Objective:To investigate whether continuous cardiac output (CO) parameters obtained by LiDCO in hemodynamic monitoring of severe patients are consistent with pulse index continuous cardiac output (PiCCO).Methods:From May 18, 2024 to January 10, 2025, 12 critically ill patients who were monitored by PiCCO in the Intensive Care Unit Department of China-Japan Friendship Hospital were prospectively collected. The PiCCO and LiDCO systems were simultaneously connected to the same critically ill patient, injected with ice saline for external calibration, and the average of paired continuous CO measurements were collected. Bland-Altman was used to analyze whether the two were consistent, and Spearman was used to analyze the correlation between norepinephrine dosage and bias.Results:In the data series of 70 pairs, the CO measured by PiCCO was 5.55±1.74, and the CO measured by LiDCO was 4.40(2.90, 6.50), with a bias of 0.52(95% CI: 0.07-0.96) and an upper limit of agreement of 4.2(95% CI: 3.4-4.9), the lower limit of the conformance limit was -3.1(95% CI: -3.9 to -2.4), and the percentage error was 66%, exceeding the clinically acceptable 45%. In the data series where norepinephrine was continuously pumped at the time of data collection, there was a moderate positive correlation between norepinephrine dosage and absolute bias ( r=0.47, P<0.05). There were statistically significant differences in absolute values of bias between groups defined as 0.5 μg/(kg·min) and 1 μg/(kg·min) ( P<0.05). Conclusions:There is no clinically acceptable consistency between LiDCO and PiCCO for continuous CO monitoring in severe patients, and the size of bias may be related to the dosage of norepinephrine.

Objective:To evaluate the predictive value of the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio(TAPSE/sPAP) in identifying precapillary pulmonary hypertension(pcPH) patients requiring repeat balloon pulmonary angioplasty(BPA) within 3 months after initial intervention, and to determine independent risk factors associated with postoperative reintervention.Methods:We retrospectively collected clinical data from 215 consecutive patients with pcPH undergoing BPA. After applying exclusion criteria, 200 patients were ultimately included in the analysis. The predictive value of the TAPSE/sPAP for short-term BPA reintervention was assessed using receiver operating characteristic( ROC) curve analysis and multivariable logistic regression. Internal validation was performed through bootstrap resampling with 1 000 iterations to evaluate model stability. Results:A risk model for echocardiography was constructed using multiple logistic regression, and the results showed that systolic pulmonary artery pressure(sPAP), peak tricuspid regurgitation velocity(TRV), tricuspid regurgitation pressure gradient(PGTR), and TAPSE/sPAP ratio were predictive factors for BPA surgery in patients with pulmonary hypertension within 3 months. Multivariate regression analysis suggests that the TAPSE/sPAP ratio is an independent influencing factor for BPA after 3 months( OR=0.023, P<0.05). The predicted area under the ROC curve( AUC) for BPA after 3 months is 0.62(95% CI: 0.530-0.648), P<0.01, which is better than other cardiac ultrasound indicators. At the same time, internal bootstrap method was used for internal self-validation, and the AUC of the internal self-validation set was 0.67. Conclusion:The TAPSE/sPAP ratio serves as an independent predictor for requiring repeat BPA within 3 months postoperatively in patients with pcPH.

Objective:To investigate whether continuous cardiac output (CO) parameters obtained by LiDCO in hemodynamic monitoring of severe patients are consistent with pulse index continuous cardiac output (PiCCO).Methods:From May 18, 2024 to January 10, 2025, 12 critically ill patients who were monitored by PiCCO in the Intensive Care Unit Department of China-Japan Friendship Hospital were prospectively collected. The PiCCO and LiDCO systems were simultaneously connected to the same critically ill patient, injected with ice saline for external calibration, and the average of paired continuous CO measurements were collected. Bland-Altman was used to analyze whether the two were consistent, and Spearman was used to analyze the correlation between norepinephrine dosage and bias.Results:In the data series of 70 pairs, the CO measured by PiCCO was 5.55±1.74, and the CO measured by LiDCO was 4.40(2.90, 6.50), with a bias of 0.52(95% CI: 0.07-0.96) and an upper limit of agreement of 4.2(95% CI: 3.4-4.9), the lower limit of the conformance limit was -3.1(95% CI: -3.9 to -2.4), and the percentage error was 66%, exceeding the clinically acceptable 45%. In the data series where norepinephrine was continuously pumped at the time of data collection, there was a moderate positive correlation between norepinephrine dosage and absolute bias ( r=0.47, P<0.05). There were statistically significant differences in absolute values of bias between groups defined as 0.5 μg/(kg·min) and 1 μg/(kg·min) ( P<0.05). Conclusions:There is no clinically acceptable consistency between LiDCO and PiCCO for continuous CO monitoring in severe patients, and the size of bias may be related to the dosage of norepinephrine.

Objective:To evaluate the predictive value of the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio(TAPSE/sPAP) in identifying precapillary pulmonary hypertension(pcPH) patients requiring repeat balloon pulmonary angioplasty(BPA) within 3 months after initial intervention, and to determine independent risk factors associated with postoperative reintervention.Methods:We retrospectively collected clinical data from 215 consecutive patients with pcPH undergoing BPA. After applying exclusion criteria, 200 patients were ultimately included in the analysis. The predictive value of the TAPSE/sPAP for short-term BPA reintervention was assessed using receiver operating characteristic( ROC) curve analysis and multivariable logistic regression. Internal validation was performed through bootstrap resampling with 1 000 iterations to evaluate model stability. Results:A risk model for echocardiography was constructed using multiple logistic regression, and the results showed that systolic pulmonary artery pressure(sPAP), peak tricuspid regurgitation velocity(TRV), tricuspid regurgitation pressure gradient(PGTR), and TAPSE/sPAP ratio were predictive factors for BPA surgery in patients with pulmonary hypertension within 3 months. Multivariate regression analysis suggests that the TAPSE/sPAP ratio is an independent influencing factor for BPA after 3 months( OR=0.023, P<0.05). The predicted area under the ROC curve( AUC) for BPA after 3 months is 0.62(95% CI: 0.530-0.648), P<0.01, which is better than other cardiac ultrasound indicators. At the same time, internal bootstrap method was used for internal self-validation, and the AUC of the internal self-validation set was 0.67. Conclusion:The TAPSE/sPAP ratio serves as an independent predictor for requiring repeat BPA within 3 months postoperatively in patients with pcPH.

Objective:To investigate whether end-tidal carbon dioxide (etCO 2) is associated with acute kidney injury (AKI) after liver transplantation. Methods:Clinical data of 83 patients undergoing classic allogeneic liver transplantation were retrospectively collected. Patients were divided into AKI group and non AKI group based on changes in serum creatinine levels within 48 hours after surgery, and differences in baseline data, intraoperative etCO 2 decrease rate [ΔetCO 2(%)], and postoperative creatinine values were analyzed between the groups. Results:The incidence of AKI within 48 hours after liver transplantation in 83 patients was 56.6%(47/83). The proportion of male patients in the AKI group was higher ( P=0.003), and the ΔetCO 2(%) in the anhepatic phase of AKI group patients was higher than that of non AKI patients [(0.26±0.08)% vs (0.22±0.07)%, P=0.024]. There was no statistically significant difference in ΔetCO 2(%) between the two groups during pre liver, inferior vena cava (IVC) occlusion, and new liver phase (all P>0.05). On the 7th day after surgery, the creatinine value in the AKI group was significantly higher than that in the non AKI group [68.7(55.4, 92.6)]μmol/L vs 52.7(44.1, 69.3)μmol/L, P<0.001], at a 3-month follow-up, creatinine levels in 43 patients (91.5%) in the AKI group returned to normal. Conclusions:The decrease in ΔetCO 2(%) during the anhepatic phase of liver transplantation reflects to some extent the severe fluctuations in circulation during the operation, which may be related to the occurrence of AKI within 48 hours after surgery.

Liver transplantation is a standard therapy for end-stage liver disease. The shortage of donor has greatly tethered the development of liver transplantation. With the use of living donors, we actually solved some problems. Nevertheless, cadaveric liver transplantation still accounts for the vast majority of liver donors. In recent years, technological innovations, including surgical methods and mechanical perfusion, have enabled the clinical realization of " multi-purpose liver" and increased graft survival rate. " Marginal donor" transplantation is a reliable way to expand the donor pool, which depends on the evaluation and maintenance of the donor liver.This review will describe the source of donors for liver transplantation and the way to expand donor pool.

Abstract OBJECTIVE To investigate the specific binding of nucleic acid aptamers(k-α2ct) with plasminogen Kringle 5(K5) on the function of K5 in inhibiting proliferation and migration of vascular endothelial cells and promoting their apoptosis. METHODS The cloning and expression of recombinant K5 protein were performed by using a prokaryotic system, and the isolation and purification of the expressed K5 protein were performed by affinity chromatography. The affinity and specificity of K-a2ct and K5 were verified using isothermal titration calorimetry(ITC) and enzyme-linked oligonucleotide adsorption assay(ELONA). The effect of K-a2ct on the function of K5 in inhibiting the proliferation and migration of human umbilical vein endothelial cells(HUVEC) was investigated by CCK-8 and cell scratch assay. The apoptotic morphology of HUVEC cells stained with Hoechst 33342 was observed by laser confocal microscopy, and the effect of K-a2ct on the apoptosis- promoting function of K5 in HUVEC cells was also examined by Annexin V/PI double-stained flow cytometry. RESULTS Recombinant protein K5 was efficiently expressed in Escherichia coli and purified by affinity chromatography, identified as having a relative molecular weight of 12 kDa and a concentration of 0.32 mg·mL-1. ITC and ELONA results demonstrated that K-a2ct had a strong affinity and good selectivity for K5, showing the affinity specificity of a typical nucleic acid aptamer. CCK-8 and cell scratching assays showed that K-a2ct could inhibit the anti-proliferation and anti-migration effects of K5 on HUVEC cells in a dose-dependent manner. The laser confocal and flow cytometry results showed that K-a2ct inhibited the apoptosis-promoting function of K5 on HUVEC cells, mainly affecting late apoptosis of HUVEC cells effected by K5 but having little effect on early apoptosis. CONCLUSION The nucleic acid aptamers K-a2ct binds to K5 with high affinity and specificity, and inhibits its anti angiogenic function in a dose-dependent manner. It has great potential in targeting the regulation of K5 concentration and function in vivo and promoting angiogenesis.

Microcystic stromal tumor (MCST) is a rare subtype of sex cord-stromal neoplasm. Tumors from all 31 previously reported cases were located in the ovary. Herein, we present a unique case of a right-side testicular tumor in a 33-year-old Chinese male. The tumor is composed of predominantly lobulated cellular nodules separated by hyalinized fibrous stroma and they expressed CD10, β-catenin (nuclear), and cyclin D1. Molecular analysis identified a point mutation (c.110C>G) in exon 3 of CTNNB1. The histopathological features, immunohistochemistry profiles, and molecular analysis of this tumor were consistent with MCST of the ovary. Therefore, a diagnosis of MCST of the right testicle was determined. To the best of our knowledge, this is the first case of MCST occurring in the testicles. The study may provide new insights to the tumor biology of MCST and a better understanding of this rare entity.
Adult ; Asian Continental Ancestry Group ; Biology ; Cyclin D1 ; Diagnosis ; Exons ; Female ; Humans ; Hyalin ; Immunohistochemistry ; Male ; Ovary ; Point Mutation ; Testis*

Histiocytosis is an uncommon disease characterized by excessive accumulation of histiocytes. Here, we report a rare case of non-Langerhans-cell histiocytosis in a 51-year-old woman who presented with severe symptoms of pericardial effusion. Radiologic investigation also detected multiple bone (lower limbs, vertebrae, ribs, and ilium) lesions. Resected pericardium showed abundant mono- or multi-nucleated non-foamy histiocytes (CD68⁺/CD163⁺/S-100⁺/CD1α⁻/langerin⁻) in a fibroinflammatory background. The histiocytes demonstrated emperipolesis of lymphocytes, a hallmark feature of Rosai-Dorfman disease (RDD). However, molecular analysis revealed a BRAF V600E mutation of the proliferating histiocytes, highlighting the neoplastic features frequently observed in another non-Langerhans-cell histiocytosis known as Erdheim-Chester Disease (ECD). We consider this case to be a unique presentation of ECD harboring some RDD-like cells with emperipolesis, but not a case of RDD with a BRAF mutation concerning its clinical manifestation (involvement of the heart and bones) and neoplastic features.
Emperipolesis* ; Erdheim-Chester Disease* ; Extremities ; Female ; Heart* ; Histiocytes ; Histiocytosis ; Histiocytosis, Non-Langerhans-Cell ; Histiocytosis, Sinus ; Humans ; Lymphocytes ; Middle Aged ; Pericardial Effusion ; Pericardium ; Ribs ; Spine

Two γ-glutamyl-cysteine peptides (γ-GCPs ) , ( SC2 RC7 )-γ-L-glutamyl-S-allyl-L-cysteine ( 1 ) and ( SC2 RC7 )-γ-L-glutamyl-S-propyl-L-cysteine ( 2 ) have been isolated from fresh garlic scales using ion-exchange chromatography and pre-HPLC. Their molecular structures were identified by HPLC-MS, CD, 1 H NMR, 13 C NMR, specific rotation and confirmed by the corresponding standard compounds. The influence of exogenously adding 1 and 2 on the bioavailability of iron and zinc from food legume was examined with soybean and mung bean, in the level of 0. 01 mmol/5 g of legume respectively. The enhancing effect of the two γ-GCPs of compound 1 and 2 on bioaccessibility of iron was generally evidenced in the case of soybean ( from 1 . 88% to 6 . 73% and 4 . 42%) and mung bean ( from 2 . 52% to 12 . 04% and 9 . 38%) . The two γ-GCPs similarly enhanced the bioaccessibility of zinc from the food legume, in soybean ranging from 13. 37% to 23. 95% and 20. 58%, and in mung bean from 15. 98% to 28. 44% and 27. 05%. Thus, both compounds 1 and 2 obviously had a promoting influence on the bioavailability of iron and zinc from food legumes. These findings are of practical value in a food-based strategy to enhance the bioavailability of trace minerals for human health.