Objective: To investigate the impact of RhE antigen-matched transfusion during liver transplantation on early postoperative recovery and complications. Methods: In this retrospective cohort study, ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled. Patients were divided into two groups: Group 1 (RhE-mismatched transfusion, n=57) and Group 2 (RhE-matched transfusion, n=38). The baseline data, complete blood counts, hepatic and renal function, coagulation parameters, and complication rates between the two groups were compared at postoperative days 1, 3, 5, 7, and 10. Survival analysis was performed using the Kaplan-Meier method. Results: The baseline characteristics were well-balanced and comparable between the two groups (all P>0.05). The early postoperative mortality rate in the mismatched group (31.58%, 18/57) was significantly higher than that in the matched group (10.53%, 4/38) (P=0.017). The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group (50.88%, 29/57) than in the matched group (10.53%, 4/38) (P<0.001). The incidence of postoperative haemorrhage in the mismatched group (24.56%, 14/57) was higher than that in the matched group (5.26%, 2/38), with a statistically significant difference (P=0.014). The incidence of perioperative infection in the mismatched group (28.07%, 16/57) was higher than that in the matched group (10.53%, 4/38), with a statistically significant difference (P=0.04). Corresponding odds ratios (OR) and 95% confidence intervals indicated a lower risk of these adverse events in the matched group. On postoperative day 1, the change in activated partial thromboplastin time (-1.6, 20.5) in the mismatched group was greater than in the matched group (-0.2, 5.5). The change in international normalised ratio (-0.56, 1.22) in the mismatched group was greater than in the matched group (-0.18, 0.32), while the change in albumin (-4.0, 4.8) was smaller in the mismatched group than in the matched group (-2.5, 8.8). On postoperative day 5, the change in albumin (-0.41±7.83) in the mismatched group was smaller than in the matched group (2.68±4.53). At postoperative day 7, the change in albumin in the mismatched group (-0.61±7.38) was smaller than that in the matched group (2.51±5.85), while the change in D-dimer in the mismatched group (0.73, 7.4) was greater than that in the matched group (-1.6, 4.3). On postoperative day 10, the mismatched group exhibited significantly higher fibrinogen levels (-1.21, 1.78) than the matched group (-0.49, 0.97), and significantly longer prothrombin times (-11.3, -2.7) than the matched group (-6.2, -0.8) (all P<0.05). The matched group exhibited a mean overall survival (OS) of 32.803 months (95% CI:29.171-36.436 months), significantly exceeding the mismatched group's 28.996 months (95% CI:24.202-33.790 months). The log-rank test yielded statistically significant results (χ =4.307, P=0.038). Conclusion: Implementing RhE blood group-matched transfusion during liver transplantation may help reduce early postoperative mortality and the incidence of major complication rates, promote faster recovery of coagulation and liver function, and thereby improve short-term patient outcomes.

Objective To explore the clinical features, diagnosis, treatment and prognosis of testicular Ewing sarcoma(ES), so as to enhance the understanding and differential diagnosis of this disease. Methods A retrospective analysis was conducted on the clinical manifestations, auxiliary examinations and pathological findings of a case of left-sided ES treated at our hospital, supplemented by a review of relevant literature. Results A 24-year-old male patient presented with left testicular enlargement with pain. Magnetic resonance imaging suggested a neoplastic lesion, with a high likelihood of testicular germ cell tumor. A radical left orchiectomy was performed. Postoperative pathology revealed testicular ES. The patient subsequently completed 8 cycles of VDC/IE chemotherapy and showed no evidence of recurrence at 10 months of follow-up. Analysis of literature on 5 previously reported cases of testicular ES had testicular enlargement as the primary presentation. All patients underwent surgery and 4 received adjuvant therapy. Follow-up revealed 1 death at 9 months postoperatively, with no recurrence or progression seen in the remainder. Conclusion ES occurring in the testis is extremely rare.Testicular ES is a poorly differentiated small round-cell malignant tumor that primarily presents as testicular enlargement. Current treatment mainly surgical resection combined with adjuvant chemotherapy.

OBJECTIVES: To explore the mechanism of cinnamic acid (CA) for improving doxorubicin-induced myocardial injury (DIC) in mice. METHODS: Network pharmacology analysis was used to obtain the key targets of CA and DIC. Male C57BL/6J mice were randomized into Sham, DOX, CA (25, 50 and 100 mg/kg)+DOX, and CA+Ferrostatin-1+DOX groups, and their myocardial function and pathology were examined by echocardiography and HE staining. Serum levels of CK-MB, LDH, MDA, IL-6, TNF‑α and myocardial ROS level were detected, and the expression levels of TLR4 and ferroptosis pathway proteins in myocardial tissue were detected by Western blotting. Cultured murine cardiomyocytes (HL-1 cells) with or without transfection with a small interfering RNA targeting TLR4 (si-TLR4) were treated with DOX or Erastin, and the cellular ROS content was measured by DCFH-DA staining; the expression level of GPX4 was detected using immunofluorescence staining. RESULTS: Network pharmacology analysis suggested that CA may improve DIC through TLR4 signaling. DOX treatment caused obvious myocardial injury in mice, which showed significantly increased serum levels of CK-MB, LDH, MDA, IL-6, TNF-α and myocardial ROS level with decreased myocardial levels of SLC7A11 and GPX4 proteins and increased levels of TLR4 and PTGS2 proteins. All these changes in the mouse models were significantly alleviated by treatment with CA, and the mice receiving CA or ferrostatin-1 treatment exhibited increased myocardial expressions of SLC7A11 and GPX4 proteins and lowered expressions of TLR4 and PTGS2 proteins. In cultured HL-1 cells, treatment with DOX and Erastin both obviously increased intracellular ROS level and decreased cellular GPX4 expression level, and these changes were strongly attenuated by TLR4 interference. CONCLUSIONS CA, as a potent herbal monomer, can effectively alleviate DIC in mice by inhibiting TLR4-mediated ferroptosis.
Animals ; Ferroptosis/drug effects* ; Toll-Like Receptor 4/metabolism* ; Myocytes, Cardiac/metabolism* ; Mice, Inbred C57BL ; Mice ; Male ; Doxorubicin/adverse effects* ; Cinnamates/pharmacology* ; Signal Transduction ; Reactive Oxygen Species/metabolism*

Objective:To evaluate the potential value of gut microbiota metabolites in predicting the efficacy of neoadjuvant chemoradiotherapy combined with immunotherapy in patients with locally advanced rectal cancer.Methods:Prospectively collected case data from 32 patients with locally advanced rectal patients, who underwent total mesorectal excision at Beijing Friendship Hospital, Capital Medical University, between October 2021 and August 2022. Among these patients, 18 (56.25%) were male and 14 (43.75%) were female, with ages ranging from 37 to 79 years and a mean age of (61.69±8.73) years. Postoperative pathological response was evaluated using the Tumor Regression Grade (TRG), dividing the patients into two groups: an efficacious group (ypT 0N 0, n=14) and a non-efficacious group (non-ypT 0N 0, n=18). Stools from 14 patients in the efficacious group and 18 patients in the non-efficacious group, who had experienced neoadjuvant chemoradiotherapy combined with immunotherapy, were collected before treatment. Metabolites were analyzed using high-performance liquid chromatography-tandem mass spectrometry, and pathway enrichment analysis was performed. A random forest model was constructed based on the differential metabolites. The data were analyzed by using R4.1.1 and 26.0 software. Results:Through untargeted metabolomics analysis, 2′-Deoxyinosine and albiflorin were enriched in the responders, while Sorbitan monooleate, 2-(Formylamino) Benzoic Acid, and 12-Hydroxydodecanoic acid were enriched in the non-responders ( P<0.05); Arachidonic acid metabolism and tryptophan metabolism were enriched, and the AUC for the model was 0.976. Conclusions:Rectal cancer patients with or without complete postoperative pathological remission exhibit differences in the metabolites of their intestinal microbiome prior to undergoing neoadjuvant chemoradiotherapy combined with immunotherapy. The identified differential metabolites have the potential to serve as predictive biomarkers for treatment efficacy.

Objective To observe the clinical efficacy of Xinglou Chengqi Decoction combined with Qingxin Xingshen Tongdu Acupuncture in treating cerebral edema after intracerebral hemorrhage(ICH).Methods Eighty-eight patients diagnosed with acute ICH who opted for conservative treatment were enrolled from the Department of Encephalopathy at Chengde Hospital of Traditional Chinese Medicine between October 2023 and July 2024.Patients were randomly divided into an observation group and a control group using a random number table,with 44 cases in each group.The control group received conventional treatment,while the observation group received additional treatment with Xinglou Chengqi Decoction combined with Qingxin Xingshen Tongdu Acupuncture,both groups were treated for 4 weeks.After one month,clinical efficacy was evaluated,and the traditional Chinese medicine(TCM)syndrome scores,National Institutes of Health Stroke Scale(NIHSS)scores,Barthel Index(BI)scores,and volumes of cerebral hematoma and edema were compared before and after treatment.Serum levels of aquaporin-4(AQP4),central nervous system-specific protein(S-100B),high-mobility group box 1(HMGB-1),and granulocyte-macrophage colony-stimulating factor(GM-CSF)were also measured.Safety and adverse events were assessed.Results(1)The total effective rate was 93.18%(41/44)in the observation group versus 77.27%(34/44)in the control group,the clinial efficacy in the observation group was superior to the control group,the difference being statistically significant(P＜0.05).(2)After treatment,the TCM syndrome scores,NIHSS scores,and BI scores of the two groups of patients significantly improved(P＜0.05),and the observation group was significantly superior to the control group,the difference was statistically significant(P＜0.05).(3)After 7 days and 14 days of treatment,the cerebral haematoma and cerebral oedema volume of patients in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group,and the difference was statistically significant(P＜0.05).(4)After treatment,the serum AQP4,S-100B,HMGB-1,and GM-CSF levels of patients in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group,with statistically significant differences(P＜0.05).(5)The adverse event rates were 6.82%(3/44)in the observation group and 4.55%(2/44)in the control group,the difference between the incidence rate of adverse reactions in the observation group and that in the control group was not statistically significant(P＞0.05).Conclusion Xinglou Chengqi Decoction combined with Qingxin Xingshen Tongdu Acupuncture significantly improves serum AQP4,S-100B,HMGB-1,and GM-CSF levels,reduces neurological damage,cerebral hematoma and edema volumes,enhances daily living ability,and demonstrates high safety and efficacy in treating cerebral edema after ICH.

Objective:To observe the efficacy and safety of subcutaneous stripping combined with gold radiofrequency dot matrix microneedles in the treatment of atrophic acne scar.Methods:A total of 122 patients with atrophic acne scar in Dongying People′s Hospital from January 2023 to January 2024 were prospectively included and divided into two groups by random number table method: Observation group, 61 patients, including 37 males and 24 females, aged 20-43 (31.5±4.7) years, received subcutaneous stripping combined with gold radiofrequency dot matrix microneedles; Control group, 61 patients, including 33 males and 28 females, aged 22-44 (32.6±4.5) years, were treated with subcutaneous dissection. Patients in both groups were treated once every 4 weeks for a total of 3 times. The total effective rate, skin barrier function, wound recovery time, scar condition and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 93.4% (57/61), which was higher than that of the control group [75.4% (46/61), P=0.005]. After treatment, the corneum protein content, lactate stimulation test score, skin erythema (a value), and transdermal water loss (TEWL) of the observation group were (29.52±3.22) μg, (1.72±0.18) min, 15.10±2.21, and (18.31±3.35) g/(h·m 2), respectively. They were lower than those (35.24±4.17) μg, (2.75±0.24) min, 19.14±2.57, and (21.23±4.52) g/(h·m 2) in the control group (all P<0.001). The wound healing time, shedding time and scab time in the observation group were (3.42±0.67), (6.57±1.21) and (1.73±0.32) d, respectively, which were shorter than those (5.31±0.99), (8.26±1.48) and (2.85±0.47) d in the control group (all P<0.001). The acne scar clinical score scale (ECCA) and Vancouver scar scale (VSS) scores in the observation group were (38.10±5.29) and (5.23±0.82) points, respectively, which were lower than those (43.65±6.44) and (6.34±0.97) points in the control group (all P<0.001). The incidence of adverse reactions was 11.5% (7/61) in the observation group and 8.2% (5/61) in the control group, the difference was not statistically significant ( P=0.540). Conclusion:Subcutaneous stripping combined with gold radiofrequency dot matrix microneedles is effective in the treatment of atrophic acne scars, which can improve skin barrier function, shorten wound recovery time, and improve scar symptoms with good safety.

Laparoscopic right hemicolectomy is the standard surgical procedure for treating right-sided colon cancer,yet its complex anatomical layers and technically demanding operations pose significant challenges to surgeons'expertise.Currently,surgical skill assessment in clinical practice still predominantly relies on subjective expert evaluation,an approach inherently limited by low efficiency and inconsistent standards.With the rapid advancement of artificial intelligence(AI)technologies(particularly breakthroughs in computer vision and deep learning algorithms),a revolutionary technical foundation has been established for developing objective and precise automated surgical evaluation systems.This article comprehensively reviewed the current clinical application status of right hemicolectomy in China,thoroughly examined the clinical necessity and technical feasibility of constructing an intelligent surgical assessment system,and systematically presented our center's cutting-edge research achievements in this field.Looking ahead,AI-driven intelligent evaluation systems are expected to standardize and quantify surgical skill assessment.Such innovation will not only transform surgical training programs and enhance the quality of multicenter clinical research,but also promote the standardization of precision surgical protocols.This advancement holds significant clinical value and societal importance by improving long-term patient outcomes and fostering more equitable distribution of medical resources.

Objective:To clarify the genetic associations between obesity, diabetes, smoking, non-alcoholic fatty liver disease, acute and chronic pancreatitis, and pancreatic cancer risk.Methods:Summary data from genome-wide association studies (GWAS) of individuals of European descent were used. Obesity, alcohol consumption, diabetes, and acute and chronic pancreatitis data for the UK population were obtained from the GWAS catalog, while alcohol consumption, non-alcoholic fatty liver disease, occasional smoking, and regular smoking data were obtained from the UK biobank. Pancreatic cancer-related data for the Finnish population were sourced from the latest R11 version of the Finnish database. Two-sample Mendelian randomization (MR) analysis was conducted on the associations between the aforementioned risk factors and pancreatic cancer using five MR methods, primarily inverse variance weighting. The robustness of the results was assessed through Q heterogeneity tests, pleiotropy tests, MR-PRESSO analysis, and reverse MR analysis.Results:Obesity showed a significant positive association with pancreatic cancer risk ( OR=1.407, 95% CI: 1.100-1.714, P=0.030), and the results were robust based on Q heterogeneity tests, pleiotropy tests, MR-PRESSO, and reverse MR analysis (all P>0.05). However, no significant associations were found between pancreatic cancer risk and alcohol consumption ( P=0.330), heavy drinking ( P=0.382), type 1 diabetes ( P=0.674), type 2 diabetes ( P=0.825), occasional smoking ( P=0.607), regular smoking ( P=0.758), non-alcoholic fatty liver disease ( P=0.287), acute pancreatitis ( P=0.336), or chronic pancreatitis ( P=0.545). Conclusion:This study further confirms the strong genetic association between obesity and increased pancreatic cancer risk.

Objective:Based on value orientation,it aimed to scientifically define the concept and connotation of accessibility to novel anticancer drugs,in order to deeply understand the nature and current status of the accessibility issues of novel anticancer drugs,and to provide a reference for the formulation and optimization of policies related to novel anticancer drugs.Methods:Data was collected through literature review and expert interviews,and the concept of drug accessibility was defined using the atomic diagram method.Results:The core images include"affordability","availability","high quality"and"patients".The concept of accessibility to novel anticancer drugs is defined as"the process of ensuring the sustainable supply,equitable access,affordability,and rational use of high-quality anticancer drugs to safeguard the realization of patient benefit goals."The connotation of the value orientation in policies on the accessibility of novel anticancer drugs is profoundly reflected in the multi-dimensional value-driven approach to ensure the ultimate benefit of patients,which includes quality,sustainability,equity,affordability,and rational use.Conclusion:The proposal of the concept and connotation of accessibility provides a theoretical basis for a deep understanding of the accessibility of novel anticancer drugs and offers valuable references for subsequent policy-making and practical operations.