BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive mod...BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive model for preoperative identification of HCC.METHODS A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital.The patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory tests.Multiple logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for malignancies.These factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%specificity.The model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.展开更多
BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver resection.Heparin,an established anticoagulant,can protect liver function through a number of mechanisms,and t...BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver resection.Heparin,an established anticoagulant,can protect liver function through a number of mechanisms,and thus,prevent liver failure.AIM To look at the safety and efficacy of heparin in preventing hepatic dysfunction after hepatectomy.METHODS The data was extracted from Multiparameter Intelligent Monitoring in Intensive Care III(MIMIC-III)v1.4 pinpointed patients who had undergone hepatectomy for liver cancer,subdividing them into two cohorts:Those who were injected with heparin and those who were not.The statistical evaluations used were unpaired ttests,Mann-Whitney U tests,chi-square tests,and Fisher’s exact tests to assess the effect of heparin administration on PHLF,duration of intensive care unit(ICU)stay,need for mechanical ventilation,use of continuous renal replacement therapy(CRRT),incidence of hypoxemia,development of acute kidney injury,and ICU mortality.Logistic regression was utilized to analyze the factors related to PHLF,with propensity score matching(PSM)aiming to balance the preoperative disparities between the two groups.RESULTS In this study,1388 patients who underwent liver cancer hepatectomy were analyzed.PSM yielded 213 matched pairs from the heparin-treated and control groups.Initial univariate analyses indicated that heparin potentially reduces the risk of PHLF in both matched and unmatched samples.Further analysis in the matched cohorts confirmed a significant association,with heparin reducing the risk of PHLF(odds ratio:0.518;95%confidence interval:0.295-0.910;P=0.022).Additionally,heparin treatment correlated with improved short-term postoperative outcomes such as reduced ICU stay durations,diminished requirements for respiratory support and CRRT,and lower incidences of hypoxemia and ICU mortality.CONCLUSION Liver failure is an important hazard following hepatic surgery.During ICU care heparin administration has been proved to decrease the occurrence of hepatectomy induced liver failure.This indicates that heparin may provide a hopeful option for controlling PHLF.展开更多
Objectives:The Kirsten rat sarcoma virus(KRAS)G12D oncogenic mutation poses a significant challenge in treating solid tumors due to the lack of specific and effective therapeutic interventions.This study aims to explore...Objectives:The Kirsten rat sarcoma virus(KRAS)G12D oncogenic mutation poses a significant challenge in treating solid tumors due to the lack of specific and effective therapeutic interventions.This study aims to explore innovative approaches in T cell receptor(TCR)engineering and characterization to target the KRAS G12D7-16 mutation,providing potential strategies for overcoming this therapeutic challenge.Methods:In this innovative study,we engineered and characterized two T cell receptors(TCRs),KDA11-01 and KDA11-02 with high affinity for the KRAS G12D7-16 mutation.These TCRs were isolated from tumor-infiltrating lymphocytes(TILs)derived from tumor tissues of patients with the KRAS G12D mutation.We assessed their specificity and anti-tumor activity in vitro using various cancer cell lines.Results:KDA11-01 and KDA11-02 demonstrated exceptional specificity for the HLA-A*11:01-restricted KRAS G12D7-16 epitope,significantly inducing IFN-γrelease and eliminating tumor cells without cross-reactivity or alloreactivity.Conclusions:The successful development of KDA11-01 and KDA11-02 introduces a novel and precise TCR-based therapeutic strategy against KRAS G12D mutation,showing potential for significant advancements in cancer immunotherapy.展开更多
Wheat bran, a principal byproduct of flour milling, stands as an abundant source of dietary fiber, yet its economic potential remains under-exploited in current forage applications. Arabinoxylan(AX), constituting the ...Wheat bran, a principal byproduct of flour milling, stands as an abundant source of dietary fiber, yet its economic potential remains under-exploited in current forage applications. Arabinoxylan(AX), constituting the core of dietary fiber, emerges as a versatile compound with multifaceted functionalities. Its nutritional significance,coupled with its role in cereal food processing, has prompted a surge of studies focusing on the valorization of wheat bran AX. Moreover, the hydrolyzed derivative, arabinoxylan oligosaccharides(AXOS), demonstrates prebiotic and antioxidant properties, offering potential avenues to mitigate the risk of chronic diseases. This review summarizes current knowledge on the valorization of wheat bran AX in terms of the processing and nutritional properties of AX. Moreover, multiple novel applications of AX in the materials area, including biodegradable food packaging films, delivery of bioactive substances as nanoparticles, and the manufacture of food emulsifiers, are also highlighted to extend the utilization of AX. This review underscores the immense potential of wheat bran AX, advocating for its exploitation not only as a nutritional asset but also as a primary ingredient in advanced materials. The synthesis of nutritional and materials perspectives accentuates the multifaceted utility of wheat bran AX, thereby paving the way for sustainable valorization pathways. By unraveling the latent potential within AX, this paper advocates for the holistic and sustainable utilization of wheat bran in diverse, value-added applications.展开更多
目的检索并获取ICU新型冠状病毒感染防护及管理的相关证据,为临床提供借鉴。方法根据患者及医务人员的具体情况,提出所要解决的临床问题,全面检索BestPractice(BMJ)、Up To Date、JBI、世界卫生组织、美国国家疾病控制与预防中心、中华...目的检索并获取ICU新型冠状病毒感染防护及管理的相关证据,为临床提供借鉴。方法根据患者及医务人员的具体情况,提出所要解决的临床问题,全面检索BestPractice(BMJ)、Up To Date、JBI、世界卫生组织、美国国家疾病控制与预防中心、中华医学会、中国疾病预防与控制中心、国家卫生健康委员会办公厅和国家中医药管理局办公室、Cochrane Library、PubMed、丁香园、中国知网、万方数据库等网站,提取新型冠状病毒救治相关的证据,并结合临床医务人员专业判断、患者意愿、临床情境等要素,为患者及医务人员制定防护及管理方案。采用美国约翰霍普金斯大学/医院的文献评价标准对非研究型文献进行质量评价。结果共纳入21篇文献:1篇临床决策,6篇临床指南、2篇证据总结,11篇专家共识,1篇专家意见,围绕呼吸治疗、血糖控制与管理、隔离与防护、营养支持、标本采集、转运、医用产品使用、医护人员职业防护、心理与社会支持和教育与培训等10个方面进行了证据总结,共形成48条新型冠状病毒救治及管理相关的最佳证据。结论本研究汇总了目前ICU新型冠状病毒感染防护及管理的文献,为ICU医护人员在诊疗和护理病毒感染患者提供循证依据,以科学的方法来应对ICU新型冠状病毒感染的问题,提升护理质量。展开更多
基金Supported by the National Natural Science Foundation of China Youth Training Project,No.2021GZR003and Medical-engineering Interdisciplinary Research Youth Training Project,No.2022YGJC001.
文摘BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive model for preoperative identification of HCC.METHODS A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital.The patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory tests.Multiple logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for malignancies.These factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%specificity.The model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.
基金Supported by the National Natural Science Foundation of China Youth Training Project,No.2021GZR003Medical-engineering Interdisciplinary Research Youth Training Project,No.2022YGJC001.
文摘BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver resection.Heparin,an established anticoagulant,can protect liver function through a number of mechanisms,and thus,prevent liver failure.AIM To look at the safety and efficacy of heparin in preventing hepatic dysfunction after hepatectomy.METHODS The data was extracted from Multiparameter Intelligent Monitoring in Intensive Care III(MIMIC-III)v1.4 pinpointed patients who had undergone hepatectomy for liver cancer,subdividing them into two cohorts:Those who were injected with heparin and those who were not.The statistical evaluations used were unpaired ttests,Mann-Whitney U tests,chi-square tests,and Fisher’s exact tests to assess the effect of heparin administration on PHLF,duration of intensive care unit(ICU)stay,need for mechanical ventilation,use of continuous renal replacement therapy(CRRT),incidence of hypoxemia,development of acute kidney injury,and ICU mortality.Logistic regression was utilized to analyze the factors related to PHLF,with propensity score matching(PSM)aiming to balance the preoperative disparities between the two groups.RESULTS In this study,1388 patients who underwent liver cancer hepatectomy were analyzed.PSM yielded 213 matched pairs from the heparin-treated and control groups.Initial univariate analyses indicated that heparin potentially reduces the risk of PHLF in both matched and unmatched samples.Further analysis in the matched cohorts confirmed a significant association,with heparin reducing the risk of PHLF(odds ratio:0.518;95%confidence interval:0.295-0.910;P=0.022).Additionally,heparin treatment correlated with improved short-term postoperative outcomes such as reduced ICU stay durations,diminished requirements for respiratory support and CRRT,and lower incidences of hypoxemia and ICU mortality.CONCLUSION Liver failure is an important hazard following hepatic surgery.During ICU care heparin administration has been proved to decrease the occurrence of hepatectomy induced liver failure.This indicates that heparin may provide a hopeful option for controlling PHLF.
基金funded by the key R&D Project of Hubei Province(Social Development),China(2022BCA018)the Cooperative Innovation Center of Industrial Fermentation(Ministry of Education&Hubei Province),China(2022KF16)to Kanghong Hu.
文摘Objectives:The Kirsten rat sarcoma virus(KRAS)G12D oncogenic mutation poses a significant challenge in treating solid tumors due to the lack of specific and effective therapeutic interventions.This study aims to explore innovative approaches in T cell receptor(TCR)engineering and characterization to target the KRAS G12D7-16 mutation,providing potential strategies for overcoming this therapeutic challenge.Methods:In this innovative study,we engineered and characterized two T cell receptors(TCRs),KDA11-01 and KDA11-02 with high affinity for the KRAS G12D7-16 mutation.These TCRs were isolated from tumor-infiltrating lymphocytes(TILs)derived from tumor tissues of patients with the KRAS G12D mutation.We assessed their specificity and anti-tumor activity in vitro using various cancer cell lines.Results:KDA11-01 and KDA11-02 demonstrated exceptional specificity for the HLA-A*11:01-restricted KRAS G12D7-16 epitope,significantly inducing IFN-γrelease and eliminating tumor cells without cross-reactivity or alloreactivity.Conclusions:The successful development of KDA11-01 and KDA11-02 introduces a novel and precise TCR-based therapeutic strategy against KRAS G12D mutation,showing potential for significant advancements in cancer immunotherapy.
基金supported by the National Key Research and Development Plan Project (2022YFD2301401)Young Elite Scientists Sponsorship Program by the CAST (2022QNRC001)+4 种基金the Outstanding Youth Science Fund Project of Natural Science Foundation of Jiangsu Province (BK20211576)the Central Government Guides Local Funds (ZYYD2023A13)Key Technology Research and Development Program of Jiangsu Province (BE2023370)Hainan Province (ZDYF2022XDNY233)a project funded by the Priority Academic Program Development (PAPD) of Jiangsu Higher Education Institutions。
文摘Wheat bran, a principal byproduct of flour milling, stands as an abundant source of dietary fiber, yet its economic potential remains under-exploited in current forage applications. Arabinoxylan(AX), constituting the core of dietary fiber, emerges as a versatile compound with multifaceted functionalities. Its nutritional significance,coupled with its role in cereal food processing, has prompted a surge of studies focusing on the valorization of wheat bran AX. Moreover, the hydrolyzed derivative, arabinoxylan oligosaccharides(AXOS), demonstrates prebiotic and antioxidant properties, offering potential avenues to mitigate the risk of chronic diseases. This review summarizes current knowledge on the valorization of wheat bran AX in terms of the processing and nutritional properties of AX. Moreover, multiple novel applications of AX in the materials area, including biodegradable food packaging films, delivery of bioactive substances as nanoparticles, and the manufacture of food emulsifiers, are also highlighted to extend the utilization of AX. This review underscores the immense potential of wheat bran AX, advocating for its exploitation not only as a nutritional asset but also as a primary ingredient in advanced materials. The synthesis of nutritional and materials perspectives accentuates the multifaceted utility of wheat bran AX, thereby paving the way for sustainable valorization pathways. By unraveling the latent potential within AX, this paper advocates for the holistic and sustainable utilization of wheat bran in diverse, value-added applications.
文摘目的检索并获取ICU新型冠状病毒感染防护及管理的相关证据,为临床提供借鉴。方法根据患者及医务人员的具体情况,提出所要解决的临床问题,全面检索BestPractice(BMJ)、Up To Date、JBI、世界卫生组织、美国国家疾病控制与预防中心、中华医学会、中国疾病预防与控制中心、国家卫生健康委员会办公厅和国家中医药管理局办公室、Cochrane Library、PubMed、丁香园、中国知网、万方数据库等网站,提取新型冠状病毒救治相关的证据,并结合临床医务人员专业判断、患者意愿、临床情境等要素,为患者及医务人员制定防护及管理方案。采用美国约翰霍普金斯大学/医院的文献评价标准对非研究型文献进行质量评价。结果共纳入21篇文献:1篇临床决策,6篇临床指南、2篇证据总结,11篇专家共识,1篇专家意见,围绕呼吸治疗、血糖控制与管理、隔离与防护、营养支持、标本采集、转运、医用产品使用、医护人员职业防护、心理与社会支持和教育与培训等10个方面进行了证据总结,共形成48条新型冠状病毒救治及管理相关的最佳证据。结论本研究汇总了目前ICU新型冠状病毒感染防护及管理的文献,为ICU医护人员在诊疗和护理病毒感染患者提供循证依据,以科学的方法来应对ICU新型冠状病毒感染的问题,提升护理质量。
