Focus on laboratory tests related to the pathological types of lupus nephritis to implement renal biopsy as early as possible:clinical and pathological analysis of 217 cases of single center lupus nephritis

Objective:To analyze the clinical and laboratory indices of patients with lupus nephritis(LN)of different pathological types and explore the related factors of LN pathological classification,it is helpful to grasp the timing of renal biopsy.Methods:The clinical manifestations,laboratory parameters and renal pathological types of LN patients in recent 20 years were analyzed retrospectively by SPSS 26.0 software.Results:In this study,the first three pathological types were V,IV,V+IV;latent nephritis was common in type II and V;nephritic syndrome was common in type V;nephrotic syndrome was common in type V+IV;chronic renal insufficiency group was mostly type IV;pathological types were correlated with serum creatinine,C3,albumin and erythrocyte sedimentation rate(r=0.315,P<0.001),and serum creatinine was moderately correlated(r=0.315,P<0.001);AI,CI and SLEDAI scores were significantly different among LN patients of different pathological types.Conclusion:LN is closely related to clinical pathology,clinical manifestations,comprehensive analysis of laboratory indicators and SLEDAI score to make a preliminary prediction of LN pathological type,help to initially assess the severity of pathology,improve the timing of renal biopsy implementation,optimize the timing of treatment.

Analysis of the Current Situation of Drug Clinical Trial Institutions in Shaanxi Province

To understand the current situation of institutional registration in Shaanxi Province after the implementation ofregistration system management in drug clinical trial institutions.Relevant information was collected on the“Announcement on the Accreditation of Drug Clinical Trial Institutions”issued by the National Medical Products Administration from 2005 to August 2022,the record management information system of drug and medical device clinical trial institutions,and the drug clinical trial registration and information publicity platform.A retrospective analysis was carried out in terms of institutional development,regional distribution,registered majors,principal investigators,and the number of drug clinical trials.After the implementation of institution registration,the number of drug clinical trial institutions in Shaanxi Province increased by 47.4%,884 principal investigators were registered,the number of registered majors expanded from 58 qualified to 117,and the professional scope increased by 50.4%.The policy of institution registration is conducive to promoting the rational use of medical resources and the development of drug clinical trial institutions and improving the healthy development of the pharmaceutical industry in Shaanxi Province.

Demand and Analysis of Clinical Research Curriculum in Medical Universities

Objective:To investigate the needs of medical students regarding clinical research curricula to provide scientifically sound offerings and cultivate their clinical research thinking.Methods:From June to October 2022,medical students at medical universities in Shaanxi Province were surveyed using online questionnaires.The survey covered their demographic information,awareness of their major,understanding of clinical research,and preferences for curriculum content.Results:A total of 341 valid questionnaires were analyzed.Medical students demonstrated a strong awareness of their majors but a relatively low awareness of clinical research.There was significant demand for clinical research courses,with preferences for professionally oriented(81.8%),market-oriented(100%),theoretically and practically integrated teaching(78.6%),and application-focused(73.0%)courses.Conclusion:Medical colleges and universities should align clinical research curricula with the actual needs of medical students and clinical practice.Reforms in curriculum design and teaching methods are essential to better prepare students for careers in public health.

Clinical Pathological Analysis in 104 Ductal Breast Cancer Cases

Ductal breast cancer is a clinically heterogeneous disease;we investigate the correlation between tumor size, comedo necrosis, number of cell mitoses and axillary lymph node metastasis in ductal breast cancer. In this study, 104 ductal breast cancer specimens were collected and divided into 3 groups: T1 group (tumor size ≤ 2 cm), T2 group (2 5.0 cm). Among those specimens, 95 cases were diagnosed with invasive ducted carcinoma, and 9 cases were ductal carcinoma in-situ (DCIS). Results show that T3 group has a higher rate of axillary lymph node metastasis than T2 group and T1 group;T2 group has a higher rate of lymph node metastasis than T1 group. The patients with the number of cell mitoses (≥10) were also has a higher rate of axillary lymph node metastasis (P = 0.0139) than the patients with the number of cell mitoses (<10). No significance was found between comedo necrosis lesions and axillary lymph node metastasis, though the frequency of comedo necrosis lesions in patients with axillary lymph node metastasis was higher than those in non-metastatic patients. It is concluded that the tumor size and the number of cell mitoses were risk factors for axillary lymph node involvement in ductal breast cancer.

Clinical Pathological Analysis of Synovial Sarcoma

OBJECTIVE To investigate the clinical diagnosis and differential diagno- sis of synovial sarcoma (SS). METHODS A total of 41 paraffin-embedded synovial sarcoma samples were examined by H&E staining, immunohistochemistry staining and the re- verse transcriptase polymerase chain reaction (RT-PCR), in order to provide a scientific bases for diagnosis and differential diagnosis. RESULTS Twelve cases were a biphasic type, 22 cases were a mono- phasic fibrous type, and 7 cases were a poorly differentiated type. Thirty-six cases were both CK (and/or EMA) and Vim positive. Five cases were only Vim positive. A SYT-SSX fusion gene was detected in 18 cases by RT-PCR. CONCLUSION By observation of the histomorphology, immunohisto- chemistry markers and detection of a SYT-SSX fusion gene, we can make a clinical pathological diagnosis of synovial sarcoma.

A clinical analysis of acute pancreatitis in pregnancy

To the Editor： Acute pancreatitis in pregnancy （APIP） is one of the acute abdomen in pregnancy. Once the disease deterio- rated rapidly, it could be a serious threat to gravida and fetus. Although the incidence of APIP has been gradually increasing due to the life style change, it is still a rare disease and the mechanism is not clear. Patients with APIP were often misdiagnosed and not managed properly.

Study of Behavioral Changes and Photosynthetic Activity of <i>Euglenas gracilis</i>in the Presence of Effluents from the Laboratory of Clinical Analysis

Healthcare waste has now been increasingly studied in terms of the risks or dangers that can cause the environment and human health. Waste generated in clinical analysis laboratories (CALs) deserves attention, because, due to the advent of the concept of emergent pollution, it is doubtful if the materials or reagents are disposed in the sewage by CALs, which are currently considered non-contaminated or with low risk potential, under current legislation, may actually impact the environment with actions not yet understood. This study was experimental and conducted at the Environmental Laboratory of the University of the Region of Joinville. It was used Euglena gracilis (primary trophic level) algae exposed to effluents from five sectors of a CAL: Biochemistry, Hematology, Viral Load, Tuberculosis and Immunochemistry. Samples were collected from the siphons attached to the wash sinks of the CAL materials. To verify changes in algae that denote environmental danger, behavioral changes were analyzed via NGTOX, and chlorophyll concentration was calculated by chlorophyll extraction according to Mendel’s method. Viral Load (VL) and Hematology (HT) sectors were the ones that most affected algae (Tukey test). In both sectors, there was inhibition of algae mobility and gravitaxy: in VL, due to the presence of chaotropic agents that denature organic structures;and in HT, due to the change in membrane permeability attributed to methylene blue. Also in HT, there was a search for algae adaptation by increasing the rise to the surface in order to overcome the lower luminosity due to the coloration of the environment, which also affects photosynthesis. Regarding the concentration of a-chlorophyll, the VL and HT were the most affected as well, being the first one the one that had more concentration reduction because of the presence of chaotropic agents. Considering new parameters evaluated, the discarded compounds need to be better evaluated for risk, as they affect algal photosynthesis. Procedures for removal of these compounds should be considered.

Neuroelectrophysiological indexes and clinical characteristics of patients with peroneal muscular atrophy: Retrospective analysis of 24 cases

BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis. Nerve conductive velocity is helpful in the diagnosis of atypical cases. OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG), motor and sensory nerve conduction velocity of patients with PMA. DESIGN: Retrospective case analysis. SETTING: Department of Neurology, Guangzhou First People's Hospital. PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old, admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited. Informed consents were obtained from all the patients. METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed. MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients. RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA. Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ②Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down, especially in 16 patients with typeⅠPMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m/s and 3.1 m/s, respectively. Slowing conduction velocity and muscular strength involvement were disproportionate, i.e. myasthenia was relatively lessened, sensory and motor conduction velocities were greatly decreased. Nerve conduction velocity in distal end of two lower extremities was not detected in 8 patients, but who could still walk. CONCLUSION: ①PMA of patients is characterized by insidious onset and gradually progressive course of disease. Clinical symptom is the base to diagnose PMA. ②Neuroelectrophysiological study is a simple and easy-to-operate means with good reproducibility in diagnosing PMA. Patients with abnormal myasthenia in lower extremity can be detected in the early stage.

A CLINICAL ANALYSIS OF 7878 PATIENTS WITH TUMORS IN THE HEAD AND NECK

7878 patients with tumors in the head and neck were analyzed in a period of twenty years. All the diagnosis were confirmed by pathologic examination. There were 5485 cases (69.62%) of malignant tumors. Nearly an half of malignant tumors were in the nasopharynx (49.32%). Among the malignant tumors of the nasopharynx, 2698 were carcinoma (99.34%) and only 18 (0.66%) sarcoma. Nine of them were under 10 years of age, the youngest patient was 3 years old, and this is rare in our county. The incidence of head and neck tumors was 37.66% and that of the head and neck malignancies was 26.22% of tumors in the whole body. This study indicates that incidence of malignant tumor in head and neck was rather higher, it is worth to improve ths procedure of treatment and prevention.

A study of clinical psychological nursing research hotspots in China and variation trends based on word frequency analysis and visualization analysis

Objective: To analyze clinical psychological nursing research hotspots in China and variation trends in order to provide reference points on the current state of development of clinical psychological nursing and future research hotspots.Method: Clinical psychological nursing research literature sourced from Wanfang Data for the three periods of 2007-2009, 2010-2012, and 2013-2015 were selected as the research sample. A bibliographic co-occurrence analysis system(BICOMB software) was used to perform keyword word frequency analysis and generate a keyword co-occurrence matrix. In addition, Ucinet software's Netdraw tool was used to create visualized network diagrams.Results: A total of 27890 articles were retrieved, and word frequency analysis revealed that the highestfrequency keywords consisted of anxiety, depression, the elderly, expectant women, coronary heart disease, diabetes, breast cancer, perioperative period, quality of life, and psychological intervention.Research hotspot analysis revealed that consistent hotspots comprised anxiety, depression, health education, and perioperative period; expectant women became a hotspot during 2010-2012, and quality of life and efficacy became hotspots during 2013-2015.Conclusions: In addition to the care process, clinical psychological nursing research hotspots in China have increasingly included the effectiveness of psychological nursing and impact on patient quality of life. In addition, research hotspots have been influenced by the incidence of illnesses and people's health consciousness.

Pathologic and Clinical Analysis of Carcinosarcoma of Esophagus (20 Cases)

Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.

A clinical analysis of risk factor with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy

Objective To investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy. Methods The subjects were 82 patients with pN0 esophagea cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005. By using RT-PCR,VEGF C mRNA was detected in tumor issues,and Mucin (MUC1) mRNA was detected in lymph nodes. The Kaplan-Meier method was used to calculate the survival

A clinical analysis of multilocular cystic renal cell carcinoma and its correlation with mutation of the von Hippel-Lindau gene

Objective To discuss the diagnosis and surgical management of multilocular cystic renal cell carcinoma ( MCRCC) and to evaluate the gene function of the mutation of von Hippel-Lindau ( VHL) gene in MCRCC. Methods Seventeen MCRCC cases ( 11 men and

Recurrence in node-negative advanced gastric cancer:Novel findings from an in-depth pathological analysis of prognostic factors from a multicentric series

AIM To analyze the clinicopathological characteristics of patients with both node-negative gastric carcinoma and diagnosis of recurrence during follow-up. METHODS We enrolled 41 patients treated with curative gastrectomy for p T2-4 a N0 gastric carcinoma between 1992 and 2010,who developed recurrence(Group 1). We retrospectively selected this group from the prospectively collected database of 4 centers belonging to the Italian Research Group for Gastric Cancer,and compared them with 437 p T2-4 a N0 patients without recurrence(Group 2). We analyzed lymphatic embolization,microvascular infiltration,perineural infiltration,and immunohistochemical determination of p53,Ki67,and HER2 in Group 1 and in a subgroup of Group 2(Group 2 bis) of 41 cases matched with Group 1 according to demographic and pathological characteristics. RESULTS T4 a stage and diffuse histotype were associated with recurrence in the group of p N0 patients. In-depth pathological analysis of two homogenous groups of p N0 patients,with and without recurrence during longterm follow-up(groups 1 and 2 bis),revealed two striking patterns: lymphatic embolization and perineural infiltration(two parameters that pathologists can easily report),and p53 and Ki67,represent significant factors for recurrence.CONCLUSION The reported pathological features should be considered predictive factors for recurrence and could be useful to stratify node-negative gastric cancer patients for adjuvant treatment and tailored follow-up.

A study on clinical nursing research trends and hotspots based on bibliometric analysis

Objective: This study was conducted to understand the trends and research hotspots of clinical nursing in China and abroad, thereby to provide guidance for nursing practice and studies.Methods: We retrieved clinical nursing literature(excluding literature related to psychological nursing and traditional Chinese medicine nursing) cited in Wanfang Data(www.wanfangdata.com.cn) and PubMed between 2007 and 2015 and subsequently performed bibliometric analyses on article volume,journal, clustering of high-frequency keywords, and co-occurrence of keywords.Results: A total of 10374 publications, excluding those related to psychological nursing, were retrieved via a PubMed search. The literature displayed a rising trend in terms of annual publication volume. The journal distribution of clinical nursing publications overall was consistent with Bradford's Law. The main contents of clinical nursing literature between 2007 and 2009 included:(1) studies on effects of the midwife and midwifery methods for natural childbirth;(2) studies on emergency nursing care;(3)studies on dementia care;(4) studies on bandage dressing in trauma nursing; and(5) studies on quality of life in cancer patients nursing. The main contents of clinical nursing literature between 2010 and 2012 included:(1) studies on obstetric nurse-patient relationships;(2) studies on patients' medical team in stroke nursing;(3) studies on cancer nursing methods;(4) studies on nursing patients with trauma related to urinary incontinence; and(5) studies on the quality of life of caregivers of dementia patients.The main contents of clinical nursing literature between 2013 and 2015 included(1) studies on skin care and bandaging in trauma nursing;(2) studies on evidence-based nursing in AIDS care;(3) studies on nurses' role in obstetric nurse-patient relationships; studies on cancer nursing methods;(4) studies on nursing for Alzheimer's disease and dementia; and(5) studies on caregivers and nursing of stroke patients. A Wanfang Data search retrieved a total of 85570 publications, whose volume also exhibited an annual rising trend, in particular with regard to those in core journals. However, percentage of total publication volume, mean cited frequency per article, and total ranking of clinical nursing publications overall displayed a decreasing trend. The main contents of clinical nursing literature between 2007 and 2009 included:(1) diabetes nursing;(2) nursing for cancer;(3) nursing for senility-related diseases;(4)nursing in the event of complications;(5) nursing for hypertension;(6) studies on quality of life after nursing interventions;(7) chemotherapy nursing;(8) studies on compliance after nursing interventions;(9) constipation nursing; and(10) nursing for stroke patients. The main contents of clinical nursing literature between 2010 and 2012 included:(1) diabetes nursing;(2) nursing for cancer;(3) nursing for senility-related diseases;(4) studies on quality of life after nursing interventions;(5) nursing in the event of complications;(6) nursing for hypertension;(7) prevention nursing;(8) perioperative nursing;(9)pain nursing; and(10) studies on compliance after nursing interventions. The main contents of clinical nursing literature between 2013 and 2015 included:(1) diabetes nursing;(2) nursing in the event of complications;(3) cancer nursing;(4) studies on quality of life after nursing interventions;(5) nursing for stroke patients;(6) nursing for the elderly;(7) studies on compliance after nursing interventions;(8)nursing for hypertension;(9) constipation nursing; and(10) prevention nursing.Conclusions: Clinical nursing research in China is in a rapid development stage as defined by Price's law whereby there is a rapid growth in publication volume. By comparison, clinical nursing research in developed countries is in the stable development stage or maturation phase, which is characterized by a flat curve of publication volume and stable development rate. There is a gap of 25-30 years between China and these countries in terms of the growth phases of clinical nursing literature.

Eye-acupuncture as adjuvant therapy for stroke:A bibliometric analysis of clinical studies

Background:Eye-acupuncture(EA)is a fine-needle acupuncture therapy for systemic diseases.This bibliometric analysis aims to provide a comprehensive review of the characteristics of EA for ischemic or hemorrhagic apoplexy based on clinical studies.Methods:A total of 195 clinical studies from six databases such as CNKI,VIP,Wanfang Data,SinoMed,PubMed and the Cochrane Library from inception to December 31,2017 were included.Bibliometric information mainly including study type,participant characteristics,intervention and comparison details,and outcomes were extracted.Data was analyzed descriptively using SPSS
software to determine their distribution(range,interquartile range)and central tendency(median).Results:The studies covered 108 RCTs,36 controlled clinical trials,45 case series and 6 case reports on EA for treatment of ischemic or hemorrhagic apoplexy,involved 15466 stroke patients.EA was used at different stages of ischemic or hemorrhagic apoplexy:acute stage(n Z 38),recovery(n Z 32),sequela(n Z 13)and unclear(n Z 112).The most frequently used EA acupoints were in the upper-jiao and lower-jiao regions.The commonly used comparisons were EA alone versus traditional acupuncture,or EA plus traditional acupuncture versus traditional acupuncture.Neurological deficit scale,Modified Barthel Index,and activities of daily living were the most frequently used outcome measures.Conclusion:EA as an adjuvant therapy is effective and safe in treating stroke at acute and recovery stages,but high-quality RCTs are lacking.

Concordance between bio-impedance analysis and clinical score in fluid-status assessment of maintenance haemodialysis patients: A single centre experience

BACKGROUND The burden of chronic kidney disease(CKD)is rising rapidly globally.Fluid overload(FO),an independent predictor of mortality in CKD,should be accurately assessed to guide estimation of the volume of fluid to be removed during haemodialysis(HD).Clinical score(CS)and bio-impedance analysis(BIA)have been utilized in assessment of FO and BIA has demonstrated reproducibility and accuracy in determination of fluid status in patients on HD.There is need to determine the performance of locally-developed CSs in fluid status assessment when evaluated against BIA.AIM To assess the hydration status of patients on maintenance HD using BIA and a CS,as well as to evaluate the performance of that CS against BIA in fluid status assessment.METHODS This was a single-centre,hospital-based cross-sectional study which recruited adult patients with CKD who were on maintenance HD at Kenyatta National Hospital.The patients were aged 18 years and above and had been on maintenance HD for at least 3 mo.Those with pacemakers,metallic implants,or bilateral limbs amputations were excluded.Data on the patients’clinical history,physical examination,and chest radiograph findings were collected.BIA was performed on each of the study participants using the Quantum®II bio-impedance analyser manufactured by RJL Systems together with the BC 4®software.In evaluating the performance of the CS,BIA was considered as the gold standard test.A 2-by-2 table of the participants’fluid status at each of the CS values obtained compared to their paired BIA results was constructed(either++,+-,--or-+for FO using the CS and BIA,respectively).The results from this 2-by-2 table were used to compute the sensitivity and specificity of the CS at the various reference points and subsequently plot a receiver operating characteristic(ROC)curve that was used to determine the best cut-off point.Those above and below the best CS cut-off point as determined by the ROC were classified as being positive and negative for FO,respectively.The proportions of participants diagnosed with FO by the CS and BIA,respectively,were computed and summarized in a 2-by-2 contingency table for comparison.McNemar’s chi-squared test was used to assess any statistically significant difference in proportions of patients diagnosed as having FO by CS and BIA.Logistic regression analysis was conducted to assess whether the variables for the duration of dialysis,the number of missed dialysis sessions,advisement by health care professional on fluid or salt intake,actual fluid intake,the number of anti-hypertensives used,or body mass index were associated with a patient’s odds of having FO as diagnosed by BIA.RESULTS From 100 patients on maintenance HD screened for eligibility,80 were recruited into this study.Seventy-one(88.75%)patients were fluid overloaded when evaluated using BIA with mean extracellular volume of 3.02±1.79 L as opposed to the forty-seven(58.25%)patients who had FO when evaluated using the CS.The difference was significant,with a P value of<0.0001(95%confidence interval:0.1758-0.4242).Using CS,values above 4 were indicative of FO while values less than or equal to 4 denoted the best cut-off for no FO.The sensitivity and specificity for the CS were 63%and 78%respectively.None of the factors evaluated for association with FO showed statistical significance on the multivariable logistic regression model.CONCLUSION FO is very prevalent in patients on chronic HD at the Kenyatta National Hospital.CS detects FO less frequently when compared with BIA.The sensitivity and specificity for the CS were 63%and 78%respectively.None of the factors evaluated for association with FO showed statistical significance on the multivariable logistic regression model.

Bioartificial liver support systems for acute liver failure: A systematic review and meta-analysis of the clinical and preclinical literature

BACKGROUND Acute liver failure(ALF) has a high mortality varying from 80% to 85% with rapid progress in multi-organ system failure. Bioartificial liver(BAL) support systems have the potential to provide temporary support to bridge patients with ALF to liver transplantation or spontaneous recovery. In the past decades, several BAL support systems have been conducted in clinical trials. More recently,concerns have been raised on the renovation of high-quality cell sources and configuration of BAL support systems to provide more benefits to ALF models in preclinical experiments.AIM To investigate the characteristics of studies about BAL support systems for ALF,and to evaluate their effects on mortality.METHODS Eligible clinical trials and preclinical experiments on large animals were identified on Cochrane Library, PubMed, and EMbase up to March 6, 2019. Two reviewers independently extracted the necessary information, including key BAL indicators, survival and indicating outcomes, and adverse events during treatment. Descriptive analysis was used to identify the characteristics of the included studies, and a meta-analysis including only randomized controlled trial (RCT) studies was done to calculate the overall effect of BAL on mortality among humans and large animals, respectively.RESULTS Of the 30 selected studies, 18 were clinical trials and 12 were preclinical experiments. The meta-analysis result suggested that BAL might reduce mortality in ALF in large animals, probably due to the recent improvement of BAL, including the type, cell source, cell mass, and bioreactor, but seemed ineffective for humans (BAL vs control: relative risk(95% confidence interval),0.27(0.12-0.62) for animals and 0.72(0.48-1.08) for humans)Liver and renal functions, hematologic and coagulative parameters, encephalopathy index, and neurological indicators seemed to improve after BAL, with neither meaningful adverse events nor porcine endogenous retrovirus infection.CONCLUSION BAL may reduce the mortality of ALF by bridging the gap between preclinical experiments and clinical trials. Clinical trials using improved BAL must be designed scientifically and conducted in the future to provide evidence for transformation.