Objective To investigate the influence of plasma infusion during orthotopic liver transplantation on the incidence of acute kidney injury (AKI) in recipients. Methods Cinical data of 473 liver transplant recipients who underwent orthotopic liver transplantation at Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2016 to December 2020 were retrospectively collected. The study included 354 recipients who received plasma infusion during the operation (plasma group) and 119 recipients who did not receive plasma infusion during the operation (control group). Preoperative conditions, donor conditions, intraoperative conditions, main outcome indicators and secondary outcome indicators of the two groups were analyzed and compared. Receiver operating characteristic curve was drawn to calculate the maximum cut-off value of intraoperative plasma infusion volume that affected the occurrence of AKI within 7 days after surgery. Logistic regression analysis was performed to analyze the correlation between intraoperative plasma infusion volume and the incidence of AKI within 7 days after surgery. Results Before propensity score matching, the incidence of AKI within 7 days after surgery and the incidence of grade Ⅲ AKI in the plasma group were higher than those in the control group (both P<0.05). After propensity score matching, 62 recipients were included in each group. There was no statistically significant difference in the incidence of AKI within 7 days after surgery between the plasma group and the control group, but the incidence of grade Ⅲ AKI within 7 days after surgery in the plasma group was higher than that in the control group (P=0.041). Logistic regression analysis showed that intraoperative plasma infusion volume >900 mL was a potential risk factor for AKI within 7 days after surgery (odds ratio=1.936, 95% confidence interval 1.193-3.142, P=0.007). There were no statistically significant differences in the incidence of 365-day postoperative fatality, reperfusion syndrome, and postoperative 30-day complications between the two groups before and after propensity score matching. In addition, the postoperative albumin, fibrinogen levels, and international normalized ratio in the plasma group were better than those in the control group before and after matching (all P<0.05). Conclusions Large amount of intraoperative plasma infusion is associated with an increased risk of grade Ⅲ AKI after orthotopic liver transplantation. Intraoperative plasma infusion volume >900 mL may increase the risk of AKI within 7 days after surgery.

Triple-negative breast cancer (TNBC) is a highly aggressive malignancy predominantly managed via chemotherapy. Our clinical sample analysis revealed a significant correlation between elevated CD24 expression in TNBC tumor cells and patient survival rates. We developed a novel antibody-drug conjugate (ADC), named HN03, consisting of an antibody with engineered cysteines for site-specific conjugation with a low toxic nitric oxide (NO) precursor as its payload through a novel Pt(IV)-mediated bioorthogonal self-cleavable linker. HN03 specifically targets tumor cells expressing high levels of CD24, concurrently generating cisplatin and releasing NO upon activation. HN03 also exhibited potent in vitro and in vivo antitumor activity. It significantly reduced tumor growth at various doses, prevented tumor metastasis, with markedly lower toxicity than traditional chemotherapy agents. We found that a key mechanism of its action involved inducing apoptosis and endoplasmic reticulum stress, substantially decreasing the number of M2-type macrophages. Overall, HN03 stands out as a promising therapeutic option for TNBC, offering a targeted treatment with reduced side effects and the potential for improved outcomes. Furthermore, using Pt(IV) in the linker and an NO precursor as the payload enhances the versatility of the Antibody-NO donor Conjugate (ANC), offering new avenues for the design of the next generation of ADCs.

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder posing significant risks to maternal and infant health, with a lack of effective early screening markers. Therefore, identifying early screening biomarkers for GDM with higher sensitivity and specificity is urgently needed. Methods: High-throughput sequencing was employed to screen for key circular RNAs (circRNAs), which were then evaluated using reverse transcription quantitative polymerase chain reaction. Logistic regression analysis was conducted to examine the relationship between clinical characteristics, circRNA expression, and adverse pregnancy outcomes. The diagnostic accuracy of circRNAs for early and mid-pregnancy GDM was assessed using receiver operating characteristic curves. Pearson correlation analysis was utilized to explore the relationship between circRNA levels and oral glucose tolerance test results. A predictive model for early GDM was established using logistic regression. Results: Significant alterations in circRNA expression profiles were detected in GDM patients, with hsa_circ_0031560 and hsa_ circ_0000793 notably upregulated during the first and second trimesters. These circRNAs were associated with adverse pregnancy outcomes and effectively differentiated GDM patients, with second trimester cohorts achieving an area under the curve (AUC) of 0.836. In first trimester cohorts, these circRNAs identified potential GDM patients with AUCs of 0.832 and 0.765, respectively. The early GDM prediction model achieved an AUC of 0.904, validated in two independent cohorts. Conclusion Hsa_circ_0031560, hsa_circ_0000793, and the developed model serve as biomarkers for early prediction or midterm diagnosis of GDM, offering clinical tools for early GDM screening.

OBJECTIVE: To explore the differences in clinical efficacy between enhanced workflows and express workflows in robotic-assisted total hip arthroplasty(THA). METHODS: A retrospective analysis was conducted on 46 patients who underwent robotic-assisted THA between November 2020 and May 2021. They were divided into the enhanced workflows group and the express workflows group based on the surgical methods. There were 20 patients in the enhanced workflows group, including 11 males and 9 females;aged from 51 to 78 years old with an average of (67.30±7.52) years old. The BMI ranged from 18.24 to 24.03 kg·m^-2 with an average of(23.80±3.01) kg·m^-2. There were 26 patients in the express workflows group, including 12 males and 14 females;aged from 57 to 84 years old with a mean age of (67.58±7.29) years old, and their BMI ranged from 19.72 to 30.08 kg·m^-2 with an average of (24.41 ±2.92) kg·m^-2. The operation time, hospital stay, and perioperative complications of the patients were recorded. The postoperative acetabular prosthesis anteversion angle, abduction angle, limb length, and offset distance data were measured. The Harris hip score at the latest follow-up was recorded. RESULTS: All patients completed the surgery as planned and were followed up, with the follow-up period ranging from 47 to 54 months with a mean of (49.78±1.85) months and the length of hospital stay ranging from 2 to 11 days with an average of (6.57±1.82 ) days. The operation time of enhanced workflows group was (93.41±16.41) minutes, which was longer than that of the express workflow groups (75.19±18.36) minutes, and the difference was statistically significant (P<0.05). In enhanced workflows group, the postoperative acetabular anteversion angle was (19.20±4.46)°, the limb length discrepancy was (-1.55±9.13) mm, and changes of the offset was (-5.15±6.77) mm. The corresponding values in express workflows group were (20.46±3.29)°, (2.19±4.39) mm, and (-2.39±4.34) mm, respectively. There was no statistically significant difference in these indicators between the two groups(P>0.05). One patient in the enhanced workflows group developed deep venous thrombosis after surgery. No cases of dislocation or periprosthetic infection. At the latest follow-up, all patients had well-positioned prostheses without loosening. Harris hip score was (90.50±1.67) points in enhanced workflows group and (90.73±2.36) points in the express workflows group, with no statistically significant difference between the two groups (P>0.05). CONCLUSION The clinical efficacy of robot assisted total hip arthroplasty technology is satisfactory. The enhanced workflows will increase the surgical time. For patients with normal anatomical hip joint disease, this study did not find significant advantages in joint stability and functional scoring for the enhanced workflows.
Humans ; Arthroplasty, Replacement, Hip/methods* ; Male ; Female ; Aged ; Middle Aged ; Robotic Surgical Procedures/methods* ; Retrospective Studies ; Aged, 80 and over ; Workflow ; Treatment Outcome

Objective:To evaluate the impact of implementing a regional hierarchical medical management model based on the medical internet of things (medical IoT) on the frequency of emergency department visits and hospitalizations, as well as related medical expenses, in patients with chronic obstructive pulmonary disease (COPD).Methods:This retrospective study included COPD patients enrolled in the regional hierarchical medical management system based on Medical IoT across 21 community health service centers in Songjiang District, Shanghai, between July 2017 and May 2018. Utilizing patient data from the year prior to enrollment as the baseline, changes in the number of emergency visits, hospitalizations, and associated medical costs during the first and second years of management were compared. Changes for patients receiving drug treatment were also analyzed.Results:A total of 973 COPD patients were enrolled. The mean age was 75.2±17.0 years, and 64.34% (626/973) were male. Compared to baseline, all COPD patients in the first year of management showed significant reductions: emergency visits decreased by 33.67%, total emergency costs by 45.60%, hospitalizations by 27.15%, and total hospitalization costs by 25.42%. In the second year, reductions were: emergency visits by 28.08%, total emergency costs by 36.10%, hospitalizations by 35.26%, and total hospitalization costs by 18.13% (all P<0.05). Among patients receiving drug therapy, reductions in the first year were: emergency visits by 39.66%, total emergency costs by 47.54%, hospitalizations by 25.19%, and total hospitalization costs by 28.40%. In the second year, reductions were: emergency visits by 46.98%, total emergency costs by 45.99%, hospitalizations by 41.98%, and total hospitalization costs by 24.94% (all P<0.05). No significant differences were observed before and after management for patients without drug treatment. Conclusion:The implementation of the regional hierarchical medical management model based on Medical IoT significantly reduced the frequency of emergency visits and hospitalizations, as well as related costs, for COPD patients.

Objective:To analyze the incidence trend of lip and oral cancer in China from 1990 to 2021.Methods:The incidence data of lip and oral cancer in China from 1990 to 2021 were obtained through the Global Health Data Exchange (GHDx) database, including incidence rates by gender and age-standardized incidence rates. Joinpoint regression was used to analyze the trend of lip and oral cancer incidence rate. Age-period-cohort (APC) model was adopted to estimate the effects of Age, Period and Cohort on the incidence of lip and oral cancer in China.Results:The crude and age-standardized incidence rates of lip and oral cancer in China from 1990 to 2021 showed an increasing trend, and the crude incidence rates of the whole population, male and female in the year 2021 increased by 216.8%, 266.7% and 130.4%, respectively, compared with 1990. The age effect, period effect and birth cohort effect of the incidence risk of lip and oral cancer in China were statistically significant (all P<0.05). People of older the age and the more recent the birth cohort, the higher the incidence risk. Conclusions:The incidence of lip and oral cancer is on the rise in China from 1990 to 2021. Age, period and birth cohort are all the factors affecting the incidence of lip and oral cancer.

Occipital lobe epilepsy （OLE） accounts for 5%-10% of all focal epilepsy cases. Ictal clinical symptoms mainly include visual and ocular movements， with common and specific elementary visual hallucinations. Electroencephalography has certain limitations， and a well-localized unifocal rhythmic ictal discharge during seizure is infrequent on ictal EEG. Detailed preoperative evaluation， especially the evaluation of symptoms and intracranial EEG monitoring， can help to obtain good outcomes after surgical treatment.

Temporal lobe epilepsy is the most common type of focal medically intractable epilepsy. Seizures with involvement of the basal temporal region are extremely rare， and there is still a lack of understanding of their characteristics. The basal temporal region is divided into the olfactory cortex （including the perirhinal cortex and the entorhinal cortex）， the parahippocampal gyrus， and the fusiform gyrus. The ictal symptoms of basal temporal lobe epilepsy include naming dysfunction， comprehension deficit， spontaneous speech， vocal automatism， and dé jà vu. Anterior temporal lobectomy is recommended due to extensive epileptogenic areas.