ObjectiveTo investigate the expression level of lysophosphatidyllecithin acyltransferase 4 （LPCAT4） in pancreatic cancer and its effect on the proliferation of pancreatic cancer cells. MethodsIn this study， the differentially expressed genes of patients with KRAS mutant and wild-type pancreatic cancer were analyzed by online database LinkedOmics. The LPCAT4 expression in pancreatic cancer tissues was analyzed online by the University of Alabama at Birmingham Cancer Data Analysis （UALCAN）， Sangerbox and gene expression profile interaction analysis 2 （GEPIA2）. Kaplan-Meier Plotter database was used to explore the correlation between LPCAT4 and the prognosis of patients with pancreatic cancer. The expression of LPCAT4 in human pancreatic cancer cells were detected by quantitative real-time PCR and Western blot analysis. LPCAT4 was knocked down in the high-expressing SW1990 cell line and overexpressed in the low-expressing MIA PaCa-2 cell line. The effects of LPCAT4 expression on cell proliferation were assessed using CCK-8 and EdU assays. STRING and GEPIA2 databases were used to obtain LPCAT4 binding and coexpressed genes in tumors， which were then analyzed by GO and KEGG. ResultsAnalysis of the LinkedOmics online database revealed a significant upregulation of LPCAT4 in patients with KRAS mutant pancreatic cancer compared to patients with KRAS wild-type pancreatic cancer. The online analysis of GEPIA2， UALCAN and Sangerbox 3.0 showed that the expression of LPCAT4 was higher in pancreatic cancer than in normal tissues. Analysis of the Kaplan-Meier Plotter database revealed that high LPCAT4 expression was associated with poorer prognosis in pancreatic cancer patients.Western blot and qPCR results showed that expression of LPCAT4 in pancreatic cancer cell lines was significantly higher than in normal pancreatic ductal epithelial cells. Knockdown of LPCAT4 in SW1990 cells inhibited proliferation， while overexpression in MIA PaCa-2 cells promoted proliferation. Enrichment analysis indicated that LPCAT4 was closely related to sulfur metabolism. ConclusionsLPCAT4 is highly expressed in pancreatic cancer and is associated with poor prognosis of patients. It plays a significant regulatory role in the proliferation of pancreatic cancer cells， with its expression level closely correlated with cell proliferation capacity. These findings reveal the critical role of LPCAT4 in the malignant progression of pancreatic cancer and provide important evidence for its potential as a therapeutic target.

BACKGROUND: Pre-transplant exposure to immune checkpoint inhibitors (ICIs) significantly increases the risk of allograft rejection after liver transplantation (LT); however, whether ICI-related rejection leads to increased graft loss remains controversial. Therefore, this study aimed to investigate the association between ICI-related allograft rejection and perioperative graft loss. METHODS: This was a retrospective analysis of adult liver transplant recipients with early biopsy-proven T-cell-mediated rejection (TCMR) at Liver Transplantation Center of Sun Yat-sen Memorial Hospital from June 2019 to September 2024. The pathological features, clinical characteristics, and perioperative graft survival were analyzed. RESULTS: Twenty-eight patients who underwent early TCMR between June 2019 and September 2024 were included. Based on pre-LT ICI exposure, recipients were categorized into ICI-related TCMR (irTCMR, n = 12) and conventional TCMR (cTCMR, n = 16) groups. Recipients with irTCMR had a higher median Banff rejection activity index (RAI) (6 vs . 5, P = 0.012) and more aggressive tissue damage and inflammation. Recipients with irTCMR showed higher proportion of treatment resistance, achieving a complete resolution rate of only 8/12 compared to 16/16 for cTCMR. Graft loss occurred in 5/12 of irTCMR recipients within 90 days after LT, with no graft loss in cTCMRs recipients. Cox analysis demonstrated that irTCMR with an ICI washout period of <30 days was an independent risk factor for perioperative graft loss (hazard ratio [HR], 6.540; 95% confidence interval [CI], 1.067-40.067, P = 0.042). CONCLUSION IrTCMR is associated with severe pathological features, increased resistance to treatment, and higher graft loss in adult liver transplant recipients.
Humans ; Liver Transplantation/adverse effects* ; Male ; Female ; Middle Aged ; Retrospective Studies ; Graft Rejection/immunology* ; Immune Checkpoint Inhibitors/therapeutic use* ; Adult ; T-Lymphocytes/drug effects* ; Graft Survival/immunology* ; Aged

Objective To learn the awareness,attitude and behavior changes of medical workers to the family doctor service and the influential factors on their utilization of such service since the service is in place.The purpose is to provide theoretical basis to establish the family doctor service model and the incentive mechanism in line with the development of community health service in Beijing.Methods Eight community health centers were sampled randomly from three representative areas of Haidian,Xicheng and Daxing districts,which were grouped randomly as one intervention group and one control group.All the medical workers surveyed were subj ect to the research.The control group was managed as to the existing management mode,and the intervention group was classified and managed according to the new family doctor service model.A questionnaire survey was made to collect data from the baseline and final stages.Comparisons were made among the districts,institutions,and before-after intervention of the institutions themselves to evaluate the effects of the service model and incentive mechanism.Results The survey found a higher awareness by medical workers to such service,higher recognition and satisfaction, and lower rate of services provided by medical workers.The logistic regression analysis found the influential factors for willingness of medical workers to work as family doctors,include group difference, workload changes after signoff as family doctors,residents′acceptance of the community first visit system,recognition or not for whether a family should have a community service team,residents′acceptance,and the general comments on family doctor service (P< 0.05 ).Conclusions Higher incentives of community doctors to embrace family doctor service,calls for the medical workers to change their perception,better incentive mechanism and greater promotion efforts for family doctors′services.

Objective To investigate the awareness and utilization of community family doctor services of residents in Beijing and analyze its influential factors.Methods Multistage random sampling was adopted to enroll residents in Beijing from eight community health centers in Haidian District, Xicheng District and Daxing District,to investigate the awareness and utilization of community family doctor services.Customized questionnaires were recovered for descriptive statistics and influential factor analysis.Results All the 3 008 effective questionnaires were recovered.The results found that 92.2% of the residents used community family doctor services.Higher utilization rates of community family doctor services was found among those residents of chronic diseases,those with their family′s annual average outpatient expenses in the medium level,those with their first choice of medical visits in the community health centers,and those who are aware of family doctor service.Services of the most frequent use in the recent year were physical examination and follow-up phone call(87.3% and 73.4% respectively);those of lower frequency were door-to-door service,health assessment,preventive health care,physical examination,health education and consulting,and rehabilitation service.Factors of statistical significance on utilization of community health services were health condition,financial condition and awareness of community family doctor service(P<0.05).Conclusions Residents in Beijing have a high awareness and utilization of community family doctor services,yet some items of services are seldom used.Health condition,financial condition and awareness of community family doctor service are major influential factors for utilization of community health services.

OBJECTIVETo compare the outcomes of hand-assisted laparoscopic liver surgery (HALS) and pure laparoscopic liver surgery (PLS).

METHODSThe clinical data were analyzed for 64 patients undergoing major hepatectomy with HALH (23 cases) and PLS (41 cases) between January, 2010 and December, 2012.

RESULTSThe general data of the two groups were comparable. Compared with PLS, HALS was associated with a significantly shorter operative time (240 vs 191 min), less intraoperative blood loss (430 vs 220 ml, P<0.05), and a lower cost (P<0.05). There was no significant difference between the two groups in postoperative hospital stay, complication rates or recurrence rate of hepatocellular carcinoma.

CONCLUSIONHALS is safe for major liver resection with such advantages over PLS as causing less trauma and a lower cost.

Blood Loss, Surgical ; Carcinoma, Hepatocellular ; surgery ; Hepatectomy ; methods ; Humans ; Laparoscopy ; methods ; Length of Stay ; Liver Neoplasms ; surgery ; Neoplasm Recurrence, Local

Heat shock protein 90 is a new target of antitumor drug, the inhibitor of Hsp90 fight against tumor by destroy and degrade the structure of protein. In recent years, looking for Hsp90 inhibitor is not only via structure modifying of natural products, but also via high throughput screening and computer aided drug design to find and synthesize new kinds of Hsp90 inhibitor. Anyway, Hsp90 inhibitor has considered as an important biology target and to pay more and more attention. This review describes recent developments of small molecule Hsp90 inhibitors.