Objective To establish a method for acquisition, perfusion, preservation and transportation of the genetically modified pig kidneys. Methods An eight genetically modified pig was utilized as experimental subject. Prior to kidneys procurement, the health status of the pig was assessed through hematology examination, and the vascular structure of the kidneys was examined using imaging techniques. Following kidneys acquisition, the pig kidneys were perfused and subsequently packaged into the cryogenic storage container labeled "For Organ Transportation Only" for interprovincial transport after communicating the transportation process with transportation department. To evaluate pathological damage to the pig kidneys, a serious of methods were employed such as hematoxylin-eosin (HE) staining, real-time fluorescent quantitative polymerase chain reaction (RT-qPCR), terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) fluorescence staining and enzyme-linked immune absorbent assay (ELISA). Results The preoperative examination of the eight genetically modified pig showed that the serum creatinine was 73.2 μmol/L, blood urea nitrogen was 2.8 mmol/L and hemoglobin was 116 g/L, all within the normal range, indicating normal renal function. CT angiography revealed no lesions in the pig kidneys, and no dilation, stenosis or premature branching of the blood vessels. The total time of obtaining the left and right kidneys from the eight genetically modified pig was (125 ± 10) min, with a blood loss of (20 ± 2) mL. The warm ischemia times were 3 min and 7 min, respectively. The perfusion and trimming times of the left and right kidneys were 36 min and 41 min, respectively. After perfusion, both kidneys were white and moist. The cold preservation and transportation time was 8 h. HE staining showed that some glomeruli were shrunk, and the lumens of the surrounding renal tubules were slightly depressed and swollen with partial inner membrane shedding and microvacuoles formed when the kidneys were preserved for 8 h. The level of cysteinyl aspartate-specific proteinase-3 messenger RNA in the kidneys tissue gradually increased with the extension of cold preservation time after 2 h (P<0.05). TUNEL fluorescence staining showed that only a small number of cells underwent apoptosis after 8 h of cold preservation, which was not significantly different from that at 0 h (P>0.05). ELISA results showed that the contents of lactate dehydrogenase (LDH) and creatinine in the preservation solution remained relatively stable, but the content of kidney injury molecule 1 (KIM-1) gradually increased with the extension of preservation time, suggesting that the pig kidneys had mild injury. Conclusions By establishing methods for acquisition, perfusion, preservation and transportation of the kidneys from genetically modified donor pig, it is possible to effectively and reliably use genetically modified pig kidneys for xenotransplantation.

Objective:To conduct a scoping review of research on the self-advocacy of adult cancer patients to identify their self-advocacy needs, behaviors, strengths and weaknesses, so as to provide guidance for future research in this field.Methods:Using the scoping review guidelines of Joanna Briggs Institute in Australia as a methodological framework, relevant literatures were searched in PubMed, Web of Science, Cochrane Library, Embase, Science Direct, CINAHL, Scopus, China National Knowledge Infrastructure, Wanfang, VIP and China Biology Medicine disc. The search period was from establishment of the databases to December 2023, and the results were summarized and analyzed.Results:A total of 14 articles were included, and self-advocacy needs included six types of needs, such as symptom management, communication, interpersonal support, disease information, decision-making and emotional management. Self-advocacy included four aspects, including seeking information, self-decision-making, strengthening contact with the outside world and effective communication.Conclusions:Adult cancer patients have diverse types of self-advocacy needs and certain self-advocacy behaviors. Future research should pay attention to self-advocacy needs assessment, develop corresponding tools, focus on self-advocacy behaviors, leverage the advantages of self-advocacy and explore strategies to achieve effective self-advocacy support.

Objective:To conduct a scoping review of the application of mobile health applications (MHA) in the care of patients with colorectal cancer, summarizing the development process, the functions achieved, as well as the evaluation metrics, to provide references for MHA practice and related research.Methods:Following the scoping review framework, a comprehensive search was conducted across both domestic and international databases, including the China Biomedical Literature Database, Wanfang Database, China National Knowledge Infrastructure (CNKI), VIP Database, Cochrane Library, PubMed, Embase, CINAHL, Web of Science, and Scopus. The search period was from the database inception to February, 2024.Results:A total of 16 studies were included. The development of MHA involved multiple methods including literature reviews, qualitative interviews, consultations with multidisciplinary teams, and guidance from theoretical models. The functions of MHA include health education, peer support, guided feedback, monitoring, and reminder features. Evaluation metrics for MHA comprise usability, adherence, and effectiveness.Conclusions:MHA has demonstrated positive effects in enhancing patients' knowledge and alleviating symptoms such as fatigue and vomiting in colorectal cancer patients. However, it is still in its early stages, and further high-quality studies are needed to scientifically develop MHA that meets patients' needs.

Objective:To explore the relationship between normal serum creatinine(Scr) level and diabetic kidney disease(DKD) in patients with type 2 diabetes mellitus(T2DM).Methods:This was a prospective cohort study. Patients with yet not DKD who were regularly followed up at six centers of Li′s United Clinic in Taiwan, China from January 1, 2002 to December 31, 2018 were selected. At baseline, clinic information and lab tests were collected. According to whether the patients developed DKD during the follow-up period, they were divided into DKD group and non-DKD(NDKD) group. The exposure factor was the Scr(μmol/L) value, and it was used as a categorical variable. According to the quartiles of Scr, they were divided into 4 groups: Q1 group(Scr<57.68 μmol/L), Q2 group(57.68 μmol/L≤Scr<68.51 μmol/L), Q3 group(68.51 μmol/L≤Scr<80.44 μmol/L) and Q4 group(Scr≥80.44 μmol/L). The Cox regression model was used to explore the relationship between Scr level and the incidence of DKD. Receiver operating characteristic(ROC) curve was used to analyze the predictive effect of normal level Scr on DKD. Results:A total of 2 202 T2DM patients without DKD at baseline were included. After a follow-up period of(5.2±2.17) years, there were 966 patients in the DKD group and 1 236 patients in the NDKD group. Compared with the NDKD group, the DKD group had older age, longer duration of diabetes, higher BMI, SBP, DBP, LDL-C, Scr, and UACR(all P<0.05). Cox regression analysis results showed that compared with the Q1 group as the reference, the risk of developing DKD in the Q2, Q3, and Q4 groups after adjusting for confounding factors was 1.394, 1.688, and 2.821 times higher, respectively(all P<0.05). ROC curve analysis results showed that the area under the curve(AUC) for predicting DKD occurrence using normal serum creatinine level was 0.70(95% CI 0.678-0.722), with an optimal cutoff value of 74.27 μmol/L, sensitivity of 0.54, and specificity of 0.76. The cumulative risk plot showed that after adjusting for confounding factors, patients in the Q4 group had a higher cumulative risk of developing DKD compared to the Q1, Q2, and Q3 groups(all P<0.05). Conclusion:Scr is an independent risk factor for developing DKD in patients with T2DM. The higher the Scr level, the greater the risk, especially when Scr is greater than 74.27 μmol/L.

Objective To design a prescription statistics prevention system to enhance the audit ability of the hospital.Methods The prescription statistics prevention system was designed based on intelligent analysis technology and developed with B/S architecture and IntelliJ IDEA,which used JAVA language for front-end programming and C language for back-end programming and had the functions for suspicious event locating and data retrieving,retrieved data translating,access tool monitoring and risk treatment.Results The system with high stability could be used for operation data monitoring,analysis and on-demand alarm of 7 key operation systems and 13 servers of the hospital.Conclusion The system developed enhances the hospital for preventing prescription statistics,and provides an effective means of supervision for the operational and disciplinary authorities.[Chinese Medical Equipment Journal,2024,45(5):47-51]

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Purpose To investigate the feasibility of apoptosis small-molecule probe CYS-F for in vivo molecular imaging in acute middle cerebral artery embolization and recalculation models,and to explore its ability to reflect lesions.Materials and Methods Hela cell apoptosis was induced by Adriamycin,and the targeting ability of the probe was verified in vitro.Clinical middle cerebral artery embolization was simulated,acute ischemic stroke model(n=15)and recanalization model(n=15)were constructed,and the vessels were evaluated by magnetic resonance angiography imaging.The distribution of CYS-F was investigated by injecting the probe into the caudal vein.24 hours after modeling,the lesion volume rate was assessed on T2WI,and apoptosis was assessed in vivo by near infrared imaging.Niss and c-fos staining were used to compare the differences between the two groups.Results CYS-F showed a good ability to target apoptosis in vitro.After modeling,Doppler flowmeter and magnetic resonance angiography showed that the middle cerebral artery was successfully embolized in the embolization group,and the artery was recanalized in the recanalization group.Near infrared imaging showed the loss of fluorescence signal in the middle cerebral artery region in the embolized group.24 hours after modeling,T2WI showed that the infarct volume rate in the recanalization group was significantly lower than that in the embolization group(0.055±0.015 vs.0.512±0.220;t=19.761,P<0.001).The fluorescence intensity of the embolization group was significantly stronger than that of the recusing group,the target to background ratio was 1.215±0.162 and 0.731±0.085,respectively(t=10.252,P<0.001).In the embolization group,a large number of activated neurons expressed c-fos protein,and a large number of cells underwent nuclear condensation and lysis by Niss staining.Conclusion The acute embolization model and recalculation model of middle cerebral artery in mice are close to the clinic.CYS-F can be used to image apoptosis in vivo,reflect the lesion degree,and reflect the local tissue blood perfusion at the initial stage of injection.

Objective:To investigate the efficacy and safety of AcoStream peripheral thrombus aspiration system combined with catheter-directed thrombolysis in the treatment of lower extremity deep vein thrombosis.Methods:The clinical data of 16 lower extremity deep vein thrombosis cases treated with AcoStream peripheral thrombus aspiration system combined with catheter-directed thrombolysis, admitted to the authors′ hospital from May 2022 to November 2022, were retrospectively analyzed. The differences in circumferential diameter between the affected limb and the healthy side, venous patency score, thrombus clearance grade and intraoperative blood loss were observed and compared. The Villalta score was used during the follow up. Paired sample t-test and Wilcoxon rank sum test were used to compare the changes in the observed indicators before and after treatment to evaluate the efficacy. Results:Treatment were successfully performed in all patients. Before treatment, the circumference differences between the affected and unaffected thighs and calves were (3.69±0.97) and (3.34±0.75)cm, respectively, the venous patency score of the affected side was 8(7.25,9) points. After treatment, the circumference differences between the affected and unaffected thighs and calves were (0.81±0.68) and (0.84±0.70)cm, respectively. The venous patency score of the affected side was 1(0,1)points, with statistically significant differences ( P<0.001). Grade Ⅲ thrombus clearance was achieved in 7 patients, grade Ⅱ thrombus clearance was achieved in 9 patients. The average blood loss during thrombus aspiration was (133.1±12.0) ml. Following up for 6 months, the Villalta score was 0(0,1.75) points. Conclusion:Acostream peripheral thrombus aspiration system combined with catheter-directed thrombolysis is safe and effective for the treatment of lower extremity deep venous thrombosis, with satisfactory short-term efficacy and high clinical application value.

Objective:To identify the dosimetric and radiobiological differences of three radiotherapy techniques of whole breast irradiation with simultaneous integrated boost (WBI-SIB) following breast-conserving surgery for early breast cancer (EBC).Methods:The data of 20 patients with early left-sided breast cancer who received radiotherapy following breast-conserving surgery were retrospectively analyzed. Three radiotherapy techniques, namely hybrid intensity-modulated radiotherapy (HIMRT), intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT), were redesigned with the same prescription dose and target conditions. Then, doses to target volume (TV) and organs at risk (OAR), along with the normal tissue complication probability (NTCP) and secondary cancer risk (SCR) for specific organs, were compared.Results:Compared to HIMRT and IMRT, VMAT led to significant decreases in various dosimetric indices of the affected lung and heart and increases in the Dmean doses to the healthy lung and healthy breast and V5 Gy doses to the healthy breast, with the differences being significantly different ( P < 0.05). The average NTCP values of cardiac death, radiation pneumonitis, and pulmonary fibrosis induced by VMAT were 0.41%, 1.62%, and 23.59%, respectively, significantly lower than those caused by other two techniques ( P < 0.05). No statistical differences were found in 10 dosimetric indices of OAR between IMRT and HIMRT, while the NTCP analysis suggested that the risks of cardiac death ( t = 2.70, P < 0.05) and pulmonary fibrosis ( t =4.11, P < 0.05) induced by IMRT were slightly lower than those caused by HIMRT. In addition, the excess absolute risk (EAR) to the healthy lung posed by VMAT was 1.65 and 1.83 times those induced by HIMRT and IMRT, respectively ( z = -3.92, t = -6.43, P < 0.05). In contrast, the EAR to the healthy breast induced by VMAT was 2.79 and 2.65 times those posed by HIMRT and IMRT, respectively ( z = -3.21, -3.70, P < 0.05). Conclusions:Among three intensive-modulated radiotherapy techniques of WBI-SIB for EBC, VMAT provides the optimal protection for the heart and affected lung but leads to the highest SCR to the healthy lung and breast. When VMAT is employed for young EBC patients or those with normal cardiopulmonary function, special attention should be paid to reducing low-dose irradiations to the healthy breast and thereby minimizing SCR. In contrast, VMAT might be more favorable for patients with pronounced cardiopulmonary risks or aged patients.

Objective:To investigate the status of personnel, facilities, and technology of radiation therapy in Henan province in 2023.Methods:A unified online survey questionnaire was designed and distributed from March to April 2023 by the Henan Cancer Diagnosis and Treatment Quality Control Center to various medical institutions throughout the province to investigate the personnel, radiotherapy equipment, quality control equipment, imaging equipment, and radiotherapy technology development of each radiotherapy unit. Descriptive statistical methods were mainly used.Results:As of April 30, 2023, there were a total of 168 units engaged in radiation therapy in Henan province. The number of physicians involved in radiation therapy was 956, along with 365 medical physicists and 680 technicians. The equipment inventory included 212 medical linear accelerators, 1 cobalt-60 therapy machine, 32 afterloading therapy apparatuses, 4 Cyber Knife, 173 CT simulators, 2 MRI simulators and 94 conventional simulators. Linear accelerators were the primary radiotherapy equipment, 2.15 units per 1 million population on average. Additionally, there were 11 units offering 2D radiotherapy, 24 units offering 3D conformal radiotherapy, 130 units offering intensity-modulated radiotherapy, 41 units offering rotational intensity-modulated radiotherapy, and 33 units offering stereotactic radiosurgery. Regarding physical quality control equipment, 16 units were equipped with three-dimensional water tanks, 162 units were equipped with radiation dose meters, 114 units were equipped with morning check meters, 60 units were equipped with film dose meters, and 108 units were equipped with intensity adjustment plan verification systems.Conclusions:In 2023, there is a shortage of radiation therapy professionals in Henan province. Disparities are observed in the distribution of radiation therapy equipment among regions. Intensity-modulated radiotherapy has become the mainstream technology for radiation therapy in Henan province. The configuration of radiation therapy quality control equipment and standardized quality control work should be further improved.