BACKGROUND: Pre-transplant exposure to immune checkpoint inhibitors (ICIs) significantly increases the risk of allograft rejection after liver transplantation (LT); however, whether ICI-related rejection leads to increased graft loss remains controversial. Therefore, this study aimed to investigate the association between ICI-related allograft rejection and perioperative graft loss. METHODS: This was a retrospective analysis of adult liver transplant recipients with early biopsy-proven T-cell-mediated rejection (TCMR) at Liver Transplantation Center of Sun Yat-sen Memorial Hospital from June 2019 to September 2024. The pathological features, clinical characteristics, and perioperative graft survival were analyzed. RESULTS: Twenty-eight patients who underwent early TCMR between June 2019 and September 2024 were included. Based on pre-LT ICI exposure, recipients were categorized into ICI-related TCMR (irTCMR, n = 12) and conventional TCMR (cTCMR, n = 16) groups. Recipients with irTCMR had a higher median Banff rejection activity index (RAI) (6 vs . 5, P = 0.012) and more aggressive tissue damage and inflammation. Recipients with irTCMR showed higher proportion of treatment resistance, achieving a complete resolution rate of only 8/12 compared to 16/16 for cTCMR. Graft loss occurred in 5/12 of irTCMR recipients within 90 days after LT, with no graft loss in cTCMRs recipients. Cox analysis demonstrated that irTCMR with an ICI washout period of <30 days was an independent risk factor for perioperative graft loss (hazard ratio [HR], 6.540; 95% confidence interval [CI], 1.067-40.067, P = 0.042). CONCLUSION IrTCMR is associated with severe pathological features, increased resistance to treatment, and higher graft loss in adult liver transplant recipients.
Humans ; Liver Transplantation/adverse effects* ; Male ; Female ; Middle Aged ; Retrospective Studies ; Graft Rejection/immunology* ; Immune Checkpoint Inhibitors/therapeutic use* ; Adult ; T-Lymphocytes/drug effects* ; Graft Survival/immunology* ; Aged

ObjectiveTo investigate the expression level of lysophosphatidyllecithin acyltransferase 4 （LPCAT4） in pancreatic cancer and its effect on the proliferation of pancreatic cancer cells. MethodsIn this study， the differentially expressed genes of patients with KRAS mutant and wild-type pancreatic cancer were analyzed by online database LinkedOmics. The LPCAT4 expression in pancreatic cancer tissues was analyzed online by the University of Alabama at Birmingham Cancer Data Analysis （UALCAN）， Sangerbox and gene expression profile interaction analysis 2 （GEPIA2）. Kaplan-Meier Plotter database was used to explore the correlation between LPCAT4 and the prognosis of patients with pancreatic cancer. The expression of LPCAT4 in human pancreatic cancer cells were detected by quantitative real-time PCR and Western blot analysis. LPCAT4 was knocked down in the high-expressing SW1990 cell line and overexpressed in the low-expressing MIA PaCa-2 cell line. The effects of LPCAT4 expression on cell proliferation were assessed using CCK-8 and EdU assays. STRING and GEPIA2 databases were used to obtain LPCAT4 binding and coexpressed genes in tumors， which were then analyzed by GO and KEGG. ResultsAnalysis of the LinkedOmics online database revealed a significant upregulation of LPCAT4 in patients with KRAS mutant pancreatic cancer compared to patients with KRAS wild-type pancreatic cancer. The online analysis of GEPIA2， UALCAN and Sangerbox 3.0 showed that the expression of LPCAT4 was higher in pancreatic cancer than in normal tissues. Analysis of the Kaplan-Meier Plotter database revealed that high LPCAT4 expression was associated with poorer prognosis in pancreatic cancer patients.Western blot and qPCR results showed that expression of LPCAT4 in pancreatic cancer cell lines was significantly higher than in normal pancreatic ductal epithelial cells. Knockdown of LPCAT4 in SW1990 cells inhibited proliferation， while overexpression in MIA PaCa-2 cells promoted proliferation. Enrichment analysis indicated that LPCAT4 was closely related to sulfur metabolism. ConclusionsLPCAT4 is highly expressed in pancreatic cancer and is associated with poor prognosis of patients. It plays a significant regulatory role in the proliferation of pancreatic cancer cells， with its expression level closely correlated with cell proliferation capacity. These findings reveal the critical role of LPCAT4 in the malignant progression of pancreatic cancer and provide important evidence for its potential as a therapeutic target.

Objective:To explore the personality latent profiles of university first-year students and examine their associations with demographic characteristics,psychological symptoms,and major satisfaction.Methods:A to-tal of 52 783 first-year university students were assessed with the Minnesota Multiphasic Personality Inventory(MMPI),Beck Depression Inventory,Beck Anxiety Inventory,self-developed major satisfaction item and demo-graphic checklist.Data were analyzed with potential profile model,chi-square test,multiple logistic regression,co-variance analysis and median test.Results:Five latent profiles of MMPI among university freshmen were found,namely gender conflict group(23.4％),real healthy group(27.9％),defensive healthy group(37.3％),borderline-psychosis risk group(6.7％)and neurosis risk group(4.8％).Gender,grade period,childhood up bringers,par-ents'marital status and family atmosphere predicted differences between profiles of MMPI.Different profiles showed statistically meaningful differences at depressive symptoms,anxiety symptoms and major satisfaction.Conclusion:The latent profiles of MMPI among first-year university students demonstrate distinct classification patterns,diffe-ring demographic characteristics and psychologically problematic levels.

Purpose Discover new prostate cancer-related single nucleotide variants.Methods Tissue wax blocks from 21 prostate cancer patients who underwent radical surgery and had relatively complete clinical data were collected for somatic mutation detection to analyze new mutated genes associated with prostate cancer.The levels of cor-responding proteins in the urine of prostate cancer patients were tested according to the results of the selected genes.Results All 21 prostate cancer patients showed obvious somatic mutations,and the mutation types were dominated by C＞T and G＞A.The number of somatic mutations was 521,of which 27 genes had high mutation proportions(≥2 ca-ses),including ZSWIM6(5/21),FOXA1(4/21),SPTA1(2/21),FAM47C(2/21),FLG2(2/21),PRSS3(2/21),TP53(2/21),FLG(2/21),UBR4(2/21),and the mutations occurring in ZSWIM6 were all deletion muta-tions,and the mutations occurring in FOXA1 were missense mutations,deletion mutations,and deletion insertion mu-tations.The urinary levels of UPF1,SPTA1,and IDH1 proteins of the 10 prostate cancer patients were significantly different than those of the healthy controls.Correlation analysis showed that FOXA1 was positively correlated with UBR4(r=0.669,P=0.001),SPTA1 was positively correlated with FLG2(r=1.000,P＜0.001),FAM47C was positively correlated with PRSS3(r=1.000,P＜0.001),and there was a significant positive correlation between TP53 and FLG(r=1.000,P＜0.001).ZSWIM6 and FOXA1 were not correlated with biochemical recurrence.SP-TA1 mutation affected progression-free survival(PFS)[(66.0±0)months vs(30.0±7.8)months,P=0.008].FAM47C was positively correlated with PFS[(66.0±0)months vs(19.0±0)months,P＜0.001].ZNF676 was correlated with PFS[(66.0±0)months vs(26.0±5.0)months,P=0.008].FLG2 was correlated with PFS[(66.0±0)months vs(30.0±7.8)months,P=0.008].PRSS3 was correlated with PFS[(66.0±0)months vs(19.0±0)months,P＜0.001].Conclusion All 21 prostate cancer patients harbored somatic mutations,including ZSWIM6(5/21)and FOXA1(4/21)mutations.SPTA1,FAM47C,ZNF676,FLG2,and PRSS3 may be associated with prognosis.

Objective:To observe the effectiveness of combining mirror therapy with pneumatic flexible glove training in treating hand dysfunction after a stroke. Its effect on cerebral cortex activation was documented using near-infrared functional imaging of the brain.Methods:A total of 84 stroke survivors with hand dysfunction were randomly divided into a Mirror Group, a Glove Group and a Combined Group, each of 28. In addition to standard rehabilitation training, the Glove Group received 20 minutes of training with a pneumatic soft glove, 5 days per week for 6 consecutive weeks. The Mirror Group received mirror therapy (MT). The Combined Group was given both simultaneously. Before and after the treatment, everyone′s upper limb functioning was evaluated (using the Fugl-Meyer Upper Limb Assessment (FMA-U)), along with their hand motor skills (using the Arm Action Test (ARAT)) and their ability in daily living activities (using the Barthel Index (BI)). Functional near-infrared spectroscopy (fNIRS) was employed to measure any changes in oxygenated hemoglobin (HBO) concentration at 730nm and 850nm wavelengths.Results:The FMA-U, ATAT and BI scores in both the proximal and distal regions of all three groups showed significant improvement after the treatments compared to pre-treatment levels. The combined group demonstrated significantly better distal FMA-U and ARAT scores after the treatment (12.25±8.80 and 20.93±15.68 respectively), outperforming both the glove and mirror groups. The infrared spectroscopy revealed that bilateral SM1 activation, affected-side somatosensory association cortex (SAC) and supplementary motor cortex excitability in both the mirror and combined groups were significantly better than among the glove group after the experiment.Conclusions:Combined with pneumatic flexible glove training, mirror therapy can not only significantly improve the hand function of stroke survivors, but also activate the relevant brain regions of both hemispheres through bilateral motor patterns combined with multisensory stimulation, promoting the balance between hemispheres.

Purpose Discover new prostate cancer-related single nucleotide variants.Methods Tissue wax blocks from 21 prostate cancer patients who underwent radical surgery and had relatively complete clinical data were collected for somatic mutation detection to analyze new mutated genes associated with prostate cancer.The levels of cor-responding proteins in the urine of prostate cancer patients were tested according to the results of the selected genes.Results All 21 prostate cancer patients showed obvious somatic mutations,and the mutation types were dominated by C＞T and G＞A.The number of somatic mutations was 521,of which 27 genes had high mutation proportions(≥2 ca-ses),including ZSWIM6(5/21),FOXA1(4/21),SPTA1(2/21),FAM47C(2/21),FLG2(2/21),PRSS3(2/21),TP53(2/21),FLG(2/21),UBR4(2/21),and the mutations occurring in ZSWIM6 were all deletion muta-tions,and the mutations occurring in FOXA1 were missense mutations,deletion mutations,and deletion insertion mu-tations.The urinary levels of UPF1,SPTA1,and IDH1 proteins of the 10 prostate cancer patients were significantly different than those of the healthy controls.Correlation analysis showed that FOXA1 was positively correlated with UBR4(r=0.669,P=0.001),SPTA1 was positively correlated with FLG2(r=1.000,P＜0.001),FAM47C was positively correlated with PRSS3(r=1.000,P＜0.001),and there was a significant positive correlation between TP53 and FLG(r=1.000,P＜0.001).ZSWIM6 and FOXA1 were not correlated with biochemical recurrence.SP-TA1 mutation affected progression-free survival(PFS)[(66.0±0)months vs(30.0±7.8)months,P=0.008].FAM47C was positively correlated with PFS[(66.0±0)months vs(19.0±0)months,P＜0.001].ZNF676 was correlated with PFS[(66.0±0)months vs(26.0±5.0)months,P=0.008].FLG2 was correlated with PFS[(66.0±0)months vs(30.0±7.8)months,P=0.008].PRSS3 was correlated with PFS[(66.0±0)months vs(19.0±0)months,P＜0.001].Conclusion All 21 prostate cancer patients harbored somatic mutations,including ZSWIM6(5/21)and FOXA1(4/21)mutations.SPTA1,FAM47C,ZNF676,FLG2,and PRSS3 may be associated with prognosis.

Objective:To explore the personality latent profiles of university first-year students and examine their associations with demographic characteristics,psychological symptoms,and major satisfaction.Methods:A to-tal of 52 783 first-year university students were assessed with the Minnesota Multiphasic Personality Inventory(MMPI),Beck Depression Inventory,Beck Anxiety Inventory,self-developed major satisfaction item and demo-graphic checklist.Data were analyzed with potential profile model,chi-square test,multiple logistic regression,co-variance analysis and median test.Results:Five latent profiles of MMPI among university freshmen were found,namely gender conflict group(23.4％),real healthy group(27.9％),defensive healthy group(37.3％),borderline-psychosis risk group(6.7％)and neurosis risk group(4.8％).Gender,grade period,childhood up bringers,par-ents'marital status and family atmosphere predicted differences between profiles of MMPI.Different profiles showed statistically meaningful differences at depressive symptoms,anxiety symptoms and major satisfaction.Conclusion:The latent profiles of MMPI among first-year university students demonstrate distinct classification patterns,diffe-ring demographic characteristics and psychologically problematic levels.

Objective:To observe the effectiveness of combining mirror therapy with pneumatic flexible glove training in treating hand dysfunction after a stroke. Its effect on cerebral cortex activation was documented using near-infrared functional imaging of the brain.Methods:A total of 84 stroke survivors with hand dysfunction were randomly divided into a Mirror Group, a Glove Group and a Combined Group, each of 28. In addition to standard rehabilitation training, the Glove Group received 20 minutes of training with a pneumatic soft glove, 5 days per week for 6 consecutive weeks. The Mirror Group received mirror therapy (MT). The Combined Group was given both simultaneously. Before and after the treatment, everyone′s upper limb functioning was evaluated (using the Fugl-Meyer Upper Limb Assessment (FMA-U)), along with their hand motor skills (using the Arm Action Test (ARAT)) and their ability in daily living activities (using the Barthel Index (BI)). Functional near-infrared spectroscopy (fNIRS) was employed to measure any changes in oxygenated hemoglobin (HBO) concentration at 730nm and 850nm wavelengths.Results:The FMA-U, ATAT and BI scores in both the proximal and distal regions of all three groups showed significant improvement after the treatments compared to pre-treatment levels. The combined group demonstrated significantly better distal FMA-U and ARAT scores after the treatment (12.25±8.80 and 20.93±15.68 respectively), outperforming both the glove and mirror groups. The infrared spectroscopy revealed that bilateral SM1 activation, affected-side somatosensory association cortex (SAC) and supplementary motor cortex excitability in both the mirror and combined groups were significantly better than among the glove group after the experiment.Conclusions:Combined with pneumatic flexible glove training, mirror therapy can not only significantly improve the hand function of stroke survivors, but also activate the relevant brain regions of both hemispheres through bilateral motor patterns combined with multisensory stimulation, promoting the balance between hemispheres.

Objective:To systematically evaluate the actual experience and needs of family caregivers for cardiac arrest patients.Methods:Qualitative research on the real experience and needs of family caregivers in patients with cardiac arrest was electronically searched in databases such as PubMed, CINAHL, and Embase. Two researchers independently screened the literature, evaluated its quality, and integrated the research results. The search period was from database establishment to May 1, 2023.Results:A total of 15 articles were included, and 51 research results were extracted. The similar results were summarized into nine categories and integrated into three results, including sudden changes in life and substantial impacts; challenges in controlling complex emotions, and multiple psychological experiences; multidimensional needs.Conclusions:Family caregivers' actual experiences and requirements for cardiac arrest patients are diverse. Medical and nursing staff need to pay attention to the emotional experiences of family caregivers and meet their multidimensional needs.

Objective:To construct the risk management model of ultrasonic scalpel based on logistic regression(LR)algorithm,and to improve the quality of ultrasonic risk management.Methods:Based on the LR algorithm,the risk management model of ultrasonic scalpel use was constructed and the model was verified.A total of 28 ultrasonic scalpels in clinical use in Shanghai Pulmonary Hospital from January 2022 to December 2023 were selected.Based on the time,the conventional management model was adopted during the use of the equipment in 2022,and the LR risk management model(referred to as risk management)was applied during the use of the equipment in 2023.The risk management quality score,risk warning score and experience score of the management personnel involved in the use of the equipment between the two management modes were compare by using the self-made evaluation scale.Results:The average scores of ultrasonic scalpel maintenance record,usage record,data filing,maintenance card hanging and scrapping treatment using risk management were(9.54±0.37),(9.67±0.34),(9.73±0.21),(9.18±0.35)and(9.92±0.31),respectively,which were higher than those of the conventional management,the difference was statistically significant(t=55.666,32.235,49.511,40.311,23.122,P<0.05).The average scores of ultrasonic scalpel risk identification accuracy,early warning timeliness and comprehensive prevention and control using risk management were(9.66±1.20),(9.92±1.48),and(9.87±1.04),respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=11.840,8.371,8.032,P<0.05).The average scores of ultrasonic scalpel preventive maintenance personnel,maintenance personnel and operators on the use experience of ultrasonic scalpel in risk management mode were(96.61±6.08),(95.07±5.19)and(97.73±5.93),respectively,which were higher than those in the conventional management mode,the difference was statistically significant(t=4.991,4.156,4.870,P<0.05).Conclusion:The application of ultrasonic scalpel risk management model based on LR algorithm to the use management of ultrasonic scalpel can improve the quality of ultrasonic scalpel risk management,avoid risk hazards,and enhance the safety and stability of clinical use of ultrasonic scalpel.