Establishment of models to predict factors influencing periodontitis in patients with type 2 diabetes mellitus

BACKGROUND Type 2 diabetes mellitus(T2DM)is associated with periodontitis.Currently,there are few studies proposing predictive models for periodontitis in patients with T2DM.AIM To determine the factors influencing periodontitis in patients with T2DM by constructing logistic regression and random forest models.METHODS In this a retrospective study,300 patients with T2DM who were hospitalized at the First People’s Hospital of Wenling from January 2022 to June 2022 were selected for inclusion,and their data were collected from hospital records.We used logistic regression to analyze factors associated with periodontitis in patients with T2DM,and random forest and logistic regression prediction models were established.The prediction efficiency of the models was compared using the area under the receiver operating characteristic curve(AUC).RESULTS Of 300 patients with T2DM,224 had periodontitis,with an incidence of 74.67%.Logistic regression analysis showed that age[odds ratio(OR)=1.047,95%confidence interval(CI):1.017-1.078],teeth brushing frequency(OR=4.303,95%CI:2.154-8.599),education level(OR=0.528,95%CI:0.348-0.800),glycosylated hemoglobin(HbA1c)(OR=2.545,95%CI:1.770-3.661),total cholesterol(TC)(OR=2.872,95%CI:1.725-4.781),and triglyceride(TG)(OR=3.306,95%CI:1.019-10.723)influenced the occurrence of periodontitis(P<0.05).The random forest model showed that the most influential variable was HbA1c followed by age,TC,TG, education level, brushing frequency, and sex. Comparison of the prediction effects of the two models showedthat in the training dataset, the AUC of the random forest model was higher than that of the logistic regressionmodel (AUC = 1.000 vs AUC = 0.851;P < 0.05). In the validation dataset, there was no significant difference in AUCbetween the random forest and logistic regression models (AUC = 0.946 vs AUC = 0.915;P > 0.05).CONCLUSION Both random forest and logistic regression models have good predictive value and can accurately predict the riskof periodontitis in patients with T2DM.

Allogeneic stem cell transplantation in the treatment of acute myeloid leukemia: An overview of obstacles and opportunities

As an important treatment for acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation(allo-HSCT) plays an important role in reducing relapse and improving long-term survival. With rapid advancements in basic research in molecular biology and immunology and with deepening understanding of the biological characteristics of hematopoietic stem cells, allo-HSCT has been widely applied in clinical practice. During allo-HSCT, preconditioning, the donor, and the source of stem cells can be tailored to the patient’s conditions, greatly broadening the indications for HSCT, with clear survival benefits. However, the risks associated with allo-HSCT remain high, i.e. hematopoietic reconstitution failure, delayed immune reconstitution, graft-versus-host disease, and posttransplant relapse, which are bottlenecks for further improvements in allo-HSCT efficacy and have become hot topics in the field of HSCT. Other bottlenecks recognized in the current treatment of individuals diagnosed with acute myeloid leukemia and subjected to allo-HSCT include the selection of the most appropriate conditioning regimen and post-transplantation management. In this paper, we reviewed the progress of relevant research regarding these aspects.

Alteration of intestinal microbiota is associated with diabetic retinopathy and its severity:Samples collected from southeast coast Chinese

BACKGROUND Current approaches for the therapy of diabetic retinopathy(DR),which was one of leading causes of visual impairment,have their limitations.Animal experiments revealed that restructuring of intestinal microbiota can prevent retinopathy.AIM To explore the relationship between intestinal microbiota and DR among patients in the southeast coast of China,and provide clues for novel ways to prevention and treatment methods of DR.METHODS The fecal samples of non-diabetics(Group C,n=15)and diabetics(Group DM,n=30),including 15 samples with DR(Group DR)and 15 samples without DR(Group D),were analyzed by 16S rRNA sequencing.Intestinal microbiota compositions were compared between Group C and Group DM,Group DR and Group D,as well as patients with proliferative diabetic retinopathy(PDR)(Group PDR,n=8)and patients without PDR(Group NPDR,n=7).Spearman correlation analyses were performed to explore the associations between intestinal microbiota and clinical indicators.RESULTS The alpha and beta diversity did not differ significantly between Group DR and Group D as well as Group PDR and Group NPDR.At the family level,Fusobacteriaceae,Desulfovibrionaceae and Pseudomonadaceae were significantly increased in Group DR than in Group D(P<0.05,respectively).At the genera level,Fusobacterium,Pseudomonas,and Adlercreutzia were increased in Group DR than Group D while Senegalimassilia was decreased(P<0.05,respectively).Pseudomonas was negatively correlated with NK cell count(r=-0.39,P=0.03).Further,the abundance of genera Eubacterium(P<0.01),Peptococcus,Desulfovibrio,Acetanaerobacterium and Negativibacillus(P<0.05,respectively)were higher in Group PDR compared to Group NPDR,while Pseudomonas,Alloprevotella and Tyzzerella(P<0.05,respectively)were lower.Acetanaerobacterium and Desulfovibrio were positively correlated with fasting insulin(r=0.53 and 0.61,respectively,P<0.05),when Negativibacillus was negatively correlated with B cell count(r=-0.67,P<0.01).CONCLUSION Our findings indicated that the alteration of gut microbiota was associated with DR and its severity among patients in the southeast coast of China,probably by multiple mechanisms such as producing short-chain fatty acids,influencing permeability of blood vessels,affecting levels of vascular cell adhesion molecule-1,hypoxia-inducible factor-1,B cell and insulin.Modulating gut microbiota composition might be a novel strategy for prevention of DR,particularly PDR in population above.

Minimally invasive treatment of hepatic hemangioma by transcatheter arterial embolization combined with microwave ablation:A case report

BACKGROUND Hepatic hemangioma is the most common benign tumor of the liver.However,patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention.It is necessary to explore additional minimally invasive and personalized treatment options for hemangiomas.CASE SUMMARY A 47-year-old woman was diagnosed with a right hepatic hemangioma for more than 10 years.Abdominal contrast-enhanced computed tomography(CT)and contrast-enhanced ultrasound revealed that there was a large hemangioma in the right liver,with a size of approximately 95 mm×97 mm×117 mm.Due to the patient's refusal of surgical treatment,hepatic artery embolization was performed in the first stage.After 25 d of liver protection treatment,the liver function indexes decreased to normal levels.Then,ultrasound-guided microwave ablation of the giant hepatic hemangioma was performed.Ten days after the treatment,hepatobiliary ultrasonography showed that the hemangioma of the right liver was smaller than the previous size(the volume was reduced by approximately 30%).Then the patient was discharged from the hospital.One year after discharge,CT showed that the hepatic hemangioma had shrunk by about 80%CONCLUSION Transcatheter arterial embolization combined with microwave ablation is a safe and effective minimally invasive treatment for hepatic hemangioma.

Rare recurrent gallstone ileus: A case report

BACKGROUND The management of recurrent gallstone ileus(GSI)is unsatisfactory,and there is no consensus on how to reduce the incidence of recurrent GSI.CASE SUMMARY A 79-year-old man presented to the Emergency Department of our hospital complaining of abdominal pain.An abdominal computed tomography(CT)scan revealed cholecystolithiasis,intrahepatic bile duct dilatation,gas accumulation,small intestinal obstruction,and circular high-density shadow in the intestinal cavity.Emergency surgery revealed that the small intestine had extensive adhesions,unclear gallbladder exposure,obvious adhesions,and difficult separation.The obstruction was located 70 cm between the ileum and the ileocecum,which was incarcerated by gallstones,and a simple enterolithotomy was carried out.On the third day after the operation,he had passed gas and defecated and had begun a liquid diet.On the fifth day after the operation,he suddenly experienced abdominal distension and discomfort.Emergency CT examination revealed recurrent GSI,and the diameter of the stone was approximately 2.0 cm(consistent with the shape of cholecystolithiasis on the abdominal CT scan before the first operation).The patient’s symptoms were not significantly relieved after conservative treatment.On the ninth day after the operation,emergency enterolithotomy was performed again along the original surgical incision.On the twentieth day after the second operation,the patient fully recovered and was discharged from the hospital.CONCLUSION We believe that a thorough examination of the bowel and gallbladder for gallstones based on preoperative imaging during surgery and removal of them as far as possible on the premise of ensuring the safety of patients are an effective strategy to reduce the recurrence of GSI.

Clinical experimental study of Arnebia root oil promoting histological change and up-regulating bFGF expression in the wound

Objective: To explore the molecular biological mechanism of Arnebia root oil promoting wound surface healing by observing histological change and bFGF expression in wound surface tissue as well as wound surface healing rate. Methods: Raw surface in patients were randomly divided into 2 groups. Experimental group was treated by Arnebia root oil and control group was treated by petrolatum gauze, then the tissular structure of raw surface was observed by histology, histochemistry. electron microscope and raw surface healing rates was compared either. bFGF expression in wound surface tissue was also evaluated by Western-blot. Results: Raw surface healing rate of experimental group and control group had obvious difference(P<0. 05). Raw surface of experimental group had more fibroblast, collagen and blood capillary. bFGF was expressed in both groups, and the level of bFGF expression in experimental group was higher than that in control group in every period. There were significant differences between 2 groups in gray-density value ( P<0. 05). Being as an internal control, no significant change was found for β-actin expression, although it occured in various phases. Conclusion: Arnebia root oil plays an important regulative role in the course of healing of wound and it can promote skin raw surface repair and accelerate wound surface healing, which are caused by enhancing bFGF in the wound tissue.

Adult duodenal intussusception with horizontal adenoma: A rare case report

BACKGROUND Adult duodenal intussusception rarely occurs,and the majority of duodenal adenomas are located in the descending part of the duodenum.Therefore,adenomas in the horizontal part of the duodenum presenting as duodenal intussusception in adults are extremely rare.CASE SUMMARY A 36-year-old man complained of abdominal pain for 13 d.Blood analysis showed anemia.Magnetic resonance cholangiopancreatography and computed tomography revealed a tumor in the horizontal part of the duodenum as the main finding,leading to duodeno-duodenal intussusception.No obvious abnormalities were found on endoscopy or upper gastrointestinal radiography.He was diagnosed with duodenal intussusception secondary to duodenal adenoma.Laparotomy showed duodeno-duodenal intussusception and a tumor in the horizontal part of the duodenum near the ascending part.Postoperative pathology revealed tubular-villous adenoma with low-grade glandular intraepithelial neoplasia(local high-grade intraepithelial neoplasia).He was discharged without complications.CONCLUSION This case highlights that rational use of computed tomography,magnetic resonance cholangiopancreatography,endoscopy and upper gastrointestinal radiography for preoperative diagnosis and timely surgery is an effective strategy for the treatment of adult duodenal intussusception with duodenal masses.

Intestinal gangrene secondary to congenital transmesenteric hernia in a child misdiagnosed with gastrointestinal bleeding: A case report

BACKGROUND Congenital transmesenteric hernia in children is a rare and potentially fatal form of internal abdominal hernia,and no specific clinical symptoms can be observed preoperatively.Therefore,this condition is not widely known among clinicians,and it is easily misdiagnosed,resulting in disastrous effects.CASE SUMMARY This report presents the case of a 13-year-old boy with a chief complaint of abdominal pain and vomiting and a history of duodenal ulcer.The patient was misdiagnosed with gastrointestinal bleeding and treated conservatively at first.Then,the patient’s symptoms were aggravated and he presented in a shock-like state.Computed tomography revealed a suspected internal hernia,extensive small intestinal obstruction,and massive effusion in the abdominal and pelvic cavity.Intraoperative exploration found a small mesenteric defect approximately 3.5 cm in diameter near the ileocecal valve,and there was about 1.8 m of herniated small intestine that was treated by resection and anastomosis.The patient recovered well and was followed for more than 5 years without developing short bowel syndrome.CONCLUSION In this report,we review the pathogenesis,presentation,diagnosis,and treatment of congenital transmesenteric hernia in children.

Photodynamic therapy regulates fate of cancer stem cells through reactive oxygen species

Photodynamic therapy(PDT)is an effective and promising cancer treatment.PDT directly generates reactive oxygen species(ROS)through photochemical reactions.This oxygen-dependent exogenous ROS has anti-cancer stem cell(CSC)effect.In addition,PDT may also increase ROS production by altering metabolism,endoplasmic reticulum stress,or potential of mitochondrial membrane.It is known that the half-life of ROS in PDT is short,with high reactivity and limited diffusion distance.Therefore,the main targeting position of PDT is often the subcellular localization of photosensitizers,which is helpful for us to explain how PDT affects CSC characteristics,including differentiation,selfrenewal,apoptosis,autophagy,and immunogenicity.Broadly speaking,excess ROS will damage the redox system and cause oxidative damage to molecules such as DNA,change mitochondrial permeability,activate unfolded protein response,autophagy,and CSC resting state.Therefore,understanding the molecular mechanism by which ROS affect CSCs is beneficial to improve the efficiency of PDT and prevent tumor recurrence and metastasis.In this article,we review the effects of two types of photochemical reactions on PDT,the metabolic processes,and the biological effects of ROS in different subcellular locations on CSCs.

Influence of the heat irrigating effect of radiofrequency ablation on regional liver tissue in Bama miniature pigs

BACKGROUND The results of the heat irrigating effect of radiofrequency ablation(RFA)are uncertain,and the accurate impact of the heat irrigating effect on regional liver tissue is unknown due to a lack of control experiments.AIM The aim of this study was to determine the influence of the heat irrigating effect of RFA on regional liver tissue in Bama miniature pigs.METHODS Eight Bama miniature pigs were randomly divided into the observation group(group A)and the control group(group B),with 4 pigs/group.An RFA electrode needle was implanted near the hepatic segment vasculature(3-5 mm from the hepatic segment portal vein)under ultrasound guidance in group A.Similarly,an RFA electrode needle was implanted far from the hepatic segment vasculature(8-10 mm from the hepatic segment portal vein)in group B.The left internal lobe and right medial lobe were chosen as RFA sites in each pig.RFA was performed at the left internal lobe on day one in each pig,and at the right medial lobe 7 d later.Each RFA lasted 12 min.The general status of the pigs and serious complications were observed during the perioperative period.The pigs were sacrificed and the livers were removed immediately after RFA on the eighth day.The samples were roughly observed.Hematoxylin-eosin and Ki67 staining,as well as TUNEL detection,were performed on the tissue sections.RESULTS All 8 animals successfully underwent ultrasound-guided RFA.No serious complications,such as massive hemorrhage,biliary fistula,severe pleural effusion,pneumothorax,peripheral organ failure,or renal failure occurred in any of the animals during the perioperative period.The RFA coagulative necrosis lesion was spherical and the surrounding liver tissue showed an inflammatory response.The difference in the Suzuki score of the liver tissue surrounding the ablated portal vein,and its distal area between groups A and B,was statistically significant(P<0.05).More apoptotic cells were seen in liver tissue surrounding the ablated portal vein and its distal area in group A,while fewer apoptotic cells in the same area were seen in group B.The difference in the apoptotic index of the above area between group A and group B was statistically significant(P<0.05).Cells staining positive for Ki67 were observed in liver tissue at the left internal lobe around the ablated portal vein and its distal area in group A.No Ki67 staining positive cells were observed in other tissue sections.The difference in the Ki67 staining positive index in the above area was statistically significant(P<0.05)between group A and group B.CONCLUSION Changes as a result of thermal damage occur in liver tissue around the ablated portal vein and its distal area due to the heat irrigating effect when the RFA electrode tip is close to(<5 mm)the portal vein.

Destroying pathogen-tumor symbionts synergizing with catalytic therapy of colorectal cancer by biomimetic protein-supported single-atom nanozyme

The crucial role of intratumoral bacteria in the progression of cancer has been gradually recognized with the development of sequencing technology.Several intratumoral bacteria which have been identified as pathogens of cancer that induce progression,metastasis,and poor outcome of cancer,while tumor vascular networks and immunosuppressive microenvironment provide shelters for pathogens localization.Thus,the mutually-beneficial interplay between pathogens and tumors,named“pathogentumor symbionts”,is probably a potential therapeutic site for tumor treatment.Herein,we proposed a destroying pathogen-tumor symbionts strategy that kills intratumoral pathogens,F.nucleatum,to break the symbiont and synergize to kill colorectal cancer(CRC)cells.This strategy was achieved by a groundbreaking protein-supported copper single-atom nanozyme(BSA-Cu SAN)which was inspired by the structures of native enzymes that are based on protein,with metal elements as the active center.BSA-Cu SAN can exert catalytic therapy by generating reactive oxygen species(ROS)and depleting GSH.The in vitro and in vivo experiments demonstrate that BSA-Cu SAN passively targets tumor sites and efficiently scavenges F.nucleatum in situ to destroy pathogentumor symbionts.As a result,ROS resistance of CRC through elevated autophagy mediated by F.nucleatum was relieved,contributing to apoptosis of cancer cells induced by intracellular redox imbalance generated by BSA-Cu SAN.Particularly,BSA-Cu SAN experiences renal clearance,avoiding long-term systemic toxicity.This work provides a feasible paradigm for destroying pathogen-tumor symbionts to block intratumoral pathogens interplay with CRC for antitumor therapy and an optimized trail for the SAN catalytic therapy by the clearable protein-supported SAN.

Generation of(E)-β-trifluoromethyl vinylsulfonohydrazides under photocatalysis and their anti-bacteria activity

Trifluoromethylation/sulfonylation of alkynes from trifluoromethyl thianthrenium triflate and sulfur dioxide under extremely mild reaction conditions provides a facile access to trifluoromethyl-substituted vinyl sulfonohydrazides in moderate to good yields.This multicomponent reaction of trifluoromethyl thianthrenium triflate,alkynes,sulfur dioxide and hydrazines proceeds efficiently under visible light irradiation in the presence of photocatalyst at room temperature with broad substrate scope and excellent functional group compatibility.This reaction is highly stereoselective,and only(E)-isomers are obtained.Additionally,these trifluoromethyl-substituted vinyl sulfonohydrazides are further evaluated for anti-bacteria activity.In vitro activities of these compounds against Staphylococcus aureus(G+)and Escherichia coli(G-)are examined.

Superlow Power Consumption Artificial Synapses Based on WSe2 Quantum Dots Memristor for Neuromorphic Computing

As the emerging member of zero-dimension transition metal dichalcogenide,WSe2 quantum dots(QDs)have been applied to memristors and exhibited better resistance switching characteristics and miniaturization size.However,low power consumption and high reliability are still challenges for WSe_(2) QDs-based memristors as synaptic devices.

Generation and metabolomic characterization of functional ductal organoids with biliary tree networks in decellularized liver scaffolds

Developing functional ductal organoids(FDOs)is essential for liver regenerative medicine.We aimed to construct FDOs with biliary tree networks in rat decellularized liver scaffolds(DLSs)with primary cholangiocytes isolated from mouse bile ducts.The developed FDOs were dynamically characterized by functional assays and metabolomics for bioprocess clarification.FDOs were reconstructed in DLSs retaining native structure and bioactive factors with mouse primary cholangiocytes expressing enriched biomarkers.Morphological assessment showed that biliary tree-like structures gradually formed from day 3 to day 14.The cholangiocytes in FDOs maintained high viability and expressed 11 specific biomarkers.Basal-apical polarity was observed at day 14 with immunostaining for E-cadherin and acetylatedα-tubulin.The rhodamine 123 transport assay and active collection of cholyl-lysyl-fluorescein exhibited the specific functions of bile secretion and transportation at day 14 compared to those in monolayer and hydrogel culture systems.The metabolomics analysis with 1075 peak pairs showed that serotonin,as a key molecule of the tryptophan metabolism pathway linked to biliary tree reconstruction,was specifically expressed in FDOs during the whole period of culture.Such FDOs with biliary tree networks and serotonin expression may be applied for disease modeling and drug screening,which paves the way for future clinical therapeutic applications.

Therapeutic targets of Traditional Chinese Medicine for colorectal cancer

OBJECTIVE: To explore the role of Traditional Chinese Medicine(TCM) in the prevention and treatment of colorectal cancer and identify possible therapeutic targets of TCM to provide clues for the use of TCM for colorectal cancer prevention and treatment in the clinic and to find novel directions for new drug discovery for colorectal cancer.METHODS: We used Pub Med and Google to search for and collect scientific publications for a full evaluation of current evidence in the literature indicating the potential role of Chinese herbal medicines and their respective ingredients as effective candidatesforcolorectalcancerpreventionandtreatment.RESULTS: We extracted a detailed description of potential therapeutic Chinese herbal medicines and their constituent ingredients that target different mechanisms in colorectal cancer such as gene mutation, dysregulation of signaling pathways, metabolism disorders, and the inflammatory microenvironment, including both conventional and non-conventional approaches.CONCLUSION: TCM may be a promising complementary and alternative therapy for the treatment of colorectal cancer.

Effects of Electroacupuncture Combined Psycho-intervention on Cognitive Function and Event-Related Potentials P300 and Mismatch Negativity in Patients with Internet Addiction

Objective： To observe the effects of comprehensive therapy （CT） with electroacupuncture （EA） in combination with psycho-intervention （PI） on the cognitive function and event-related potentials （ERP）, P300 and mismatch negativity （MMN）, in patients with internet addiction （IA） for a preliminary exploration of the possible mechanism of the therapy. Metheds： One hundred and twenty patients with IA were randomly divided into three groups, and a total of 112 subjects reached the final analysis of the trial, the EA group （39 patients）, the PI group （36 patients） and the CT group （37 patients）. EA was applied at acupoints Baihui （GV20）, Sishencong （EX-HN1）, Hegu （LI4）, Neiguan （PC6）, Taichong （LR3） and Sanyinjiao （SP6）, once every other day; PI with the cognition- behavior mode was implemented every 4 days; both EA and PI were used in the CT group. The treatment course for all patients was 40 days. Changes before and after treatment in terms of scoring by the IA self-rating scale, short-term memory capacity, short-term memory span, and the latency and amplitude of P300 and MMN in patients were observed. Results： After treatment, in all groups, the IA score was lowered significantly （P〈0.05） and scores of short-term memory capacity and short-term memory span increased significantly （P〈0.05）, while the decreased IA score in the CT group was more significant than that in the other two groups （P〈0.05）. ERP measurements showed that P300 latency was depressed and its amplitude raised in the EA group; MMN amplitude increased in the CT group （all P〈0.05）. Cenclusien： The EA in combination with PI could improve the cognitive function of IA patients, and its mechanism might be related to the speedup of cerebral discrimination on external stimulus and the enhancement of effective resource mobilization during information processing of the brain.

Clinical characteristics and prognostic values of 1p32.3 deletion detected through fluorescence in situ hybridization in patients with newly diagnosed multiple myeloma: a single-center study in China

This study aimed to investigate the prevalence,clinical characteristics,and prognostic impact of 1p32.3 deletion in patients with newly diagnosed multiple myeloma (MM).A retrospective analysis was conducted on 411 patients with newly diagnosed MM;among which,270 received bortezomib-based therapies,and 141 received thalidomide-based therapies.Fluorescence in situ hybridization (FISH) was performed to detect six cytogenetic abnormalities,namely,del(1p32.3),gain(1q21),del(17p13),del(13q14),t(4;14),and t(11;14).Results showed that 8.3% of patients with MM were detected with del(1p32.3) and had significantly more bone marrow plasma cells (P =0.025),higher β2-microglobulin levels (P =0.036),and higher lactate dehydrogenase levels (P =0.042) than those without del(1p32.3).Univariate analysis showed that patients with del(1p32.3) under thalidomide-based therapies were strongly associated with short progression-free survival (PFS) (median PFS 11.6 vs.31.2 months,P =0.002) and overall survival (OS) (median OS 16.8 vs.45.9 months,P < 0.001).Multivariate analysis revealed that del(1p32.3) remained a powerful independent factor with worse PFS (P =0.006) and OS (P =0.016) for patients under thalidomide-based treatments.Patients with del(1 p32.3) under bortezomib-based treatments tended to have short PFS and OS.In conclusion,del(1p32.3) is associated with short PFS and OS in patients with MM who received thalidomide-or bortezomib-based treatments.

Giant cell angiofibroma in the vocal cord

Giant cell angiofibroma （GCA） was first described in 1995, and it is a rare tumor in soft tissues,1 Since the initial report of the disease in orbital tissue, GCA has been reported in a variety of other soft tissues.2,3 The morphological hallmark is richly vascularized, patternless spindle cell proliferation in the presence of pseudovascular spaces and multinucleated giant cells. The pathological diagnosis of GCA is mainly based on positive staining of CD34. GCA is usually considered to be a benign tumor. In clinic, GCA needs to be distinguished from other tumors in soft tissues. Herein,we report two rare cases of GCA in the vocal cord and describe its histological features.

Prospect of Animal Models for Acute-on-chronic Liver Failure:A Mini-review

Acute-on-chronic liver failure(ACLF)is a clinical syndrome that develops in patients with chronic liver diseases following a precipitating event and associated with a high mortality rate due to systemic multiorgan failure.Establishing a suitable and stable animal model to precisely elucidate the molecular basis of ACLF pathogenesis is essential for the development of effective early diagnostic and treatment strategies.In this context,this article provides a concise and inclusive review of breakthroughs in ACLF animal model development.

Pulmonary Lymphangiomyomatosis Associated with Renal and Hepatic Angiomyolipoma Mass in a Patient with Tuberous Sclerosis Complex

To the Editor：Tuberous sclerosis complex （TSC）,a rare autosomal dominant and variable penetrance,affects about 10 in every 100,000 people.[1] In general,it is described as a clinical triad of adenomas,mental disorders,and seizures.However,due to incomplete penetrance,symptoms may be involved in isolated organs,which may manifest as mild incomplete diseases or involve multiple organs.Pulmonary lymphangiomyomatosis （LAM） associated with both renal and hepatic angiomyolipomas （AMLs） in a TSC patient is very rare.To the best of our knowledge,only one case has been reported by Ciftci et al.[2] Here,we present such a case with clinical and pathological analysis.