Objective To assess the current status and outcomes of living donor liver transplantation (LDLT) in patients with unresectable colorectal cancer liver metastases (CRLM). Methods Two reviewers independently conducted a systematic search of Medline (via PubMed), the Cochrane Library, and ClinicalTrials.gov in accordance with preferred reporting items for systematic reviews guidelines. English-language publications reporting LDLT for unresectable CRLM were identified; study characteristics and recipient outcomes were extracted. Results Twelve studies were retrieved, six completed studies enrolling 55 patients and six ongoing trials. Selected patients appeared to derive benefit from LDLT. Reported overall survival was 100% at 1 year and 100%, 71.4% at 3 years. The 1-year progression-free survival was 85.7% and 75.1%, and 3-year progression-free survival was 68.6% and 53.7%. Conclusions Prospective data on LDLT for unresectable CRLM remain scarce. The approach is still investigational and warrants validation through prospective clinical trials.

BACKGROUND:Currently,there have been studies on three-dimensional digitalization and visualization systems for adult acupoints,but there are not many reports on the visualization of pediatric acupoints based on real pediatric digital sectional anatomical datasets. OBJECTIVE:To design and develop a digital three-dimensional visualization system for children's neck acupoints,to provide a basis for acupuncture and moxibustion,meridian and acupoint science teaching,clinical practice,acupuncture manipulation practice,and acupuncture safety research,and to provide a basis for the development of children's acupoint simulation system. METHODS:Based on a real cross-sectional anatomical dataset of pre-school boys,a three-dimensional digital virtual anatomical model of the neck region of children and internal multi-organ three-dimensional reconstruction were completed using PhotoShop 2021 and Digihuman Reconstruction System software.A database of 11 acupoints was compiled,including Fengfu and Fengchi,using the Unity database language.A three-dimensional model of children's neck anatomy,acupoint database,and writing acupuncture operation codes were integrated in Unity3D software.A three-dimensional digital visualization system for children's neck acupoints was successfully created,which integrated simulation acupoint positioning,three-dimensional acupoint anatomy,acupuncture training,clinical teaching,and acupuncture safety research. RESULTS AND CONCLUSION:(1)This study was based on real child specimens.Manual layer by layer segmentation of cross-sectional images was used to ensure the accuracy of the three-dimensional model to the greatest extent possible.The 3D software Digihuman Reconstruction System was utilized to extract and save independent segmentation data.PhotoShop 2021 software was collaborated with to complete dozens of three-dimensional reconstruction anatomical models of the outer skin of the neck and its internal bone structure,cervical spinal cord,blood vessels and nerves,muscles,and ligaments in children.The basic morphology and overall contour integrity verification of each independent structure were completed in MeshLab software.The 3-material research 13.0 software was applied for final fine tuning and anatomical position confirmation,successfully simulating and restoring the true anatomical morphology of the neck of preschool children.(2)Based on and referring to the national standards of the People's Republic of China,a database of commonly used acupoints in children's neck region was collected and organized,including their names,meridians,positioning,local anatomy,needle insertion levels,acupuncture methods,acupuncture accidents and prevention,acupoint indications,and two-dimensional anatomical sectional images.(3)Unity3D software was employed to integrate the three-dimensional model of children's neck,acupuncture simulation operation,and acupoint database,and a three-dimensional digital children's neck acupoint acupuncture visualization system was successfully constructed.The system displayed information on children's neck acupoints,two-dimensional and three-dimensional anatomical structures,and achieved two-dimensional and three-dimensional acupuncture simulation functions and acupuncture safety research functions for children's neck acupoints.Based on the ultra-thin sectional anatomical dataset of real child specimens,the first three-dimensional digital and visualization system for acupoints in the neck region of children had been constructed.Compared with previous acupoint acupuncture systems,it is more in line with the anatomical and morphological development characteristics of Asian children and has high application value in the fields of acupuncture safety research,clinical teaching,and acupuncture simulation training.

Maidong products are categorized into "Hang Maidong" and "Chuan Maidong". Since the Ming and Qing Dynasties, "Hang Maidong" has been regarded as having superior quality, but currently, it remains in name only in the market. This article reviewed historical materia medica and local chronicles from the Ming and Qing Dynasties and analyzed the historical evolution of Maidong production areas. The history of Maidong production in Zhejiang can be traced back to the Song Dynasty, and cultivation had already developed by at least the Ming Dynasty. During the Ming and Qing Dynasties, it was consistently used as a tribute. Ming Dynasty chronicles record "Chuan Maidong", which had already been cultivated on a large scale by the Qing Dynasty. "Hang Maidong" and "Chuan Maidong" share the same origin, with the former identifiable by the "gourd waist" shape of its tuberous root. Based on this, it can be inferred that the "Maimendong" herb illustrated in the Origins of Materia Medica(Ben Cao Yuan Shi) and the Maidong stored in the Qing Palace Imperial Pharmacy were both "Hang Maidong". The protection and development of the authentic "Hang Maidong" medicinal herb are urgently needed.
China ; Drugs, Chinese Herbal/history* ; History, 17th Century ; History, Ancient ; Medicine, Chinese Traditional/history* ; History, Medieval ; History, 16th Century ; History, 18th Century ; History, 15th Century ; Plants, Medicinal/chemistry* ; History, 19th Century ; History, 20th Century ; Humans ; Materia Medica/history* ; History, 21st Century

OBJECTIVE: To standardize the operative procedure for tissue-engineered cartilage repair, by demonstrating surgical technique of arthroscopic implantation of decalcified cortex-cancellous bone scaffolds, and summarizing the surgical experience of the sports medicine department team at Peking University Third Hospital. METHODS: This article elaborates on surgical techniques and skills, focusing on the unabridged implantation technology and surgical procedure of decalcified cortex-cancellous bone scaffolds under arthroscopy: First, the patient was placed in the supine position. After anesthesia had been established, the surgeon established an arthroscope and explored the damaged area under the scope. After confirming the size and location of the injury site, the surgeon cleaned the damaged cartilage, and also trimmed the edges of the cartilage to ensure that the cut surface was smooth and stable. the surgeon performed the micro-fracture surgery in the area of cartilage injury, and then measured the size of the injured area under the scope. Next, the surgeon manually trimmed the tissue-engineered scaffold based on the measurements taken under the arthroscope, and then directly implanted the scaffold using a sleeve. A honeycomb-shaped fixator was used to implant absorbable nails to fix the scaffold. After the scaffold was installed, the knee was repeatedly flexed and extended for 10-20 times to ensure stability and range of motion. Finally, the arthroscope was withdrawn and the wound was closed. RESULTS: Decalcified cortex-cancellous bone scaffolds possessed unparalleled advantages over synthetic materials in terms of morphology and biomechanics. The cancellous bone part of the scaffold provided a three-dimensional, porous space for cell growth, while the cortical bone part offered the necessary mechanical strength. The surgery was performed entirely under arthroscopy to minimize invasiveness to the patient. Absorbable pins were used for fixation to ensure the stability of the scaffold. This technique could effectively improve the prognosis of the patients with cartilage injuries and standardized the surgical procedures for arthroscopic tissue-engineered scaffold operations in the patients with cartilage damage. CONCLUSION With the standard arthroscopic tissue-engineered scaffold repair technique, it is possible to successfully repair damaged cartilage, alleviate symptoms in the short term, and provide a more ideal long-term prognosis. The author and their team explain the surgical procedures for tissue-engineered scaffolds under arthroscopy, with the aim of guiding future clinical practice.
Tissue Engineering/methods* ; Humans ; Tissue Scaffolds ; Arthroscopy/methods* ; Cartilage, Articular/surgery*

Objective To construct 5 machine-learning models and compare their performance in predicting the associations between pre-pregnancy socio-psycho-behavioral exposures of both spouses and preconception outcomes.Methods Based on Chongqing Preconception Reproductive Health and Birth Outcome Cohort of volunteers recruited from Chongqing Health Center for Women and Children during January 2019 and March 2022,5 447 couples were recruited and surveyed through interviewer-interview for the demographic and social-psychological-behavioral data of both spouses(221 variables).According to the inclusion and exclusion criteria,4 097 couples were finally included,and randomly assigned into a training set(n=2 867 spouses)and a validation set(n=1 230 spouses)at a ratio of 7∶3.Feature analysis and collinear screening were applied to select the potential exposure factors.In consideration of difficulty to carry out semen parameters analysis in primary healthcare institutions,feature Set 1 including sperm parameters and feature Set 2 excluding semen parameters were constructed by including or excluding sperm quality simultaneously in the training set and the validation set.Five algorithms,that is,Logistic Regression,Naive Bayes,Random Forest,Gradient Boosting Machine,and Support Vector Machine,were used to construct preconception outcome prediction models,and the parameters of each model were optimized using random search combined with grid search.The predictive performance of each model was compared using precision,recall,F1 score,area under the receiver operating characteristic curve(AUC),and calibration curve.The optimal model was then selected by comparing the changes in the predictive ability of the questionnaire data for fertility outcomes with or without semen parameters.Results There were 24 variables screened out in feature Set 1,and 16 variables in feature Set 2.In feature Set 1,the gradient boosting machine performed better,with a relatively higher AUC value(0.651)and better F1 score(0.61).The logistic regression model performed stably(AUC value=0.647)and was suitable as the reference model.The random forest(AUC value=0.641),Naive Bayes(AUC value=0.641),and support vector machine(AUC value=0.634)performed second-best.By utilizing the gradient boosting machine,comparable results were found between the predictions from feature sets with or without semen parameters,as in feature Set 1,the AUC value of its validation set was 0.651(95%CI:0.629～0.681),the prediction accuracy was 0.63,the recall rate was 0.65,and the average precision value F1 was 0.61;and in feature Set 2,the AUC value of its validation set was 0.649(95%CI:0.624～0.663),and both the calibration curves were close to the ideal curve.The prediction results indicated that in feature Set 1,the features highly negatively correlated with preconception outcomes were female age,male age,and no pregnancy within 1 year without contraception,while the features highly positively correlated with preconception outcomes were female pregnancy history,total sperm vitality,and use of contraceptive measures before enrollment.Conclusion Among the 5 machine-learning algorithms performed in this cohort data,the gradient boosting machine shows slightly better performance.There are 24 factors being associated with preconception outcomes in both spouses,and the performance of the simplified model excluding semen parameters is not significantly declined.It is feasible to use machine-learning methods to predict human preconception outcomes through social-psychological-behavioral questionnaires.

Objective To systematically evaluate the clinical efficacy of the prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium in the treatment of postoperative thyroid cancer,and to provide evidence-based medical proof for clinical treatment of postoperative thyroid cancer.Methods Computer search was performed in the major domestic and oversea databases for the retrieval of clinical randomized controlled trials(RCTs)of prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium for the treatment of postoperative thyroid cancer.After screening the literature according to the inclusion and exclusion criteria,the quality of the included literature was evaluated using the tools for analysis of the bias recommended by Cochrane Reviewer's Handbook and the modified JADAD rating scale,and meta-analysis was performed using RevMan 5.4 software.Results A total of 11 RCTs involving 749 patients were eventually included.The results of meta-analysis showed that compared with Levothyroxine Sodium alone,prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium significantly enhanced the efficacy of postoperative patients with thyroid cancer(RR=1.30,95%CI[1.21,1.41],Z = 6.81,P＜0.000 01),and improved the thyroid functions parameters of serum thyroid stimulating hormone(TSH)(SMD=-1.75,95%CI[-2.38,-1.13],Z = 5.47,P＜0.000 01),thyroglobulin(TG)(SMD=-1.13,95%CI[-1.71,-0.55],Z = 3.81,P = 0.000 1),free triiodothyronine(FT3)(SMD=3.42,95%CI[0.73,6.10],Z = 2.50,P = 0.01),free thyroxine(FT4)(SMD=1.85,95%CI[0.05,3.66],Z = 2.02,P = 0.04),and thyroglobulin antibody(TgAb)(SMD=-0.63,95%CI[-1.11,-0.15],Z = 2.55,P = 0.01),increased Karnofsky Performance Status(KPS)scores(SMD= 2.19,95%CI[1.30,3.08],Z = 4.81,P＜0.000 01),shortened the time for the relief of clinical symptoms after thyroid cancer surgery(MD=-4.67,95%CI[-5.38,-3.96],Z = 12.87,P＜0.000 01),reduced the diameter of the largest thyroid nodule after thyroid cancer surgery(MD=-2.51,95%CI[-3.13,-1.89],Z = 7.94,P＜0.000 01),regulated the immune function indicators of T lymphocyte population CD3+(MD=8.68,95%CI[4.97,12.39],Z = 4.59,P＜0.000 01)and CD4+(MD=10.77,95%CI[5.46,16.08],Z = 3.97,P＜0.000 1)levels,and reduced the incidence of postoperative complications of thyroid cancer(RR=0.34,95%CI[0.18,0.65],Z = 3.26,P = 0.001).The differences were all statistically significant(P＜0.05).Conclusion prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium can enhance the efficacy of postoperative patients with thyroid cancer.The combined therapy is superior to Levothyroxine Sodium alone in improving thyroid function indicators,KPS score,time for the relief of clinical symptoms,diameter of the largest thyroid nodule,immune function indicators,and the incidence of postoperative complications.However,due to the small amount of included trials and the fact that the prescriptions for softening hardness to dissipate mass vary in the composition,the conclusions of the analysis need to be confirmed by more high-quality,multi-center,large-sample clinically randomized controlled trials.

Objective:To evaluate knee biomechanics of patients about 12 months after anterior cruciate ligament(ACL)reconstruction during cutting and determine the abnormal biomechanical characteristics.Methods:Sixteen males about 12 months after ACL reconstruction were recruited for this study.Three-dimensional kinematic and kinetic data were collected during cutting movement.Knee joint angles and moments were calculated.Paired t-tests were used to compare the differences in knee biomechanics be-tween the surgical leg and nonsurgical leg.Results:The peak posterior ground reaction force(surgical leg:0.380±0.071;nonsurgical leg:0.427±0.069,P=0.003)and vertical ground reaction force(surgical leg:1.996±0.202,nonsurgical leg:2.110±0.182,P=0.001)were significantly smaller in the surgical leg than in the nonsurgical leg.When compared with the uninjured leg,the surgical leg demonstrated a smaller knee flexion angle(surgical leg:38.3°±7.4°;nonsurgical leg:42.8°±7.9°,P＜0.001)and larger external rotation angle(surgical leg:10.3°±2.4°;nonsurgical leg:7.7°±2.1°,P=0.008).The surgical leg also demonstrated a smaller peak knee extension moment(surgical leg:0.092±0.031;nonsurgical leg:0.133±0.024,P＜0.001)and peak knee external rotation moment(surgical leg:0.005±0.004;nonsurgical leg:0.008±0.004,P=0.015)when com-pared with the nonsurgical leg.Conclusion:The individuals with ACL reconstruction mainly showed asymmetrical movements in the sagittal and horizontal planes.The surgical leg demonstrated a smaller peak knee flexion angle,knee extension moment,and knee external rotation moment,with greater knee external rotation angle.

Severe asthma stands as a formidable contributor to both mortality and morbidity of pa-tients suffering asthma,casting substantial social and economic shadows on communities.As our un-derstanding of asthma's pathophysiology deepens,a beacon of hope emerges in the form of biological targeted therapies,offering a promising avenue for the management of this challenging condition.These therapies,by precisely inhibiting or modulat-ing pivotal molecules in the inflammatory cascade,offer potential benefits in symptom alleviation,lung function enhancement,and risk reduction of acute exacerbations.They signify a paradigm shift in severe asthma treatment.Within the confines of this article,we embark on a systematic exploration of the immunological underpinnings that define se-vere asthma.By delving into the intricacies of the immune system's role in exacerbating this condi-tion,we aim to offer a comprehensive assessment of both the current landscape and the future pros-pects of biological therapies.Our objective is to provide a scientifically robust and valuable refer-ence that can guide the individualized treatment of patients grappling with severe asthma.

Severe asthma stands as a formidable contributor to both mortality and morbidity of pa-tients suffering asthma,casting substantial social and economic shadows on communities.As our un-derstanding of asthma's pathophysiology deepens,a beacon of hope emerges in the form of biological targeted therapies,offering a promising avenue for the management of this challenging condition.These therapies,by precisely inhibiting or modulat-ing pivotal molecules in the inflammatory cascade,offer potential benefits in symptom alleviation,lung function enhancement,and risk reduction of acute exacerbations.They signify a paradigm shift in severe asthma treatment.Within the confines of this article,we embark on a systematic exploration of the immunological underpinnings that define se-vere asthma.By delving into the intricacies of the immune system's role in exacerbating this condi-tion,we aim to offer a comprehensive assessment of both the current landscape and the future pros-pects of biological therapies.Our objective is to provide a scientifically robust and valuable refer-ence that can guide the individualized treatment of patients grappling with severe asthma.

Severe asthma stands as a formidable contributor to both mortality and morbidity of pa-tients suffering asthma,casting substantial social and economic shadows on communities.As our un-derstanding of asthma's pathophysiology deepens,a beacon of hope emerges in the form of biological targeted therapies,offering a promising avenue for the management of this challenging condition.These therapies,by precisely inhibiting or modulat-ing pivotal molecules in the inflammatory cascade,offer potential benefits in symptom alleviation,lung function enhancement,and risk reduction of acute exacerbations.They signify a paradigm shift in severe asthma treatment.Within the confines of this article,we embark on a systematic exploration of the immunological underpinnings that define se-vere asthma.By delving into the intricacies of the immune system's role in exacerbating this condi-tion,we aim to offer a comprehensive assessment of both the current landscape and the future pros-pects of biological therapies.Our objective is to provide a scientifically robust and valuable refer-ence that can guide the individualized treatment of patients grappling with severe asthma.