Objective: To evaluate the safety and efficacy of preoperative autologous blood donation (PABD) under anesthesia monitoring in elective surgical procedures, and to provide scientific data for promoting its clinical application. Methods: 1) A total of 1 164 patients scheduled for elective surgery and met the criteria for stored autologous blood transfusion in our hospital from March 2022 to September 2023 were enrolled. Prior to surgery, stored autotransfusion was performed under anesthesia monitoring. During the operation, blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO ) and other basic life indicators before and after blood collection were recorded and analyzed. Adverse reactions during blood collection were documented, and potential influencing factors were analyzed. 2) The autologous transfusion group (experimental group, patients receiving intraoperative autologous blood reinfusion) was compared with the allogeneic transfusion group (control group, patients without PABD during the same period) using propensity score matching. The length of hospital stay, transfusion-related costs, perioperative hemoglobin (Hb), hematocrit (Hct), platelet count (Plt) and coagulation function were compared between the two groups after matching. Results: 1) Three patients (0.26%) had adverse reactions during blood collection. Autologous blood transfusion was performed in 443 patients (38.1%) during or after operation, with no adverse reaction during blood transfusion. 2) The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of patients after blood collection were lower than before blood collection, and the SpO was higher than before blood collection, with statistically significant differences (P<0.05); There was no significant difference in heart rate before and after blood collection (P>0.05); Our analysis found that age, gender, blood collection volume, department, or mild-to-moderate circulatory system complications didn’t significantly affect BP, HR and SpO fluctuations (P>0.05). 3) The experimental group had shorter hospital stays and lower transfusion costs than the control group (P<0.05). 4) No significant differences were observed in Hb, Hct, Plt levels or coagulation function (PT, APTT) between the two groups after operation (P>0.05). The hospitalization duration and transfusion related expenses in the experimental group were lower than those in the control group (P<0.05). Conclusion: PABD under anesthesia monitoring is safe and feasible in elective surgeries across diverse patient groups and surgical fields. It reduces the costs and conserves blood resources, which is worthy of further promotion.

BACKGROUND: Molecular subtyping is an essential complementarity after pathological analyses for targeted therapy. This study aimed to investigate the consistency of next-generation sequencing (NGS) results between circulating tumor DNA (ctDNA)-based and tissue-based in non-small cell lung cancer (NSCLC) and identify the patient characteristics that favor ctDNA testing. METHODS: Patients who diagnosed with NSCLC and received both ctDNA- and cancer tissue-based NGS before surgery or systemic treatment in Lung Cancer Center, Sichuan University West China Hospital between December 2017 and August 2022 were enrolled. A 425-cancer panel with a HiSeq 4000 NGS platform was used for NGS. The unweighted Cohen's kappa coefficient was employed to discriminate the high-concordance group from the low-concordance group with a cutoff value of 0.6. Six machine learning models were used to identify patient characteristics that relate to high concordance between ctDNA-based and tissue-based NGS. RESULTS: A total of 85 patients were enrolled, of which 22.4% (19/85) had stage III disease and 56.5% (48/85) had stage IV disease. Forty-four patients (51.8%) showed consistent gene mutation types between ctDNA-based and tissue-based NGS, while one patient (1.2%) tested negative in both approaches. Patients with advanced diseases and metastases to other organs would be suitable for the ctDNA-based NGS, and the generalized linear model showed that T stage, M stage, and tumor mutation burden were the critical discriminators to predict the consistency of results between ctDNA-based and tissue-based NGS. CONCLUSION ctDNA-based NGS showed comparable detection performance in the targeted gene mutations compared with tissue-based NGS, and it could be considered in advanced or metastatic NSCLC.
Humans ; Carcinoma, Non-Small-Cell Lung/pathology* ; Circulating Tumor DNA/blood* ; High-Throughput Nucleotide Sequencing/methods* ; Female ; Male ; Lung Neoplasms/pathology* ; Middle Aged ; Mutation/genetics* ; Aged ; Adult ; Aged, 80 and over

Regarding biological samples,compared to the Measures of Ethical Review of Biomedical Research Involving Humans,the newly released Measures of Ethical Review of Life Science and Medical Research Involving Humans updated the definitions,clarified the scope,defined the responsibilities of the subject,as well as emphasized the management system,ethical review,and informed consent.By comparing and analyzing the current management status of biological samples at home and abroad,it was found that there were still many problems in the management and ethical review of biological samples in China,such as a chaotic management system of biological samples,unclear responsible entities for management,lack of widely recognized management standards of biological samples in the industry,absence of ethics committee,the non-standard ethical review,the inadequacy or inability to implement informed consent,and the difficulty in providing feedback on research results.Therefore,it is recommended to establish a standardized management system of biological samples,conduct a standardized and effective ethical review,as well as sufficient and necessary informed consent,in order to comply with the requirements of the Measures of Ethical Review of Life Science and Medical Research Involving Humans on biological samples,and enhancing the quality of the management of biological samples in China.

Nowadays,both international and domestic scientific and technological innovation activities are facing different types and degrees of ethical risks,which bring many negative impacts to human society and even threaten the safety of individuals'lives and properties.To further standardize the ethics review of science and technology,strengthen risk prevention and control,and promote responsible innovation,ten ministries and commissions jointly issued the Measures for Scientific and Technological Ethics Review(for Trial Implementation)in September 2023.The Measures for Scientific and Technological Ethics Review(for Trial Implementation)required that ethical review should be implemented for science and technology innovation activities in many fields,ethical review should be more practicable.It strengthened emergency management of major public emergencies,proposed that research institutions should establish risk assessment methods,new unorganized personnel can apply for entrusted ethical review,and an ethics committee certification system should be established.The Measures for Scientific and Technological Ethics Review(for Trial Implementation)had outstanding highlights and distinctive features,clarified the responsible parties for scientific and technological innovation activities,strengthened their responsibilities and management of ethical review,introduced a management system for the list of scientific and technological activities,and created an expert review model for addressing the challenges of greater ethical risks.The interpretation and implementation reflection on the Measures for Scientific and Technological Ethics Review(for Trial Implementation)can provide a reference for the implementation of it,with a view to promoting the ethical review of science and technology as a normative force,as well as facilitating the upward and positive development of scientific and technological innovation activities for the benefit of humanity.

Hormonal receptor positive human epidermal receptor 2 negative (HR⁺/HER2^-) is the commonest molecular subtype of breast cancer (BC). Patients with HR⁺/HER2^- BC may manifest clinically a late recurrence whose BC metastasizes 10-15 years post-operatively. We report one case who presented with pulmonary mass in upper lobe of lung and Horner syndrome 16 years after BC surgery. FDG PET/CT suggested pulmonary malignancy but could not differentiate between primary or metastatic cancer when invasive biopsy was quite risky. Novel ¹⁸F-FES PET/CT facilitated the non-invasive functional diagnosis of estrogen-receptor positive (ER+) pulmonary metastasis of BC, and the patient experienced partial response (PR) after CDK4/6 inhibitor and aromatase inhibitor as endocrine therapy. This article reviews the diagnosis and treatment process of this case, to provide guidance for non-invasive global evaluation of ER status among metastatic HR⁺/HER2^- BC patients with ¹⁸F-FES PET/CT.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.

Severe acute pancreatitis (SAP) is a serious disease commonly encountered in the emergency department and can precipitate systemic inflammatory response syndrome and multiple organ dysfunction syndrome with high morbidity and mortality. However, its etiology and pathogenesis are complex and have not been fully elucidated. Clinical studies can provide some data on the etiology, pathophysiology, and outcome associated with the disease. However, research on SAP cannot be carried out in humans directly for ethical considerations. It is very important to establish an appropriate animal model of SAP to elucidate its pathogenesis and seek innovative therapeutic methods. In this paper, we reviewed the latest research progress at home and abroad in animal models of SAP over the past several years.

Objective:This study aimed to sort out the problems of research participant recruitment based on the chain of ethical review, exploring coping strategies, and managing the whole cycle.Methods:Through policy interpretation and literature review, we analyzed and discussed issues related to recruitment principles, recruitment pathways, recruitment programs, and recruitment advertisements, so as to provide references for the principal investigator to make appropriate plans before recruitment, implement them with high quality during recruitment, and summarize and improve them after recruitment, so as to facilitate the completion of the study with high quality.Results:There were various problems at various stages of recruitment, such as insufficient attention to representativeness before recruitment, lack of a recruitment plan, irrational design and release of recruitment advertisements, lack of attention to fairness and voluntariness during recruitment, failure to face up to possible risks and benefits, coercion or misunderstanding, inappropriate use of specialized medical terminology, insufficient informed consent, lack of attention to the protection of privacy and personal information, failure to summarize and improve the recruitment in a timely manner, lack of attention to the training of recruitment teams and talent development, and lack of regulation of third-party recruitment companies and unregulated behaviors. summarize and improve, insufficient attention to recruitment team training and talent development, and lack of regulation of third-party recruitment companies and irregularities.Conclusions:In order to improve the quality and efficiency of research participant recruitment, proper planning should be made before recruitment to avoid under-representation, select appropriate recruitment methods, formulate a scientific recruitment plan, design standardized and reasonable recruitment advertisements, appropriately increase the frequency of publication of recruitment advertisements, and clarify whether to commission a third-party recruitment company. Recruitment should be carried out with high quality, strictly implement fair and voluntary recruitment, face the potential risks and benefits, avoid coercion or misunderstanding, use easy-to-understand layman's medical terminology, give full informed consent, pay attention to the protection of privacy and personal information, identify and avoid " professional research participants", and pay attention to the recruitment of pregnant women, children, and patients with critical illnesses, etc.. After recruitment, the recruitment should be summarized and perfected, and the recruitment team training and human resources training should be strengthened. After recruitment, we should summarize and improve the recruitment tools, develop and promote systematic recruitment tools, strengthen the training of the recruitment team and talent cultivation, improve the conversion rate of Internet recruitment, give appropriate compensation to the research participants or their guardians, focus on the supervision of irregularities, and set up a system for qualification and supervision of third-party recruitment companies.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.