Effects of mesenchymal stem cell on dopaminergic neurons,motor and memory functions in animal models of Parkinson's disease:a systematic review and meta-analysis

Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols.

Interplay between mesenchymal stromal cells and the immune system after transplantation: implications for advanced cell therapy in the retina

Advanced mesenchymal stromal cell-based therapies for neurodegenerative diseases are widely investigated in preclinical models.Mesenchymal stromal cells are well positioned as therapeutics because they address the underlying mechanisms of neurodegeneration,namely trophic factor deprivation and neuroinflammation.Most studies have focused on the beneficial effects of mesenchymal stromal cell transplantation on neuronal survival or functional improvement.However,little attention has been paid to the interaction between mesenchymal stromal cells and the host immune system due to the immunomodulatory properties of mesenchymal stromal cells and the long-held belief of the immunoprivileged status of the central nervous system.Here,we review the crosstalk between mesenchymal stromal cells and the immune system in general and in the context of the central nervous system,focusing on recent work in the retina and the importance of the type of transplantation.

Validation and performance of three scoring systems for predicting primary non-function and early allograft failure after liver transplantation

Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.

Use of machine learning models for the prognostication of liver transplantation: A systematic review

BACKGROUND Liver transplantation(LT)is a life-saving intervention for patients with end-stage liver disease.However,the equitable allocation of scarce donor organs remains a formidable challenge.Prognostic tools are pivotal in identifying the most suitable transplant candidates.Traditionally,scoring systems like the model for end-stage liver disease have been instrumental in this process.Nevertheless,the landscape of prognostication is undergoing a transformation with the integration of machine learning(ML)and artificial intelligence models.AIM To assess the utility of ML models in prognostication for LT,comparing their performance and reliability to established traditional scoring systems.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines,we conducted a thorough and standardized literature search using the PubMed/MEDLINE database.Our search imposed no restrictions on publication year,age,or gender.Exclusion criteria encompassed non-English studies,review articles,case reports,conference papers,studies with missing data,or those exhibiting evident methodological flaws.RESULTS Our search yielded a total of 64 articles,with 23 meeting the inclusion criteria.Among the selected studies,60.8%originated from the United States and China combined.Only one pediatric study met the criteria.Notably,91%of the studies were published within the past five years.ML models consistently demonstrated satisfactory to excellent area under the receiver operating characteristic curve values(ranging from 0.6 to 1)across all studies,surpassing the performance of traditional scoring systems.Random forest exhibited superior predictive capabilities for 90-d mortality following LT,sepsis,and acute kidney injury(AKI).In contrast,gradient boosting excelled in predicting the risk of graft-versus-host disease,pneumonia,and AKI.CONCLUSION This study underscores the potential of ML models in guiding decisions related to allograft allocation and LT,marking a significant evolution in the field of prognostication.

Efficacy and safety of fecal microbiota transplantation for treatment of ulcerative colitis:A post-consensus systematic review and metaanalysis

BACKGROUND Numerous studies have assessed the efficacy and safety of fecal microbiota transplantation(FMT)as a therapy for ulcerative colitis(UC).However,the treatment processes and outcomes of these studies vary.AIM To evaluate the efficacy and safety of FMT for treating UC by conducting a systematic meta-analysis.METHODS The inclusion criteria involved reports of adult patients with UC treated with FMT,while studies that did not report clinical outcomes or that included patients with infection were excluded.Clinical remission(CR)and endoscopic remission(ER)were the primary and secondary outcomes,respectively.RESULTS We included nine studies retrieved from five electronic databases.The FMT group had better CR than the control group[relative risk(RR)=1.53;95%confidence interval(CI):1.19-1.94;P<0.0008].ER was statistically significantly different between the two groups(RR=2.80;95%CI:1.93-4.05;P<0.00001).Adverse events did not differ significantly between the two groups.CONCLUSION FMT demonstrates favorable performance and safety;however,well-designed randomized clinical trials are still needed before the widespread use of FMT can be recommended.Furthermore,standardizing the FMT process is urgently needed for improved safety and efficacy.

Correlation Analysis between Well-cellar Early Transplanting of Robust Seedlings and Diseases in Shiyan Tobacco-growing Area

[Objectives]The paper was to investigate the relationship between the well-cellar early transplanting of robust seedlings and the prevalence of diseases in the Shiyan tobacco-growing area.[Methods]The relationship between disease occurrence and meteorological factors during the field growth period was examined by analyzing the prevalence of flue-cured tobacco virus diseases,brown spot,and total disease in the Shiyan tobacco-growing area before(2013-2017)and after(2018-2022)the well-cellar early transplanting of robust tobacco seedlings.[Results]The implementation of a well-cellar early transplanting technique of robust seedlings resulted in a reduction in the average incidence of tobacco virus disease,brown spot,and total disease by 0.83%,8.85%,and 7.91%,respectively,in comparison to the incidence observed prior to early transplanting.These findings suggest that early transplanting can significantly reduce the incidence of flue-cured tobacco diseases.Prior to the well-cellar early transplanting of robust tobacco seedlings,there was a significant(including highly significant)positive correlation between the incidence of brown spot and total disease and precipitation in August and September.The incidence of brown spot and total disease in tobacco plants was found to be significantly positively correlated with May precipitation and significantly negatively correlated with May sunshine hours following the well-cellar early transplanting of robust seedlings.The advancement of the transplanting period by 20 d resulted in a reduction in the growing period of tobacco plants in the field under autumn rains(late August to November)in western China.This effectively circumvented the suitable conditions for disease occurrence and can reduce the incidence of disease.[Conclusions]This study offers a framework for enhancing the quality and efficiency of flue-cured tobacco production in the northwest tobacco-growing area of Hubei.

Palliative care for end-stage liver disease and acute on chronic liver failure:A systematic review

BACKGROUND End stage liver disease(ESLD)represents a growing health concern characterized by elevated morbidity and mortality,particularly among individual ineligible for liver transplantation.The demand for palliative care(PC)is pronounced in patients grappling with ESLD and acute on chronic liver failure(ACLF).Unfortunately,the historical underutilization of PC in ESLD patients,despite their substantial needs and those of their family caregivers,underscores the imperative of seamlessly integrating PC principles into routine healthcare practices across the entire disease spectrum.AIM To comprehensively investigate the evidence surrounding the benefits of incorporating PC into the comprehensive care plan for individuals confronting ESLD and/or ACLF.METHODS A systematic search in the Medline(PubMed)database was performed using a predetermined search command,encompassing studies published in English without any restrictions on the publication date.Subsequently,the retrieved studies were manually examined.Simple descriptive analyses were employed to summarize the results.RESULTS The search strategies yielded 721 references.Following the final analysis,32 fulllength references met the inclusion criteria and were consequently incorporated into the study.Meticulous data extraction from these 32 studies was undertaken,leading to the execution of a comprehensive narrative systematic review.The review found that PC provides significant benefits,reducing symptom burden,depressive symptoms,readmission rates,and hospital stays.Yet,barriers like the appeal of transplants and misconceptions about PC hinder optimal utilization.Integrating PC early,upon the diagnosis of ESLD and ACLF,regardless of transplant eligibility and availability,improves the quality of life for these patients.CONCLUSION Despite the substantial suffering and poor prognosis associated with ESLD and ACLF,where liver transplantation stands as the only curative treatment,albeit largely inaccessible,PC services have been overtly provided too late in the course of the illness.A comprehensive understanding of PC's pivotal role in treating ESLD and ACLF is crucial for overcoming these barriers,involving healthcare providers,patients,and caregivers.

Study on Sowing Date for Mechanicaltransplanting Rice under Wheat-Rice Cropping System in Chengdu Basin

Nurturing sturdy mechanical-transplanting seedlings is the key to achieve high yield using mechanical-transplanting technology under wheat-rice cropping conditions in Chengdu Basin. In this study, super hybrid rice II You 602 was adopted as experimental material, to investigate the effects of sowing date on seedling growth,transplanting quality, growth process and yield of mechanical-transplanting seedlings in wheat-rice cropping region of Chengdu Basin, thus exploring supporting high-yield cultivation techniques for mechanical-transplanting technology in Chengdu Basin, Results showed that the appropriate sowing date for mechanical transplanting in wheatrice cropping region of Chengdu Basin was April 10-15, and the appropriate seedling age was 45-50 d, which led to the highest yield of mechanical-transplanting seedlings. Although postponing sowing was conducive to improving transplanting quality and increasing the percentage of earbearing tillers, it would result in lagged group growth, poor spike quality and reduced effective number of panicles, grain number, seed-setting rate, 1 000-seed weight and other yield components, thus declining the yield. Yield reduction rate would be above 10% with sowing date postponed by 15 d.

Design and experiment of intelligent sorting and transplanting system for healthy vegetable seedlings

Healthy vegetable seedlings are surviving seedlings with good biological characteristics.Selective planting of healthy seedlings in the mechanized transplanting process can effectively avoid the reduction in yield caused by missed planting.Aiming at the current transplanting machinery that cannot achieve the selective planting of healthy seedlings,a healthy seedling intelligent sorting and transplanting system was proposed.The system consisted of a seedling delivery mechanism,sorting mechanism,photoelectric sensor,image sensor,PLC control system,and computer control system.It can realize automatic transmission of seedling trays,automatically identify the information of healthy seedlings in the trays and selectively transplant them.Also it can reduce the missed planting rate caused by the poor quality of plug seedlings after planting and the lack of seedlings in the hole.A sorting test of plug seedlings was carried out for the age-appropriate pepper plug seedlings cultivated in the factory.The results showed that the system had an average recognition accuracy rate of 89.14%and an average sorting success rate of 93.20%in the process of sorting suitable age pepper plug seedlings.The whole system can identify,sort and transplant the plug seedlings of appropriate age according to healthy information,and effectively avoid missing planting.This research can provide technical support for the intelligent upgrade of transplanting equipment.

Development of embedded automatic transplanting system in seedling transplanters for precision agriculture

Hand transplanting of vegetable seedlings is always been a time consuming and labourious activity which often leads to muscular fatigue.Use of hitech instrumentation increased to achieve precision and automation in agricultural operations.At present the transplanting is done manually which accounts for large amount of hand labour and time.To ensure precision and timeliness in operation,an automatic transplanting based on embedded systemfor use in seedling transplanters was developed.The developed systemconsists of feed roller,pro-tray belt,a pair of L-shaped rotating fingers,embedded system,DC and stepper motor.The plug seedlings were released into the furrow with use of developed embedded system by actuating DC as well as stepper motor.The performances of the developed system was tested rigorously at four different operating speeds(1.0,1.5,2.0 and 2.5 km/h)and three angles of pro-tray feed roller(00,300,450)for attaining optimum plant to plant spacing in soil bin.The result indicated that percent transplanting and plant to plant spacing was found optimum at 2.0 km/h forward speed and 300 angle of pro-tray feed roller.The average plant spacing,transplanting efficiency,furrow closer,angle of inclination and miss planting were 600 mm,91.7%,90.3%,18.30 and 2.1%,respectively.The developed system ensures the precision by sigulating the placement of seedlings at optimumspacing for sustainable agriculture production.It also enabled the optimumtransplanting rate,the ability to transplant at higher speeds and maintaining proper plant to plant spacing.

Mechanized Transplanting of Rice(Oryza sativa L.)in Nonpuddled and No-Till Conditions in the Rice-Wheat Cropping System in Haryana,India

The common practice of establishing rice in the rice-wheat system in India is manual transplanting of seedlings in the puddled soil. Besides being costly, cumbersome, and time consuming, puddling results in degradation of soil and the formation of a hard pan, which impedes root growth of subsequent upland crops. In addition, decreased availability and increasing cost of labor have increased the cost of rice cultivation through conventional methods. Because of these concerns, there is a need for mechanized transplanting of rice which is less labor-intensive and can ensure optimum plant population under nonpuddled and/or no-till conditions. A large number of on-farm trials were conducted at farmers’ fields in Haryana, India, from 2006 to 2010 to evaluate the performance of the mechanical transplanted rice (MTR) under nonpuddled and no-till situations as compared to conventional puddled transplant rice (CPTR). Compared with CPTR, nonpuddled MTR produced 3%-11% higher grain yield in different years. Rice cultivars, viz. HKR47, HKR127, PR113, PR114, PB1, PB1121, CSR30, and Arize6129, performed consistently better under nonpuddled MTR as compared to CPTR. Performance of different cultivars (PR113, PR114, HKR47, and Pusa 44) was also better under no-till MTR as compared to CPTR. The “basmati” cultivar CSR30 performed equally in no-till MTR and CPTR systems. The results of our study suggest that rice can be easily grown under nonpuddled and no-till conditions with yield advantages over the CPTR system. Even in the case of similar yield between CPTR and MTR systems, the MTR system will help in reducing labor requirement and ultimately, will increase overall profits to farmers.

Fecal microbiota transplantation for the treatment of irritable bowel syndrome:A systematic review and meta-analysis

BACKGROUND Irritable bowel syndrome(IBS)is the most prevalent gastrointestinal disorder in developed countries and reduces patients’quality of life,hinders their ability to work,and increases health care costs.A growing number of trials have demonstrated an aberrant gut microbiota composition in IBS,also known as‘gut dysbiosis’.Fecal microbiota transplantation(FMT)has been suggested as a treatment for IBS.AIM To assess the efficacy and safety of FMT for the treatment of IBS.METHODS We searched Cochrane Central,MEDLINE,EMBASE and Web of Science up to 24 October 2022 for randomised controlled trials(RCTs)investigating the effectiveness of FMT compared to placebo(including autologous FMT)in treating IBS.The primary outcome was the number of patients with improvements of symptoms measured using a validated,global IBS symptoms score.Secondary outcomes were changes in quality-of-life scores,non-serious and serious adverse events.Risk ratios(RR)and corresponding 95%CI were calculated for dichotomous outcomes,as were the mean differences(MD)and 95%CI for continuous outcomes.The Cochrane risk of bias tool was used to assess the quality of the trials.GRADE criteria were used to assess the overall quality of the evidence.RESULTS Eight RCTs(484 participants)were included in the review.FMT resulted in no significant benefit in IBS symptoms three months after treatment compared to placebo(RR 1.19,95%CI:0.68-2.10).Adverse events were reported in 97 participants in the FMT group and in 45 participants in the placebo group(RR 1.17,95%CI:0.63-2.15).One serious adverse event occurred in the FMT group and two in the placebo group(RR 0.42,95%CI:0.07-2.60).Endoscopic FMT delivery resulted in a significant improvement in symptoms,while capsules did not.FMT did not improve the quality of life of IBS patients but,instead,appeared to reduce it,albeit non significantly(MD-6.30,95%CI:-13.39-0.79).The overall quality of the evidence was low due to moderate-high inconsistency,the small number of patients in the studies,and imprecision.CONCLUSION We found insufficient evidence to support or refute the use of FMT for IBS.Larger trials are needed.

Corrected QT interval in cirrhosis:A systematic review and metaanalysis

BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the disease.However,the effects of sex,age,severity,and etiology of cirrhosis on QTc have not been elucidated.At the same time,the role of treatment,acute illness,and liver transplantation(Tx)remains largely unknown.AIM To determine the mean QTc in patients with cirrhosis,assess whether QTc is prolonged in patients with cirrhosis,and investigate whether QTc is affected by factors such as sex,age,severity,etiology,treatment,acute illness,and liver Tx.METHODS In the present systematic review and meta-analysis,the searching protocol“{[QTc]OR[QT interval]OR[QT-interval]OR[Q-T syndrome]}AND{[cirrhosis]OR[Child-Pugh]OR[MELD]}”was applied in PubMed,EMBASE,and Google Scholar databases to identify studies that reported QTc in patients with cirrhosis and published after 1998.Seventy-three studies were considered eligible.Data concerning first author,year of publication,type of study,method used,sample size,mean age,female ratio,alcoholic etiology of cirrhosis ratio,Child-Pugh A/B/C ratio,mean model for end-stage liver disease(MELD)score,treatment withβ-blockers,episode of acute gastrointestinal bleeding,formula for QT correction,mean pulse rate,QTc in patients with cirrhosis and controls,and QTc according to etiology of cirrhosis,sex,Child-Pugh stage,MELD score,and liver Tx status(pre-Tx/post-Tx)were retrieved.The Newcastle-Ottawa quality assessment scale appraised the quality of the eligible studies.Effect estimates,expressed as proportions or standardized mean differences,were combined using the randomeffects,generic inverse variance method of DerSimonian and Laird.Subgroup,sensitivity analysis,and meta-regressions were applied to assess heterogeneity.RESULTS QTc combined mean in patients with cirrhosis was 444.8 ms[95%confidence interval(CI):440.4-449.2;P<0.001 when compared with the upper normal limit of 440 ms],presenting high heterogeneity(I2=97.5%;95%CI:97.2%-97.8%);both Egger’s and Begg’s tests showed non-significance.QTc was elongated in patients with cirrhosis compared with controls(P<0.001).QTc was longer in patients with Child-Pugh C cirrhosis when compared with Child-Pugh B and A(P<0.001);Child-Pugh B patients presented longer QTc when compared with Child-Pugh A patients(P=0.003).The MELD score was higher in patients with cirrhosis with QTc>440 ms when compared with QTc≤440 ms(P<0.001).No correlation of QTc with age(P=0.693),sex(P=0.753),or etiology(P=0.418)was detected.β-blockers shortened QTc(P<0.001).QTc was prolonged during acute gastrointestinal bleeding(P=0.020).Tx tended to improve QTc(P<0.001).No other sources of QTc heterogeneity were revealed.CONCLUSION QTc is prolonged in cirrhosis independently of sex,age,and etiology but is correlated with severity and affected byβ-blockers and acute gastrointestinal bleeding.QTc is improved after liver Tx.

Influence of Transplanting Age on Paddy Yield under the System of Rice Intensification

Agronomic practices such as transplanting age, plant spacing, and water application regimes in irrigated paddy production can have a significant impact towards the performance in rice growth and yield. A study was conducted to investigate the optimum transplanting age for maximum rice productivity under the systems of rice intensification (SRI) technology. The study treatments adopted were three representing 8, 12 and 15 days old seedlings replicated 3 times each. The experiment was set in randomized complete block design (RCBD) and transplanted at spacing 25 cm × 25 cm between rice hills. The rice variety tested was TXD 306 Super SARO, which was recommended by the ministry of Agriculture in Tanzania. Data was collected throughout the growing season in two mixed short rains and dry season of September 2013/2014 and September 2014/2015. Data collected included biomass at vegetative, flowering and harvesting stages, total number of tillers per hill, number of productive tillers per hill, number of grains per panicle and rice grain yield at the end of the season. Data was analyzed using SAS software version 9.1. The results suggested that transplanting at younger age of 8 to 12 days was recommended for Mkindo area in Mvomero Distirct, and other areas with similar soil conditions and agro ecological characteristics.

Donor-Derived Transmission of Scedosporiosis in Kidney Transplant Recipients from a Systemic lupus erythematosus donor

Donor-derived infection(DDI)associated with Scedosporium spp is extremely rare,and results in a very poor prognosis.The present study reports a probable DDI due to Scedosporium boydii(S.boydii)from a donor with neuropsychiatric systemic lupus erythematosus.Two recipients developed Scedosporiosis after kidney transplantation from the same donor.Recipient 1 died of central nervous system infection due to S.boydii based on the clinical presentations,and the positive metagenomic next-generation sequencing(mNGS)and culture results for the cerebrospinal fluid.The other recipient with urinary tract obstruction due to S.boydii,which was identified through the positive culture and mNGS results of the removed stents,was successfully treated by stent replacement and voriconazole administration.Undiagnosed disseminated donor infection and the transmission of S.boydii should be given attention,particularly when the donor and recipients have primary immunodeficiency disease.The screening of donors and recipients for S.boydii using mNGS may be helpful in guiding antifungal prophylaxis and treatment recipients,due to its higher sensitivity and shorter diagnostic time relative to other traditional techniques.

Study on a Bowl-based Mechanism for Transplanting Potted Strawberry Seedlings

To improve the efficiency of fetching and transplanting seedlings for the mechanization of strawberry planting,an integrated transplanting mechanism was designed with protruding,fetching and planting performance to achieve rapid fetching and pushing bowl movements.According to the working principle of the slewing mechanism,a kinematics model and the optimization goal were established,respectively.Based on visual auxiliary analysis software,optimal parameters were obtained.A three-dimensional model was established to obtain a simulation trajectory by means of a virtual simulation design analysis.Three-dimensional printing technology was used to manufacture the test prototype,and the actual working trajectories of the test prototype were extracted using high-speed photography technology,which verified the consistency of the actual trajectory with the theoretical and simulated trajectories.A prototype transplanting experiment was performed with the success rate of seedling extraction of 91.2%and excellent planting rate of 82.8%,which met the requirements for integrated strawberry harvesting,planting and transplanting.The experimental results verified the correctness and feasibility of the design of integrated transplanting mechanism.

Outcome of split liver transplantation vs living donor liver transplantation:A systematic review and meta-analysis

BACKGROUND The outcomes of liver transplantation(LT)from different grafts have been studied individually and in combination,but the reports were conflicting with some researchers finding no difference in both short-term and long-term outcomes between the deceased donor split LT(DD-SLT)and living donor LT(LDLT).AIM To compare the outcomes of DD-SLT and LDLT we performed this systematic review and meta-analysis.METHODS This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.The following databases were searched for articles comparing outcomes of DD-SLT and LDLT:PubMed;Google Scholar;Embase;Cochrane Central Register of Controlled Trials;the Cochrane Database of Systematic Reviews;and Reference Citation Analysis(https://www.referencecitationanalysis.com/).The search terms used were:“liver transplantation;”“liver transplant;”“split liver transplant;”“living donor liver transplant;”“partial liver transplant;”“partial liver graft;”“ex vivo splitting;”and“in vivo splitting.”RESULTS Ten studies were included for the data synthesis and meta-analysis.There were a total of 4836 patients.The overall survival rate at 1 year,3 years and 5 years was superior in patients that received LDLT compared to DD-SLT.At 1 year,the hazard ratios was 1.44(95%confidence interval:1.16-1.78;P=0.001).The graft survival rate at 3 years and 5 years was superior in the LDLT group(3 year hazard ratio:1.28;95%confidence interval:1.01-1.63;P=0.04).CONCLUSION This meta-analysis showed that LDLT has better graft survival and overall survival when compared to DD-SLT.

Exercise training as an intervention for frailty in cirrhotic patients on the liver transplant waiting list:A systematic review

BACKGROUND The existing literature suggests that exercise for cirrhotic patients is safe and favours significant improvement to their physical capacity.However,exercise training for this population and how to deliver activities,especially in severe stages of the disease and while waiting for a liver transplant(LT),remain undefined.AIM To review the existing exercise prescriptions for cirrhotic patients on the waiting list for LT,their results for frailty evolution and their effect on clinical outcomes.METHODS A systematic review was performed following the Preferred Reporting Review and Meta-Analysis guidelines and searching the PubMed,MEDLINE,and Scopus databases.The keyword“liver transplant”was used in combination with the free terms“frailty”and“exercise”for the literature review.Clinical studies that evaluated the effect of a regular training program,independent of supervision or the duration or intensity of physical exercise,in cirrhotic patients on the waiting list for LT were reviewed.The data on safe physical activity prescriptions following Frequency,Intensity,Time,and Type recommendations were extracted and summarised.RESULTS Nine articles met the inclusion criteria for this review.Various instruments for frailty assessment were used,frequently in combination.Five studies prescribed physical activity for patients,one in-person and four to be performed remotely and unsupervised.The remaining four studies only used a self-report instrument to assess the level of physical activity.None reported adverse events related to exercise training.The exercise frequency mainly varied from daily to a minimum of twice per week.The intensity depended on frailty and included increasing levels of activity.The type of exercise was predominantly a combination of aerobic and resistance training.The duration of exercise varied from 4 to 12 wk.Three articles evaluated the effect of the exercise program on clinical outcomes,reporting a reduction in 90-d readmission rates post-transplant and improved frailty scores,as well as improved survival of cirrhotic patients waiting for LT.CONCLUSION Routine frailty assessment is essential for this population.Although more robust evidence is required,the prescription of exercise is safe and can improve patients’functional capacity,improving pre-and post-LT outcomes.

Hepatic ischemia-reperfusion syndrome and its effect on the cardiovascular system: The role of treprostinil, a synthetic prostacyclin analog

Hepatic ischemia-reperfusion syndrome has been the subject of intensive study and experimentation in recent decades since it is responsible for the outcome of several clinical entities,such as major hepatic resections and liver transplantation.In addition to the organ’s post reperfusion injury,this syndrome appears to play a central role in the dysfunction of distant tissues and systems.Thus,continuous research should be directed toward finding effective therapeutic options to improve the outcome and reduce the postoperative morbidity and mortality rates.Treprostinil is a synthetic analog of prostaglandin I2,and its experimental administration has shown encouraging results.It has already been approved by the Food and Drug Administration in the United States for pulmonary arterial hypertension and has been used in liver transplantation,where preliminary encouraging results showed its safety and feasibility by using continuous intravenous administration at a dose of 5 ng/kg/min.Treprostinil improves renal and hepatic function,diminishes hepatic oxidative stress and lipid peroxidation,reduces hepatictoll-like receptor 9 and inflammation,inhibits hepatic apoptosis and restores hepatic adenosine triphosphate(ATP)levels and ATP synthases,which is necessary for functional maintenance of mitochondria.Treprostinil exhibits vasodilatory properties and antiplatelet activity and regulates proinflam-matory cytokines;therefore,it can potentially minimize ischemia-reperfusion injury.Additionally,it may have beneficial effects on cardiovascular parameters,and much current research interest is concentrated on this compound.

Primary cutaneous anaplastic large cell lymphoma with overexpressed Ki-67 transitioning into systemic anaplastic large cell lymphoma:A case report

BACKGROUND Primary cutaneous anaplastic large cell lymphoma(PC-ALCL)differs from systemic anaplastic large cell lymphoma(sALCL)in cell biological behavior,clinical features,treatment,and outcome.PC-ALCL has been reported to rarely transition into sALCL,but the underlying mechanism is not clear.Here we report such a case with certain characteristics that shed light on this.CASE SUMMARY Herein,we report a 43-year-old male with symptoms of a skin nodule and histologically confirmed PC-ALCL with high expression of Ki-67.After three months of observation,two skin nodules re-appeared with muscle layer involvement and was histologically confirmed as sALCL.Seventeen months after receiving six cycles of CHOP regimen,the patient had pain in the chest and back,cough,shortness of breath,and night sweats.This was confirmed as relapse of sALCL by immunohistochemistry and several organs,such as the lung were involved as shown by positron emission tomography/computed tomography.After four cycles of DICE plus chidamide regimens followed by auto-hematopoietic stem cell transplantation(ASCT),complete remission(CR)duration was achieved for twelve months while the patient was on maintenance with chidamide(20 mg)pills.CONCLUSION This case had significantly high expression of Ki-67 when diagnosed as PC-ALCL initially and then transitioned into sALCL,which is rare.Auto-ASCT combined with demethylation drugs effectively maintained CR and prolonged progression free survival.