The synthesis and characterization of two new aluminate（Ⅲ） complexes with general formula K[AlCl3X] are reported. These compounds derived from aluminate trichloride and related salts. Potassium trichlorothiocyanoal...The synthesis and characterization of two new aluminate（Ⅲ） complexes with general formula K[AlCl3X] are reported. These compounds derived from aluminate trichloride and related salts. Potassium trichlorothiocyanoaluminate, PCTA, and potassium trichlorocyanatoalu-minate, PCCA, are two new ionic aluminate complexes. They can be easily synthesized in a nearly quantitative yield by using the direct reaction of AlCl3 and KX. The complexes were characterized by physico-chemical and spectroscopic methods. Theoretical calculations have been used for the extraction of structural and spectroscopic data of these new synthesized complexes. The antibacterial activities of such compounds were studied against the Staphylococcus aureus, Escherichia coli, Staphylococcus Epidermidis, Estreptococo B and Shigella.展开更多
BACKGROUND Identifying a potential single monogenetic disorder in healthy couples is costly due to the Assisted Reproduction facilities'current methodology for screening,which focuses on the detecting multiple gen...BACKGROUND Identifying a potential single monogenetic disorder in healthy couples is costly due to the Assisted Reproduction facilities'current methodology for screening,which focuses on the detecting multiple genetic disorders at once.Here,we report the successful application of a low-cost and fast preimplantation genetic testing for monogenic/single gene defects(PGT-M)approach for detecting propionic acidemia(PA)in embryos obtained from a confirmed heterozygous propionyl-CoA carboxylase alpha subunit(PCCA)couple.CASE SUMMARY A fertile 32-years old Mexican couple with denied consanguinity sought antenatal genetic counseling.They were suspected obligate PA carriers due to a previous deceased PA male newborn with an unknown PCCA/propionyl-CoA carboxylase beta subunit(PCCB)genotype.Next-Generation Sequencing revealed a heterozygous genotype for a pathogenic PCCA variant(c.2041-1G>T,ClinVar:RCV-000802701.1;dbSNP:rs1367867218)in both parents.The couple requested in vitro fertilization(IVF)and PGT-M for PA.From IVF,12 oocytes were collected and fertilized,of which two resulted in high-quality embryos.Trophectoderm biopsies and Whole Genome Amplification by a fragmentation/amplification-based method were performed and revealed that the two embryos were euploid.Endpoint polymerase chain reaction and further Sanger sequencing of the exon-intron borders revealed a wild-type PCCA male embryo and a heterozygous c.2041-1G>T female embryo.Both embryos were transferred,resulting in a clinical pregnancy and the delivery of a healthy male newborn(38 wk,weight:4080 g,length:49 cm,APGAR 9/9).The absence of PA was confirmed by expanded newborn screening.CONCLUSION We show that using PGT-M with Whole Genome Amplification templates,coupled with IVF,can reduce the transmission of a pathogenic variant of the PCCA gene.展开更多
Background:Although offering the best chance of potential cure for patients with localized perihilar cholangiocarcinoma(pCCA),resection has been associated with high morbidity and sometimes poor long-term outcomes due...Background:Although offering the best chance of potential cure for patients with localized perihilar cholangiocarcinoma(pCCA),resection has been associated with high morbidity and sometimes poor long-term outcomes due to recurrence.We sought to develop a predictive model to identify individuals at high risk for very early recurrence(VER)after curative-intent surgery for pCCA.Methods:Patients who underwent curative-intent surgery for pCCA between 2000-2023 were identified from a multi-institutional database.An eXtreme Gradient Boosting(XGBoost)model was developed to estimate the risk of VER,defined as recurrence within 6 months after resection.The relative importance of clinicopathologic factors was determined using SHapley Additive exPlanations(SHAP)values.Results:Among 434 patients undergoing curative-intent resection for pCCA,65(15.0%)patients developed VER.Median overall survival(OS)among patients with and without VER was 8.4[interquartile range(IQR)6.6-11.3]versus 38.5(IQR 31.9-45.7)months(P<0.001).An XGBoost model was able to stratify patients relative to the risk of VER[low-risk:6-month recurrence-free survival(RFS)94.6%vs.intermediate-risk:6-month RFS 88.3%vs.high-risk:6-month RFS 40.0%;P<0.001].Similarly,3-year OS incrementally worsened based on VER risk(low-risk:75.3%vs.intermediate-risk:19.5%vs.high-risk:4.6%;P<0.001).The SHAP algorithm identified age,preoperative carbohydrate antigen 19-9(CA19-9)levels,tumor size and differentiation/grade,as well as lymph node metastasis as the five most important predictors of VER.The predictive accuracy of the model was good in the training[c-index:0.74,95%confidence interval(CI):0.67-0.81]and internal validation(c-index:0.77,95%CI:0.71-0.83)cohorts.An easy-to-use risk calculator for VER was developed and made available online at:https://junkawashima.shinyapps.io/VER_hilar/.Conclusions:A novel,machine learning based model was able to predict accurately the chance of VER after curative-intent resection of pCCA.In turn,the tool may help surgeons in the selection of patients likely to benefit the most from resection,as well as counsel individuals about the anticipated risk of recurrence in the early post-operative period.展开更多
Background:Laparoscopic resection(LR)of perihilar cholangiocarcinoma(pCCA)is still in the exploratory stage due to its exacting technical requirements,and its feasibility remains controversial.The objective of this st...Background:Laparoscopic resection(LR)of perihilar cholangiocarcinoma(pCCA)is still in the exploratory stage due to its exacting technical requirements,and its feasibility remains controversial.The objective of this study was to compare the short-and long-term outcomes of LR and open resection(OR)of pCCA.Methods:This study analyzed the data of pCCA patients who underwent LR or OR from January 2012 to January 2020 at Southwest Hospital.Inverse probability of treatment weighting(IPTW)and propensity score matching(PSM)were used to balance the baseline characteristics between the LR and OR groups.The short-and long-term outcomes were compared between the LR and OR groups.Results:Forty-five patients in the LR group and 243 in the OR group were analyzed.After IPTW and PSM,the amount of intraoperative blood loss,incidence of surgical site infections(SSIs),length of stay(LOS),and number of perioperative blood transfusions(PBTs)were significantly lower in the LR group than in the OR group(after IPTW:P<0.001,P=0.009,P=0.01,P<0.001 respectively;after PSM:P<0.001,P=0.003,P=0.03,P=0.04 respectively).Only after IPTW was the 30-day mortality rate significantly lower in the LR group than in the OR group(P=0.005).There was no significant difference in overall survival(OS)or recurrence-free survival(RFS)between the two groups after IPTW or PSM.Conclusions:LR of pCCA is an achievable procedure whose long-term outcomes are similar to those of OR,and LR outperforms OR in short-term outcomes such as intraoperative blood loss,SSI,LOS,30-day mortality,and PBTs.It is believed that it is safe and feasible to treat pCCA with LR after rigorous patient selection.展开更多
Perihilar cholangiocarcinoma(pCCA)is a rare tumor that arises at the biliary confluence.Curative treatment entails extrahepatic bile duct resection,usually combined with major liver resection to obtain negative margin...Perihilar cholangiocarcinoma(pCCA)is a rare tumor that arises at the biliary confluence.Curative treatment entails extrahepatic bile duct resection,usually combined with major liver resection to obtain negative margins.These major procedures harbor considerable risks that are the highest among any elective cancer surgery.The 90-day mortality rate after these procedures is 12%,which can be attributed to postoperative liver failure in about 85%of patients(1-3).The risk of postoperative liver failure can be decreased with preoperative management(e.g.,biliary drainage and portal vein embolization)and intraoperative management(e.g.,minimizing blood loss).展开更多
It is well known that radical intent surgery is,as of today,the only curative treatment available for perihilar cholangiocarcinoma(pCCA);the standard surgical procedure includes major hepatectomy with caudate lobe res...It is well known that radical intent surgery is,as of today,the only curative treatment available for perihilar cholangiocarcinoma(pCCA);the standard surgical procedure includes major hepatectomy with caudate lobe resection and extrahepatic bile duct resection(1).A recent paper set the benchmark values for pCCA surgery:in this paper,acceptable benchmark values for morbidity.展开更多
基金the research Office of Azad Islamic University,Ardebil,for supporting this work
文摘The synthesis and characterization of two new aluminate（Ⅲ） complexes with general formula K[AlCl3X] are reported. These compounds derived from aluminate trichloride and related salts. Potassium trichlorothiocyanoaluminate, PCTA, and potassium trichlorocyanatoalu-minate, PCCA, are two new ionic aluminate complexes. They can be easily synthesized in a nearly quantitative yield by using the direct reaction of AlCl3 and KX. The complexes were characterized by physico-chemical and spectroscopic methods. Theoretical calculations have been used for the extraction of structural and spectroscopic data of these new synthesized complexes. The antibacterial activities of such compounds were studied against the Staphylococcus aureus, Escherichia coli, Staphylococcus Epidermidis, Estreptococo B and Shigella.
文摘BACKGROUND Identifying a potential single monogenetic disorder in healthy couples is costly due to the Assisted Reproduction facilities'current methodology for screening,which focuses on the detecting multiple genetic disorders at once.Here,we report the successful application of a low-cost and fast preimplantation genetic testing for monogenic/single gene defects(PGT-M)approach for detecting propionic acidemia(PA)in embryos obtained from a confirmed heterozygous propionyl-CoA carboxylase alpha subunit(PCCA)couple.CASE SUMMARY A fertile 32-years old Mexican couple with denied consanguinity sought antenatal genetic counseling.They were suspected obligate PA carriers due to a previous deceased PA male newborn with an unknown PCCA/propionyl-CoA carboxylase beta subunit(PCCB)genotype.Next-Generation Sequencing revealed a heterozygous genotype for a pathogenic PCCA variant(c.2041-1G>T,ClinVar:RCV-000802701.1;dbSNP:rs1367867218)in both parents.The couple requested in vitro fertilization(IVF)and PGT-M for PA.From IVF,12 oocytes were collected and fertilized,of which two resulted in high-quality embryos.Trophectoderm biopsies and Whole Genome Amplification by a fragmentation/amplification-based method were performed and revealed that the two embryos were euploid.Endpoint polymerase chain reaction and further Sanger sequencing of the exon-intron borders revealed a wild-type PCCA male embryo and a heterozygous c.2041-1G>T female embryo.Both embryos were transferred,resulting in a clinical pregnancy and the delivery of a healthy male newborn(38 wk,weight:4080 g,length:49 cm,APGAR 9/9).The absence of PA was confirmed by expanded newborn screening.CONCLUSION We show that using PGT-M with Whole Genome Amplification templates,coupled with IVF,can reduce the transmission of a pathogenic variant of the PCCA gene.
文摘Background:Although offering the best chance of potential cure for patients with localized perihilar cholangiocarcinoma(pCCA),resection has been associated with high morbidity and sometimes poor long-term outcomes due to recurrence.We sought to develop a predictive model to identify individuals at high risk for very early recurrence(VER)after curative-intent surgery for pCCA.Methods:Patients who underwent curative-intent surgery for pCCA between 2000-2023 were identified from a multi-institutional database.An eXtreme Gradient Boosting(XGBoost)model was developed to estimate the risk of VER,defined as recurrence within 6 months after resection.The relative importance of clinicopathologic factors was determined using SHapley Additive exPlanations(SHAP)values.Results:Among 434 patients undergoing curative-intent resection for pCCA,65(15.0%)patients developed VER.Median overall survival(OS)among patients with and without VER was 8.4[interquartile range(IQR)6.6-11.3]versus 38.5(IQR 31.9-45.7)months(P<0.001).An XGBoost model was able to stratify patients relative to the risk of VER[low-risk:6-month recurrence-free survival(RFS)94.6%vs.intermediate-risk:6-month RFS 88.3%vs.high-risk:6-month RFS 40.0%;P<0.001].Similarly,3-year OS incrementally worsened based on VER risk(low-risk:75.3%vs.intermediate-risk:19.5%vs.high-risk:4.6%;P<0.001).The SHAP algorithm identified age,preoperative carbohydrate antigen 19-9(CA19-9)levels,tumor size and differentiation/grade,as well as lymph node metastasis as the five most important predictors of VER.The predictive accuracy of the model was good in the training[c-index:0.74,95%confidence interval(CI):0.67-0.81]and internal validation(c-index:0.77,95%CI:0.71-0.83)cohorts.An easy-to-use risk calculator for VER was developed and made available online at:https://junkawashima.shinyapps.io/VER_hilar/.Conclusions:A novel,machine learning based model was able to predict accurately the chance of VER after curative-intent resection of pCCA.In turn,the tool may help surgeons in the selection of patients likely to benefit the most from resection,as well as counsel individuals about the anticipated risk of recurrence in the early post-operative period.
基金supported by Chongqing‘Direct Ph.D.Express’Research Project(CSTB2022BSXM-JCX0017)Chongqing Natural Science Foundation General Project(CSTB2022NSCQ-MSX0204).
文摘Background:Laparoscopic resection(LR)of perihilar cholangiocarcinoma(pCCA)is still in the exploratory stage due to its exacting technical requirements,and its feasibility remains controversial.The objective of this study was to compare the short-and long-term outcomes of LR and open resection(OR)of pCCA.Methods:This study analyzed the data of pCCA patients who underwent LR or OR from January 2012 to January 2020 at Southwest Hospital.Inverse probability of treatment weighting(IPTW)and propensity score matching(PSM)were used to balance the baseline characteristics between the LR and OR groups.The short-and long-term outcomes were compared between the LR and OR groups.Results:Forty-five patients in the LR group and 243 in the OR group were analyzed.After IPTW and PSM,the amount of intraoperative blood loss,incidence of surgical site infections(SSIs),length of stay(LOS),and number of perioperative blood transfusions(PBTs)were significantly lower in the LR group than in the OR group(after IPTW:P<0.001,P=0.009,P=0.01,P<0.001 respectively;after PSM:P<0.001,P=0.003,P=0.03,P=0.04 respectively).Only after IPTW was the 30-day mortality rate significantly lower in the LR group than in the OR group(P=0.005).There was no significant difference in overall survival(OS)or recurrence-free survival(RFS)between the two groups after IPTW or PSM.Conclusions:LR of pCCA is an achievable procedure whose long-term outcomes are similar to those of OR,and LR outperforms OR in short-term outcomes such as intraoperative blood loss,SSI,LOS,30-day mortality,and PBTs.It is believed that it is safe and feasible to treat pCCA with LR after rigorous patient selection.
文摘Perihilar cholangiocarcinoma(pCCA)is a rare tumor that arises at the biliary confluence.Curative treatment entails extrahepatic bile duct resection,usually combined with major liver resection to obtain negative margins.These major procedures harbor considerable risks that are the highest among any elective cancer surgery.The 90-day mortality rate after these procedures is 12%,which can be attributed to postoperative liver failure in about 85%of patients(1-3).The risk of postoperative liver failure can be decreased with preoperative management(e.g.,biliary drainage and portal vein embolization)and intraoperative management(e.g.,minimizing blood loss).
文摘It is well known that radical intent surgery is,as of today,the only curative treatment available for perihilar cholangiocarcinoma(pCCA);the standard surgical procedure includes major hepatectomy with caudate lobe resection and extrahepatic bile duct resection(1).A recent paper set the benchmark values for pCCA surgery:in this paper,acceptable benchmark values for morbidity.
