AIM:To investigate the effect of pentagonal conjunctival autograft on reducing graft retraction following pterygium surgery.METHODS:This retrospective comparative study included patients who underwent primary pterygiu...AIM:To investigate the effect of pentagonal conjunctival autograft on reducing graft retraction following pterygium surgery.METHODS:This retrospective comparative study included patients who underwent primary pterygium excision with either pentagonal(created by shaping the junction with the recipient conjunctiva into a wedge)or quadrangular conjunctival autograft transplantation.All patients completed a 6mo postoperative follow-up.The primary outcome measure was the incidence of graft retraction;secondary outcomes included graft displacement requiring re-suturing and pterygium recurrence rate.RESULTS:The study enrolled 58 participants,comprising 26(15 males,11 females)in the pentagonal graft group(mean age:54.9±13.1y),and 32(17 males,15 females)in the quadrangular graft group(mean age:57.6±10.4y).Graft retraction occurred in only 1 eye(3.8%)in the pentagonal autograft group,compared to 9 eyes(28.1%)in the quadrangular autograft group.No cases of graft displacement requiring re-suturing were reported in the pentagonal autograft group.Although graft displacement and recurrence requiring re-suturing were observed less frequently in surgeries with a pentagonal graft,the difference was not statistically significant(P>0.05).CONCLUSION:Designing the conjunctival autograft in a pentagonal shape—mimicking geodesic dome architecture and conforming to the eye’s spherical structure—enhances compatibility with the recipient conjunctiva and improves resistance to physical traction forces.This design effectively reduces the incidence of graft retraction and other related complications,providing a more favorable surgical option for pterygium treatment.展开更多
BACKGROUND Pediatric liver transplantation(LT)is the definitive treatment for end-stage liver disease and acute liver failure in children.However,graft size mismatch poses significant challenges,particularly in infant...BACKGROUND Pediatric liver transplantation(LT)is the definitive treatment for end-stage liver disease and acute liver failure in children.However,graft size mismatch poses significant challenges,particularly in infants weighing less than 10 kg.Large-forsize grafts can lead to severe complications,including vascular thrombosis and impaired graft perfusion.Surgical innovations,such as hyper-reduced left lateral segment(HRLLS)grafts and monosegmental grafts(MSG),offer viable solutions by tailoring graft size without compromising vascular or biliary integrity.AIM To analyze the techniques and outcomes of HRLLS and MSG grafts in pediatric liver trabsplantation.METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a comprehensive literature search was conducted across PubMed,Scopus,and Google Scholar,including studies up to February 2025.Eligible studies included case-control,observational,and randomized controlled trials reporting clinical outcomes of HRLLS,MSG,or reduced left lateral segment grafts(RLLS)in pediatric LT.The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment.Meta-analysis was performed using MetaXL software to pool survival outcomes and assess complication profiles.RESULTS Eighteen studies involving various graft reduction techniques were included.Both HRLLS and MSG demonstrated comparable one-year survival rates exceeding 80%,with some studies reporting rates above 95%.Complications such as hepatic artery thrombosis,portal vein thrombosis,and sepsis were slightly more frequent in HRLLS/RLLS recipients but remained within acceptable limits.Meta-analysis revealed no significant differences in survivability between graft types.CONCLUSION HRLLS and MSG techniques enable successful liver transplantation in small pediatric recipients,achieving longterm outcomes comparable to standard approaches.These graft modification strategies expand donor pool utilization and optimize patient survival while mitigating large-for-size complications.展开更多
BACKGROUND The use of induction immunosuppression agents has improved kidney transplant outcomes,but selecting the optimal agent remains a point of debate.AIM To compare the long-term outcomes of kidney transplant rec...BACKGROUND The use of induction immunosuppression agents has improved kidney transplant outcomes,but selecting the optimal agent remains a point of debate.AIM To compare the long-term outcomes of kidney transplant recipients receiving alemtuzumab vs basiliximab induction,focusing on graft function,acute rejection,infection,malignancy,post-transplant glomerulonephritis,and survival,using a propensity score matched cohort design.METHODS Kidney transplant recipients who received alemtuzumab or basiliximab induction from 2014 to 2019 across two nephrology centres in Northwest England were evaluated.Propensity score matching at a 1:1.5 ratio ensured comparability between cohorts.Baseline characteristics,immunosuppression regimens,and outcomes were analyzed.Linear,binary logistic and Cox proportional hazard regression models.RESULTS A total of 436 recipients were included,with a median follow-up of 5.2 years.The matched cohort(n=262)had a mean age of 51.1±13.5 years;39%were female and 92%were white.There was no significant difference in the cumulative incidence of acute rejection[odds ratio(OR)=2.10;95%CI:0.9-4.9;P=0.110].Compared with basiliximab,alemtuzumab was associated with lower estimated glomerular filtration rate at 12 months(-6.6 mL/minute/1.73 m2;95%CI:-10.5 to-2.7;P<0.001)and higher risks of cytomegalovirus viremia(OR=3.2;95%CI:1.6-6.5;P<0.001),BK viremia(OR=2.4;95%CI:1.1-5.5;P=0.02),post-transplant malignancy(OR=6.2;95%CI:1.6-29.9;P=0.013),and death-censored graft loss(hazard ratio=3.6;95%CI:1.2-11.4;P=0.03).No significant differences were observed in post-transplant glomerulonephritis or recipient mortality.CONCLUSION In this propensity score-matched analysis,alemtuzumab induction was associated with lower graft function at 12 months and higher risks of viral infection,post-transplant malignancy,and graft loss compared with basiliximab.These findings highlight the need for further studies to confirm the long-term safety and effectiveness of alemtuzumab in kidney transplantation.展开更多
BACKGROUND An echocardiogram is an essential tool in the evaluation of potential kidney transplant recipients(KTRs).Despite cardiac clearance,potential KTRs still have structural and functional abnormalities.Identifyi...BACKGROUND An echocardiogram is an essential tool in the evaluation of potential kidney transplant recipients(KTRs).Despite cardiac clearance,potential KTRs still have structural and functional abnormalities.Identifying the prevalence of these abnormalities and understanding their predictors is vital for optimizing pretransplant risk stratification and improving post-transplant outcomes.AIM To determine the prevalence of left ventricular hypertrophy(LVH),left ventricular systolic dysfunction(LVSD),diastolic dysfunction(DD),pulmonary hypertension(PH),and their predictors,and to assess their impact on graft function in pre-transplant candidates.METHODS The study included all successful transplant candidates older than 14 who had a baseline echocardiogram.Binary logistic regression models were constructed to identify factors associated with LVH,LVSD,DD,and PH.RESULTS Out of 259 patients,LVH was present in 64%(166),12%(31)had LVSD,27.5%(71)had DD,and 66(25.5%)had PH.Independent predictors of LVH included male gender[odds ratio(OR):2.51;95%CI:1.17-5.41 P=0.02],PH(OR=2.07;95%CI:1.11-3.86;P=0.02),DD(OR:2.47;95%CI:1.29-4.73;P=0.006),and dyslipidemia(OR=1.94;95%CI:1.07-3.53;P=0.03).Predictors for LVSD included patients with DD(OR=3.3,95%CI:1.41-7.81;P=0.006)and a family history of coronary artery disease(OR=4.50,95%CI:1.33-15.20;P=0.015).Peritoneal dialysis was an independent predictor for DD(OR=10.03;95%CI:1.71-58.94,P=0.011).The presence of LVH(OR=3.32,95%CI:1.05-10.55,P=0.04)and mild to moderate or moderate to severe mitral regurgitation(OR=4.63,95%CI:1.45-14.78,P=0.01)were significant factors associated with PH.These abnormalities had no significant impact on estimated glomerular filtration at discharge,6 months,1 year,or 2 years post-transplant.CONCLUSION Significant echocardiographic abnormalities persist in a potential transplant candidate despite cardiac clearance,although they don’t affect future graft function.Understanding the risk factors associated with these abnormalities may help clinicians address these factors pre-and post-transplant to achieve better outcomes.展开更多
The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discov...The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discovery.[2]Due to its rarity,knowledge mainly comes from case reports and small case series,though some decision algorithms have been proposed in systematic reviews.展开更多
The milestone reported by He et al.—demonstrating pig‐tohuman lung xenotransplantation in a brain‐dead recipient—is a seminal moment in organ xenografting.It extends the horizons of xenotransplantation beyond the ...The milestone reported by He et al.—demonstrating pig‐tohuman lung xenotransplantation in a brain‐dead recipient—is a seminal moment in organ xenografting.It extends the horizons of xenotransplantation beyond the breakthroughs achieved in porcine heart and kidney grafts and aligns with the emergent clinical data on porcine liver applications[1].展开更多
Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patient...Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patients on LT waiting lists is increasing,and the organ shortage crisis is obvious,various efforts have been made to increase the pool of available liver grafts[1].In addition to living donor liver transplantation(LDLT),improving the utilization rate of extended criteria donor(ECD)livers is an important way.However,under traditional cold storage,ECD livers are usually associated with a higher risk of ischemic biliary disease,early allograft dysfunction(EAD)or even primary nonfunction(PNF).The frequently described definition in the literature for ECD grafts generally includes elderly,steatotic,long cold ischemia time(CIT),grafts obtained from donation after circulatory death(DCD),split liver grafts,donors with increased risk of infectious disease transmission and prolonged donor intensive care unit stay[2].展开更多
BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from mode...BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.展开更多
BACKGROUND Transplantectomy has long been considered the preferred treatment for spontaneous renal graft rupture,prioritizing patient safety over kidney salvage.In the last decade,there has been an increasing number o...BACKGROUND Transplantectomy has long been considered the preferred treatment for spontaneous renal graft rupture,prioritizing patient safety over kidney salvage.In the last decade,there has been an increasing number of reports showing that,in selected scenarios,conservative management through graft repair represents a feasible option,challenging traditional approaches.CASE SUMMARY We describe the case of a 37-year-old sensitized XY patient who experienced early spontaneous graft rupture after receiving his second deceased donor kidney transplant.Following temporary hemodynamic stabilization and abdominal contrast enhanced computed tomography scan assessment,the recipient was brought back to theatre for surgical exploration.Possible causes of irreversible graft damage were immediately ruled out.The fractured upper pole of the transplanted kidney was repaired using a fibrin sealant,external compression,and a tailored polyglactin 910 mesh wrapped around the graft.The post-operative course was uneventful.After 20 months of follow up,the patient is doing very well,with excellent renal function and complete reabsorption of the mesh,as demonstrated by serial ultrasound evaluations of the graft.CONCLUSION Amid organ shortages and sensitized patients,graft nephrectomy is reserved for severe injuries;repair using sealants and mesh is effective.展开更多
Paediatric liver transplantation(PLT)is a life-saving procedure for children with advanced liver disease or hepatoblastoma.The number of available grafts is limited in relation to the number of children on PLT waiting...Paediatric liver transplantation(PLT)is a life-saving procedure for children with advanced liver disease or hepatoblastoma.The number of available grafts is limited in relation to the number of children on PLT waiting list.This graft shortage has led transplant societies and healthcare organizations to explore ways to investigate possible options and expand the donor pool.The safe use of grafts from obese donors has always been a subject of debate among PLT specialists.Donors’obesity is strongly associated with hepatic steatosis which can affect graft function by impairing microcirculation and maximizing the potential of ischemiareperfusion injury.Donor body mass index consideration should go hand in hand with the workup for hepatic steatosis which is an independent predictor for early graft dysfunction.New strategies to optimize the grafts before PLT such as normothermic regional perfusion and ex vivo liver perfusion can potentially mitigate the risk of using grafts from obese donors.This review summarizes the available evidence about the impact of donor obesity on PLT and highlights the current policies to widen the graft pool and suggest future research directions to improve donor selection and patient outcomes.展开更多
BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;ho...BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.展开更多
BACKGROUND Childhood obesity is a significant public health concern,particularly amongst children with chronic kidney disease requiring kidney transplant(KT).Obesity,defined as a body mass index(BMI)of 30 kg/m^(2) or ...BACKGROUND Childhood obesity is a significant public health concern,particularly amongst children with chronic kidney disease requiring kidney transplant(KT).Obesity,defined as a body mass index(BMI)of 30 kg/m^(2) or greater,is prevalent in this population and is associated with disease progression.While BMI in-fluences adult KT eligibility,its impact on pediatric transplant outcomes remains unclear.This study investigates the effect of BMI on graft survival and patient outcomes,addressing gaps in the literature and examining disparities across BMI classifications.AIM To assess the impact of BMI classifications on graft and patient survival following KT.METHODS A retrospective cohort study analyzed 23081 pediatric transplant recipients from the Standard Transplant Analysis and Research database(1987-2022).Patients were grouped into six BMI categories:Underweight,healthy weight,overweight,and Class 1,2,and 3 obesity.Data were analyzed using one-way way analysis of variance,Kruskal-Wallis tests,Chi-squared tests,Kaplan-Meier survival analysis with log-rank tests,and Cox proportional hazard regressions.Statistical significance was set at P<0.05.RESULTS Class 3 obese recipients had lower 1-year graft survival(88.7%)compared to healthy-weight recipients(93.1%,P=0.012).Underweight recipients had lower 10-year patient survival(81.3%,P<0.05)than healthy-weight recipients.Class 2 and 3 obese recipients had the lowest 5-year graft survival(67.8%and 68.3%,P=0.013)and Class 2 obesity had the lowest 10-year graft survival(40.7%).Cox regression identified increases in BMI category as an independent predictor of graft failure[hazard ratio(HR)=1.091,P<0.001]and mortality(HR=1.079,P=0.008).Obese patients experienced longer cold ischemia times(11.6 and 13.1 hours vs 10.2 hours,P<0.001).Class 3 obesity had the highest proportion of Black recipients(26.2%vs 17.9%,P<0.001).CONCLUSION Severe obesity and underweight status are associated with poorer long-term outcomes in pediatric KT recipients,emphasizing the need for nuanced transplant eligibility criteria addressing obesity-related risks and socioeconomic disparities.展开更多
Melon fruit flavor is a key quality characteristic that influences consumer preference.Grafting is an effective technique to enhance fruit quality but yields divergent outcomes in terms of fruit flavor.To address this...Melon fruit flavor is a key quality characteristic that influences consumer preference.Grafting is an effective technique to enhance fruit quality but yields divergent outcomes in terms of fruit flavor.To address this problem,we analyzed parallel changes in flavor-related metabolite accumulation and gene expression in two pumpkin rootstock grafted melons during four fruit developmental stages.We identified 26061 expressed genes and 840 metabolites from 21 different compound classes,including carbohydrates,amino acids,and lipids.We also detected 50 aroma volatile compounds in the grafted melons.Results showed that genes and metabolites associated with metabolic pathways(carbohydrate,amino acid,lipid,and phenylpropanoid)play a key role in flavor formation.Compared with‘Sizhuang 12’,‘Tianzhen 1’rootstock improved melon fruit flavor by upregulating sugar-related genes(HK,MPI,MIOX,and STP)and inducing metabolite accumulation(d-ribose-5-phosphate,d-galactose,and trehalose 6-phosphate),whereas decreasing bitterness-related amino acids(l-arginine,l-asparagine,and l-tyrosine)and associated genes(thrC,ACS,and GLUL)expression at ripening stage.Furthermore,‘Tianzhen 1’exhibited higher expression levels of enzyme-coding genes(4CL,CSE,and COMT)responsible for aroma volatile synthesis than‘Sizhuang 12’rootstock.Taken together,our results decipher the basis of the molecular mechanism underlying fruit flavor in grafted melons and provide valuable information for the melons genetic improvement.展开更多
Grafting is widely used in cucumbers to enhance their tolerance to environmental stress.Compatibility is a key factor for successful grafting,however,the physiological mechanisms that affect grafting compatibility are...Grafting is widely used in cucumbers to enhance their tolerance to environmental stress.Compatibility is a key factor for successful grafting,however,the physiological mechanisms that affect grafting compatibility are not clear.This study aimed to investigate the physiological mechanism underlying cucumber/pumpkin grafting compatibility.Two pumpkin cultivars with significant differences in compatibility,Figleaf gourd(compatible rootstock,Cf)and Dongyangshenli(incompatible rootstock,Cmo),were used as rootstocks.Three cucumber cultivars with different growth rates were used as scions,including cucumber‘Shenluchunsi’(strong growth,V1),‘Cuilü’(weak growth,V2),and‘Liangyoulüjian 102’(medium growth,V3).Six grafting combinations(V1/Cf,V2/Cf,V3/Cf,V1/Cmo,V2/Cmo,and V3/Cmo)were used to analyze the effect of scion and rootstock varieties,as well as the chemical composition of the exudate from the stem cutting surface,on the compatibility of grafted plants.Here,we found that rootstock was closely correlated with the compatibility of cucumber/pumpkin grafted plants.The sucrose content in the exudate of the stem,enzyme activity,and the expression of genes related to sucrose biosynthesis in Cmo were significantly higher than those in Cf.Correlation analysis showed that the sucrose content difference between the exudate of rootstock and scion stems was negatively correlated with graft compatibility.Exogenous treatment with a 0.5%sucrose solution on the scions significantly reduced the difference in sucrose content between rootstock and scion and enhanced graft survival rate in the incompatible combination.The stem segment grafting experiment in vitro found that the high difference in sucrose concentration between the rootstock and scion decreased the grafting compatibility of cucumber/pumpkin by reducing the adhesion of the cutting surface.Taken together,the higher sucrose concentration difference between rootstock and scion decreased the adhesion of the cutting surface,resulting in the incompatibility of cucumber/pumpkin grafted plants.展开更多
Vein graft(VG)failure(VGF)is associated with VG intimal hyperplasia,which is characterized by abnormal accumulation of vascular smooth muscle cells(VSMCs).Most neointimal VSMCs are derived from pre-existing VSMCs via ...Vein graft(VG)failure(VGF)is associated with VG intimal hyperplasia,which is characterized by abnormal accumulation of vascular smooth muscle cells(VSMCs).Most neointimal VSMCs are derived from pre-existing VSMCs via a process of VSMC phenotypic transition,also known as dedifferentiation.There is increasing evidence to suggest that ginger or its bioactive ingredients may block VSMC dedifferentiation,exerting vasoprotective functions;however,the precise mechanisms have not been fully characterized.Therefore,we investigated the effect of ginger on VSMC phenotypic transition in VG remodeling after transplantation.Ginger significantly inhibited neointimal hyperplasia and promoted lumen(L)opening in a 3-month VG,which was primarily achieved by reducing ferroptotic stress.Ferroptotic stress is a pro-ferroptotic state.Contractile VSMCs did not die but instead gained a proliferative capacity and switched to the secretory type,forming neointima(NI)after vein transplantation.Ginger and its two main vasoprotective ingredients(6-gingerol and 6-shogaol)inhibit VSMC dedifferentiation by reducing ferroptotic stress.Network pharmacology analysis revealed that 6-gingerol inhibits ferroptotic stress by targeting P53,while 6-shogaol inhibits ferroptotic stress by targeting 5-lipoxygenase(Alox5),both promoting ferroptosis.Furthermore,both ingredients co-target peroxisome proliferator-activated receptor gamma(PPARγ),decreasing PPARγ-mediated nicotinamide adenine dinucleotide phosphate(NADPH)oxidase 1(Nox1)expression.Nox1 promotes intracellular reactive oxygen species(ROS)production and directly induces VSMC dedifferentiation.In addition,Nox1 is a ferroptosis-promoting gene that encourages ferroptotic stress production,indirectly leading to VSMC dedifferentiation.Ginger,a natural multi-targeted ferroptotic stress inhibitor,finely and effectively prevents VSMC phenotypic transition and protects against venous injury remodeling.展开更多
BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of t...BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous junction.Possible treatments include direct tendon suture or tendon transfer,most commonly from the ring finger.To optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon graft.CASE SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a handrail.The patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and nerves.The patient was treated with two stage thumb repair.The first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon prosthesis.The second intervention consisted of PL tendon graft and BR tendon transfer.Follow-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 mm.CONCLUSION Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.展开更多
Diabetic foot ulcers(DFUs)represents a significant public health issue,with a rising global prevalence and severe potential complications including amputation.Traditional treatments often fall short due to various lim...Diabetic foot ulcers(DFUs)represents a significant public health issue,with a rising global prevalence and severe potential complications including amputation.Traditional treatments often fall short due to various limitations such as high recurrence rates and extensive resource utilization.This editorial explores the innovative use of acellular fish skin grafts as a transformative approach in DFU management.Recent studies and a detailed case report highlight the efficacy of acellular fish skin grafts in accelerating wound closure,reducing dressing changes,and enhancing patient outcomes with a lower socio-economic burden.Despite their promise,challenges such as limited availability,patient acceptance,and the need for further research persist.Addressing these through more extensive randomized controlled trials and fostering a multidisciplinary treatment approach may optimize DFU care and reduce the global health burden associated with these complex wounds.展开更多
Grafting is an effective technique for increasing the resistance of vegetables to biotic and abiotic stresses.It has been widely applied to produce solanaceous and melon vegetables.Temperature is an important external...Grafting is an effective technique for increasing the resistance of vegetables to biotic and abiotic stresses.It has been widely applied to produce solanaceous and melon vegetables.Temperature is an important external factor affecting graft formation.However,the molecular mechanism by which external ambient temperature affects tomato graft formation remains unclear.In this study,we demonstrated that elevating ambient temperature during grafting to 35℃ for more than 24 h after grafting accelerated vascular reconnection.We generated self-or heterografted combinations between phyB1B2 and pif4 loss-of-function mutant and wild-type plants,and were mutants unresponsive to graft formation at elevated ambient temperature.In addition,elevated ambient temperature induced SlPIF4 expression during grafting.SlPIF4 directly binds the promoters of auxin biosynthesis genes SlYUCCAs and activates their expression.Further investigation revealed auxin accumulation in the graft junction under elevated ambient temperature.The results illuminate the mechanism by which the PHYB-PIF4-auxin module promotes tomato graft formation in response to elevated ambient temperature.展开更多
In this study,injectable bone graft putty samples were developed using fine and coarse melt-quenched 45S5 bioactive glass(BG)incorporated into a carrier system composed of glycerol and polyethylene glycol(PEG)with dif...In this study,injectable bone graft putty samples were developed using fine and coarse melt-quenched 45S5 bioactive glass(BG)incorporated into a carrier system composed of glycerol and polyethylene glycol(PEG)with different average molecular weights.Selected putty samples were further incorporated with varying amounts of Denosumab(5wt%-10wt%)to investigate its influence on rhe-ological behavior and flow properties using mathematical modeling.All PEG/glycerol/45S5-based putty samples exhibited viscoelastic behavior(storage modulus>loss modulus)and pseudoplastic behavior(n<1),with viscosity values required for optimal flow remaining below 1000 Pa∙s.Both viscosity and thixotropic area increased proportionally with higher BG content and smaller-sized BG particles.All putty samples showed more than 98%injectability through a 12G cannula,suggesting potential clinical suitability.However,injectability decreased with smaller cannulas,dropping to 34.7%-58.3%with a 19G cannula and further decreasing with a 23G cannula at higher BG contents.Incorporation of Denosumab preserved viscoelasticity and injectability but modified the flow behavior,shifting it from pseudo-plastic to more Newtonian with higher Denosumab content,while also reducing viscosity and thixotropic area values.Among all tested samples,putty containing a lower amount of Denosumab and smaller-sized BG exhibited the most suitable combination of injectability and rheological features.All putty samples were well described by both the Power law and Herschel-Bulkley rheological models(coeffi-cient of determination>0.95).This study highlights the influence of Denosumab on flowability and rheological relationships and sug-gests potential improvements in bioactivity through a dual synergistic effect of BG and Denosumab in minimally invasive bone graft sys-tems.展开更多
BACKGROUND The Luminex platform,where beads are coated with single human leukocyte antigens(HLA),detects HLA antibodies with higher sensitivity and specificity compared to complement-dependent cytotoxicity(CDC)assay a...BACKGROUND The Luminex platform,where beads are coated with single human leukocyte antigens(HLA),detects HLA antibodies with higher sensitivity and specificity compared to complement-dependent cytotoxicity(CDC)assay and flow crossmatch(FCXM).The clinical significance of donor-specific antibodies(DSAs)detected by this method is still under investigation.AIM To report the impact of low-level pretransplant DSAs detected by the Luminex platform on the rates of acute rejection(AR),allograft function,and long-term graft survival.METHODS This retrospective study was conducted at the Immunology Department of Sindh Institute of Urology and Transplantation,Karachi,Pakistan between January 2013 and December 2022.During this period 2714 patients were transplanted.Out of these patients 78(2.9%)patients had low-level DSAs detected by the Luminex flow beads method and were negative by CDC and FCXM with their donors.All recipients received ABO-compatible live-related kidney transplants.All patients had a minimum follow-up of 1 year.Graft rejection rates,graft function,and patient and graft survival were analyzed.The estimated glomerular filtration rate was calculated by the full CKD-EPI formula.RESULTS The mean age of all recipients was 29.57±10.11 years and 34.53±9.09 years for the donors.In 48(61.5%)patients,the cause of end-stage kidney disease was unknown.DSA against HLA class I was detected in 36(46.1%)patients,class II in 35(44.8%)patients,and both class I and II in 7(8.9%)patients.AR episodes were encountered in 8(10.3%)cases.Seven(87.5%)had T cell mediated rejection(type IA)and one acute antibody-mediated rejection.Antibody status was re-evaluated at the time of biopsy-proven ARs.Five(62.5%)patients lost their DSAs,while three(37.5%)had persistent DSAs.The mean estimated glomerular filtration rate at 1 year was 80.56±27.48 mL/min/1.73 m2 and at the last follow-up 73.41±28.80 mL/min/1.73 m2.The 1-year and 10-year patient and graft survival rates were 99%and 79%and 95%and 75%,respectively.During the follow-up period,10(12.8%)patients died,8 patients had a functioning graft,and 2 patients had failed grafts.Eight patients died due to cardiopulmonary arrest,and two died due to sepsis with failed grafts.CONCLUSION Patients with pretransplant low-level DSAs on Luminex without CDC and FCXM reactivity had good allograft outcomes at 1 year and 10 years as long as they are induced with biological agents and given potent maintenance immunosuppressants.展开更多
文摘AIM:To investigate the effect of pentagonal conjunctival autograft on reducing graft retraction following pterygium surgery.METHODS:This retrospective comparative study included patients who underwent primary pterygium excision with either pentagonal(created by shaping the junction with the recipient conjunctiva into a wedge)or quadrangular conjunctival autograft transplantation.All patients completed a 6mo postoperative follow-up.The primary outcome measure was the incidence of graft retraction;secondary outcomes included graft displacement requiring re-suturing and pterygium recurrence rate.RESULTS:The study enrolled 58 participants,comprising 26(15 males,11 females)in the pentagonal graft group(mean age:54.9±13.1y),and 32(17 males,15 females)in the quadrangular graft group(mean age:57.6±10.4y).Graft retraction occurred in only 1 eye(3.8%)in the pentagonal autograft group,compared to 9 eyes(28.1%)in the quadrangular autograft group.No cases of graft displacement requiring re-suturing were reported in the pentagonal autograft group.Although graft displacement and recurrence requiring re-suturing were observed less frequently in surgeries with a pentagonal graft,the difference was not statistically significant(P>0.05).CONCLUSION:Designing the conjunctival autograft in a pentagonal shape—mimicking geodesic dome architecture and conforming to the eye’s spherical structure—enhances compatibility with the recipient conjunctiva and improves resistance to physical traction forces.This design effectively reduces the incidence of graft retraction and other related complications,providing a more favorable surgical option for pterygium treatment.
文摘BACKGROUND Pediatric liver transplantation(LT)is the definitive treatment for end-stage liver disease and acute liver failure in children.However,graft size mismatch poses significant challenges,particularly in infants weighing less than 10 kg.Large-forsize grafts can lead to severe complications,including vascular thrombosis and impaired graft perfusion.Surgical innovations,such as hyper-reduced left lateral segment(HRLLS)grafts and monosegmental grafts(MSG),offer viable solutions by tailoring graft size without compromising vascular or biliary integrity.AIM To analyze the techniques and outcomes of HRLLS and MSG grafts in pediatric liver trabsplantation.METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a comprehensive literature search was conducted across PubMed,Scopus,and Google Scholar,including studies up to February 2025.Eligible studies included case-control,observational,and randomized controlled trials reporting clinical outcomes of HRLLS,MSG,or reduced left lateral segment grafts(RLLS)in pediatric LT.The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment.Meta-analysis was performed using MetaXL software to pool survival outcomes and assess complication profiles.RESULTS Eighteen studies involving various graft reduction techniques were included.Both HRLLS and MSG demonstrated comparable one-year survival rates exceeding 80%,with some studies reporting rates above 95%.Complications such as hepatic artery thrombosis,portal vein thrombosis,and sepsis were slightly more frequent in HRLLS/RLLS recipients but remained within acceptable limits.Meta-analysis revealed no significant differences in survivability between graft types.CONCLUSION HRLLS and MSG techniques enable successful liver transplantation in small pediatric recipients,achieving longterm outcomes comparable to standard approaches.These graft modification strategies expand donor pool utilization and optimize patient survival while mitigating large-for-size complications.
文摘BACKGROUND The use of induction immunosuppression agents has improved kidney transplant outcomes,but selecting the optimal agent remains a point of debate.AIM To compare the long-term outcomes of kidney transplant recipients receiving alemtuzumab vs basiliximab induction,focusing on graft function,acute rejection,infection,malignancy,post-transplant glomerulonephritis,and survival,using a propensity score matched cohort design.METHODS Kidney transplant recipients who received alemtuzumab or basiliximab induction from 2014 to 2019 across two nephrology centres in Northwest England were evaluated.Propensity score matching at a 1:1.5 ratio ensured comparability between cohorts.Baseline characteristics,immunosuppression regimens,and outcomes were analyzed.Linear,binary logistic and Cox proportional hazard regression models.RESULTS A total of 436 recipients were included,with a median follow-up of 5.2 years.The matched cohort(n=262)had a mean age of 51.1±13.5 years;39%were female and 92%were white.There was no significant difference in the cumulative incidence of acute rejection[odds ratio(OR)=2.10;95%CI:0.9-4.9;P=0.110].Compared with basiliximab,alemtuzumab was associated with lower estimated glomerular filtration rate at 12 months(-6.6 mL/minute/1.73 m2;95%CI:-10.5 to-2.7;P<0.001)and higher risks of cytomegalovirus viremia(OR=3.2;95%CI:1.6-6.5;P<0.001),BK viremia(OR=2.4;95%CI:1.1-5.5;P=0.02),post-transplant malignancy(OR=6.2;95%CI:1.6-29.9;P=0.013),and death-censored graft loss(hazard ratio=3.6;95%CI:1.2-11.4;P=0.03).No significant differences were observed in post-transplant glomerulonephritis or recipient mortality.CONCLUSION In this propensity score-matched analysis,alemtuzumab induction was associated with lower graft function at 12 months and higher risks of viral infection,post-transplant malignancy,and graft loss compared with basiliximab.These findings highlight the need for further studies to confirm the long-term safety and effectiveness of alemtuzumab in kidney transplantation.
文摘BACKGROUND An echocardiogram is an essential tool in the evaluation of potential kidney transplant recipients(KTRs).Despite cardiac clearance,potential KTRs still have structural and functional abnormalities.Identifying the prevalence of these abnormalities and understanding their predictors is vital for optimizing pretransplant risk stratification and improving post-transplant outcomes.AIM To determine the prevalence of left ventricular hypertrophy(LVH),left ventricular systolic dysfunction(LVSD),diastolic dysfunction(DD),pulmonary hypertension(PH),and their predictors,and to assess their impact on graft function in pre-transplant candidates.METHODS The study included all successful transplant candidates older than 14 who had a baseline echocardiogram.Binary logistic regression models were constructed to identify factors associated with LVH,LVSD,DD,and PH.RESULTS Out of 259 patients,LVH was present in 64%(166),12%(31)had LVSD,27.5%(71)had DD,and 66(25.5%)had PH.Independent predictors of LVH included male gender[odds ratio(OR):2.51;95%CI:1.17-5.41 P=0.02],PH(OR=2.07;95%CI:1.11-3.86;P=0.02),DD(OR:2.47;95%CI:1.29-4.73;P=0.006),and dyslipidemia(OR=1.94;95%CI:1.07-3.53;P=0.03).Predictors for LVSD included patients with DD(OR=3.3,95%CI:1.41-7.81;P=0.006)and a family history of coronary artery disease(OR=4.50,95%CI:1.33-15.20;P=0.015).Peritoneal dialysis was an independent predictor for DD(OR=10.03;95%CI:1.71-58.94,P=0.011).The presence of LVH(OR=3.32,95%CI:1.05-10.55,P=0.04)and mild to moderate or moderate to severe mitral regurgitation(OR=4.63,95%CI:1.45-14.78,P=0.01)were significant factors associated with PH.These abnormalities had no significant impact on estimated glomerular filtration at discharge,6 months,1 year,or 2 years post-transplant.CONCLUSION Significant echocardiographic abnormalities persist in a potential transplant candidate despite cardiac clearance,although they don’t affect future graft function.Understanding the risk factors associated with these abnormalities may help clinicians address these factors pre-and post-transplant to achieve better outcomes.
文摘The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discovery.[2]Due to its rarity,knowledge mainly comes from case reports and small case series,though some decision algorithms have been proposed in systematic reviews.
文摘The milestone reported by He et al.—demonstrating pig‐tohuman lung xenotransplantation in a brain‐dead recipient—is a seminal moment in organ xenografting.It extends the horizons of xenotransplantation beyond the breakthroughs achieved in porcine heart and kidney grafts and aligns with the emergent clinical data on porcine liver applications[1].
文摘Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patients on LT waiting lists is increasing,and the organ shortage crisis is obvious,various efforts have been made to increase the pool of available liver grafts[1].In addition to living donor liver transplantation(LDLT),improving the utilization rate of extended criteria donor(ECD)livers is an important way.However,under traditional cold storage,ECD livers are usually associated with a higher risk of ischemic biliary disease,early allograft dysfunction(EAD)or even primary nonfunction(PNF).The frequently described definition in the literature for ECD grafts generally includes elderly,steatotic,long cold ischemia time(CIT),grafts obtained from donation after circulatory death(DCD),split liver grafts,donors with increased risk of infectious disease transmission and prolonged donor intensive care unit stay[2].
文摘BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.
文摘BACKGROUND Transplantectomy has long been considered the preferred treatment for spontaneous renal graft rupture,prioritizing patient safety over kidney salvage.In the last decade,there has been an increasing number of reports showing that,in selected scenarios,conservative management through graft repair represents a feasible option,challenging traditional approaches.CASE SUMMARY We describe the case of a 37-year-old sensitized XY patient who experienced early spontaneous graft rupture after receiving his second deceased donor kidney transplant.Following temporary hemodynamic stabilization and abdominal contrast enhanced computed tomography scan assessment,the recipient was brought back to theatre for surgical exploration.Possible causes of irreversible graft damage were immediately ruled out.The fractured upper pole of the transplanted kidney was repaired using a fibrin sealant,external compression,and a tailored polyglactin 910 mesh wrapped around the graft.The post-operative course was uneventful.After 20 months of follow up,the patient is doing very well,with excellent renal function and complete reabsorption of the mesh,as demonstrated by serial ultrasound evaluations of the graft.CONCLUSION Amid organ shortages and sensitized patients,graft nephrectomy is reserved for severe injuries;repair using sealants and mesh is effective.
文摘Paediatric liver transplantation(PLT)is a life-saving procedure for children with advanced liver disease or hepatoblastoma.The number of available grafts is limited in relation to the number of children on PLT waiting list.This graft shortage has led transplant societies and healthcare organizations to explore ways to investigate possible options and expand the donor pool.The safe use of grafts from obese donors has always been a subject of debate among PLT specialists.Donors’obesity is strongly associated with hepatic steatosis which can affect graft function by impairing microcirculation and maximizing the potential of ischemiareperfusion injury.Donor body mass index consideration should go hand in hand with the workup for hepatic steatosis which is an independent predictor for early graft dysfunction.New strategies to optimize the grafts before PLT such as normothermic regional perfusion and ex vivo liver perfusion can potentially mitigate the risk of using grafts from obese donors.This review summarizes the available evidence about the impact of donor obesity on PLT and highlights the current policies to widen the graft pool and suggest future research directions to improve donor selection and patient outcomes.
文摘BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.
文摘BACKGROUND Childhood obesity is a significant public health concern,particularly amongst children with chronic kidney disease requiring kidney transplant(KT).Obesity,defined as a body mass index(BMI)of 30 kg/m^(2) or greater,is prevalent in this population and is associated with disease progression.While BMI in-fluences adult KT eligibility,its impact on pediatric transplant outcomes remains unclear.This study investigates the effect of BMI on graft survival and patient outcomes,addressing gaps in the literature and examining disparities across BMI classifications.AIM To assess the impact of BMI classifications on graft and patient survival following KT.METHODS A retrospective cohort study analyzed 23081 pediatric transplant recipients from the Standard Transplant Analysis and Research database(1987-2022).Patients were grouped into six BMI categories:Underweight,healthy weight,overweight,and Class 1,2,and 3 obesity.Data were analyzed using one-way way analysis of variance,Kruskal-Wallis tests,Chi-squared tests,Kaplan-Meier survival analysis with log-rank tests,and Cox proportional hazard regressions.Statistical significance was set at P<0.05.RESULTS Class 3 obese recipients had lower 1-year graft survival(88.7%)compared to healthy-weight recipients(93.1%,P=0.012).Underweight recipients had lower 10-year patient survival(81.3%,P<0.05)than healthy-weight recipients.Class 2 and 3 obese recipients had the lowest 5-year graft survival(67.8%and 68.3%,P=0.013)and Class 2 obesity had the lowest 10-year graft survival(40.7%).Cox regression identified increases in BMI category as an independent predictor of graft failure[hazard ratio(HR)=1.091,P<0.001]and mortality(HR=1.079,P=0.008).Obese patients experienced longer cold ischemia times(11.6 and 13.1 hours vs 10.2 hours,P<0.001).Class 3 obesity had the highest proportion of Black recipients(26.2%vs 17.9%,P<0.001).CONCLUSION Severe obesity and underweight status are associated with poorer long-term outcomes in pediatric KT recipients,emphasizing the need for nuanced transplant eligibility criteria addressing obesity-related risks and socioeconomic disparities.
基金supported by the National Natural Science Foundation of China(31972435)to Jintao Cheng,and Agriculture Research System of MOF and MORA(CARS-25)Natural Science Foundation of Hubei Province(2019CFA017)Ningbo Scientific and Technological Project(2021Z006)to Zhilong Bie.
文摘Melon fruit flavor is a key quality characteristic that influences consumer preference.Grafting is an effective technique to enhance fruit quality but yields divergent outcomes in terms of fruit flavor.To address this problem,we analyzed parallel changes in flavor-related metabolite accumulation and gene expression in two pumpkin rootstock grafted melons during four fruit developmental stages.We identified 26061 expressed genes and 840 metabolites from 21 different compound classes,including carbohydrates,amino acids,and lipids.We also detected 50 aroma volatile compounds in the grafted melons.Results showed that genes and metabolites associated with metabolic pathways(carbohydrate,amino acid,lipid,and phenylpropanoid)play a key role in flavor formation.Compared with‘Sizhuang 12’,‘Tianzhen 1’rootstock improved melon fruit flavor by upregulating sugar-related genes(HK,MPI,MIOX,and STP)and inducing metabolite accumulation(d-ribose-5-phosphate,d-galactose,and trehalose 6-phosphate),whereas decreasing bitterness-related amino acids(l-arginine,l-asparagine,and l-tyrosine)and associated genes(thrC,ACS,and GLUL)expression at ripening stage.Furthermore,‘Tianzhen 1’exhibited higher expression levels of enzyme-coding genes(4CL,CSE,and COMT)responsible for aroma volatile synthesis than‘Sizhuang 12’rootstock.Taken together,our results decipher the basis of the molecular mechanism underlying fruit flavor in grafted melons and provide valuable information for the melons genetic improvement.
基金supported by grants from the Gansu Provincial Science and Technology Plan Project(Grant No.22CX8NA030)the National Natural Science Foundation of China(Grant No.32272793)the China Agriculture Research System(Grant No.CARS-23).
文摘Grafting is widely used in cucumbers to enhance their tolerance to environmental stress.Compatibility is a key factor for successful grafting,however,the physiological mechanisms that affect grafting compatibility are not clear.This study aimed to investigate the physiological mechanism underlying cucumber/pumpkin grafting compatibility.Two pumpkin cultivars with significant differences in compatibility,Figleaf gourd(compatible rootstock,Cf)and Dongyangshenli(incompatible rootstock,Cmo),were used as rootstocks.Three cucumber cultivars with different growth rates were used as scions,including cucumber‘Shenluchunsi’(strong growth,V1),‘Cuilü’(weak growth,V2),and‘Liangyoulüjian 102’(medium growth,V3).Six grafting combinations(V1/Cf,V2/Cf,V3/Cf,V1/Cmo,V2/Cmo,and V3/Cmo)were used to analyze the effect of scion and rootstock varieties,as well as the chemical composition of the exudate from the stem cutting surface,on the compatibility of grafted plants.Here,we found that rootstock was closely correlated with the compatibility of cucumber/pumpkin grafted plants.The sucrose content in the exudate of the stem,enzyme activity,and the expression of genes related to sucrose biosynthesis in Cmo were significantly higher than those in Cf.Correlation analysis showed that the sucrose content difference between the exudate of rootstock and scion stems was negatively correlated with graft compatibility.Exogenous treatment with a 0.5%sucrose solution on the scions significantly reduced the difference in sucrose content between rootstock and scion and enhanced graft survival rate in the incompatible combination.The stem segment grafting experiment in vitro found that the high difference in sucrose concentration between the rootstock and scion decreased the grafting compatibility of cucumber/pumpkin by reducing the adhesion of the cutting surface.Taken together,the higher sucrose concentration difference between rootstock and scion decreased the adhesion of the cutting surface,resulting in the incompatibility of cucumber/pumpkin grafted plants.
基金supported by grants from the Natural Science Foundation of Shandong Province,China(Grant Nos.:ZR2019ZD28 and ZR2022QH008)the National Natural Science Foundation of China(Grant Nos.:82270301 and 82200465)+1 种基金China Postdoctoral Science Foundation(Grant No.:2023M731842)Shandong Postdoctoral Science Foundation,China(Grant No.:SDCX-ZG-202203013).
文摘Vein graft(VG)failure(VGF)is associated with VG intimal hyperplasia,which is characterized by abnormal accumulation of vascular smooth muscle cells(VSMCs).Most neointimal VSMCs are derived from pre-existing VSMCs via a process of VSMC phenotypic transition,also known as dedifferentiation.There is increasing evidence to suggest that ginger or its bioactive ingredients may block VSMC dedifferentiation,exerting vasoprotective functions;however,the precise mechanisms have not been fully characterized.Therefore,we investigated the effect of ginger on VSMC phenotypic transition in VG remodeling after transplantation.Ginger significantly inhibited neointimal hyperplasia and promoted lumen(L)opening in a 3-month VG,which was primarily achieved by reducing ferroptotic stress.Ferroptotic stress is a pro-ferroptotic state.Contractile VSMCs did not die but instead gained a proliferative capacity and switched to the secretory type,forming neointima(NI)after vein transplantation.Ginger and its two main vasoprotective ingredients(6-gingerol and 6-shogaol)inhibit VSMC dedifferentiation by reducing ferroptotic stress.Network pharmacology analysis revealed that 6-gingerol inhibits ferroptotic stress by targeting P53,while 6-shogaol inhibits ferroptotic stress by targeting 5-lipoxygenase(Alox5),both promoting ferroptosis.Furthermore,both ingredients co-target peroxisome proliferator-activated receptor gamma(PPARγ),decreasing PPARγ-mediated nicotinamide adenine dinucleotide phosphate(NADPH)oxidase 1(Nox1)expression.Nox1 promotes intracellular reactive oxygen species(ROS)production and directly induces VSMC dedifferentiation.In addition,Nox1 is a ferroptosis-promoting gene that encourages ferroptotic stress production,indirectly leading to VSMC dedifferentiation.Ginger,a natural multi-targeted ferroptotic stress inhibitor,finely and effectively prevents VSMC phenotypic transition and protects against venous injury remodeling.
文摘BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous junction.Possible treatments include direct tendon suture or tendon transfer,most commonly from the ring finger.To optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon graft.CASE SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a handrail.The patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and nerves.The patient was treated with two stage thumb repair.The first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon prosthesis.The second intervention consisted of PL tendon graft and BR tendon transfer.Follow-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 mm.CONCLUSION Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.
基金Supported by the Zhejiang Medical Technology Project,No.2022RC009 and No.2024KY645.
文摘Diabetic foot ulcers(DFUs)represents a significant public health issue,with a rising global prevalence and severe potential complications including amputation.Traditional treatments often fall short due to various limitations such as high recurrence rates and extensive resource utilization.This editorial explores the innovative use of acellular fish skin grafts as a transformative approach in DFU management.Recent studies and a detailed case report highlight the efficacy of acellular fish skin grafts in accelerating wound closure,reducing dressing changes,and enhancing patient outcomes with a lower socio-economic burden.Despite their promise,challenges such as limited availability,patient acceptance,and the need for further research persist.Addressing these through more extensive randomized controlled trials and fostering a multidisciplinary treatment approach may optimize DFU care and reduce the global health burden associated with these complex wounds.
基金supported by China Agriculture Research System of MOF and MARA(Grant No.CARS23-B10)The Major Science and Technology Projects in Hainan Province(Grant No.ZDKJ2021005)+1 种基金Key R&D projects in Shandong Province(Grant No.LJNY202106)Central Public-interest Scientific Institution Basal Research Fund(Grant No.IVF-BRF2023006)。
文摘Grafting is an effective technique for increasing the resistance of vegetables to biotic and abiotic stresses.It has been widely applied to produce solanaceous and melon vegetables.Temperature is an important external factor affecting graft formation.However,the molecular mechanism by which external ambient temperature affects tomato graft formation remains unclear.In this study,we demonstrated that elevating ambient temperature during grafting to 35℃ for more than 24 h after grafting accelerated vascular reconnection.We generated self-or heterografted combinations between phyB1B2 and pif4 loss-of-function mutant and wild-type plants,and were mutants unresponsive to graft formation at elevated ambient temperature.In addition,elevated ambient temperature induced SlPIF4 expression during grafting.SlPIF4 directly binds the promoters of auxin biosynthesis genes SlYUCCAs and activates their expression.Further investigation revealed auxin accumulation in the graft junction under elevated ambient temperature.The results illuminate the mechanism by which the PHYB-PIF4-auxin module promotes tomato graft formation in response to elevated ambient temperature.
基金supported by Yildiz Technical University Scientific Research Projects Coordination Unit under project number FBA-2023-5377support from the Scientific and Technological Research Council of Turkey(TUBITAK)under the BIDEB/2211-A National PhD Scholarship Program and 2250-Performance-Based Scholarships Program for PhD.
文摘In this study,injectable bone graft putty samples were developed using fine and coarse melt-quenched 45S5 bioactive glass(BG)incorporated into a carrier system composed of glycerol and polyethylene glycol(PEG)with different average molecular weights.Selected putty samples were further incorporated with varying amounts of Denosumab(5wt%-10wt%)to investigate its influence on rhe-ological behavior and flow properties using mathematical modeling.All PEG/glycerol/45S5-based putty samples exhibited viscoelastic behavior(storage modulus>loss modulus)and pseudoplastic behavior(n<1),with viscosity values required for optimal flow remaining below 1000 Pa∙s.Both viscosity and thixotropic area increased proportionally with higher BG content and smaller-sized BG particles.All putty samples showed more than 98%injectability through a 12G cannula,suggesting potential clinical suitability.However,injectability decreased with smaller cannulas,dropping to 34.7%-58.3%with a 19G cannula and further decreasing with a 23G cannula at higher BG contents.Incorporation of Denosumab preserved viscoelasticity and injectability but modified the flow behavior,shifting it from pseudo-plastic to more Newtonian with higher Denosumab content,while also reducing viscosity and thixotropic area values.Among all tested samples,putty containing a lower amount of Denosumab and smaller-sized BG exhibited the most suitable combination of injectability and rheological features.All putty samples were well described by both the Power law and Herschel-Bulkley rheological models(coeffi-cient of determination>0.95).This study highlights the influence of Denosumab on flowability and rheological relationships and sug-gests potential improvements in bioactivity through a dual synergistic effect of BG and Denosumab in minimally invasive bone graft sys-tems.
文摘BACKGROUND The Luminex platform,where beads are coated with single human leukocyte antigens(HLA),detects HLA antibodies with higher sensitivity and specificity compared to complement-dependent cytotoxicity(CDC)assay and flow crossmatch(FCXM).The clinical significance of donor-specific antibodies(DSAs)detected by this method is still under investigation.AIM To report the impact of low-level pretransplant DSAs detected by the Luminex platform on the rates of acute rejection(AR),allograft function,and long-term graft survival.METHODS This retrospective study was conducted at the Immunology Department of Sindh Institute of Urology and Transplantation,Karachi,Pakistan between January 2013 and December 2022.During this period 2714 patients were transplanted.Out of these patients 78(2.9%)patients had low-level DSAs detected by the Luminex flow beads method and were negative by CDC and FCXM with their donors.All recipients received ABO-compatible live-related kidney transplants.All patients had a minimum follow-up of 1 year.Graft rejection rates,graft function,and patient and graft survival were analyzed.The estimated glomerular filtration rate was calculated by the full CKD-EPI formula.RESULTS The mean age of all recipients was 29.57±10.11 years and 34.53±9.09 years for the donors.In 48(61.5%)patients,the cause of end-stage kidney disease was unknown.DSA against HLA class I was detected in 36(46.1%)patients,class II in 35(44.8%)patients,and both class I and II in 7(8.9%)patients.AR episodes were encountered in 8(10.3%)cases.Seven(87.5%)had T cell mediated rejection(type IA)and one acute antibody-mediated rejection.Antibody status was re-evaluated at the time of biopsy-proven ARs.Five(62.5%)patients lost their DSAs,while three(37.5%)had persistent DSAs.The mean estimated glomerular filtration rate at 1 year was 80.56±27.48 mL/min/1.73 m2 and at the last follow-up 73.41±28.80 mL/min/1.73 m2.The 1-year and 10-year patient and graft survival rates were 99%and 79%and 95%and 75%,respectively.During the follow-up period,10(12.8%)patients died,8 patients had a functioning graft,and 2 patients had failed grafts.Eight patients died due to cardiopulmonary arrest,and two died due to sepsis with failed grafts.CONCLUSION Patients with pretransplant low-level DSAs on Luminex without CDC and FCXM reactivity had good allograft outcomes at 1 year and 10 years as long as they are induced with biological agents and given potent maintenance immunosuppressants.
