Pegaspargase induced multiple organ failure with acute lymphoblastic leukemia:A case report

BACKGROUND The introduction of pegaspargase has greatly advanced the treatment of acute lymphoblastic leukemia(ALL).In the literature,only one case of pegaspargaseinduced multiple organ failure has been reported,and the patient died due to multiple organ failure.CASE SUMMARY Herein,we present a rare case of a 40-year-old man with ALL who developed multiple organ failure after treatment with pegaspargase.The patient had two rare phenomena reflecting poor prognosis,including the discrepancy between clinical manifestations and liver function and persistently low alpha-fetoprotein(AFP)levels from subacute liver failure.However,the patient was successfully treated using a multidisciplinary team approach.CONCLUSION This is the first case report of successful treatment of pegaspargase-induced multiple organ failure.The findings emphasize the importance of a multidisciplinary team approach in treating pegaspargase-induced multiple organ failure.

King's College criteria and the Clichy-Villejuif criteria require adjustments for assessing acute liver failure due to yellow fever

BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.

Effect of insomnia on anxiety and depression:Mediation of cognitive failures and moderated mediation of neuroticism

BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.

Dyssynchronous heart failure models in canines:New insights into electrocardiographic,echocardiographic and histological features

Background:We investigated the similarities and differences between two experi-mental approaches using tachy-pacing technology to induce desynchronized heart failure in canines.Methods:A total of eight dogs were included in the experiment,four were tachy-paced in right ventricle apex(RVAP)and 4 were paced in right atrium after the ablation of left bundle branch to achieve left bundle branch block(RAP+LBBB).Three weeks of follow-up were conducted to observe the changes in cardiac function and myocar-dial staining was performed at the end of the experiment.Results:Both experimental approaches successfully established heart failure with reduced ejection fraction models,with similar trends in declining cardiac function.The RAP+LBBB group exhibited a prolonged overall ventricular activation time,de-layed left ventricular activation,and lesser impact on the right ventricle.The RVAP approach led to a reduction in overall right ventricular compliance and right ventricu-lar enlargement.The RAP+LBBB group exhibited significant reductions in left heart compliance(LVGLS,%:RAP+LBBB−12.60±0.12 to−5.93±1.25;RVAP−13.28±0.62 to−8.05±0.63,p=0.023;LASct,%:RAP+LBBB−15.75±6.85 to−1.50±1.00;RVAP−15.75±2.87 to−10.05±6.16,p=0.035).Histological examination revealed more pronounced fibrosis in the left ventricular wall and left atrium in the RAP+LBBB group while the RVAP group showed more prominent fibrosis in the right ventricular myocardium. Conclusion : Both approaches establish HFrEF models with comparable trends. The RVAP group shows impaired right ventricular function, while the RAP+LBBB group exhibits more severe decreased compliance and fibrosis in left ventricle.

Failure behaviors of anisotropic shale with a circular cavity subjected to uniaxial compression

Layered rock formations are frequently encountered during the excavation of underground structures. The stability of such structures is influenced not only by the stress concentration caused by the cavities in the strata but also by the anisotropy of the layered rock mass. The interaction between them can lead to critical structural failure, such as rupture, collapse, or significant deformation within the adjacent rock mass, thereby jeopardizing operational safety. However, the coupling law and mechanism between the stress concentration resulting from the cavities and the anisotropy of a layered rock mass remain unclear. In this study, a uniaxial compression test was performed on shale specimens containing a circular hole to investigate the effects of layer inclination and circular holes on the mechanical properties, elastic energy storage, and failure behaviors of these specimens. The failure mechanism of the rock surrounding the hole was analyzed on the basis of the single plane of weakness theory and the Kirsch solution. The test results indicated pronounced anisotropy in the compressive strength, elastic modulus, and elastic strain energy of the specimens, with distinct “V”, “M” and “U”-shaped patterns correlated with varying layer inclination angles. In addition, the combined effect of stress concentration and layer inclination resulted in different failure types, which were classified into four groups according to their failure behavior. Theoretical analysis revealed that failure around circular holes in layered rock is affected by a range of variables, such as layer inclination, layer strength, lateral pressure coefficient, azimuth, and loading stress.

Prognostic value of combined detection of alpha-fetoprotein,plasma prothrombin activity,and serum prealbumin in acute-on-chronic liver failure

BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple prognostic assessment indicators for ACLF,the overall sensitivity and accuracy are relatively low.AIM To investigate the prognostic value of the combined detection of alpha-fetoprotein(AFP),plasma prothrombin activity(PTA),and serum prealbumin(PA)in ACLF.METHODS This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival(n=47)and death(n=40)groups according to their clinical outcomes 3 months posttreatment.All the participants underwent AFP,PTA,and PA level measurements upon admission.Baseline data,as well as AFP,PTA,and PA levels,were comparatively analyzed.Pearson correlation coefficients were utilized to analyze the correlations of AFP,PTA,and PA with different survival outcomes in patients with ACLF.Receiver operating characteristic(ROC)curves and areas under the curves were used to evaluate the predictive value of AFP,PTA,and PA for ACLF prognosis.RESULTS AFP,PTA,and PA levels were markedly decreased in the death group than in the survival group(P<0.05).Pearson analysis indicated a positive association of the AFP,PTA,and PA levels with the survival of patients with ACLF(P<0.05).ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24%and 100.00%,respectively,both of which were notably increased compared to the single-index diagnosis.The ROC of their combined diagnosis was 0.989,significantly surpassing 0.907,0.849,and 0.853 of AFP,PTA,and PA,respectively.No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection(P>0.05).CONCLUSION The combined detection of AFP,PTA,and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF,featuring high sensitivity and specificity.

Predicting post-hepatectomy liver failure using a nomogram based on portal vein width,inflammatory indices,and the albumin-bilirubin score

BACKGROUND Post-hepatectomy liver failure(PHLF)after liver resection is one of the main complications causing postoperative death in patients with hepatocellular carcinoma(HCC).It is crucial to help clinicians identify potential high-risk PHLF patients as early as possible through preoperative evaluation.AIM To identify risk factors for PHLF and develop a prediction model.METHODS This study included 248 patients with HCC at The Second Affiliated Hospital of Air Force Medical University between January 2014 and December 2023;these patients were divided into a training group(n=164)and a validation group(n=84)via random sampling.The independent variables for the occurrence of PHLF were identified by univariate and multivariate analyses and visualized as nomograms.Ultimately,comparisons were made with traditional models via receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS In this study,portal vein width[odds ratio(OR)=1.603,95%CI:1.288-1.994,P≤0.001],the preoperative neutrophil-to-lymphocyte ratio(NLR)(OR=1.495,95%CI:1.126-1.984,P=0.005),and the albumin-bilirubin(ALBI)score(OR=8.868,95%CI:2.144-36.678,P=0.003)were independent risk factors for PHLF.A nomogram prediction model was developed using these factors.ROC and DCA analyses revealed that the predictive efficacy and clinical value of this model were better than those of traditional models.CONCLUSION A new Nomogram model for predicting PHLF in HCC patients was successfully established based on portal vein width,the NLR,and the ALBI score,which outperforms the traditional model.

Using fracture mechanics method to analyze the failure mechanism and equilibrium equation of interfacial loess-mudstone landslides

Loess-mudstone landslides are common in the Loess Plateau.Investigations into the mechanical theory of loess-mudstone landslides have become a challenging undertaking due to the distinctive interfacial properties of loess-mudstone and the unique water sensitivity characteristics of mudstone.Hence,it is imperative to develop innovative mechanical models and mathematical equations specifically tailored to loess-mudstone landslides.In this study,we analyze the fracture mechanism of the loess-mudstone sliding zone using plastic fracture mechanics and develop a unique fracture yield model.To calculate the energy release rate during the expansion of the loess-mudstone interface tip region,the shear fracture energy G is applied,which reflects both the yield failure criterion and the fracture failure criterion.To better understand the instability mechanism of loess-mudstone landslides,equilibrium equations based on G are established for tractive,compressive,and tensile loess-mudstone landslides.Based on the equilibrium equation,the critical length Lc of the sliding zone can be used for the safety evaluation of loess-mudstone landslides.In this way,this study proposes a new method for determining the failure mechanism and equilibrium equation of loessmudstone landslides,which resolves their starting mechanism,mechanical equilibrium equations,and safety evaluation indicators,thus justifying the scientific significance and practical value of this research.

Failure rate analysis and maintenance plan optimization method for civil aircraft parts based on data fusion

In the face of data scarcity in the optimization of maintenance strategies for civil aircraft,traditional failure data-driven methods are encountering challenges owing to the increasing reliability of aircraft design.This study addresses this issue by presenting a novel combined data fusion algorithm,which serves to enhance the accuracy and reliability of failure rate analysis for a specific aircraft model by integrating historical failure data from similar models as supplementary information.Through a comprehensive analysis of two different maintenance projects,this study illustrates the application process of the algorithm.Building upon the analysis results,this paper introduces the innovative equal integral value method as a replacement for the conventional equal interval method in the context of maintenance schedule optimization.The Monte Carlo simulation example validates that the equivalent essential value method surpasses the traditional method by over 20%in terms of inspection efficiency ratio.This discovery indicates that the equal critical value method not only upholds maintenance efficiency but also substantially decreases workload and maintenance costs.The findings of this study open up novel perspectives for airlines grappling with data scarcity,offer fresh strategies for the optimization of aviation maintenance practices,and chart a new course toward achieving more efficient and cost-effective maintenance schedule optimization through refined data analysis.

Application of ultrasound elastography and splenic size in predicting post-hepatectomy liver failure:Unveiling new clinical perspectives

In this article,we discuss the study by Cheng et al,published in the World Journal of Gastroenterology,focusing on predictive methods for post-hepatectomy liver failure(PHLF).PHLF is a common and serious complication,and accurate prediction is critical for clinical management.The study examines the potential of ultrasound elastography and splenic size in predicting PHLF.Ultrasound elastography reflects liver functional reserve,while splenic size provides additional predictive value.By integrating these factors with serological markers,we developed a comprehensive prediction model that effectively stratifies patient risk and supports personalized clinical decisions.This approach offers new insights into predicting PHLF.These methods not only assist clinicians in identifying high-risk patients earlier but also provide scientific support for personalized treatment strategies.Future research will aim to validate the model's accuracy with larger sample sizes,further enhancing the clinical application of these non-invasive indicators.

Forming limit and failure behavior of fiber metal laminates under low-constraint conditions

Fiber Metal Laminates(FMLs),as high-performance composite materials,demonstrate exceptional potential in a wide range of applications,such as aeronautical and astronautical industries.However,the traditional cured FMLs possess complex interlayer stresses and low forming limits,restricting further promotion and application of FMLs.Low-constraint FMLs exhibit a lower forming resistance and better formability due to no curing during the forming process;however,the formation mechanism and response are not clear.This paper presents the Forming Limit Diagram(FLD)of low-constraint GLARE(glass fiber reinforced aluminum laminates)based on the forming limit test,and compares it with the conventionally cured laminates to evaluate the differences in the forming limit.In addition,combined with the analysis of failure mechanism and micro-deformation mechanism of specimens,the influence of different temperatures(20–80℃)and forming states(width)on the deformation performance of laminates is further explored.The results reveal that the forming limit curve of low-constraint laminates shifts up with the increase of temperature,the forming limit initially increases with the increase of width,then followed by a gradual decrease,and the maximum principal strain of low-constraint laminates is increased by 29% at 80℃ compared to 20℃.The cured laminate has a principal strain range of 0–0.02,while the low-constraint laminates have a principal strain range of 0.03–0.14.Compared with cured laminates,low-constraint laminates possess a higher forming limit due to the improvement in deformable degree between layers by resin flow and fiber slippage,which enhances their formability.This study is expected to serve as a reference for establishing forming limit criteria and optimizing forming schemes for low-constraint laminates.

Prediction of posthepatectomy liver failure in patients withhepatocellular carcinoma through ultrasound elastography

In this article,we comment on the article by Cheng et al published in recently.Posthepatectomy liver failure(PHLF)remains a leading cause of hepatectomyrelated mortality and can be evaluated according to liver reserve function.Liver stiffness(LS)measured by ultrasonic elastography and spleen area demonstrate a strong correlation with hepatic proliferation,fibrosis,and portal vein congestion,thus indirectly reflecting liver reserve function.This article highlights a meticulous study aimed at investigating the potential of two-dimensional shear wave elastography in assessing LS,as well as its integration with spleen area,surgical factors,and laboratory indicators,for predicting the risk of PHLF in hepatocellular carcinoma patients.In this article,we discussed the non-invasive elastography modality by ultrasound and magnetic resonance imaging to assess LS.Based on literature data,we subsequently suggested that several risk factors may contribute to PHLF,including excessive intrahepatic neutrophil accumulation,the formation of neutrophil extracellular traps,end-stage liver disease scores,and albumin-bilirubin scores.Therefore,a more comprehensive study incor-porating detailed information requires further investigation.

A New Approach for the Calculation of Slope Failure Probability with Fuzzy Limit-State Functions

This study presents an innovative approach to calculating the failure probability of slopes by incorporating fuzzylimit-state functions,a method that significantly enhances the accuracy and efficiency of slope stability analysis.Unlike traditional probabilistic techniques,this approach utilizes a least squares support vector machine(LSSVM)optimized with a grey wolf optimizer(GWO)and K-fold cross-validation(CV)to approximate the limit-statefunction,thus reducing computational complexity.The novelty of this work lies in its application to one-dimensional(1D),two-dimensional(2D),and three-dimensional(3D)slope models,demonstrating its versatility andhigh precision.The proposed method consistently achieves error margins within 3%of Monte Carlo simulation(MCS)results,while substantially reducing computation time,particularly for 2D and 3D models.This makes theapproach highly practical for real-world engineering applications.Furthermore,by applying fuzzy mathematics tohandle uncertainties in geotechnical properties,the method offers a more realistic and comprehensive understandingof slope stability.As water is the main factor influencing the stability of slopes,this aspect is investigatedby calculating the phreatic line after the change in water level.Relevant examples are used to show that the failureprobability of a slope under water wading condition can increase by more than 20%(increase rates in 1D,2D and3D conditions being 25%,27%and 31%,respectively)compared with the natural condition.The influence ofdiverse fuzzy membership functions—linear,normal,and Cauchy—on failure probability is also considered.Thisresearch not only provides a strategy for better calculation of the slope failure probability but also pioneers theintegration of computational intelligence,fuzzy logic and fluid-dynamics in geotechnical engineering,presentingan innovative and efficient tool for slope stability analysis.

Genetic factors that predict response and failure of biologic therapy in inflammatory bowel disease

Inflammatory bowel disease(IBD)represents a significant disease burden marked by chronic inflammation and complications that adversely affect patients’quality of life.Effective diagnostic strategies involve clinical assessments,endoscopic evaluations,imaging studies,and biomarker testing,where early diagnosis is essential for effective management and prevention of long-term complications,highlighting the need for continual advancements in diagnostic methods.The intricate interplay between genetic factors and the outcomes of biological therapy is of critical importance.Unraveling the genetic determinants that influence responses and failures to biological therapy holds significant promise for optimizing treatment strategies for patients with IBD on biologics.Through an indepth examination of current literature,this review article synthesizes critical genetic markers associated with therapeutic efficacy and resistance in IBD.Understanding these genetic actors paves the way for personalized approaches,informing clinicians on predicting,tailoring,and enhancing the effectiveness of biological therapies for improved outcomes in patients with IBD.

情报失误概念界定问题研究——兼析“Intelligence Failure”的翻译

[目的/意义]厘清各界对情报失误概念的认识分歧,准确认识和界定情报失误概念的内涵与外延,推动学界在对情报失误的定义上达成共识,为进一步深化情报失误研究提供支撑。[方法/过程]通过对中英文主流文献的梳理,比较分析国内外对情报失误概念的基本认识,并对相关争议性问题予以针对性回应。[结果/结论]将情报失误定义为情报机构在情报生产与分发、反情报以及其他情报活动过程中的差错,更加符合其本质属性。决策者对情报的不当使用更多地属于决策问题,而非情报范畴,因而不宜归为情报失误。“Intelligence Failure”不宜译为“情报失察”,直译为“情报失败”更为贴切。在能准确关照“Intelligence Failure”与“情报失误”的细微差异的情况下,在一定范围内也可有选择地继续沿用“情报失误”这一译法。

Prediction of brittle rock failure severity:An approach based on rock mass failure progress

This study presents the classification and prediction of severity for brittle rock failure,focusing on failure behaviors and excessive determination based on damage depth.The research utilizes extensive field survey data from the Shuangjiangkou Hydropower Station and previous research findings.Based on field surveys and previous studies,four types of brittle rock failure with different failure mechanisms are classified,and then a prediction method is proposed.This method incorporates two variables,i.e.Kv(modified rock mass integrity coefficient)and GSI(geological strength index).The prediction method is applied to the first layer excavation of the powerhouse cavern of Shuangjiangkou Hydropower Station.The results show that the predicted brittle rock failure area agrees with the actual failure area,demonstrating the method’s applicability.Next,it extends to investigate brittle rock failure in two locations.The first is the k0-890 m section of the traffic cavern,and the second one is at K0-64 m of the main powerhouse.The criterion-based prediction indicates a severity brittle rock failure in the K0-890 m section,and a moderate brittle rock failure in the K0-64 m section,which agrees with the actual occurrence of brittle rock failure in the field.The understanding and application of the prediction method using Kv and GSI are vital for implementing a comprehensive brittle rock failure prediction process in geological engineering.To validate the adaptability of this criterion across diverse tunnel projects,a rigorous verification process using statistical findings was conducted.The assessment outcomes demonstrate high accuracy for various tunnel projects,allowing establishment of the correlations that enable valuable conclusions regarding brittle rock failure occurrence.Further validation and refinement through field and laboratory testing,as well as simulations,can broaden the contribution of this method to safer and more resilient underground construction.

Mechanism of principal stress rotation and deformation failure behavior induced by excavation in roadways

The failure modes of rock after roadway excavation are diverse and complex.A comprehensive investigation of the internal stress field and the rotation behavior of the stress axis in roadways is essential for elucidating the mechanism of roadway failure.This study aimed to examine the spatial relationship between roadways and stress fields.The law of stress axis rotation under three-dimensional(3D)stress has been extensively studied.A stress model of roadways in the spatial stress field was established,and the far-field stress state at different spatial positions of the roadways was analyzed.A mechanical model of roadways under a 3D stress state was established using far-field stress solutions as boundary conditions.The distribution of principal stressesσ1,σ2 andσ3 around the roadways and the variation of the stress principal axis were solved.It was found that the stability boundary of the stress principal axis exhibits hysteresis when compared with that of the principal stress magnitudes.A numerical analysis model for spatial roadways was established to validate the distribution of principal stress and the mechanism of principal axis rotation.Research has demonstrated that the stress axis undergoes varying degrees of spatial rotation in different orientations and radial depths.Based on the distribution of principal stress and the rotation law of the stress principal axis,the entire evolution mechanism of the two stress adjustments to form the final failure form after roadway excavation has been revealed.The on-site detection results also corroborate the findings presented in this paper.The results provide a basis for the analysis of the failure mechanism under a 3D stress state.

Nomogram based on liver stiffness and spleen area with ultrasound for posthepatectomy liver failure:A multicenter study

BACKGROUND Liver stiffness(LS)measurement with two-dimensional shear wave elastography(2D-SWE)correlates with the degree of liver fibrosis and thus indirectly reflects liver function reserve.The size of the spleen increases due to tissue proliferation,fibrosis,and portal vein congestion,which can indirectly reflect the situation of liver fibrosis/cirrhosis.It was reported that the size of the spleen was related to posthepatectomy liver failure(PHLF).So far,there has been no study combining 2D-SWE measurements of LS with spleen size to predict PHLF.This prospective study aimed to investigate the utility of 2D-SWE assessing LS and spleen area(SPA)for the prediction of PHLF in hepatocellular carcinoma(HCC)patients and to develop a risk prediction model.AIM To investigate the utility of 2D-SWE assessing LS and SPA for the prediction of PHLF in HCC patients and to develop a risk prediction model.METHODS This was a multicenter observational study prospectively analyzing patients who underwent hepatectomy from October 2020 to March 2022.Within 1 wk before partial hepatectomy,ultrasound examination was performed to measure LS and SPA,and blood was drawn to evaluate the patient’s liver function and other conditions.Least absolute shrinkage and selection operator logistic regression and multivariate logistic regression analysis was applied to identify independent predictors of PHLF and develop a nomogram.Nomogram performance was validated further.The diagnostic performance of the nomogram was evaluated with receiver operating charac-teristic curve compared with the conventional models,including the model for end-stage liver disease(MELD)score and the albumin-bilirubin(ALBI)score.RESULTS A total of 562 HCC patients undergoing hepatectomy(500 in the training cohort and 62 in the validation cohort)were enrolled in this study.The independent predictors of PHLF were LS,SPA,range of resection,blood loss,international normalized ratio,and total bilirubin.Better diagnostic performance of the nomogram was obtained in the training[area under receiver operating characteristic curve(AUC):0.833;95%confidence interval(95%CI):0.792-0.873;sensitivity:83.1%;specificity:73.5%]and validation(AUC:0.802;95%CI:0.684-0.920;sensitivity:95.5%;specificity:52.5%)cohorts compared with the MELD score and the ALBI score.CONCLUSION This PHLF nomogram,mainly based on LS by 2D-SWE and SPA,was useful in predicting PHLF in HCC patients and presented better than MELD score and ALBI score.

AGK2 pre-treatment protects against thioacetamide-induced acute liver failure via regulating the MFN2-PERK axis and ferroptosis signaling pathway

Background:Acute liver failure(ALF)is an unpredictable and life-threatening critical illness.The pathological characteristic of ALF is massive necrosis of hepatocytes and lots of inflammatory cells infiltration which may lead to multiple organ failure.Methods:Animals were divided into 3 groups,normal,thioacetamide(TAA,ALF model)and TAA+AGK2.Cultured L02 cells were divided into 5 groups,normal,TAA,TAA+mitofusin 2(MFN2)-siRNA,TAA+AGK2,and TAA+AGK2+MFN2-siRNA groups.The liver histology was evaluated with hematoxylin and eosin staining,inositol-requiring enzyme 1(IRE1),activating transcription factor 6β(ATF6β),protein kinase R(PKR)-like endoplasmic reticulum kinase(PERK)and phosphorylated-PERK(p-PERK).C/EBP homologous protein(CHOP),reactive oxygen species(ROS),MFN2 and glutathione peroxidase 4(GPX4)were measured with Western blotting,and cell viability and liver chemistry were also measured.Mitochondriaassociated endoplasmic reticulum membranes(MAMs)were measured by immunofluorescence.Results:The liver tissue in the ALF group had massive inflammatory cell infiltration and hepatocytes necrosis,which were reduced by AGK2 pre-treatment.In comparison to the normal group,apoptosis rate and levels of IRE1,ATF6β,p-PERK,CHOP,ROS and Fe2+in the TAA-induced ALF model group were significantly increased,which were decreased by AGK2 pre-treatment.The levels of MFN2 and GPX4 were decreased in TAA-induced mice compared with the normal group,which were enhanced by AGK2 pretreatment.Compared with the TAA-induced L02 cell,apoptosis rate and levels of IRE1,ATF6β,p-PERK,CHOP,ROS and Fe2+were further increased and levels of MFN2 and GPX4 were decreased in the MFN2-siRNA group.AGK2 pre-treatment decreased the apoptosis rate and levels of IRE1,ATF6β,p-PERK,CHOP,ROS and Fe2+and enhanced the protein expression of MFN2 and GPX4 in MFN2-siRNA treated L02 cell.Immunofluorescence observation showed that level of MAMs was promoted in the AGK2 pre-treatment group when compared with the TAA-induced group in both mice and L02 cells.Conclusions:The data suggested that AGK2 pre-treatment had hepatoprotective role in TAA-induced ALF via upregulating the expression of MFN2 and then inhibiting PERK and ferroptosis pathway in ALF.

Disturbance failure mechanism of highly stressed rock in deep excavation:Current status and prospects

This article reviews the current status on the dynamic behavior of highly stressed rocks under disturbances.Firstly,the experimental apparatus,methods,and theories related to the disturbance dynamics of deep,high-stress rock are reviewed,followed by the introduction of scholars’research on deep rock deformation and failure from an energy perspective.Subsequently,with a backdrop of highstress phenomena in deep hard rock,such as rock bursts and core disking,we delve into the current state of research on rock microstructure analysis and residual stresses from the perspective of studying the energy storage mechanisms in rocks.Thereafter,the current state of research on the mechanical response and the energy dissipation of highly stressed rock formations is briefly retrospected.Finally,the insufficient aspects in the current research on the disturbance and failure mechanisms in deep,highly stressed rock formations are summarized,and prospects for future research are provided.This work provides new avenues for the research on the mechanical response and damage-fracture mechanisms of rocks under high-stress conditions.