OBJECTIVES: To analyze the early clinical outcomes of the Xcor^TM transcatheter aortic valve replacement (TAVR) system in treating severe aortic stenosis. This study has been registered at Chinese Clinical Trial Registry (ChiCTR2200065593). METHODS: This single-arm, prospective clinical trial enrolled patients with severe aortic stenosis treated with the Xcor^TM TAVR system at the Section of Heart Valve & Coronary Artery Surgery, Guangdong Provincial People's Hospital. Perioperative and follow-up parameters were compared to evaluate differences in hemodynamic outcomes. All-cause mortality, aortic regurgitation, paravalvular leakage, cerebrovascular events, and reoperation were analyzed. RESULTS: Thirty-two patients with severe aortic stenosis were included (20 males, 12 females), with (70.9±4.3) years old and a Society of Thoracic Surgeons (STS) score of 6.45% (6.07%, 7.28%). Notably, 87.5% of patients had New York Heart Association (NYHA) class≥Ⅲ. All patients underwent successful Xcor^TM bioprosthesis implantation, achieving an immediate technical success rate of 100.0% and device success rate of 96.9%. Mean aortic valve gradient decreased from (55.21±23.17) mmHg (1 mmHg=0.133 kPa) to (8.45±5.30) mmHg, peak aortic jet velocity decreased from (4.66±0.85) m/s to (1.99±0.48) m/s, aortic valve area increased from (0.66±0.21) cm² to (2.09±0.67) cm² (all P<0.01). Intraoperative ventricular fibrillation occurred in one patient, while one case exhibited moderate prosthetic valve regurgitation and paravalvular leakage post-procedure. At 12-month follow-up, sustained improvements were observed in cardiac function, left ventricular ejection fraction, hemodynamic parameters, and SF-12 quality-of-life scores (all P<0.01). All-cause mortality was 12.5% (4/32), with 13.8% (4/29) developing moderate paravalvular leakage. CONCLUSIONS The Xcor^TM TAVR system demonstrated favorable early outcomes in severe aortic stenosis patients, significantly improving symptoms and hemodynamics while exhibiting excellent performance in preventing malignant arrhythmias and coronary obstruction.
Humans ; Male ; Female ; Aortic Valve Stenosis/surgery* ; Transcatheter Aortic Valve Replacement/methods* ; Aged ; Follow-Up Studies ; Prospective Studies ; Treatment Outcome ; Aged, 80 and over ; Heart Valve Prosthesis ; Middle Aged

Microorganisms, abundant in nature, are prolific producers of a diverse array of natural products (NPs) that are fundamental in the development of innovative therapeutics. Despite their significant potential, the field faces considerable challenges, including the continuous emergence of potential health threats, as well as novel pathogen strains and viruses. The advent and implementation of advanced technologies, such as culture strategies, genomics mining, and artificial intelligence (AI), are facilitating a paradigm shift in pharmaceutical research, introducing innovative methodologies and perspectives. The development and maturation of these technologies have enhanced the exploration of microbial-derived NPs, thereby advancing pharmaceutical research and development. This review synthesizes recent developments in this context, emphasizing their applications in pharmaceutical discovery and development. Through systematic analysis and synthesis, it provides objective insights into the promising prospects and future direction of this essential field.
Biological Products/chemistry* ; Drug Discovery ; Humans ; Artificial Intelligence ; Bacteria/metabolism*

Objective:To explore the clinicopathologic features of early-onset pancreatic cancer (EOPC) and its correlation with dyslipidemia and prognostic analysis.Methods:This is a retrospective cohort study. Clinical and pathological data of 455 patients with pancreatic cancer who underwent radical surgery from January 2013 to September 2020 in the Department of Pancreatic Surgery, Qilu Hospital, Shandong University were retrospectively collected. According to the onset age≤50 years, the patients were divided into EOPC group(67 cases) and later-onset pancreatic cancer (LOPC) group(388 cases). There were 48 males and 19 females in the EOPC group, aged (44.4±5.7) years(range: 28.0 to 50.0 years); and 230 males and 158 females in the LOPC group, aged (63.0±7.2)years (range: 51.0 to 86.0 years). EOPC was divided into two groups according to the blood lipid status: dyslipidemia (50 cases) and normal (17 cases). General information, blood lipid data, clinicopathological parameters and follow-up information were collected. χ2 test, Mann-Whitney U test and Logistic regression analysis were used to evaluate the difference or correlation between groups, and Cox regression analysis and Kaplan-Meier survival curve were used to analyze the impact of EOPC and dyslipidemia on the prognosis. Propensity score matching was used to match two groups of patients in a 1∶1 ratio using nearest neighbor matching, with a caliper set at 0.05. Results:Compared with LOPC group, EOPC group with a higher proportion of patients with body mass index ≥24 kg/m 2 (55.8%(24/43) vs. 38.7%(113/292), χ2=4.542 ,P=0.033), dyslipidemia(74.6%(50/67) vs. 57.7%(224/388), χ2=6.808, P=0.009), pancreatic head cancer (73.1% (49/67) vs. 60.0%(231/385), χ2=4.176, P=0.041) and a lower proportion of patients with type 2 diabetes (9.0%(6/67) vs. 24.2%(94/388), χ2=7.771, P=0.005) and hypertension (9.0%(6/67) vs. 33.0%(128/388), χ2=15.885, P<0.01). Compared the proportion of dyslipidemia in the two groups,there was a higher proportion of high density lipoprotein cholesterol(HDL-C) abnormality in the EOPC group (65.7%(44/67) vs. 42.8%(166/388), χ2=12.044, P<0.01), whereas there was no significant difference in other lipid indices. Kaplan-Meier survival curve analysis of dyslipidemia did not have a significant effect on the prognosis of EOPC patients ( P=0.430). The results of further Logistic regression analysis showed that gender( OR=6.445 (95% CI: 1.692 to 24.548), P=0.006) and tumor location ( OR=5.352 (95% CI: 1.374 to 20.846), P=0.016) were independent related factors with serum lipid level in patients with EOPC. Conclusions:Compared with LOPC, EOPC is more likely to be combined with obesity and HDL-C abnormalities, and the proportion of pancreatic head cancer is also higher, but there is no significant difference in prognosis between the two groups. In the EOPC patients, serum lipid level is associated with gender and tumor site, but has no effect on survival.

Objective:To investigate the application value of scenario simulation combined with standardized patient teaching in the training of doctor-patient communication skills among interns.Methods:A total of 110 clinical medicine interns were selected from Qilu Hospital of Shandong University and were divided into experimental group and control group using a random number table, with 55 interns in each group. The interns in the control group received traditional lecturing, and those in the experimental group received scenario simulation combined with standardized patient case-based teaching. The SEGUE Communication Skill Evaluation Scale and Patient Satisfaction Questionnaire were used to assess the improvement in communication skills in both groups, and Physician Self-Evaluation Scale and Course Satisfaction Questionnaire were used to assess the effectiveness of the course and the degree of satisfaction with the course. SPSS 26.0 was used for the t-test, the Mann-Whitney U test, and the rank sum test. Results:After training, both groups showed significant improvements in communication skills and patient satisfaction [experimental group in terms of communication skills: (55.38±13.11) vs. (74.82±6.75), P<0.001; experimental group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 81.00 (79.00, 83.00), P<0.01; control group in terms of communication skills: (56.53±12.34) vs. (65.45±10.18), P<0.001; control group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 73.00 (68.00, 77.00), P<0.001], and the experimental group had significantly higher scores than the control group [communication skills: (74.82±6.75) vs. (65.45±10.18), P<0.001; patient satisfaction: 81.00 (79.00, 83.00) vs. 73.00 (68.00, 77.00), P<0.001]. The Physician Self-Evaluation Scale showed that the experimental group had a significant improvement compared with the control group ( P<0.05). The results of the Course Satisfaction Questionnaire showed that the degree of overall satisfaction of the course was only 87.28% in the control group, while all the interns in the experimental group were satisfied with the course ( P<0.001); the new teaching method showed great advantages ( P<0.001). Conclusions:In the training of doctor-patient communication skills among interns, the application of scenario simulation combined with standardized patient case-based teaching can significantly improve their abilities of the application of knowledge application, humanistic concern, and communication skills, and therefore, it is an effective and promising method for the training of doctor-patient communication skills.

Purpose To investigate the clinicopathological features and molecular genetic alteration of Epstein-Barr virus-positive diffuse large B-cell lymphoma(EBV+DLBCL)in pediatric patients.Methods Clinical data were collected for 3 pediatric patients diagnosed with EBV+DLBCL.Immunohistochemistry(EnVision two-step method)was used to evaluate expression of CD20,CD79α,CD3,CD5,CD30,EBNA2,Fascin,and GATA3.In situ hybridization detected EBER1/2 expression.B-cell receptor(BCR)and T-cell receptor(TCR)gene rearrangements were performed to evaluate the clonal rearrangement of tumor lymphocytes.Results Among the 3 pediatric patients(ages 13-18),there were 2 males and 1 female.All patients presented with painless lymphadenopathy without bone marrow involve-ment.One female patient exhibited B symptoms(fever,night sweats,and weight loss),whereas both male patients were asymptomatic.According to the Lugano classification,2 cases were stage Ⅲand one was stage Ⅳ.Histopathologi-cally,2 cases exhibited a polymorphic morphology resembling T-cell/histiocyte-rich large B-cell lymphoma,and one case demonstrated monomorphic morphology typical of conventional DLBCL.Immunophenotypically,all cases strongly expressed various B-cell transcription factors;CD30 expression varied in intensity;EBNA2,Fascin and GATA3 were uniformly negative.In situ hybridization indicated EBER1/2 positive expression in large tumor cells and scattered back-ground small lymphocytes.Clonal Ig gene rearrangement peaks were detected in all 3 cases.Each patient received standard DLBCL chemotherapy,and follow-up PET-CT scans indicated complete remission in all.Conclusion Pediat-ric EBV+DLBCL is rare,and diagnosing the polymorphic subtype poses particular challenges.In China,many patholo-gists consider detection of clonal Ig gene rearrangement as the diagnostic"gold standard".Even when clinical course and imaging data strongly support EBV+DLBCL,final diagnosis can remain controversial.Further accumulation of ca-ses and long-term follow-up are needed to elucidate optimal diagnostic criteria,treatment responses,and prognostic fac-tors.

Purpose To investigate the clinicopathological features and molecular genetic alteration of Epstein-Barr virus-positive diffuse large B-cell lymphoma(EBV+DLBCL)in pediatric patients.Methods Clinical data were collected for 3 pediatric patients diagnosed with EBV+DLBCL.Immunohistochemistry(EnVision two-step method)was used to evaluate expression of CD20,CD79α,CD3,CD5,CD30,EBNA2,Fascin,and GATA3.In situ hybridization detected EBER1/2 expression.B-cell receptor(BCR)and T-cell receptor(TCR)gene rearrangements were performed to evaluate the clonal rearrangement of tumor lymphocytes.Results Among the 3 pediatric patients(ages 13-18),there were 2 males and 1 female.All patients presented with painless lymphadenopathy without bone marrow involve-ment.One female patient exhibited B symptoms(fever,night sweats,and weight loss),whereas both male patients were asymptomatic.According to the Lugano classification,2 cases were stage Ⅲand one was stage Ⅳ.Histopathologi-cally,2 cases exhibited a polymorphic morphology resembling T-cell/histiocyte-rich large B-cell lymphoma,and one case demonstrated monomorphic morphology typical of conventional DLBCL.Immunophenotypically,all cases strongly expressed various B-cell transcription factors;CD30 expression varied in intensity;EBNA2,Fascin and GATA3 were uniformly negative.In situ hybridization indicated EBER1/2 positive expression in large tumor cells and scattered back-ground small lymphocytes.Clonal Ig gene rearrangement peaks were detected in all 3 cases.Each patient received standard DLBCL chemotherapy,and follow-up PET-CT scans indicated complete remission in all.Conclusion Pediat-ric EBV+DLBCL is rare,and diagnosing the polymorphic subtype poses particular challenges.In China,many patholo-gists consider detection of clonal Ig gene rearrangement as the diagnostic"gold standard".Even when clinical course and imaging data strongly support EBV+DLBCL,final diagnosis can remain controversial.Further accumulation of ca-ses and long-term follow-up are needed to elucidate optimal diagnostic criteria,treatment responses,and prognostic fac-tors.

Objective:To investigate the application value of scenario simulation combined with standardized patient teaching in the training of doctor-patient communication skills among interns.Methods:A total of 110 clinical medicine interns were selected from Qilu Hospital of Shandong University and were divided into experimental group and control group using a random number table, with 55 interns in each group. The interns in the control group received traditional lecturing, and those in the experimental group received scenario simulation combined with standardized patient case-based teaching. The SEGUE Communication Skill Evaluation Scale and Patient Satisfaction Questionnaire were used to assess the improvement in communication skills in both groups, and Physician Self-Evaluation Scale and Course Satisfaction Questionnaire were used to assess the effectiveness of the course and the degree of satisfaction with the course. SPSS 26.0 was used for the t-test, the Mann-Whitney U test, and the rank sum test. Results:After training, both groups showed significant improvements in communication skills and patient satisfaction [experimental group in terms of communication skills: (55.38±13.11) vs. (74.82±6.75), P<0.001; experimental group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 81.00 (79.00, 83.00), P<0.01; control group in terms of communication skills: (56.53±12.34) vs. (65.45±10.18), P<0.001; control group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 73.00 (68.00, 77.00), P<0.001], and the experimental group had significantly higher scores than the control group [communication skills: (74.82±6.75) vs. (65.45±10.18), P<0.001; patient satisfaction: 81.00 (79.00, 83.00) vs. 73.00 (68.00, 77.00), P<0.001]. The Physician Self-Evaluation Scale showed that the experimental group had a significant improvement compared with the control group ( P<0.05). The results of the Course Satisfaction Questionnaire showed that the degree of overall satisfaction of the course was only 87.28% in the control group, while all the interns in the experimental group were satisfied with the course ( P<0.001); the new teaching method showed great advantages ( P<0.001). Conclusions:In the training of doctor-patient communication skills among interns, the application of scenario simulation combined with standardized patient case-based teaching can significantly improve their abilities of the application of knowledge application, humanistic concern, and communication skills, and therefore, it is an effective and promising method for the training of doctor-patient communication skills.

Objective:To explore the clinicopathologic features of early-onset pancreatic cancer (EOPC) and its correlation with dyslipidemia and prognostic analysis.Methods:This is a retrospective cohort study. Clinical and pathological data of 455 patients with pancreatic cancer who underwent radical surgery from January 2013 to September 2020 in the Department of Pancreatic Surgery, Qilu Hospital, Shandong University were retrospectively collected. According to the onset age≤50 years, the patients were divided into EOPC group(67 cases) and later-onset pancreatic cancer (LOPC) group(388 cases). There were 48 males and 19 females in the EOPC group, aged (44.4±5.7) years(range: 28.0 to 50.0 years); and 230 males and 158 females in the LOPC group, aged (63.0±7.2)years (range: 51.0 to 86.0 years). EOPC was divided into two groups according to the blood lipid status: dyslipidemia (50 cases) and normal (17 cases). General information, blood lipid data, clinicopathological parameters and follow-up information were collected. χ2 test, Mann-Whitney U test and Logistic regression analysis were used to evaluate the difference or correlation between groups, and Cox regression analysis and Kaplan-Meier survival curve were used to analyze the impact of EOPC and dyslipidemia on the prognosis. Propensity score matching was used to match two groups of patients in a 1∶1 ratio using nearest neighbor matching, with a caliper set at 0.05. Results:Compared with LOPC group, EOPC group with a higher proportion of patients with body mass index ≥24 kg/m 2 (55.8%(24/43) vs. 38.7%(113/292), χ2=4.542 ,P=0.033), dyslipidemia(74.6%(50/67) vs. 57.7%(224/388), χ2=6.808, P=0.009), pancreatic head cancer (73.1% (49/67) vs. 60.0%(231/385), χ2=4.176, P=0.041) and a lower proportion of patients with type 2 diabetes (9.0%(6/67) vs. 24.2%(94/388), χ2=7.771, P=0.005) and hypertension (9.0%(6/67) vs. 33.0%(128/388), χ2=15.885, P<0.01). Compared the proportion of dyslipidemia in the two groups,there was a higher proportion of high density lipoprotein cholesterol(HDL-C) abnormality in the EOPC group (65.7%(44/67) vs. 42.8%(166/388), χ2=12.044, P<0.01), whereas there was no significant difference in other lipid indices. Kaplan-Meier survival curve analysis of dyslipidemia did not have a significant effect on the prognosis of EOPC patients ( P=0.430). The results of further Logistic regression analysis showed that gender( OR=6.445 (95% CI: 1.692 to 24.548), P=0.006) and tumor location ( OR=5.352 (95% CI: 1.374 to 20.846), P=0.016) were independent related factors with serum lipid level in patients with EOPC. Conclusions:Compared with LOPC, EOPC is more likely to be combined with obesity and HDL-C abnormalities, and the proportion of pancreatic head cancer is also higher, but there is no significant difference in prognosis between the two groups. In the EOPC patients, serum lipid level is associated with gender and tumor site, but has no effect on survival.

Animals ; Macaca mulatta ; Optic Disk ; Glaucoma ; Craniocerebral Trauma ; Intraocular Pressure ; Low Tension Glaucoma

Objective:To examine the characteristics of blood lipid profile and the correlation with clinic-pathological features of pancreatic cancer patients.Methods:The clinical and pathological data of 265 pancreatic cancer patients who received radical surgical treatment at Department of General Surgery,Qilu Hospital,Shandong University from January 2013 to September 2020 were collected and analyzed retrospectively. Among the 265 pancreatic cancer patients,there were 170 males and 95 females,with age of (61.0±9.6)years(range:28 to 86 years). General information,lipid indicators and clinic-pathological information were collected from electronic medical record system,and follow-up information gained by telephone. According to level of serum lipid in pancreatic cancer patients,265 patients were divided into dyslipidemia group( n=115) and normal lipid group( n=150). Pearson χ 2,Student′s t tests, variance analysis or univariate Logistic regression was used to analyze the correlation between dyslipidemia and clinico-pathological characteristics of pancreatic cancer,respectively. Kaplan-Meier survival curve was used to assessed the influence of dyslipidemia on prognosis of pancreatic cancer patients. Results:In 265 pancreatic cancer patients,115(43.4%)of them had dyslipidemias,and the most common form was increase of triglyceride(TG)(72.2%). In pancreatic cancer with dyslipidemias group,patients with body mass index ≥25 kg/m 2 had higher proportion than normal lipid group(36.1%(26/72) vs. 21.2%(21/99),χ2=4.643, P=0.031); The proportion of carcinoma located at head of pancreas(83.5%(96/115) vs. 40.7%(61/150),χ2=49.412, P<0.01), staging of T1/T2(79.1%(91/115) vs. 60.7%(91/150),χ2=10.316, P<0.01) and lymphatic metastasis(36.5%(42/115) vs. 22.7%(34/150),χ2=6.007, P<0.01) were higher. In patients of pancreatic cancer, dyslipidemias were closely associated with tumor location( OR=10.529, P<0.01)and body mass index( OR=3.671, P=0.008). Serum lipid profile results showed that TG,total cholesterol and high-density lipoprotein(HDL) disorders were associated with tumor location( P<0.05). TG disorder had association with body mass index( P<0.05), and HDL disorder had association with tumor stage( P<0.05). Moreover, the result of survival analysis showed that dyslipidemia was not a factor to impact the prognosis of pancreatic cancer patients underwent surgery( P>0.05). Conclusions:In pancreatic cancer patients,TG disorder was the most common type of dyslipidemia. Dyslipidemia has closely association with clinicopathologic features,including tumor location,body mass index,tumor stage. However,dyslipidemia had little effect on prognosis of pancreatic cancer patients.