Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome

Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are an increasingly recognized and growing population and include various groups, such as undiagnosed cases in childhood and palliated and/or corrected cases, which require subsequent care because of residual lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions. In addition, these patients are prone to developing pathologies that are typical of adulthood with a generally increased risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart disease, which makes them candidates for ECMO. These patients represent an additional challenge in this therapy because malformations and the presence of a shunt can generally affect the usual cannulation methods and hemodynamic and oximetry monitoring. Thus, the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method, venopulmonary artery ECMO, which provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in patients with congenital heart diseases.

Addressing Japan’s disposal of nuclear-contaminated water from the perspective of international human rights law

The discharge of nuclear-contaminated water containing radionuclides into the ocean by Japan will lead to its integration into the entire ecosystem through processes of circulation and biomagnification,eventually entering the human body via the food chain.This poses a substantial risk of irreversible damage to both the ecosystem and human health,a situation that will worsen with the ongoing discharge of such water.The respect and protection of human rights represent an international consensus,and safeguarding fundamental human rights is a substantial obligation that states must undertake in accordance with both international and domestic law.Since the Fukushima nuclear disaster,Japan has continuously violated its international legal obligations to protect human rights in several areas,including the resettlement of disaster victims,the reduction of nuclear radiation levels,and the handling of contaminated water.Such actions have compromised and will continue to compromise the basic human rights of not only its citizens but also those of people worldwide,including environmental rights,the right to life,development rights,and food rights.In the aftermath of the Fukushima meltdown,the public and workers involved in handling nuclear contaminants have been continually exposed to high radiation levels,endangering their rights to life,development,and health.Japan’s inadequate efforts in victim resettlement and environmental restoration have jeopardized the environmental and food rights of its citizens to live healthily and access food in an environment unaffected by nuclear radiation.The release of nuclear-contaminated water poses a risk of Japan’s nuclear pollution to the people of neighboring countries and the global population at large.The principle of human rights underpins the theory of a community with a shared future for humanity,and human rights are a crucial area of China’s active participation in United Nations affairs and global governance.By voicing concerns over Japan’s potential human rights violations globally,China demonstrates its role as a responsible major country.In response to Japan’s breach of legal obligations and human rights violations,China can adopt a reasoned and beneficial approach,including calling on the international community to hold Japan criminally accountable for crimes against humanity under the Rome Statute and advancing scholarly discussions on ecocide and crimes against the marine environment.Furthermore,China should persist in seeking advisory opinions from the International Court of Justice and strive for substantive accountability,utilizing the mechanisms of international human rights organizations to make its voice heard.

Expression of cyclin-dependent kinase 9 is positively correlated with the autophagy level in colon cancer

BACKGROUND Cyclin-dependent kinase 9(CDK9)expression and autophagy in colorectal cancer(CRC)tissues has not been widely studied.CDK9,a key regulator of transcription,may influence the occurrence and progression of CRC.The expression of auto-phagy-related genes BECN1 and drug resistance factor ABCG2 may also play a role in CRC.Under normal physiological conditions,autophagy can inhibit tumorigenesis,but once a tumor forms,autophagy may promote tumor growth.Therefore,understanding the relationship between autophagy and cancer,partic-ularly how autophagy promotes tumor growth after its formation,is a key motivation for this research.AIM To investigate the relationship between CDK9 expression and autophagy in CRC,assess differences in autophagy between left and right colon cancer,and analyze the associations of autophagy-related genes with clinical features and prognosis.METHODS We collected tumor tissues and paracarcinoma tissues from colon cancer patients with liver metastasis to observe the level of autophagy in tissues with high levels of CDK9 and low levels of CDK9.We also collected primary tissue from left and right colon cancer patients with liver metastasis to compare the autophagy levels and the expression of BECN1 and ABCG2 in the tumor and paracarcinoma tissues.RESULTS The incidence of autophagy and the expression of BECN1 and ABCG2 were different in left and right colon cancer,and autophagy might be involved in the occurrence of chemotherapy resistance.Further analysis of the rela-tionship between the expression of autophagy-related genes CDK9,ABCG2,and BECN1 and the clinical features and prognosis of colorectal cancer showed that the high expression of CDK9 indicated a poor prognosis in colorectal cancer.CONCLUSION This study laid the foundation for further research on the combination of CDK9 inhibitors and autophagy inhibitors in the treatment of patients with CRC.

The Historical Position and Value Dimensions of Human Rights Civilization

Human beings are the mainstay and the ultimate goal of civilization.The history of human civilization is a continuous struggle to realize the respect,liberation,protection,and development of humanity.Human rights are an achievement of humanity and a symbol of progress,and the human rights civilization is an important component of human civilization.Understanding and interpreting human rights from the perspective of human rights civilization means that human rights are not only a concept or an idea but also a grand historical and long-term social practice.Up to now,the development of human rights civilization has roughly experienced four awakening eras:initialization,revolution,popularization,and globalization.In terms of its value dimensions,it has the characteristics of progressiveness,diversity,commonality,inclusiveness,indivisibility,openness,and so on.The historical position of human rights civilization and the development of its value dimensions have shown to the world that human rights are the common wealth of humanity,and human rights belong to all mankind;human rights are historical,concrete,and developmental;the concept of human rights is constantly evolving,and its connotations and categories are constantly expanding;achieving the free and well-rounded development of every person is the highest value realm of human rights civilization.The Chinese modernization endows Chinese civilization with modern strength and opens up new horizons for human rights civilization.The new pattern of human rights civilization to be created by Chinese modernization not only possesses the common characteristics of human rights civilization but also enjoys Chinese characteristics based on its own national conditions,enriching and developing the diversity of human rights civilization for all mankind.

Understanding the Human Rights of Modern Individuals—Revisiting Habermas’s Dual Critique and the Reconstruction of Intersubjectivity

Human rights are not only pivotal in depicting the relationship between individuals and communities but also a focal point of political philosophical concerns oriented towards reality. The inseparability of human rights from individual self-identity reveals a contradiction between practicality and historicity in understanding individuals, as highlighted in the debate between liberalism and communitarianism. In order to reconcile this contradiction, Habermas,drawing from German classical philosophy, examines practicality and historicity separately: while Fichte intertwines objectivity in self-identity, revealing the practicality of individuals but neglecting their real elements, Hegel interprets self-identity under the concept of unity,examining individuals from a historical dimension but letting rational rules dominate reality. Ultimately, Habermas reconstructs the process of modern individual self-identity from the theory of communicative action by critiquing the shackles of subjective philosophy. He not only reconciles the divergence between practicality and historicity in self-identity, but also elucidates the intersubjective core inherent in human rights.

Comparative Analysis and Legal Reflection on the Boundaries of Human Rights Due Diligence in the Supply Chain

As global supply chains become increasingly lengthy and complex, human rights due diligence in the supply chain is becoming a controversial focal point in the accountability of multinational corporations. In recent years, legislative practices in the field of human rights due diligence have shown a trend from voluntary soft law toward mandatory hard law, and from corporate due diligence for their own operations towards extended due diligence for the entire supply chain. However, there is a divergence in national practices regarding the extent to which human rights due diligence should extend along the supply chain and the manner in which it should be incorporated into domestic legal policies. International soft law interpretations surrounding the boundaries of human rights due diligence in the supply chain are decentralized, posing risks of interpretation diversification, boundary blurring, and procedural formalization, as well as risks of misinterpretation and misuse. Meanwhile, some countries and regions are vigorously promoting mandatory legislation on human rights due diligence in the supply chain, which has profound implications for the stability of global supply chains and the international economic and trade order. Against this backdrop, it is crucial to explore the reasonable boundaries of human rights due diligence in the supply chain. Instead of applying a one-size-fits-all approach,the rationality of legal factors and the complexity of practical factors should be considered, applying context-specific measures based on the varying degrees of linkage between companies and negative human rights impacts in the supply chain. China should be particularly wary of the “chilling effect” of mandatory legislation on human rights due diligence in the supply chain, attaching great importance to national supply chain security and international supply chain competitiveness.Additionally,China should actively promote the implementation of voluntary human rights due diligence under the United Nations framework, and accelerate the enhancement of China's discourse power in the international rule-making process in the fields of industry and commerce as well as human rights.

Revisiting the Spirit of the UDHR and Discussing Human Rights Development——Summary of Views from the Seminar Commemorating the 75th Anniversary of the Universal Declaration of Human Rights

On December 4,2023,the China Society for Human Rights Studies hosted a seminar in Beijing commemorating the 75^(th) Anniversary of the Universal Declaration of Human Rights.Participants discussed topics such as the significance of the Universal Declaration of Human Rights,China’s theories and practices in respecting and safeguarding human rights,the three global initiatives and global human rights governance,human rights protection in the digital age,and telling Chinese stories of human rights in the new era.The discussions led to a broad consensus and achieved positive results.

Access to Financial Services——An Analysis from the Human Rights Perspective

There is a broad connection between finance and human rights,with finance having both positive and negative impacts on human rights.Everyone has a need for access to financial services.Documents in both the international human rights and international finance fields address the relationship between financial services and human rights.Among financial services,microcredit and inclusive finance have the closest connection to human rights and potentially the greatest impact on human rights.Access to financial services promotes economic,social,and cultural rights as well as the rights of specific groups.The conditions for access to financial services to promote human rights require the state to assume obligations to recognize,respect,protect,and fulfill the need for individuals to access financial services,and to ensure the availability,accessibility,acceptability,and adaptability of basic financial services.Access to financial services has played a significant role in China’s comprehensive victory in the battle of poverty alleviation,providing valuable experience for the international community in poverty eradication,achieving sustainable development goals,and protecting and promoting human rights.

The Historic Achievements of the Communist Party of China in Respecting and Protecting Human Rights in the New Era

In the new era,the Communist Party of China(CPC)has made historic achievements in respecting and protecting human rights.Building upon the principle of the“two integrations”(integrating the basic tenets of Marxism with China’s specific realities and fine traditional culture),it has nurtured new theories on respecting and protecting human rights in the new era,which can address the fundamental questions of whom and what the human rights protection efforts in the new era are for.Guided by the principle of“taking our own path,”it has charted a distinct course for the development of human rights,diverging from the Western approach.The CPC has maintained the unity between Party leadership and the respect for and protection of human rights,promoting progress in human rights through the pursuit of“high-quality development,”and ensuring various fundamental rights of the people through the rule of law.Building upon the past experience,the CPC has established the“source”of the institutional framework for respecting and protecting human rights in the new era,crafted the“body”of this institutional framework,and introduced its practical“application.”In promoting the comprehensive advancement of human rights protection,the CPC has facilitated the connotative development of human rights protection in China,empowering China in international human rights discourse,and contributing Chinese strength and wisdom to global human rights governance.

Systematic and Theoretical Unfolding of Research on Xi Jinping’s Discourses on Respecting and Protecting Human Rights

Xi Jinping’s discourses on respecting and protect-ing human rights stand as a shining example of the sinicization and modernization of Marxist human rights theory,embodying profound theoretical,political,practical,and cultural logic.Existing research has conducted comprehensive and systematic theoretical analysis and academic extractions on the following contents:the core essence in-herent in these important discourses,including the“theory of human rights concepts,”the“theory of human rights paths,”the“theory of human rights practices,”the“theory of human rights protection,”and the“theory of human rights governance,”along with their profound theoretical significance,practical significance,and global signifi-cance.In the future,researchers should emphasize efforts on studying the original texts and understanding the original principles.While focusing on the precision of concepts,the scientific nature of the prop-ositions,the maturity of theoretical systems,and the rigor of internal logic related to Xi Jinping’s discourses on respecting and protecting human rights,researchers should also pay attention to constructing a discourse system on human rights from the dimensions of discourse power,discourse cluster,and discourse field.Researchers should be adept at drawing innovative insights into human rights theory from China’s vibrant human rights practices and the vast masses of people.This approach will facilitate the systematic unfolding,academic trans-formation,and innovative development of Xi Jinping’s discourses on respecting and protecting human rights.

Development of Human Rights-Based Practices in Psychiatry from People Living with Mental Health Problems During Involuntary Hospitalization or Treatment - A Secondary Publication

This article presents the research protocol of an interpretative phenomenological study that aims to understand the lived experiences of coercion and human rights-based practices in psychiatry from the perspectives of people living with mental health problems during involuntary hospitalization or treatment.This qualitative study used an interpretative phenomenological analysis design.In-depth,one-on-one interviews along with a socio-demographic questionnaire were conducted with approximately 10 participants.Data analysis was followed by an iterative and hermeneutic emergence coding process.By centering human rights-based practices on the lived experiences of people living with mental health problems who encountered coercion,this study highlighted the contributing and limiting factors to the recognition of human rights in nursing practices.This study also promoted the development of nursing knowledge and practices that can significantly contribute to an individual’s recovery process.

Right ventricle dysfunction does not predict mortality in patients with SARS-CoV-2-related acute respiratory distress syndrome on extracorporeal membrane oxygenation support

BACKGROUND The prognostic role of right ventricle dilatation and dysfunction(RVDD)has not been elucidated in patients with coronavirus disease(COVID)-related respiratory failure refractory to standard treatment needing extracorporeal membrane oxygenation(ECMO)support.AIM To assess whether pre veno-venous(VV)ECMO RVDD were related to inintensive care unit(ICU)mortality.METHODS We enrolled 61 patients with COVID-related acute respiratory distress syndrome refractory to conventional treatment submitted to VV ECMO and consecutively admitted to our ICU(an ECMO referral center)from 31th March 2020 to 31th August 2021.An echocardiographic exam was performed immediately before VV ECMO implantation.RESULTS Males were prevalent(73.8%)and patients with a body mass index>30 kg/m^(2) were the majority(46/61,75%).The overall in-ICU mortality rate was 54.1%(33/61).RVDD was detectable in more than half of the population(34/61,55.7%)and associated with higher simplified organ functional assessment(SOFA)values(P=0.029)and a longer mechanical ventilation duration prior to ECMO support(P=0.046).Renal replacement therapy was more frequently needed in RVDD patients(P=0.002).A higher in-ICU mortality(P=0.024)was observed in RVDD patients.No echo variables were independent predictors of in-ICU death.CONCLUSION In patients with COVID-related respiratory failure on ECMO support,RVDD(dilatation and dysfunction)is a common finding and identifies a subset of patients characterized by a more severe disease(as indicated by higher SOFA values and need of renal replacement therapy)and by a higher in-ICU mortality.RVDD(also when considered separately)did not result independently associated with in-ICU mortality in these patients.

A Sandwich Technique Employing Right Ventricular Incision to Repair Posterior Ventricular Septal Rupture with Right Ventricular Wall Dissection: A Case Report

Background: Ventricular septal rupture (VSR) leading to right ventricular (RV) wall dissection is an extremely rare and life-threatening complication of inferior myocardial infarction (MI) with posterior VSR. Its rare incidence and complex pathology make it difficult to select the appropriate surgical procedures to prevent fatalities. Case Presentation: A 68-year-old woman was transferred to our hospital because of a post-infarction VSR 12 days after symptom onset. Short-axis image obtained using transthoracic echocardiography demonstrated a large posterior VSR. Moreover, the VSR was continuous, with a large echo-free space in the posterior wall of the right ventricle. Color echocardiography showed blood flowing into the echo-free space through the septal defect and blood flowing out into the RV lumen. Coronary angiography revealed complete occlusion of the second segment of the right coronary artery. Thus, dissection of the posterior wall of the right ventricle that continued into the RV lumen was considered to have been caused by the posterior VSR caused by an inferior MI. The patient underwent urgent surgery to repair the VSR using the sandwich double-patch technique by making a posterior RV incision that was repaired using a third patch. No additional procedure was required to block the flow from the cavity of the RV wall dissection into the RV lumen. Postoperative echocardiography and contrast-enhanced computed tomography demonstrated that the VSR was closed securely and the RV wall dissection was almost completely thrombosed. Conclusion: In this case, a patient with a posterior VSR and RV wall dissection was successfully treated using the sandwich double-patch technique with a posterior RV incision. No additional procedure may be needed for RV wall dissection when a secure VSR repair is complete;however, close follow-up is essential to improve the long-term prognosis.

The Four Categories of Chinese Discourse on Human Rights and Their Interrelationships

In China,the main discourse on human rights can be classified into four categories:political discourse,policy discourse,institutional discourse,and academic discourse.These four categories show significant differences in terms of the context,content,mode of expression,characteristics,and functions of the discourse.They cannot be simply equated or interchangeable with one another.However,they also rely on,restrict,and promote each other,and under certain conditions,they can be transformed into one another.It is needed to prevent imbalances,mismatches in context,isolation,and inadequate translation among human rights discourses.Meanwhile,it is essential to promote balanced development among different discourses,where each discourse maintains its own boundaries,refers to one another,and undergoes accurate translation,in order to construct their healthy interrelationships.Exploring appropriate methods of translation between discourses is an important and worthwhile topic for research in Chinese human rights discourse.It holds significant practical significance and academic value in constructing the Chinese human rights discourse system.

Right Post-Traumatic Diaphragmatic Hernia with Liver Dislocation

Diaphragmatic hernia is a rare consequence of thoraco-abdominal trauma. It may be associated with high morbidity and mortality, particularly if surgical intervention is delayed. We report a case of a right diaphragmatic hernia in a 75-year-old woman. The patient was referred to our hospital with mild dyspnea. Chest radiograph showed an overtly elevated right hemi-diaphragm. Thoracic and abdominal computed tomographic scan was requested and showed a defect of the right diaphragmatic muscle wall with intrathoracic ascension of the liver. During the postoperative course, the patient was still on mechanical ventilation, hemodynamically unstable. She developped urinary peritonitis and an extensive bowel ischemia worsening. We report this case to show that the prognosis is related to associated injuries and possible complications. The possibility of a diaphragmatic rupture should be kept in mind and surgery is mandatory in order to avoid complications.

Pulmonary Arterial Hypertension in Congenital Heart Disease with Left-to-Right Shunt: According to a Retrospective Study at Albert Royer’s National Children’s Hospital Center

Pulmonary arterial hypertension PAH is a progressive disease characterized by an increase in pulmonary arterial pressure and resistance. It often complicates congenital heart disease with a left-to-right shunt. The objective of this study is to evaluate the evolutionary profile of the pulmonary pressures of children with congenital heart disease with left-to-right shunt and to identify the factors favoring an evolution towards PAH. This is a retrospective, descriptive and analytical study over a period of four years and six months (from January 1, 2016 to June 30, 2020) at the Center National d’Enfant Albert Royer in Dakar on a series of 87 cases. The hospital frequency was 3.98 per thousand, and the incidence of PAH was 9.44%. The sex ratio of 0.74. The average age was 44.76 months. The average time between the onset of symptoms and the diagnosis of heart disease is 78.81 days. Dyspnea was found in 70.11% of cases, the burst of pulmonary B2 was found in 55%. Global heart failure was noted in 39.08% of cases. Cardiomegaly was found in 89.66% and pulmonary hypervascularization was found in 57.72% of cases. CIV was present in 54.02% of cases, followed by PCA in 21.14% and CAVc in 18.39% of cases. furosemide was used in 97.70% of cases and Captopril in 74.71% of cases. Sildenafil was used in 10.34% of patients, and 12.64% of patients benefited from surgical management. Eisenmenger syndrome was found in 12.64% of patients. PAH in these heart diseases is a formidable and frequent complication, due to an increase in precapillary flow. The major improvement in mortality and morbidity is early surgical management, in the first months of life, to prevent pulmonary vascular disease.

Give Play to the Role of NGOs Create a New Situation for the Cause of Human Rights with Chinese Characteristics

It’s a great pleasure to meet you in Beijing and solemnly commemorate the 70th anniversary of the universal Declaration of Human Rights. First, on behalf of the China Foundation for Human Rights Development, I would like to express my sincere gratitude and heartfelt thanks to all the friends who have been committed to supporting and promoting the development of China’s human rights cause over the years.

Outcome of patients undergoing right lobe living donor liver transplantation with small-for-size grafts

AIM:To investigate the outcome of living donor liver transplantation(LDLT)recipients transplanted with small-for-size grafts(SFSGs).METHODS:Between November 2001 and December2010,196 patients underwent LDLT with right lobe liver grafts at our center.Recipients were divided into 2 treatment groups:group A with an actuarial graft-to-recipient weight ratio(aGRWR)<0.8%(n=45)and group B with an aGRWR≥0.8%(n=151).We evaluated serum liver function markers within 4 wk after transplantation.We also retrospectively evaluated the outcomes of these patients for potential effects related to the recipients,the donors and the transplantation procedures based upon a review of their medical records.RESULTS:Small-for-size syndrome(SFSS)developed in 7 of 45 patients(15.56%)in group A and 9 of 151patients(5.96%)in group B(P=0.080).The levels of alanine aminotransferase and aspartate aminotransferase in group A were higher than those in group B during early period after transplantation,albeit not significantly.The cumulative 1-,3-and 5-year liver graft survival rates were 82.22%,71.11%and 71.11%for group A and 81.46%,76.82%,and 75.50%for group B patients,respectively(P=0.623).However,univariate analysis of risk factors associated with graft survival in group A demonstrated that the occurrence of SFSS after LDLT was the only significant risk factor affecting graft survival(P<0.001).Furthermore,multivariate analysis of our data did not identify any additional significant risk factors accounting for poor graft survival.CONCLUSION:Our study suggests that LDLT recipients with an aGRWR<0.8%may have liver graft outcomes comparable to those who received larger size grafts.Further studies are required to ascertain the safety of using SFSGs.

Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer:A comprehensive review

Aim of the study is to comprehensively review the latest trends in laparoscopic complete mesocolic excision(CME) with central vascular ligation(CVL) for the multimodal management of right colon cancer. Historical and up-to-date anatomo-embryological concepts are analyzed in detail,focusing on the latest studies of the mesenteric organ,its dissection by mesofascial and retrofascial cleavage planes,and questioning the need for a new terminology in colonic resections. The rationale behind Laparoscopic CME with CVL is thoroughly investigated and explained. Attention is paid to the current surgical techniques and the quality of the surgical specimen,yielded through mesocolic,intramesocolic and muscularis propria plane of surgery. We evaluate the impact on long term oncologic outcome in terms of local recurrence,overall and disease-free survival,according to the plane of resection achieved. Conclusions are drawn on the basis of the available evidence,which suggests a pivotal role of laparoscopic CME with CVL in the multimodal management of right sided colonic cancer: performed in the right mesocolic plane of resection,laparoscopic CME with CVL demonstrates better oncologic results when compared to standard non-mesocolic planes of surgery,with all the advantages of laparoscopic techniques,both in faster recovery and better immunological response. The importance of minimally invasive mesoresectional surgery is thus stressed and highlighted as the new frontier for a modern laparoscopic total right mesocolectomy.

Right hepatectomy for giant cavernous hemangioma with diffuse hemangiomatosis around Glisson's capsule

Diffuse liver hemangiomatosis with giant cavernous hemangioma in adult is extremely rare. A 35 year-old woman presented to hospital with main complaint of epigastric pain and abdominal fullness. An enhanced computed tomography scan revealed a massive liver tumor in right lobe about 150 mm in size. There was contrast enhancement at the periphery of the mass consistent with a cavernous hemangioma. She underwent right hepatectomy. Histologically, it was diagnosed as a cavernous hemangioma. And also, hemangiomatous lesions were scattered around the Glisson's capsule on the back ground liver. These hemangiomatous lesions were not recognized preoperatively. Even if we couldn't diagnose hemangiomatosis around the main giant hemangioma preoperatively, we need to take enough surgical margins because the giant hemangioma has the potential to have small hemangiomatous lesions around the tumor. We reported right hepatectomy for giant cavern-ous hemangioma with diffuse hepatic hemangiomatosis without an extrahepatic lesion in an adult.