rejection,and treated rejection in the first year(P<0.05 for all).However,there were no significant differences in midterm survival(P=0.18).Following matching,those in the EVLP group again had significantly increased post-operative morbidity to include dialysis,extracorporeal membrane oxygenation use,ventilator use,and treated rejection in the first year(P<0.05 for all).As before,there were no significant differences in midterm survival following matching(P=0.08).CONCLUSION While there was no significant difference in survival,EVLP patients had increased peri-operative morbidity.With the advent of changes in CSS with 10℃storage further analysis is necessary to evaluate the best methods for utilizing organs from increased distances.
基金Supported by National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority’Ascent Plan(No.DFL20190201)+1 种基金Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202503)Natural Science Foundation of Beijing(No.7222025).
文摘AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.
文摘CD34+ cells from human umbilical cord blood were purified by Dynal beads M-450 CD34 immunoselection system and cultured in the presence of various cytokines alone or in combination, including stem cell factor (SCF), interleukin-6 (IL-6) and erythropoietin (EPO). The results revealed that: (D In methylcellulose culture, the plating efficiencies of purified cord blood CD34+ cells were much different when stimulated by various cytokines. IL-6 alone had the lowest colo-ny yield, while the combination of SCF, IL-6 and EPO had the highest yield. ② In the suspension culture, IL-6 alone or IL-6 + EPO had little expanding effect on cord blood CD34+ celis, the other cytokine combinations could expand cord blood CD34+ celis at different Ievels. Among them, the combination of SCF, IL-6 and EPO had the maximal expanding effect on cord blood CD34+ celis, the number of progenitor celis peaked at day 21, about 29-fold increase and nucleated celis increased approximately 3676-fold at day 28. The expanding effect of
