Objective To systematically evaluate the similarities between six-gene-modified pig red blood cells and human red blood cells in multiple dimensions, including cell morphology, hematological parameters, microbial safety and serological compatibility, and to verify the feasibility of using six-gene-modified pig red blood cells as an alternative for blood transfusion in cases of traumatic hemorrhage. Methods Blood samples from O-type human donor, six-gene-modified O-type pig and wild-type O-type pig were collected. The pig gene-modified phenotype was identified by flow cytometry. The morphology was observed using field emission scanning electron microscopy and the diameter was measured. Hematological tests, including blood routine, osmotic fragility test, adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) content and partial pressure of oxygen at 50% hemoglobin saturation (P50), were conducted to assess the deformability of red blood cells. Real-time fluorescent quantitative polymerase chain reaction was used to screen for zoonotic viruses, and cross-matching was performed using column gel method, condensation amine method and saline tube method. Results The six-gene-modified pig red blood cells successfully knocked out the α-Gal, Neu5Gc and Sda antigens and expressed hCD55. Wild-type pig red blood cells expressed these three antigens but did not express human complement regulatory proteins. All three types of red blood cells presented a biconcave discoid morphology. The diameter of O-type human red blood cells was larger than that of the six-gene-modified porcine red blood cells and wild-type pig red blood cells (all P < 0.05). The average red blood cell volume and average red blood cell hemoglobin of O-type humans were higher than those of the six-gene-modified pig red blood cells, and the distribution width-variable coefficient of O-type human red blood cells was lower than that of the six-gene-modified pig red blood cells (all P < 0.05). There were no statistically significant differences in the permeability fragility, ATP content, 2,3-DPG content, P50 and red blood cell deformability indicators of the three types of red blood cells (all P > 0.05). The screening for zoonotic viruses in human and animal cells of the six-gene-modified pigs and wild-type pigs was negative. The cross-matching results showed that in the column gel method and condensation amine method, the primary and secondary sides of the six-gene-modified pig red blood cells did not agglutinate with human red blood cells, while the wild-type pig red blood cells agglutinated with human red blood cells in all cross-matching methods. Conclusions The six-gene-modified pig red blood cells are highly similar to human red blood cells in terms of morphology, key hematological parameters, energy metabolism, oxygen-carrying capacity, mechanical properties, microbial safety and serological compatibility, providing an experimental basis for the clinical transformation of xenotransfusion.

Objective:To investigate the iodine nutrition status of key populations in Linfen City, scientifically evaluate the current situation of iodine deficiency disorders prevention and control, and provide scientific basis for timely and targeted prevention and control of iodine deficiency disorders.Methods:According to the requirements of the "Monitoring Plan for Iodine Deficiency Disorders in Shanxi Province", from 2019 to 2023, monitoring was conducted annually in 17 counties (cities, districts, hereinafter referred to as county) under the jurisdiction of Linfen City. Each county was divided into five districts: east, west, south, north, and middle. One township/street was selected from each district, and 40 students aged 8 to 10 years from one primary school and 20 pregnant women were selected from each township/street as survey subjects. Household edible salt samples and one random urine samples were collected to test salt iodine and urinary iodine levels, and thyroid volume was measured on some children.Results:From 2019 to 2023, a total of 25 695 household edible salt samples were collected from children and pregnant women in 17 counties of Linfen City, with an average salt iodine range of 22.20 - 23.80 mg/kg. The qualified iodized salt consumption rates were 90.99% (4 674/5 137), 94.75% (4 889/5 160), 95.27% (4 889/ 5 132), 94.50% (4 843/5 125), and 95.82% (4 926/5 141), respectively; the iodized salt coverage rates were > 95%, and the qualified iodized salt rates were > 90%. And all the three showed an increasing trend year by year (χ 2trend = 56.31, 110.92, 137.24, P < 0.001). A total of 17 145 urine samples were collected from children, and the medians urinary iodine from 2019 to 2023 were 213.03, 187.40, 185.07, 190.70, and 189.30 μg/L, respectively. There were 8, 8, 9, 5, and 11 counties with appropriate iodine for children in each year, 0, 1, 0, 2, and 1 county with excessive iodine, and no county with iodine deficiency. A total of 8 548 urine samples were collected from pregnant women. The medians urinary iodine for pregnant women from 2019 to 2023 were 181.59, 187.40, 194.40, 187.25, and 187.10 μg/L, respectively. There were 14, 13, 15, 15, and 16 counties with appropriate iodine levels for pregnant women in each year, and 2, 4, 1, 0, and 1 county with iodine deficiency. A total of 5 670 children were examined for thyroid. The thyroid enlargement rates in children from 2019 to 2023 were 1.57%, 2.94%, 2.86%, 3.80%, and 2.82%, respectively. From 2019 to 2023, there were no new cases of endemic cretinism in Linfen City, and the thyroid enlargement rates in children were < 5%. Conclusions:From 2019 to 2023, all 17 counties in Linfen City are in a state of eliminating iodine deficiency disorders, and children and pregnant women are generally at an appropriate iodine and exceeding the appropriate iodine level. We should continue to strengthen the monitoring of iodine nutrition for key populations, carry out health education on scientific iodine supplementation, and effectively consolidate the achievements of iodine deficiency disorders prevention and control.

Purpose To explore the diagnostic value of two-dimensional speckle tracking echocardiography(2D-STE)in differentiating left ventricular hypertrophy(LVH)caused by Fabry disease from other etiologies.Materials and Methods A total of 23 patients clinically confirmed Fabry disease with LVH(Fabry disease group)in Peking University First Hospital from August 2014 to February 2023,retrospectively.23 patients with hypertensive LVH(hypertensive LVH group)and 23 with hypertrophic cardiomyopathy(HCM)(HCM group)were also included.Conventional echocardiographic parameters and 2D-STE-derived left atrial strain and left ventricular longitudinal strain were analyzed and compared among the three groups.LASSO regression was used to select variables and construct a diagnostic model to differentiate hypertensive LVH,HCM and Fabry disease group.Results The Fabry disease group showed significantly reduced left ventricular global longitudinal strain and segmental left ventricular longitudinal strain in the basal anterior wall,basal anterolateral wall and mid inferior wall compared to the hypertensive LVH group(P<0.05).There were no significant differences in left atrial strain,left ventricular global longitudinal strain and segmental left ventricular longitudinal strain between the Fabry disease and HCM groups(P>0.05).Compared to the conventional echocardiography-based model,the combined model did not significantly improve diagnostic accuracy for differentiating the three etiologies(Z=-1.314--0.594,all P>0.05).Conclusion Compared to patients with hypertensive LVH,HCM and Fabry disease group exhibit varying degrees of decrease in global and segmental longitudinal strain of the left atrium and left ventricle.Additional measurements of left ventricular longitudinal strain and left atrial strain do not provide significant incremental diagnostic value over conventional echocardiography in distinguishing among Fabry disease,hypertensive LVH and HCM.

Purpose To explore the diagnostic value of two-dimensional speckle tracking echocardiography(2D-STE)in differentiating left ventricular hypertrophy(LVH)caused by Fabry disease from other etiologies.Materials and Methods A total of 23 patients clinically confirmed Fabry disease with LVH(Fabry disease group)in Peking University First Hospital from August 2014 to February 2023,retrospectively.23 patients with hypertensive LVH(hypertensive LVH group)and 23 with hypertrophic cardiomyopathy(HCM)(HCM group)were also included.Conventional echocardiographic parameters and 2D-STE-derived left atrial strain and left ventricular longitudinal strain were analyzed and compared among the three groups.LASSO regression was used to select variables and construct a diagnostic model to differentiate hypertensive LVH,HCM and Fabry disease group.Results The Fabry disease group showed significantly reduced left ventricular global longitudinal strain and segmental left ventricular longitudinal strain in the basal anterior wall,basal anterolateral wall and mid inferior wall compared to the hypertensive LVH group(P<0.05).There were no significant differences in left atrial strain,left ventricular global longitudinal strain and segmental left ventricular longitudinal strain between the Fabry disease and HCM groups(P>0.05).Compared to the conventional echocardiography-based model,the combined model did not significantly improve diagnostic accuracy for differentiating the three etiologies(Z=-1.314--0.594,all P>0.05).Conclusion Compared to patients with hypertensive LVH,HCM and Fabry disease group exhibit varying degrees of decrease in global and segmental longitudinal strain of the left atrium and left ventricle.Additional measurements of left ventricular longitudinal strain and left atrial strain do not provide significant incremental diagnostic value over conventional echocardiography in distinguishing among Fabry disease,hypertensive LVH and HCM.

Objective:To investigate the iodine nutrition status of key populations in Linfen City, scientifically evaluate the current situation of iodine deficiency disorders prevention and control, and provide scientific basis for timely and targeted prevention and control of iodine deficiency disorders.Methods:According to the requirements of the "Monitoring Plan for Iodine Deficiency Disorders in Shanxi Province", from 2019 to 2023, monitoring was conducted annually in 17 counties (cities, districts, hereinafter referred to as county) under the jurisdiction of Linfen City. Each county was divided into five districts: east, west, south, north, and middle. One township/street was selected from each district, and 40 students aged 8 to 10 years from one primary school and 20 pregnant women were selected from each township/street as survey subjects. Household edible salt samples and one random urine samples were collected to test salt iodine and urinary iodine levels, and thyroid volume was measured on some children.Results:From 2019 to 2023, a total of 25 695 household edible salt samples were collected from children and pregnant women in 17 counties of Linfen City, with an average salt iodine range of 22.20 - 23.80 mg/kg. The qualified iodized salt consumption rates were 90.99% (4 674/5 137), 94.75% (4 889/5 160), 95.27% (4 889/ 5 132), 94.50% (4 843/5 125), and 95.82% (4 926/5 141), respectively; the iodized salt coverage rates were > 95%, and the qualified iodized salt rates were > 90%. And all the three showed an increasing trend year by year (χ 2trend = 56.31, 110.92, 137.24, P < 0.001). A total of 17 145 urine samples were collected from children, and the medians urinary iodine from 2019 to 2023 were 213.03, 187.40, 185.07, 190.70, and 189.30 μg/L, respectively. There were 8, 8, 9, 5, and 11 counties with appropriate iodine for children in each year, 0, 1, 0, 2, and 1 county with excessive iodine, and no county with iodine deficiency. A total of 8 548 urine samples were collected from pregnant women. The medians urinary iodine for pregnant women from 2019 to 2023 were 181.59, 187.40, 194.40, 187.25, and 187.10 μg/L, respectively. There were 14, 13, 15, 15, and 16 counties with appropriate iodine levels for pregnant women in each year, and 2, 4, 1, 0, and 1 county with iodine deficiency. A total of 5 670 children were examined for thyroid. The thyroid enlargement rates in children from 2019 to 2023 were 1.57%, 2.94%, 2.86%, 3.80%, and 2.82%, respectively. From 2019 to 2023, there were no new cases of endemic cretinism in Linfen City, and the thyroid enlargement rates in children were < 5%. Conclusions:From 2019 to 2023, all 17 counties in Linfen City are in a state of eliminating iodine deficiency disorders, and children and pregnant women are generally at an appropriate iodine and exceeding the appropriate iodine level. We should continue to strengthen the monitoring of iodine nutrition for key populations, carry out health education on scientific iodine supplementation, and effectively consolidate the achievements of iodine deficiency disorders prevention and control.

Advanced hepatocellular carcinoma has a high degree of malignancy and poor prognosis. Studies showed that there is a close relationship between the progression of hepatocellular carcinoma and the immune status in tumor microenvironment. Adoptive cell therapy showed anti-tumor effects and improve immunosuppression by infusing patients with activated specific immune cells, which become a central issue in tumor therapy and shown promising effects in the treatment of various malignant tumors, indicating great application potential. Adoptive cell therapy based on neoantigen may become a new hot spot in the treatment of hepatocellular carcinoma, and their application, safety and effectiveness evaluation, efficacy prediction and assessment have become urgent issues to be solved. The purpose of this article is to introduce the progress related to adoptive cell therapy for advanced hepatocellular carcinoma and elaborate the problems that need to be solved in the future.

Objective To investigate the value of strong ion gap (SIG) for predicting acute heart failure (AHF) after acute myocardial infarction. Methods A total of 189 patients with acute myocardial infarction were enrolled from July 2015 to December 2016 in the First Affiliated Hospital of Soochow University. Based on AHF occurrence, the patients were divided into the AHF group (n=76) and the non-AHF group (n=113). General clinical data and laboratory tests were compared between the two groups. The univariate analysis and multivariate logistic regression analysis were performed to estimate the contribution of clinical risk factors to triggering AHF after acute myocardial infarction. Spearman correlation analysis was performed to estimate the correlation between SIG and Killip classification. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of ALB, anion gap (AG) and SIG in AHF after acute myocardial infarction. Results Age, proportion of history of diabetes, the serum level of C-reactive protein (CRP), AG and SIG of the AHF group were higher than those of the non-AHF group (P<0.05). Meanwhile, the serum level of albumin (ALB) of the AHF group were lower than those of the non-AHF group (P<0.05). Univariate analysis showed AHF after acute myocardial infarction was closely associated with age, history of diabetes, serum ALB, AG and SIG (P<0.05). Multivariate logistic regression analysis showed that history of diabetes (OR=2.034, 95％CI:1.075-4.113, P<0.05) and SIG (OR=2.445, 95％CI: 1.538-4.297, P<0.05) were significantly correlated with AHF after acute myocardial infarction. The ROC analysis revealed SIG (AUC=0.837,95％CI:0.781-0.893) had a large area under curve compared to ALB (AUC=0.671,95％CI: 0.593-0.750) and AG (AUC=0.728,95％CI: 0.654-0.802). The optimal diagnostic intercept value was 5.24 mmol/L, and the sensitivity and specificity were 76.32％ and 78.36％, respectively. Conclusions SIG could be used as an independent predictor for AHF secondary to acute myocardial infarction, and was significantly correlated with severity of AHF.

Pyroptosis is a form of new programmed cell death which is dependent on Caspase-1 in recent years.When it' s stimulated by various dangerous signals from hepatic ischemia-reperfusion injury,the intracellular pattern recognition receptors are assembled into inflammasomes and Caspase-1 which was transformed into active form.Activated Caspase-1 promotes the maturation and secretion of pro-inflammatory cytokines IL-1β and IL-18,initiates the innate immunity rapidly and then induces severe inflammatory reaction.In addition,Caspase-1 can also cleave Gasdermin D and release its N-terminal domain triggering pyroptosis.Many studies showed that pyroptosis play a crucial role in hepatic ischemia-reperfusion injury.In this review,we discussed the activation mechanism and research progress of pyroptosis in hepatic ischemia-reperfusion injury.

Objective To compare the analgesia effects of Oxycodone hydrochloride with Sufentanil in laparoscopic cholecystectomy (LC) anesthesia induction. Method Sixty patients scheduled for elective LC, ASAⅠ or Ⅱ , were randomly divided into two groups (30 in each): Oxycodone group (group O) and Sufentanil group (Group S). Induction of anesthesia: group O: Propofol 1.0 ~ 2.0 mg/kg, Oxycodone 0.3 mg/kg, Vecuronium 0.1 mg/kg. Group S: Propofol 1.0 ~ 2.0 mg/kg, Sufentanil 0.3 μg/kg and Vecuronium 0.1 mg/kg. The value of HR, SBP, DBP of the two groups were recorded in the operation room (T0), after anesthesia induction (T1), 1 min after insertion laryngeal mask (T2), the instant of pneumoperitoneum establishment (T3), separation of the gallbladder (T4), the time of wake up (T5), leave the recovery room (T6). The numeric pain rating scale (NRS) were recorded at T4, T5, 4 hours later (T7), 8 hours later (T8), one day later (T9). Then recorded the wake time and additional analgetic cases. Recorded the adverse reactions. Results The average HR, SBP and DBP fluctuations in the two groups were not more than 20.0 % of the basal values. There was no significant difference in wake time between the two groups. There were 11 cases of patients, the NRS>4, in Sufentanil group requires additional analgesics after they wake up, more than Oxycodone group (P = 0.040). The NRS score was lower in Oxycodone group than group S in T5, T7, T8, T9, but they had no statistically significant difference. There was no significant difference in adverse reactions between the two groups. Conclusion 0.3 mg/kg Oxycodone and 0.3 μg/kg Sufentanil for anesthesia induction of LC, the anesthesia and analgesia effect is good, can satisfy the clinical anesthesia and postoperative analgesic requirements. The analgesic effect of 0.3 mg/kg Oxycodone may be comparable or better than 0.3 μg/kg Sufentanil.

Objective To explore the correlation between hypokalemia and sudden death in young and middle-aged people. Methods One hundred and twenty-nine young and middle-aged patients with sudden death during treatment were selected as observation group. Then 100 cases of healthy volunteers were randomly selected as control group. The incidence of cardiovascular disease, incidence of hypokalemia and intake of potassium were compared between 2 groups. Results The incidences of hypertension, arrhythmia, myocardial infarction, heart failure and hypokalemia in observation group were significantly higher than those in control group: 17.05% (22/129) vs. 5.00%(5/100), 13.18% (17/129) vs. 2.00% (2/100), 26.36% (34/129) vs. 9.00% (9/100), 9.30% (12/129) vs. 1.00% (1/100) and 55.04% (71/129) vs. 12.00% (12/100), and there were statistical differences (P<0.01). The ratios of higher, common, lower intake of potassium in observation group were 1.55%(2/129), 27.91% (36/129) and 70.54%(91/129), in control group were 15.00% (15/100), 58.00% (58/100) and 27.00% (27/100), and there was statistical difference (P<0.01). Logistic regression analysis result showed that hypertension, arrhythmia, myocardial infarction, heart failure, hypokalemia and lower intake of potassium were the risk factor for sudden death (P<0.01). The incidences of hypertension, arrhythmia, myocardial infarction and heart failure in hypokalemia patients were significantly higher than those in normokalemia patients: 28.92% (24/83) vs. 2.05% (3/146), 19.28% (16/83) vs. 2.05% (3/146), 44.58%(37/83) vs. 4.11% (6/146) and 13.25% (11/83) vs. 1.37% (2/146), and there were statistical differences (P<0.01). The incidence of hypokalemia in people with lower intake of potassium was significantly higher than that in people with higher and common intake of potassium: 56.78% (67/118) vs. 2/17 and 14.89%(14/94), and there was statistical difference (P<0.01). Conclusions There is a significant correlation between hypokalemia and sudden death in young and middle-aged people. Preventive measures of sudden death should be made according to serum potassium level in clinic. People should pay attention to the uptake of potassium in daily life.