BACKGROUND Infection by the hepatitis B virus(HBV)represents a significant global sociosanitary burden.While liver transplantation(LT)is an important therapeutic option,treatments that prevent HBV reinfection are nece...BACKGROUND Infection by the hepatitis B virus(HBV)represents a significant global sociosanitary burden.While liver transplantation(LT)is an important therapeutic option,treatments that prevent HBV reinfection are necessary.The combination of anti-hepatitis B immunoglobulin(HBIG)and nucleoside/nucleotide analogs(NA)is the standard post-transplant treatment;however,there are limitations in using HBIG,particularly its cost.We present two illustrative clinical cases as examples of post-transplant management using dual NA therapy,unaccompanied by HBIG.CASE SUMMARY The first case involves a 42-year-old man with HBV-related cirrhosis,who,in the context of a diagnosis of hepatocellular carcinoma and hepatopulmonary syndrome,underwent LT without viremia at the time of transplantation.A lack of availability of HBIG led to the combined use of two NAs,entecavir,and tenofovir alafenamide—resulting in the negativization of hepatitis B surface antigen(HBsAg)and maintenance of a negative viral load in the post-transplant period.In the second case,a 63-year-old woman presented with acute hepatic failure due to HBV with viremia during transplantation.Combined therapy with entecavir and tenofovir alafenamide,again due to the unavailability of HBIG,ultimately led to the negativization of HBsAg and viral load.CONCLUSION These cases suggest the efficacy of dual NA therapy in post-transplant HBV management,emphasizing the need to reconsider traditional treatment approaches.展开更多
INTRODUCTIONIn China,primary liver cancer (PLC) ranks secondin cancer mortality since the 1990s.In the field ofPLC treatment,surgical resection remains the best,which includes large PLC resection,small PLCresection,re...INTRODUCTIONIn China,primary liver cancer (PLC) ranks secondin cancer mortality since the 1990s.In the field ofPLC treatment,surgical resection remains the best,which includes large PLC resection,small PLCresection,re-resection of subclinical recurrence,aswell as cytoreduction and sequential resection forunresectable PLC.However,recurrence展开更多
Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmenta...Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.展开更多
Objectives:Tumor recurrence is a major determinant of poor prognosis in hepatocellular carcinoma(HCC),yet its cellular and molecular basis remains incompletely understood.This study aimed to identify recurrenceassocia...Objectives:Tumor recurrence is a major determinant of poor prognosis in hepatocellular carcinoma(HCC),yet its cellular and molecular basis remains incompletely understood.This study aimed to identify recurrenceassociated genes at single-cell resolution and to develop a prognostic model for predicting survival outcomes and immunotherapy responsiveness in HCC.Methods:Single-cell RNA sequencing data from 12 primary and 6 recurrent HCC samples were integrated and analyzed to identify genes characteristic of recurrence.After quality control,principal component analysis,and t-SNE-based clustering were used to identify highly variable genes for cell clustering and annotation.Based on macrophage characteristic genes,a recurrence-related risk score was constructed using a LASSOCox regression model,and a nomogram integrating clinical variables was developed.Prognostic performance was assessed using Kaplan-Meier analysis and time-dependent ROC curves.Immune infiltration profiling was performed to compare immune characteristics between risk groups defined by the prognostic model.Multivariate Cox regression was applied to identify independent prognostic biomarkers,which were subsequently validated by cell function experiments.Results:The risk model effectively stratified patients into high-and low-risk groups with distinct survival outcomes,demonstrating high predictive accuracy for 1-,3-,and 5-year survival.High-risk patients showed altered immune profiles and a reduced predicted response to immunotherapy.GRID2,RNF186,and SLC4A10 were identified as independent prognostic genes,with RNF186 promoting HCC cell proliferation in a SESN2-dependent manner.Conclusion:This prognostic model provides new insights into precision medicine and immunotherapy for HCC,highlighting the potential clinical significance of RNF186 as a therapeutic target.展开更多
BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehe...BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.展开更多
This paper presents an overview of the pathogens, symptoms of damage, patterns of occurrence, and chemical control methods associated with four major pear tree diseases: pear scab, pear ring rot, pear anthracnose, and...This paper presents an overview of the pathogens, symptoms of damage, patterns of occurrence, and chemical control methods associated with four major pear tree diseases: pear scab, pear ring rot, pear anthracnose, and pear speckle. The objective is to provide valuable references for the scientific and precise prevention and management of diseases in pear orchards, thereby contributing to the production of high-quality and high-yield pear fruits.展开更多
1.Introduction Injury prevention is an essential element of science and medicine in sports,and it garners attention from stakeholders focused on minimizing athletes’injury risk.Catchy titles including“injury risk”o...1.Introduction Injury prevention is an essential element of science and medicine in sports,and it garners attention from stakeholders focused on minimizing athletes’injury risk.Catchy titles including“injury risk”or“injury prevention”are likely to grab the readers’attention.Meanwhile,studies on injury prevention might assess the impact of interventions on mitigating injury risk factors(e.g.,strength,range of motion(ROM))but fail to report injury data(e.g.,incidence).1,2 Likewise,observational studies may include“injury risk”in their titles,but fail to provide injury data.3 Without injury data.展开更多
To uncover the decision-making mechanisms and evolutionary dynamics of multiple stakeholders in highway noise pollution control,a three-party evolutionary game model involving the government,operators,and the public i...To uncover the decision-making mechanisms and evolutionary dynamics of multiple stakeholders in highway noise pollution control,a three-party evolutionary game model involving the government,operators,and the public is constructed.The operation period is divided into different stages for differentiated analysis.A simulation analysis was performed on the Lituo sinking section of the Beijing-Hong Kong-Macao Highway to assess the impact of variations in critical elements on the system.The results indicate that the Lituo sinking section of the Beijing-Hong Kong-Macao Highway is currently in its early stage of development,with the corresponding strategies being active regulation,excessive emissions,and supervision.When the cost of the government’s active regulation decreases from 1×10^(5) to 5×10^(4) yuan,the system converges more rapidly toward the active regulation strategy.When the cost of the operator’s excessive emissions increases from 14.08×10^(6) to 20.00×10^(6) yuan,the system drives the operator toward the standardized emission strategy.In addition,when the cost of public supervision decreases from 15×10^(4) to 5×10^(4) yuan and the compensation paid by operators to the public increases from 1.288×10^(6) to 2.576×10^(6) yuan,the system converges more quickly toward the supervision strategy.The cost of the operator’s excessive emissions serves as the core decision variable for achieving the ideal equilibrium in the three-party game involving government active regulation,operator standardized emissions,and public supervision.展开更多
Deepfake is a sort of fake media made by advanced AI methods like Generative Adversarial Networks(GANs).Deepfake technology has many useful uses in education and entertainment,but it also raises a lot of ethical,socia...Deepfake is a sort of fake media made by advanced AI methods like Generative Adversarial Networks(GANs).Deepfake technology has many useful uses in education and entertainment,but it also raises a lot of ethical,social,and security issues,such as identity theft,the dissemination of false information,and privacy violations.This study seeks to provide a comprehensive analysis of several methods for identifying and circumventing Deepfakes,with a particular focus on image-based Deepfakes.There are three main types of detection methods:classical,machine learning(ML)and deep learning(DL)-based,and hybrid methods.There are three main types of preventative methods:technical,legal,and moral.The study investigates the effectiveness of several detection approaches,such as convolutional neural networks(CNNs),frequency domain analysis,and hybrid CNN-LSTM models,focusing on the respective advantages and disadvantages of each method.We also look at new technologies like Explainable Artificial Intelligence(XAI)and blockchain-based frameworks.The essay looks at the use of algorithmic protocols,watermarking,and blockchain-based content verification as possible ways to stop certain things from happening.Recent advancements,including adversarial training and anti-Deepfake data generation,are essential because of their potential to alleviate rising concerns.This reviewshows that there aremajor problems,such as the difficulty of improving the capabilities of existing systems,the high running expenses,and the risk of being attacked by enemies.It stresses the importance of working together across fields,including academia,business,and government,to create robust,scalable,and ethical solutions.Themain goals of futurework should be to create lightweight,real-timedetection systems,connect them to large language models(LLMs),and put in place worldwide regulatory frameworks.This essay argues for a complete and varied plan to keep digital information real and build confidence in a time when media is driven by artificial intelligence.It uses both technical and non-technical means.展开更多
Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurr...Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurrence and survival rates in patients with early gastric cancer,providing evidence-based support for optimizing clinical surgical plans.Methods:A retrospective analysis was conducted on the clinical data of 100 patients with early gastric cancer who underwent surgical treatment at our hospital from October 2021 to October 2023.Patients were divided into Group D1(n=50)and Group D2(n=50)based on the extent of lymph node dissection.Group D1 underwent limited lymph node dissection(dissection of the first station of lymph nodes around the stomach),while Group D2 underwent standard lymph node dissection(dissection of the first and second stations of lymph nodes around the stomach).Surgical-related indicators,the incidence of postoperative complications,the 2-year recurrence rate,and the 2-year survival rate were compared between the two groups of patients.Results:The operative time,intraoperative blood loss,postoperative hospital stay,and the number of lymph nodes dissected were significantly higher in the D2 group than in the D1 group(all P<0.001).The overall incidence of postoperative complications was higher in the D1 group than in the D2 group,but the difference was not statistically significant(χ^(2)=0.884,P=0.766).After a 2-year follow-up,the recurrence rate was significantly higher in the D1 group than in the D2 group(χ^(2)=4.000,P=0.046).The 2-year survival rate was significantly lower in the D1 group than in the D2 group(χ^(2)=5.005,P=0.025).A total of 100 patients with early-stage gastric cancer were grouped according to the depth of invasion,degree of differentiation,and lymph node metastasis status,and the recurrence rates of different subgroups were compared.The results showed that the recurrence rate was higher in patients with T1b stage than in those with T1a stage(χ^(2)=5.005,P=0.025),higher in poorly differentiated patients than in moderately and well-differentiated patients(χ^(2)=4.155,P=0.042),and higher in patients with lymph node metastasis than in those without lymph node metastasis(χ^(2)=4.512,P=0.034).Conclusion:Compared with D1 limited lymph node dissection,D2 standard lymph node dissection can significantly reduce the postoperative recurrence rate and improve the 2-year survival rate in patients with early-stage gastric cancer without significantly increasing the risk of postoperative complications.Although the surgical trauma is slightly greater,the overall prognosis is better,making it a preferred surgical treatment option for patients with early-stage gastric cancer.展开更多
The prevention of a disease process has always been superior to the treatment of the same disease throughout the history of medicine and surgery. Local recurrence and peritoneal metastases occur in approximately 8% of...The prevention of a disease process has always been superior to the treatment of the same disease throughout the history of medicine and surgery. Local recurrence and peritoneal metastases occur in approximately 8% of colon cancer patients and 25% of rectal cancer patients and should be prevented. Strategies to prevent colon or rectal cancer local recurrence and peritoneal metastases include cytoreductive surgery and hyperthermic perioperative chemotherapy (HIPEC). These strategies can be used at the time of primary colon or rectal cancer resection if the HIPEC is available. At institutions where HIPEC is not available with the treatment of primary malignancy, a proactive second-look surgery is recommended. Several phase II studies strongly support the proactive approach. If peritoneal metastases were treated along with the primary colon resection, 5-year survival was seen and these results were superior to the results of treatment after peritoneal metastases had developed as recurrence. Also, prophylactic HIPEC improved survival with T3/T4 mucinous or signet ring colon cancers. A second-look has been shown to be effective in two published manuscripts. Unpublished data from MedStar Washington Cancer Institute also produced favorable date. Rectal cancer with peritoneal metastases may not be so effectively treated. There are both credits and debits of this proactive approach. Selection factors should be reviewed by the multidisciplinary team for individualized management of patients with or at high risk for peritoneal metastases.展开更多
Liver transplantation is the only effective treatment for hepatitis B virus(HBV)-related end-stage liver disease.However,without antiviral prophylaxis,the recurrence rate of hepatitis B is as high as 80%-100%,which le...Liver transplantation is the only effective treatment for hepatitis B virus(HBV)-related end-stage liver disease.However,without antiviral prophylaxis,the recurrence rate of hepatitis B is as high as 80%-100%,which leads to a 50% mortality rate in the first 2 years after liver transplantation.Combination therapy of hepatitis B immunoglobulin(HBIG) and lamivudine demonstrated a higher efficacy of prophylaxis and further reduced the rate of recurrence to < 10%.The strategy of HBIG combined with lamivudine has been the standard treatment in many centers.However,the high rate of lamivudine resistance and the many disadvantages of HBIG have compelled surgeons to reconsider the longterm efficacy of this strategy for the prevention of HBV reinfection.Recently,new nucleos(t)ide analogues,such as entecavir and tenofovir,have been approved as first-line monotherapies for the treatment of chronic hepatitis B infection.These antiviral medicines have replaced lamivudine as the first choice in the prevention of HBV recurrence after liver transplantation.Various therapies that are composed of entecavir,tenofovir,and lamivudine plus adefovir,with or without HBIG have been adopted in several liver transplant centers.This article reviews the recent advances in prophylaxis for the recurrence of hepatitis B after liver transplantation.展开更多
In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice productio...In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice production. In order to curb the recurrence momentum of rice C. suppressalis,according to the dynamic monitoring and field system survey of rice C. suppressalis in Longyou County since 2015,the causes of the annual increase of rice C. suppressalis in recent years were analyzed,and the recurrence area of C. suppressalis was introduced,and finally some prevention and control measures were put forward.展开更多
Hepatitis C virus(HCV)-related liver disease, including cirrhosis and hepatocellular carcinoma is the main indication for liver transplantation(LT) worldwide. Posttransplant HCV re-infection is almost universal and re...Hepatitis C virus(HCV)-related liver disease, including cirrhosis and hepatocellular carcinoma is the main indication for liver transplantation(LT) worldwide. Posttransplant HCV re-infection is almost universal and results in accelerated progression from acute hepatitis to chronic hepatitis, and liver cirrhosis. Comprehension and treatment of recurrent HCV infection after LT have been major issues for all transplant hepatologists and transplant surgeons for the last decades. The aim of this paper is to review the evolution of our knowledge on the natural history of HCV recurrence after LT, including risk factors for disease progression, and antiviral therapy. We will focus our attention on possible ways(present and future) to improve the final longterm results of LT for HCV-related liver disease.展开更多
After surgery for Crohn's disease (CD), early endoscopic lesions are frequently observed despite no symptomatic recurrence. The severity of lesions found at postoperative endoscopy is reported to be a strong predi...After surgery for Crohn's disease (CD), early endoscopic lesions are frequently observed despite no symptomatic recurrence. The severity of lesions found at postoperative endoscopy is reported to be a strong predictive factor for future clinical recurrence. If endoscopic lesions in the early postoperative period can be reduced with medications, symptomatic recurrence will likely be delayed and decreased. Before the introduction of biologic therapies, various medications were used for the maintenance of clinical remission after surgery; however, few demonstrated consistent efficacy. Infliximab is a recombinant anti-tumor necrosis factor-α antibody. Although infliximab is one of the most effective medications in the management of CD, its efficacy for early endoscopic lesions after surgery has not yet been assessed. The author and colleagues recently conducted a prospective study in order to investigate the impact of infliximab on early endoscopic lesions after resection for CD. We found that infliximab therapy showed clear suppressive effects on clinical and endoscopic disease activity in patients with early endoscopic lesions after resection.展开更多
In this study a cisplatin-loaded, multilayered polylactide （PLA） electrospun nanofibers, with the structure of two layers of drug-loaded mat being sandwiched by three layers of blank mat, were designed for prolonged...In this study a cisplatin-loaded, multilayered polylactide （PLA） electrospun nanofibers, with the structure of two layers of drug-loaded mat being sandwiched by three layers of blank mat, were designed for prolonged cisplatin release at surgical margin to prevent local cancer recurrence following surgical resection in a murine model. In vivo drug release and biodistribution study suggested that the multilayered fibrous mat displayed a slower cisplatin release behavior and a more stable drug rentention in the local tissue within 24 h than that of single-layered fibrous mat. By covering the surgical site with the multilayered fibrous mat following resection of subcutaneous liver cancer in mice, retarded tumor recurrence, prolonged survival time and less systemic toxicity were observed compared with other treatment groups.展开更多
The coronavirus disease 2019(COVID-19)epidemic is a major public health emergency characterized by fast spread,a wide range of infections,and enormous control difficulty.Since the end of December 2019,Wuhan has become...The coronavirus disease 2019(COVID-19)epidemic is a major public health emergency characterized by fast spread,a wide range of infections,and enormous control difficulty.Since the end of December 2019,Wuhan has become the first core infection area of China's COVID-19 outbreak.Since March 2020,the domestic worst-hit areas have moved to the Heilongjiang Province due to the increased number of imported COVID-19 cases.Herein,we reported the major COVID-19 outbreak,which caused a rebound of the epidemic in Harbin,China.After the rebound,different levels of causes for the recurrence of COVID-19,including citylevel,hospital-level,and medical staff-level cause,were investigated.Meanwhile,corresponding countermeasures to prevent the recurrence of the epidemic were also carried out on the city level,hospital level,and medical staff level,which eventually showed the effect of infection control function in a pandemic.In this study,we described the complete transmission chain,analyzed the causes of the outbreak,and proposed corresponding countermeasures from our practical clinical experience,which can be used as a valuable reference for COVID-19 control.展开更多
Hepatitis C related liver failure and hepatocarcinoma are the most common indications for liver transplantation in Western countries.Recurrent hepatitis C infection of the allograft is universal and immediate followin...Hepatitis C related liver failure and hepatocarcinoma are the most common indications for liver transplantation in Western countries.Recurrent hepatitis C infection of the allograft is universal and immediate following liver transplantation,being associated with accelerated progression to cirrhosis,graft loss and death.Graft and patient survival is reduced in liver transplant recipients with recurrent Hepatitis C virus(HCV) infection compared to HCV-negative recipients.Many variables may impact on recurrent HCV liver disease.Overall,excess immunosuppression is believed to be a key factor;however,no immunosuppressive regimen has been identified to be more beneficial or less harmful.Donor age limitations,exclusion of moderately to severely steatotic livers and minimization of ischemic times could be a potential strategy to minimize the severity of HCV disease in transplanted subjects.After transplantation,antiviral therapy based on pegylated IFN alpha with or without ribavirin is associated with far less results than that reported for immunocompetent HCV-infected patients.New findings in the field of immunotherapy and genomic medicine applied to this context are promising.展开更多
OBJECTIVE: To study the efficacy of liver transplantation on end-stage hepatitis B related liver diseases, and the prevention and treatment strategies of hepatitis B recurrence after the transplantation. METHODS: The ...OBJECTIVE: To study the efficacy of liver transplantation on end-stage hepatitis B related liver diseases, and the prevention and treatment strategies of hepatitis B recurrence after the transplantation. METHODS: The efficacy of combined treatment of lamivudine and hepatitis B immune globulin (HBIG) therapy on 24 patients who had received liver transplantation was retrospectively studied. RESULTS: All the 24 patients with end-stage hepatitis B-related liver diseases treated with lamivudine alone or combined therapy of lamivudine and HBIG showed normal liver function and 21 of them lost hepatitis B virus (HBV) markers. However, the remaining 3 patients became HBsAg positive again soon after liver transplantation. CONCLUSIONS: Liver transplantation is effective for patients with end-stage hepatitis B-related liver diseases. Combined treatment of lamivudine and HBIG may prevent the recurrence of hepatitis B after the operation.展开更多
BACKGROUND:Combined hepatitis B immune globulin(HBIg)and lamivudine in prophylaxis of the recurrence of hepatitis B after liver transplantation has significantly improved the survival of HBsAg positive patients.This s...BACKGROUND:Combined hepatitis B immune globulin(HBIg)and lamivudine in prophylaxis of the recurrence of hepatitis B after liver transplantation has significantly improved the survival of HBsAg positive patients.This study was undertaken to evaluate the outcomes of liver transplantation for patients with hepatitis B virus(HBV).METHODS:A retrospective chart analysis and a review of the organ transplant database identified 51 patients(43 men and 8 women)transplanted for benign HBV-related cirrhotic diseases between June 2002 and December 2004 who had survived more than 3 months.HBIg was administered intravenously during the first week and intramuscularly thereafter.RESULTS:At a median follow-up of 14.1 months,the overall recurrence rate in the 51 patients was 3.9%(2/51).The overall patient survival was 88.3%,and 82.4%after 1 and 2 years,respectively.A daily oral dose of 100 mg lamivudine for 2 weeks before transplantation for 10 patients enabled 57.1%(4/7)and 62.5%(5/8)of HBV-DNA and HBeAg positive patients respectively to convert to be negative.Intramuscular HBIg was well tolerated in all patients.CONCLUSION:Lamivudine combined with intramuscular HBIg can effectively prevent allograft from the recurrence of HBV after liver transplantation.展开更多
文摘BACKGROUND Infection by the hepatitis B virus(HBV)represents a significant global sociosanitary burden.While liver transplantation(LT)is an important therapeutic option,treatments that prevent HBV reinfection are necessary.The combination of anti-hepatitis B immunoglobulin(HBIG)and nucleoside/nucleotide analogs(NA)is the standard post-transplant treatment;however,there are limitations in using HBIG,particularly its cost.We present two illustrative clinical cases as examples of post-transplant management using dual NA therapy,unaccompanied by HBIG.CASE SUMMARY The first case involves a 42-year-old man with HBV-related cirrhosis,who,in the context of a diagnosis of hepatocellular carcinoma and hepatopulmonary syndrome,underwent LT without viremia at the time of transplantation.A lack of availability of HBIG led to the combined use of two NAs,entecavir,and tenofovir alafenamide—resulting in the negativization of hepatitis B surface antigen(HBsAg)and maintenance of a negative viral load in the post-transplant period.In the second case,a 63-year-old woman presented with acute hepatic failure due to HBV with viremia during transplantation.Combined therapy with entecavir and tenofovir alafenamide,again due to the unavailability of HBIG,ultimately led to the negativization of HBsAg and viral load.CONCLUSION These cases suggest the efficacy of dual NA therapy in post-transplant HBV management,emphasizing the need to reconsider traditional treatment approaches.
文摘INTRODUCTIONIn China,primary liver cancer (PLC) ranks secondin cancer mortality since the 1990s.In the field ofPLC treatment,surgical resection remains the best,which includes large PLC resection,small PLCresection,re-resection of subclinical recurrence,aswell as cytoreduction and sequential resection forunresectable PLC.However,recurrence
文摘Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.
文摘Objectives:Tumor recurrence is a major determinant of poor prognosis in hepatocellular carcinoma(HCC),yet its cellular and molecular basis remains incompletely understood.This study aimed to identify recurrenceassociated genes at single-cell resolution and to develop a prognostic model for predicting survival outcomes and immunotherapy responsiveness in HCC.Methods:Single-cell RNA sequencing data from 12 primary and 6 recurrent HCC samples were integrated and analyzed to identify genes characteristic of recurrence.After quality control,principal component analysis,and t-SNE-based clustering were used to identify highly variable genes for cell clustering and annotation.Based on macrophage characteristic genes,a recurrence-related risk score was constructed using a LASSOCox regression model,and a nomogram integrating clinical variables was developed.Prognostic performance was assessed using Kaplan-Meier analysis and time-dependent ROC curves.Immune infiltration profiling was performed to compare immune characteristics between risk groups defined by the prognostic model.Multivariate Cox regression was applied to identify independent prognostic biomarkers,which were subsequently validated by cell function experiments.Results:The risk model effectively stratified patients into high-and low-risk groups with distinct survival outcomes,demonstrating high predictive accuracy for 1-,3-,and 5-year survival.High-risk patients showed altered immune profiles and a reduced predicted response to immunotherapy.GRID2,RNF186,and SLC4A10 were identified as independent prognostic genes,with RNF186 promoting HCC cell proliferation in a SESN2-dependent manner.Conclusion:This prognostic model provides new insights into precision medicine and immunotherapy for HCC,highlighting the potential clinical significance of RNF186 as a therapeutic target.
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.
基金Supported by Innovation Project of Hebei Academy of Agricultural and Forestry Sciences(2022KJCXZX-CGS-7)Hebei Agriculture Research System(HBCT2024170406).
文摘This paper presents an overview of the pathogens, symptoms of damage, patterns of occurrence, and chemical control methods associated with four major pear tree diseases: pear scab, pear ring rot, pear anthracnose, and pear speckle. The objective is to provide valuable references for the scientific and precise prevention and management of diseases in pear orchards, thereby contributing to the production of high-quality and high-yield pear fruits.
基金Centre of Research,Education,Innovation,and Intervention in Sport(CIFI2D)is financed by the Portuguese Foundation for Science and Technology,under the DOI https://doi.org/10.54499/UIDB/05913/2020。
文摘1.Introduction Injury prevention is an essential element of science and medicine in sports,and it garners attention from stakeholders focused on minimizing athletes’injury risk.Catchy titles including“injury risk”or“injury prevention”are likely to grab the readers’attention.Meanwhile,studies on injury prevention might assess the impact of interventions on mitigating injury risk factors(e.g.,strength,range of motion(ROM))but fail to report injury data(e.g.,incidence).1,2 Likewise,observational studies may include“injury risk”in their titles,but fail to provide injury data.3 Without injury data.
基金The Natural Science Foundation of Heilongjiang Province(No.LH2023E011)Open Fund of National Key Laboratory of Green and Long-Life Road Engineering in Extreme Environment in Changsha University of Science and Technology(No.kfj230105).
文摘To uncover the decision-making mechanisms and evolutionary dynamics of multiple stakeholders in highway noise pollution control,a three-party evolutionary game model involving the government,operators,and the public is constructed.The operation period is divided into different stages for differentiated analysis.A simulation analysis was performed on the Lituo sinking section of the Beijing-Hong Kong-Macao Highway to assess the impact of variations in critical elements on the system.The results indicate that the Lituo sinking section of the Beijing-Hong Kong-Macao Highway is currently in its early stage of development,with the corresponding strategies being active regulation,excessive emissions,and supervision.When the cost of the government’s active regulation decreases from 1×10^(5) to 5×10^(4) yuan,the system converges more rapidly toward the active regulation strategy.When the cost of the operator’s excessive emissions increases from 14.08×10^(6) to 20.00×10^(6) yuan,the system drives the operator toward the standardized emission strategy.In addition,when the cost of public supervision decreases from 15×10^(4) to 5×10^(4) yuan and the compensation paid by operators to the public increases from 1.288×10^(6) to 2.576×10^(6) yuan,the system converges more quickly toward the supervision strategy.The cost of the operator’s excessive emissions serves as the core decision variable for achieving the ideal equilibrium in the three-party game involving government active regulation,operator standardized emissions,and public supervision.
基金funded by the Arab Open University,Riyadh,Saudi Arabia.
文摘Deepfake is a sort of fake media made by advanced AI methods like Generative Adversarial Networks(GANs).Deepfake technology has many useful uses in education and entertainment,but it also raises a lot of ethical,social,and security issues,such as identity theft,the dissemination of false information,and privacy violations.This study seeks to provide a comprehensive analysis of several methods for identifying and circumventing Deepfakes,with a particular focus on image-based Deepfakes.There are three main types of detection methods:classical,machine learning(ML)and deep learning(DL)-based,and hybrid methods.There are three main types of preventative methods:technical,legal,and moral.The study investigates the effectiveness of several detection approaches,such as convolutional neural networks(CNNs),frequency domain analysis,and hybrid CNN-LSTM models,focusing on the respective advantages and disadvantages of each method.We also look at new technologies like Explainable Artificial Intelligence(XAI)and blockchain-based frameworks.The essay looks at the use of algorithmic protocols,watermarking,and blockchain-based content verification as possible ways to stop certain things from happening.Recent advancements,including adversarial training and anti-Deepfake data generation,are essential because of their potential to alleviate rising concerns.This reviewshows that there aremajor problems,such as the difficulty of improving the capabilities of existing systems,the high running expenses,and the risk of being attacked by enemies.It stresses the importance of working together across fields,including academia,business,and government,to create robust,scalable,and ethical solutions.Themain goals of futurework should be to create lightweight,real-timedetection systems,connect them to large language models(LLMs),and put in place worldwide regulatory frameworks.This essay argues for a complete and varied plan to keep digital information real and build confidence in a time when media is driven by artificial intelligence.It uses both technical and non-technical means.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund,“Research on the Role and Mechanism of PIGU in Regulating MUC-1 in Gastric Cancer Immune Escape”(Project No.:2023YJY-29)Shaanxi Provincial Natural Science Basic Research Program,“Research on the Mechanism and Clinical Significance of miR-140-5p Related to Gastric Cancer Recurrence and Metastasis”(Project No.:2023-JC-YB-639)。
文摘Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurrence and survival rates in patients with early gastric cancer,providing evidence-based support for optimizing clinical surgical plans.Methods:A retrospective analysis was conducted on the clinical data of 100 patients with early gastric cancer who underwent surgical treatment at our hospital from October 2021 to October 2023.Patients were divided into Group D1(n=50)and Group D2(n=50)based on the extent of lymph node dissection.Group D1 underwent limited lymph node dissection(dissection of the first station of lymph nodes around the stomach),while Group D2 underwent standard lymph node dissection(dissection of the first and second stations of lymph nodes around the stomach).Surgical-related indicators,the incidence of postoperative complications,the 2-year recurrence rate,and the 2-year survival rate were compared between the two groups of patients.Results:The operative time,intraoperative blood loss,postoperative hospital stay,and the number of lymph nodes dissected were significantly higher in the D2 group than in the D1 group(all P<0.001).The overall incidence of postoperative complications was higher in the D1 group than in the D2 group,but the difference was not statistically significant(χ^(2)=0.884,P=0.766).After a 2-year follow-up,the recurrence rate was significantly higher in the D1 group than in the D2 group(χ^(2)=4.000,P=0.046).The 2-year survival rate was significantly lower in the D1 group than in the D2 group(χ^(2)=5.005,P=0.025).A total of 100 patients with early-stage gastric cancer were grouped according to the depth of invasion,degree of differentiation,and lymph node metastasis status,and the recurrence rates of different subgroups were compared.The results showed that the recurrence rate was higher in patients with T1b stage than in those with T1a stage(χ^(2)=5.005,P=0.025),higher in poorly differentiated patients than in moderately and well-differentiated patients(χ^(2)=4.155,P=0.042),and higher in patients with lymph node metastasis than in those without lymph node metastasis(χ^(2)=4.512,P=0.034).Conclusion:Compared with D1 limited lymph node dissection,D2 standard lymph node dissection can significantly reduce the postoperative recurrence rate and improve the 2-year survival rate in patients with early-stage gastric cancer without significantly increasing the risk of postoperative complications.Although the surgical trauma is slightly greater,the overall prognosis is better,making it a preferred surgical treatment option for patients with early-stage gastric cancer.
文摘The prevention of a disease process has always been superior to the treatment of the same disease throughout the history of medicine and surgery. Local recurrence and peritoneal metastases occur in approximately 8% of colon cancer patients and 25% of rectal cancer patients and should be prevented. Strategies to prevent colon or rectal cancer local recurrence and peritoneal metastases include cytoreductive surgery and hyperthermic perioperative chemotherapy (HIPEC). These strategies can be used at the time of primary colon or rectal cancer resection if the HIPEC is available. At institutions where HIPEC is not available with the treatment of primary malignancy, a proactive second-look surgery is recommended. Several phase II studies strongly support the proactive approach. If peritoneal metastases were treated along with the primary colon resection, 5-year survival was seen and these results were superior to the results of treatment after peritoneal metastases had developed as recurrence. Also, prophylactic HIPEC improved survival with T3/T4 mucinous or signet ring colon cancers. A second-look has been shown to be effective in two published manuscripts. Unpublished data from MedStar Washington Cancer Institute also produced favorable date. Rectal cancer with peritoneal metastases may not be so effectively treated. There are both credits and debits of this proactive approach. Selection factors should be reviewed by the multidisciplinary team for individualized management of patients with or at high risk for peritoneal metastases.
基金Supported by Shanghai Jiaotong University School of Medicine Science and Technology Fund,No.11XJ21016Training Program for Super Academic Leaders in the Shanghai Health System,No.XBR2011029
文摘Liver transplantation is the only effective treatment for hepatitis B virus(HBV)-related end-stage liver disease.However,without antiviral prophylaxis,the recurrence rate of hepatitis B is as high as 80%-100%,which leads to a 50% mortality rate in the first 2 years after liver transplantation.Combination therapy of hepatitis B immunoglobulin(HBIG) and lamivudine demonstrated a higher efficacy of prophylaxis and further reduced the rate of recurrence to < 10%.The strategy of HBIG combined with lamivudine has been the standard treatment in many centers.However,the high rate of lamivudine resistance and the many disadvantages of HBIG have compelled surgeons to reconsider the longterm efficacy of this strategy for the prevention of HBV reinfection.Recently,new nucleos(t)ide analogues,such as entecavir and tenofovir,have been approved as first-line monotherapies for the treatment of chronic hepatitis B infection.These antiviral medicines have replaced lamivudine as the first choice in the prevention of HBV recurrence after liver transplantation.Various therapies that are composed of entecavir,tenofovir,and lamivudine plus adefovir,with or without HBIG have been adopted in several liver transplant centers.This article reviews the recent advances in prophylaxis for the recurrence of hepatitis B after liver transplantation.
文摘In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice production. In order to curb the recurrence momentum of rice C. suppressalis,according to the dynamic monitoring and field system survey of rice C. suppressalis in Longyou County since 2015,the causes of the annual increase of rice C. suppressalis in recent years were analyzed,and the recurrence area of C. suppressalis was introduced,and finally some prevention and control measures were put forward.
文摘Hepatitis C virus(HCV)-related liver disease, including cirrhosis and hepatocellular carcinoma is the main indication for liver transplantation(LT) worldwide. Posttransplant HCV re-infection is almost universal and results in accelerated progression from acute hepatitis to chronic hepatitis, and liver cirrhosis. Comprehension and treatment of recurrent HCV infection after LT have been major issues for all transplant hepatologists and transplant surgeons for the last decades. The aim of this paper is to review the evolution of our knowledge on the natural history of HCV recurrence after LT, including risk factors for disease progression, and antiviral therapy. We will focus our attention on possible ways(present and future) to improve the final longterm results of LT for HCV-related liver disease.
文摘After surgery for Crohn's disease (CD), early endoscopic lesions are frequently observed despite no symptomatic recurrence. The severity of lesions found at postoperative endoscopy is reported to be a strong predictive factor for future clinical recurrence. If endoscopic lesions in the early postoperative period can be reduced with medications, symptomatic recurrence will likely be delayed and decreased. Before the introduction of biologic therapies, various medications were used for the maintenance of clinical remission after surgery; however, few demonstrated consistent efficacy. Infliximab is a recombinant anti-tumor necrosis factor-α antibody. Although infliximab is one of the most effective medications in the management of CD, its efficacy for early endoscopic lesions after surgery has not yet been assessed. The author and colleagues recently conducted a prospective study in order to investigate the impact of infliximab on early endoscopic lesions after resection for CD. We found that infliximab therapy showed clear suppressive effects on clinical and endoscopic disease activity in patients with early endoscopic lesions after resection.
文摘In this study a cisplatin-loaded, multilayered polylactide （PLA） electrospun nanofibers, with the structure of two layers of drug-loaded mat being sandwiched by three layers of blank mat, were designed for prolonged cisplatin release at surgical margin to prevent local cancer recurrence following surgical resection in a murine model. In vivo drug release and biodistribution study suggested that the multilayered fibrous mat displayed a slower cisplatin release behavior and a more stable drug rentention in the local tissue within 24 h than that of single-layered fibrous mat. By covering the surgical site with the multilayered fibrous mat following resection of subcutaneous liver cancer in mice, retarded tumor recurrence, prolonged survival time and less systemic toxicity were observed compared with other treatment groups.
基金Supported by The National Natural Science Foundation of China,No.81770276,and No.81571871Nn10 Program of Harbin Medical University Cancer Hospital and Scientific Research Project of Heilongjiang Health and Family Planning Commission,No.2018086.
文摘The coronavirus disease 2019(COVID-19)epidemic is a major public health emergency characterized by fast spread,a wide range of infections,and enormous control difficulty.Since the end of December 2019,Wuhan has become the first core infection area of China's COVID-19 outbreak.Since March 2020,the domestic worst-hit areas have moved to the Heilongjiang Province due to the increased number of imported COVID-19 cases.Herein,we reported the major COVID-19 outbreak,which caused a rebound of the epidemic in Harbin,China.After the rebound,different levels of causes for the recurrence of COVID-19,including citylevel,hospital-level,and medical staff-level cause,were investigated.Meanwhile,corresponding countermeasures to prevent the recurrence of the epidemic were also carried out on the city level,hospital level,and medical staff level,which eventually showed the effect of infection control function in a pandemic.In this study,we described the complete transmission chain,analyzed the causes of the outbreak,and proposed corresponding countermeasures from our practical clinical experience,which can be used as a valuable reference for COVID-19 control.
文摘Hepatitis C related liver failure and hepatocarcinoma are the most common indications for liver transplantation in Western countries.Recurrent hepatitis C infection of the allograft is universal and immediate following liver transplantation,being associated with accelerated progression to cirrhosis,graft loss and death.Graft and patient survival is reduced in liver transplant recipients with recurrent Hepatitis C virus(HCV) infection compared to HCV-negative recipients.Many variables may impact on recurrent HCV liver disease.Overall,excess immunosuppression is believed to be a key factor;however,no immunosuppressive regimen has been identified to be more beneficial or less harmful.Donor age limitations,exclusion of moderately to severely steatotic livers and minimization of ischemic times could be a potential strategy to minimize the severity of HCV disease in transplanted subjects.After transplantation,antiviral therapy based on pegylated IFN alpha with or without ribavirin is associated with far less results than that reported for immunocompetent HCV-infected patients.New findings in the field of immunotherapy and genomic medicine applied to this context are promising.
文摘OBJECTIVE: To study the efficacy of liver transplantation on end-stage hepatitis B related liver diseases, and the prevention and treatment strategies of hepatitis B recurrence after the transplantation. METHODS: The efficacy of combined treatment of lamivudine and hepatitis B immune globulin (HBIG) therapy on 24 patients who had received liver transplantation was retrospectively studied. RESULTS: All the 24 patients with end-stage hepatitis B-related liver diseases treated with lamivudine alone or combined therapy of lamivudine and HBIG showed normal liver function and 21 of them lost hepatitis B virus (HBV) markers. However, the remaining 3 patients became HBsAg positive again soon after liver transplantation. CONCLUSIONS: Liver transplantation is effective for patients with end-stage hepatitis B-related liver diseases. Combined treatment of lamivudine and HBIG may prevent the recurrence of hepatitis B after the operation.
文摘BACKGROUND:Combined hepatitis B immune globulin(HBIg)and lamivudine in prophylaxis of the recurrence of hepatitis B after liver transplantation has significantly improved the survival of HBsAg positive patients.This study was undertaken to evaluate the outcomes of liver transplantation for patients with hepatitis B virus(HBV).METHODS:A retrospective chart analysis and a review of the organ transplant database identified 51 patients(43 men and 8 women)transplanted for benign HBV-related cirrhotic diseases between June 2002 and December 2004 who had survived more than 3 months.HBIg was administered intravenously during the first week and intramuscularly thereafter.RESULTS:At a median follow-up of 14.1 months,the overall recurrence rate in the 51 patients was 3.9%(2/51).The overall patient survival was 88.3%,and 82.4%after 1 and 2 years,respectively.A daily oral dose of 100 mg lamivudine for 2 weeks before transplantation for 10 patients enabled 57.1%(4/7)and 62.5%(5/8)of HBV-DNA and HBeAg positive patients respectively to convert to be negative.Intramuscular HBIg was well tolerated in all patients.CONCLUSION:Lamivudine combined with intramuscular HBIg can effectively prevent allograft from the recurrence of HBV after liver transplantation.
