Effect of remote ischemic preconditioning among donors and recipients following pediatric liver transplantation:A randomized clinical trial

BACKGROUND Studies suggested that remote ischemic preconditioning(RIPC)may effectively lessen the harmful effects of ischemia reperfusion injury during organ transplantation surgery.AIM To investigate the protective effects of RIPC on living liver donors and recipients following pediatric liver transplantation.METHODS From January 2016 to January 2019 at Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine,208 donors were recruited and randomly assigned to four groups:S-RIPC group(no intervention;n=55),D-RIPC group(donors received RIPC;n=51),R-RIPC group(recipients received RIPC,n=51)and DR-RIPC group(both donors and recipients received RIPC;n=51).We primarily evaluated postoperative liver function among donors and recipients and incidences of early allograft dysfunction,primary nonfunction and postoperative complications among recipients.RESULTS RIPC did not significantly improve alanine transaminase and aspartate aminotransferase levels among donors and recipients or decrease the incidences of early allograft dysfunction,primary nonfunction,and postoperative complications among recipients.Limited protective effects were observed,including a lower creatinine level in the D-RIPC group than in the S-RIPC group on postoperative day 0(P<0.05).However,no significant improvements were found in donors who received RIPC.Furthermore,RIPC had no effects on the overall survival of recipients.CONCLUSION The protective effects of RIPC were limited for recipients who received living liver transplantation,and no significant improvement of the prognosis was observed in recipients.

Value of shear wave elastography for evaluating the pathological features of breast cancer

Objective: To explore the value of Shear Wave Elastography (SWE) for evaluating the pathologic features of breast cancer. Methods: A total of 76 patients with primary breast cancer who were diagnosed and underwent radical mastectomy in our hospital between May 2016 and January 2018 were selected as the breast cancer group, and 89 patients with breast adenoma who underwent breast nodule resection in our hospital during the same period were selected as the breast adenoma group. The differences in lesion SWE parameter as well as the expression of proliferation, apoptosis and invasion genes in the lesions were compared between the two groups of patients, and correlation analysis was used to judge the correlation between Emax level and gene expression in breast cancer tissue. Results: The Emax level in the lesions of breast cancer group was higher than that of breast adenoma group;proliferation-related genes Ghrelin, Jab1, galectin-3, TRIM11, RRS1 and MTDH mRNA expression in the lesions were higher than those of breast adenoma group;apoptosis-related gene SFRP2 mRNA expression in the lesions was lower than that of breast adenoma group whereas Smo and TPX2 mRNA expression were higher than those of breast adenoma group;invasion-related genes AEG-1 and HERC4 mRNA expression in the lesions were higher than those of breast adenoma group whereas HSPC238 and TET1 mRNA expression were lower than those of breast adenoma group;correlation analysis showed that the SWE parameter Emax level in breast cancer lesions was directly correlated with the proliferation, apoptosis and invasion activity of cancer cells. Conclusion: SWE parameter level in breast cancer tissue is significantly different from that in benign lesions, and the specific level can be used to determine the malignant degree of cancer cells.