Background: Living donor liver transplantation (LDLT) is lifesaving for patients with end-stage liver disease, especially where cadaveric grafts are limited. Some centers may exclude potential donors with positive auto-antibodies (AAbs) due to concerns of autoimmune hepatitis (AIH) and jeopardizing donor safety. This scoping review evaluates the natural history and clinical significance of AAbs in LDLT donors. Methods: A comprehensive search of PubMed, Embase, and Cochrane Library was conducted, following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines and under consultation with an experienced librarian. English articles published from 2000 to 2024 were included. Two reviewers independently assessed eligibility and extracted relevant data on study characteristics, AAb types, donor demographics, follow-up duration, and clinical outcomes. Results: Of 1,067 screened studies, 22 were relevant (20 focused on donor outcomes and protocols, 2 on AAb screening in donor selection). Only one study specifically mentioned that a normal autoimmune workup is necessary for donor eligibility. Regarding the natural history of AAbs, 10 studies were relevant, including 2 reviews on prognosis. No conclusive evidence linked AAbs to increased AIH risk in donors with normal liver function. Conclusion Significant knowledge gaps exist regarding AAbs in donor safety and their natural history. Donor screening practices varied widely across institutions.AAbs are neither routinely screened nor considered an exclusion criterion in most centres. In asymptomatic individuals with normal liver function and AAbs, there does not appear to be an elevated risk for developing AIH. This review maps existing gaps in literature and highlights areas for future research.

INTRODUCTION: Acute malignant large bowel obstruction (MBO) occurs in 8%-15% of colorectal cancer patients. Self-expandable metal stents (SEMS) have progressed from a palliative modality to use as bridge to surgery (BTS). We aimed to assess the safety and efficacy of SEMS for MBO in our institution. METHODS: The data of patients undergoing SEMS insertion for MBO were reviewed. Technical success was defined as successful SEMS deployment across tumour without complications. Clinical success was defined as colonic decompression without requiring further surgical intervention. Rates of complications, median time to surgery, types of surgery and rates of recurrence were studied. RESULTS: Seventy-nine patients underwent emergent SEMS placement from September 2013 to February 2020. Their mean age was 68.8 ± 13.8 years and 43 (54%) patients were male. Mean tumour length was 4.2 cm ± 2.2 cm; 89.9% of malignant strictures were located distal to the splenic flexure. Technical and clinical success was 94.9% and 98.7%, respectively. Perforation occurred in 5.1% of patients, with none having stent migration or bleeding. Fifty (63.3%) patients underwent SEMS insertion as BTS. Median time to surgery was 20 (range 6-57) days. Most (82%) patients underwent minimally invasive surgery. Primary anastomosis rate was 98%. Thirty-nine patients had follow-up beyond 1-year posttreatment (median 34 months). Local recurrence and distant metastasis were observed in 4 (10.3%) and 5 (12.8%) patients, respectively. CONCLUSION Insertion of SEMS for acute MBO has high success rates and a good safety profile. Most patients in this audit underwent minimally invasive surgery and primary anastomosis after successful BTS.
Humans ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Colorectal Neoplasms/pathology* ; Singapore ; Tertiary Care Centers ; Stents/adverse effects* ; Intestinal Obstruction/etiology* ; Treatment Outcome ; Retrospective Studies ; Palliative Care

Objective To explore the method of Oncomelania hupensis snail surveillance in transmission?interrupted re?gions of schistosomiasis,so as to provide a new pattern for the surveillance of snail status in the transmission?interrupted areas. Methods In Dongtai County,north of Jiangsu Province where the transmission of schistosomiasis was interrupted,the surveil?lance of snail status was performed by means of the village?level general survey,village?level sampling survey,snail survey in key settings of township and county,and snail reporting by residents. In addition,quality?control snail sites were set up for quali?ty control. The effectiveness and cost of the four methods of snail surveillance was compared. Results A total of 163 079 set?tings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013,and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village?level general survey,village?level sampling survey,and snail survey in key settings of township and county were employed for investigation of 94 550,45 033 and 23 496 settings,consisting of 57.98%, 27.61%and 14.41%of total settings,and 2,0 and 6 settings were found with snails,with 0.021/thousand,0,and 0.255/thou?sand detection rates of settings with snail breading sites,respectively. The pattern of snail survey in key settings of township and county was more effective than that of village?level survey to detect snail breeding sites(χ2 =19.158,P=0). The recovery rate of quality?control snail breeding sites was 52.56%,38.27%and 73.62%for the three patterns of snail survey,respectively,and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village?lev?el survey(χ2 =111.597 and 85.991,both P=0). During the period from 2008 to 2013,289 person?times reported 279 sus?pected snail habitats and 1 501 living snails,and no Oncomelania snails were found. During the 6?year period,there were 1617.5,964.7 and 527.7 thousand RMB invested for village?level general survey,village?level sampling survey,and snail sur?vey in key settings of township and county,and the cost of snail survey per hm2 was 129.88,133.6 and 162.57 RMB/hm2,re?spectively. The cost of village?level general survey and snail survey in key settings of township and county to detect a snail?breed?ing site was 808 800 and 88 000 RMB,respectively(t=12.850,P=0.000),and the cost of snail survey in key settings of town?ship and county was 10.88%of that of village?level general survey. Conclusion The snail survey in key settings of township and county is a highly effective and high?quality method for snail surveillance,which may serve as a prior way for the surveil?lance of snail status in the transmission?interrupted areas of schistosomiasis.

Objective To study the value of CT diagnosis of atraumatic acute abdominal disease and how to select CT scan rationally.Methods The CT findings of 319 cases of atraumatic acute abdominal disease were reviewed restrospectively.Results Of 319 cases,226 cases of non-traumatic acute abdomen had positive findings on CT,the positive rate was 70.84%.Of them,the diseases included:urinary tract system in 63 cases,bile system in 62 cases,pancreas in 41 cases,gastro-intestinal system in 37 cases and others in 23 cases.The positive rate of CT findings was higher with aging in non-traumatic acute abdomen.Conclusion CT is of diagnostic value in atraumatic acute abdominal disease.