Objective To analyze the main causes and risk factors of unplanned reoperation after liver transplantation. Methods The clinical data of 242 liver transplant recipients in the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2024 were retrospectively analyzed. According to whether unplanned reoperation was performed during the same hospitalization after surgery, the recipients were divided into the reoperation group (n=36) and the non-reoperation group (n=206). The preoperative, intraoperative and postoperative data of the two groups, as well as donor and graft-related data, were compared to analyze the risk factors of unplanned reoperation after liver transplantation and the survival status of the two groups. Results Among the 242 liver transplant recipients, 36 underwent unplanned reoperations, with a total of 54 procedures including various laparotomies, endoscopic and interventional surgeries, among which there were 20 laparotomies, 18 endoscopic surgeries and 16 interventional surgeries. The most common cause of unplanned reoperation was biliary complications (20 times), followed by vascular complications (17 times). Compared with the non-reoperation group, the reoperation group had longer graft cold ischemia time, higher postoperative fatality rate of recipients, longer length of stay in the intensive care unit and postoperative hospital stay, and higher total hospitalization costs (all P<0.05). The incidence of unplanned reoperation was higher in recipients who underwent split liver transplantation (P<0.05). Multivariate analysis showed that intraoperative blood loss ≥1 000 mL, positive culture of graft perfusate and split liver transplantation were independent risk factors for unplanned reoperation (all P<0.05). The postoperative 7-day, 1-month, 3-month and 6-month survival rates of recipients in the reoperation group and the non-reoperation group were 100% vs. 98.1%, 88.9% vs. 94.2%, 69.4% vs. 90.8% and 66.7% vs. 90.8%, respectively, and the postoperative survival rate of recipients in the reoperation group was lower than that in the non-reoperation group (P<0.05). Conclusions The main causes of unplanned reoperation after liver transplantation are biliary complications, vascular complications, abdominal incision infection and intra-abdominal hemorrhage. Intraoperative massive blood loss, positive culture of graft perfusate and split liver transplantation are the risk factors associated with unplanned reoperation after liver transplantation.

OBJECTIVES: To analyze MYO1B expression in gastric cancer, its association with long-term prognosis and its role in regulating biological behaviors of gastric cancer cells. METHODS: We analyzed MYO1B expression in gastric cancer and its correlation with tumor grade, tumor stage, and patient survival using the Cancer Public Database. We also examined MYO1B expression with immunohistochemistry in gastric cancer and paired adjacent tissues from 105 patients receiving radical surgery and analyzed its correlation with cancer progression and postoperative 5-year survival of the patients. GO and KEGG enrichment analyses were used to explore the biological functions of MYO1B and the key pathways. In cultured gastric cancer cells, we examined the changes in cell proliferation, migration and invasion following MYO1B overexpression and knockdown. RESULTS: Data from the Cancer Public Database showed that MYO1B expression was significantly higher in gastric cancer tissues than in normal tissues with strong correlations with tumor grade, stage and patient prognosis (P<0.05). In the clinical tissue samples, MYO1B was significantly overexpressed in gastric cancer tissues in positive correlation with Ki67 expression (r=0.689, P<0.05) and the parameters indicative of gastric cancer progression (CEA ≥5 μg/L, CA19-9 ≥37 kU/L, G3-4, T3-4, and N2-3) (P<0.05). Kaplan-Meier analysis and multivariate Cox regression analysis suggested that high MYO1B expression was associated with decreased postoperative 5-year survival and was an independent risk factor (HR: 3.522, 95%CI: 1.783-6.985, P<0.05). MYO1B expression level was a strong predictor of postoperative survival (cut-off value: 3.11, AUC: 0.753, P<0.05). GO and KEGG analyses suggested that MYO1B may regulate cell migration and the mTOR signaling pathway. In cultured gastric cancer cells, MYO1B overexpression significantly enhanced cell proliferation, migration, and invasion and promoted the phosphorylation of Akt and mTOR. CONCLUSIONS High MYO1B expression promotes proliferation, migration and invasion of gastric cancer cells and is correlated with poor patient prognosis.
Humans ; Stomach Neoplasms/metabolism* ; Cell Proliferation ; Prognosis ; Cell Movement ; Myosin Type I/genetics* ; Neoplasm Invasiveness ; Cell Line, Tumor ; Female ; Male

Objective:To explore the implementation effects of an proactive health management model for elderly patients with multimorbidity in comprehensive hospitals based on the concept of people-centered integrated care (PCIC).Methods:This study was a randomized controlled trial. Elderly patients who were hospitalized in the Department of General Practice at Shanghai East Hospital Tongji University and also suffered from hypertension, type 2 diabetes and dyslipidemia from November 2022 to January 2024 were included, and were divided into the control group (traditional health management, n=25) and the intervention group (proactive health management, n=25) using the random number table method. A research team comprising experts in general medicine, pharmacy, nutrition, rehabilitation medicine, psychology, and other relevant specialties was formed. Based on literature analysis, clinical experience, and hospital resources, the team collaborated to develop a comprehensive, hospital-based proactive health management model for elderly patients with comorbidities based on the PCIC concept. Patients in the control group were managed using the traditional health management model. Patients in the intervention group were managed using the proactive health management model. Baseline clinical data was collected and the patients were followed up for 6 months. At the 6-month follow-up, data on blood pressure, fasting blood glucose, and blood lipids were collected, as well as information on polypharmacy, activities of daily living (ADL) ability, 10-year atherosclerotic cardiovascular disease (ASCVD) risk, and unplanned rehospitalization were recorded. Results:A total of 50 patients were enrolled, with 25 patients in each group. The control group had an average age of (70.40±6.54) years, with 15 males(60.0%). The intervention group had an average age of (71.20±5.14) years, with 16 males(64.0%). At the 6-month follow-up, the standardization rates of blood pressure, fasting blood glucose, glycated hemoglobin, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides (TG) in both groups were higher than those in the baseline (all P<0.05).In addition, patients in the intervention group had the compliance rates for higher blood pressure, fasting blood glucose, 2-hour postprandial blood glucose, HbA1c, LDL-C, non-HDL-C, and TG than the control group (all P<0.05).At the 6-month follow-up, the 10-year ASCVD high-risk patient percentage decreased in the intervention group compared with baseline ( P=0.023) and was lower than that of the control group ( P=0.045), and the unanticipated readmission rate of patients in the intervention group was also lower than that of the control group ( P=0.042). Conclusions:A proactive health management model for elderly patients with geriatric multimorbidity in a comprehensive hospital, based on the concept of PCIC, was applied to an elderly population with concurrent hypertension, type 2 diabetes and dyslipidemia. The results of the management were favorable.

Objective:To investigate the mechanisms of S100 calcium binding protein A10 (S100A10) regulating the proliferation and inflammation of psoriatic keratinocytes by targeting nuclear factor-κB (NF-κB) and signal transduction and activator of transcription 3 (STAT3).Methods:Skin lesion tissues from psoriasis patients (10 cases) and normal skin tissues from healthy control (10 cases) who underwent plastic surgery at the Department of Dermatology and Medical Cosmetology, Honghui Hospital Affiliated to Xi′an Jiaotong University from January to June 2024 were collected. The pCMV plasmid and small interfering RNA plasmid were transfected into human immortalized epidermal HaCaT cells to establish the S100A10 overexpression group and the S100A10 knockdown group, respectively. Untreated HaCaT cells were used as the control group. NF-κB and STAT3 pathway inhibitors were added to the cells in the S100A10 overexpression group to create two subgroups: the S100A10 overexpression+NF-κB inhibitor group and the S100A10 overexpression+STAT3 inhibitor group. The effect of S100A10 on HaCaT cell proliferation was determined by cell counting kit-8 assay. The effect of S100A10 on HaCaT cell apoptosis was detected by extracellular phosphatidylserine binding protein V-fluorescein isothiocyanate/ propidium iodide double staining. The expression of S100A10 in normal skin tissue and skin lesion tissues of psoriasis patients was detected by Western blotting. The relative expression of apoptosis-related protein cysteine aspartic acid specific protease-3 (Caspase-3) and NF-κB and STAT3 pathway-related proteins phosphorylated NF-κB p65 (p-NF-κB p65) and phosphorylated STAT3 (p-STAT3) was detected. The effects of S100A10 on the relative expression of interleukin (IL)-6, tumor necrosis factor-α ( TNF-α), IL-1β, and CXC chemokine ligand 8 ( CXCL8) mRNA were detected by real-time reverse transcription-PCR. The effects of S100A10 on the levels of IL-6, TNF-α, IL-1β and CXCL8 in cell supernatant were detected by enzyme-linked immunosorbent assay. One-way analysis of variance and independent t test were used for data analysis. Results:The expression of S100A10 protein in the skin lesion tissues of psoriasis patients was higher than that in normal skin tissues (1.58±0.13 vs 1.00±0.09, P<0.05). Compared with the control group, the cell survival rates of the S100A10 knockdown group [(99.89±1.03)% vs (82.24±6.03)%], the relative expression of p-NF-κB p65 (0.47±0.06 vs 0.21±0.03) and p-STAT3 protein (0.59±0.12 vs 0.17±0.03), the relative expression of IL-6 (0.98±0.12 vs 0.63±0.07), TNF-α (0.97±0.13 vs 0.71±0.09), IL-1β (1.02±0.14 vs 0.51±0.09) and CXCL8 mRNA (1.01±0.16 vs 0.59±0.11), the levels of IL-6 [(27.69±3.47) pg/ml vs (13.65±2.11) pg/ml], TNF-α [(19.21±2.16) pg/ml vs (10.06±1.44) pg/ml], IL-1β [(15.52±1.03) pg/ml vs (5.17±0.96) pg/ml] and CXCL8 [(62.87±8.48) pg/ml vs (47.11±6.35) pg/ml] in the cell supernatant were lower (all P<0.05), and the cell apoptosis rate [(15.41±2.37)% vs (26.38±4.16)%] and Caspase-3 protein relative expression (0.31±0.04 vs 0.74±0.12) were higher (both P<0.05). The cell survival rates [(145.24±6.03)%], the relative expression of p-NF-κB p65 and p-STAT3 protein (2.37±0.25, 3.98±0.47), the relative expression of IL-6, TNF-α, IL-1β and CXCL8 mRNA (2.27±0.64, 3.31±0.61, 2.74±0.43, 3.11±0.48), the levels of IL-6, TNF-α, IL-1β and CXCL8 in the cell supernatant [(51.17±7.95), (33.65±4.19), (29.95±4.07), (79.97±10.32) pg/ml] in the S100A10 overexpression group were higher than those in the control group (all P<0.05), and the cell apoptosis rate [(5.09±0.73)%] and Caspase-3 protein relative expression (0.09±0.01) were lower than those in the control group (both P<0.05). The cell survival rates [(123.65±9.42)%, (122.94±8.14)%], the relative expression of p-NF-κB p65 (1.51±0.19, 1.49±0.21) and p-STAT3 protein (1.67±0.29, 1.69±0.31), the relative expression of IL-6 (1.69±0.14, 1.73±0.15), TNF-α (1.92±0.27, 1.94±0.25), IL-1β (1.85±0.16, 1.87±0.21) and CXCL8 mRNA (2.02±0.34, 2.01±0.39), the levels of IL-6 [(35.55±5.12), (36.18±5.24) pg/ml], TNF-α [(25.17±3.08), (25.23±3.17) pg/ml], IL-1β [(22.08±3.11), (22.11±3.24) pg/ml] and CXCL8 [(70.04±9.31), (70.11±10.29) pg/ml] in the cell supernatant in the S100A10 overexpression+NF-κB inhibitor group and the S100A10 overexpression+STAT3 inhibitor group were higher than those in S100A10 knockdown group (all P<0.05), and the cell apoptosis rates [(20.13±4.62)%, (20.21±4.91)%] and Caspase-3 protein relative expression (0.15±0.03, 0.16±0.04) were lower than those in S100A10 knockdown group (all P<0.05).The cell survival rates, the relative expression of p-NF-κB p65 and p-STAT3 protein, the relative expression of IL-6, TNF-α, IL-1β and CXCL8 mRNA, the levels of IL-6, TNF-α, IL-1β and CXCL8 in the cell supernatant in the S100A10 overexpression+NF-κB inhibitor group and the S100A10 overexpression+STAT3 inhibitor group were lower than those in S100A10 overexpression group (all P<0.05), and the cell apoptosis rates and Caspase-3 protein relative expression were higher than those in S100A10 overexpression group (all P<0.05). Conclusions:S100A10 may regulate the proliferation and inflammation of keratinocytes in psoriasis by targeting NF-κB and STAT3.

BACKGROUND:Neuroinflammation is a major cause of exacerbation after spinal cord injury.In recent years,pyroptosis has received much attention due to its remarkable pro-inflammatory features.Some of these natural products can significantly inhibit the inflammatory response and improve the damaged nerve function by regulating the level of pyroptosis after spinal cord injury,which provides a new therapeutic idea for spinal cord injury.OBJECTIVE:To summarize the mechanism of action of natural products in regulating pyroptosis for the treatment of spinal cord injury,with a view to providing lessons and references for future research on the treatment of spinal cord injury.METHODS:The search terms"spinal cord injury,pyroptosis,inflammasome,natural products,natural compounds,traditional Chinese medicine"in Chinese and English were used to search for relevant literature since the establishment of the database up to September 2024 in the databases of PubMed,Web of Science,WanFang,and CNKI.According to the inclusion and exclusion criteria,75 relevant articles were finally obtained.RESULTS AND CONCLUSION:(1)Pyroptosis is an important pro-inflammatory pathway in spinal cord injury,and controlling pyroptosis is an effective way to improve damaged nerve function.(2)Some natural products can regulate pyroptosis via the NLRP3/Caspase-1 classical pyroptosis pathway,the NF-κB-related pathway,other upstream pathways such as Nrf2/HO-1,and autophagy,thereby affecting the level of tissue inflammation and accelerating neurological recovery after spinal cord injury.(3)The anti-pyroptosis effects of these natural products are mostly dependent on the NLRP3 classical pyroptosis pathway,and there is a lack of studies on other pyroptosis pathways.(4)There are still many problems in this field,such as the fact that these natural products are not currently supported by evidence from appropriate clinical studies.(5)The natural product has great potential in regulating pyroptosis and is expected to be a powerful weapon in the treatment of spinal cord injury.

Objective To explore the potential central mechanisms of functional electrical stimulation(FES)hand cycling in promot-ing upper limb motor recovery after stroke.Methods A total of 35 stroke patients hospitalized in the Rehabilitation Center of Changzhou De'an Hospital from May,2023 to December,2024 were enrolled.They sequentially completed 10-minute FES hand cycling and 10-minute sham stimulation(simple hand cycling)tasks.The task order was randomized via dice rolling.Functional near-in-frared spectroscopy(fNIRS)was used to monitor real-time cerebral hemodynamic changes during both tasks to calculate the overall functional connectivity(FC)strength and the FC strength within regions of interest.Results The overall FC strength was higher during the FES hand cycling task than during the sham task(t=2.591,P<0.05),as well as FC between the ipsilateral primary motor cortex(iM1)and ipsilateral somatosensory association cortex(iSAC),iM1 and contralateral somatosensory association cortex(cSAC),ipsilateral pre-motor and supple-mentary motor cortex(iPMC)and iSAC,iPMC and cSAC,iPMC and ipsilateral primary somatosensory cortex(iS1),iPMC and iM1,and contralateral pre-motor and supplementary motor cortex(cPMC)and iSAC(PFDR<0.05).Conclusion FES hand cycling can promote the cortical function remodeling between cerebral hemispheres and the af-fected hemisphere,to integrate sensory-motor function.

Objective To determine the related substances in ornidazole active pharmaceutical ingredient(API)and injections using high performance liquid chromatography(HPLC)and to study the impurity profile of ornidazole using liquid chromatography-tandem mass spectrometry(LC-MS/MS)combined with forced degradation tests,aiming to clarify the sources of impurities and their correlation with the prescription and production process and providing technical support for the unified evaluation and quality control of this product.Methods A Phenomenex Luna C18column(4.6 mm×250 mm,5 μm)was used for the separation of ornidazole and its impurities,with 0.000 5%formic acid as mobile phase A and methanol as mobile phase B under gradient elution.The impurity content of 4 batches of APIs,3 batches of reference preparations,and 11 batches of domestic generic preparations were determined.The structure of unknown impurities was predicted using Jet Stream Ion Focusing Electrospray Ionization-Time of Flight Mass Spectrometry(AJS-TOF-MS/MS),and the sources of impurities were identified combined with forced degradation experiments,the prescription and the production process of various manufacturers.Results Ornidazole and its known impurities were well separated under the chromatographic conditions.The structures of five unknown impurities were inferred,and the sources of the impurities were identified.Conclusion This study provides a reference for impurity analysis,quality control,and overall evaluation of ornidazole API and injection.

Objective To explore the potential central mechanisms of functional electrical stimulation(FES)hand cycling in promot-ing upper limb motor recovery after stroke.Methods A total of 35 stroke patients hospitalized in the Rehabilitation Center of Changzhou De'an Hospital from May,2023 to December,2024 were enrolled.They sequentially completed 10-minute FES hand cycling and 10-minute sham stimulation(simple hand cycling)tasks.The task order was randomized via dice rolling.Functional near-in-frared spectroscopy(fNIRS)was used to monitor real-time cerebral hemodynamic changes during both tasks to calculate the overall functional connectivity(FC)strength and the FC strength within regions of interest.Results The overall FC strength was higher during the FES hand cycling task than during the sham task(t=2.591,P<0.05),as well as FC between the ipsilateral primary motor cortex(iM1)and ipsilateral somatosensory association cortex(iSAC),iM1 and contralateral somatosensory association cortex(cSAC),ipsilateral pre-motor and supple-mentary motor cortex(iPMC)and iSAC,iPMC and cSAC,iPMC and ipsilateral primary somatosensory cortex(iS1),iPMC and iM1,and contralateral pre-motor and supplementary motor cortex(cPMC)and iSAC(PFDR<0.05).Conclusion FES hand cycling can promote the cortical function remodeling between cerebral hemispheres and the af-fected hemisphere,to integrate sensory-motor function.

BACKGROUND:Neuroinflammation is a major cause of exacerbation after spinal cord injury.In recent years,pyroptosis has received much attention due to its remarkable pro-inflammatory features.Some of these natural products can significantly inhibit the inflammatory response and improve the damaged nerve function by regulating the level of pyroptosis after spinal cord injury,which provides a new therapeutic idea for spinal cord injury.OBJECTIVE:To summarize the mechanism of action of natural products in regulating pyroptosis for the treatment of spinal cord injury,with a view to providing lessons and references for future research on the treatment of spinal cord injury.METHODS:The search terms"spinal cord injury,pyroptosis,inflammasome,natural products,natural compounds,traditional Chinese medicine"in Chinese and English were used to search for relevant literature since the establishment of the database up to September 2024 in the databases of PubMed,Web of Science,WanFang,and CNKI.According to the inclusion and exclusion criteria,75 relevant articles were finally obtained.RESULTS AND CONCLUSION:(1)Pyroptosis is an important pro-inflammatory pathway in spinal cord injury,and controlling pyroptosis is an effective way to improve damaged nerve function.(2)Some natural products can regulate pyroptosis via the NLRP3/Caspase-1 classical pyroptosis pathway,the NF-κB-related pathway,other upstream pathways such as Nrf2/HO-1,and autophagy,thereby affecting the level of tissue inflammation and accelerating neurological recovery after spinal cord injury.(3)The anti-pyroptosis effects of these natural products are mostly dependent on the NLRP3 classical pyroptosis pathway,and there is a lack of studies on other pyroptosis pathways.(4)There are still many problems in this field,such as the fact that these natural products are not currently supported by evidence from appropriate clinical studies.(5)The natural product has great potential in regulating pyroptosis and is expected to be a powerful weapon in the treatment of spinal cord injury.

Objective To determine the related substances in ornidazole active pharmaceutical ingredient(API)and injections using high performance liquid chromatography(HPLC)and to study the impurity profile of ornidazole using liquid chromatography-tandem mass spectrometry(LC-MS/MS)combined with forced degradation tests,aiming to clarify the sources of impurities and their correlation with the prescription and production process and providing technical support for the unified evaluation and quality control of this product.Methods A Phenomenex Luna C18column(4.6 mm×250 mm,5 μm)was used for the separation of ornidazole and its impurities,with 0.000 5%formic acid as mobile phase A and methanol as mobile phase B under gradient elution.The impurity content of 4 batches of APIs,3 batches of reference preparations,and 11 batches of domestic generic preparations were determined.The structure of unknown impurities was predicted using Jet Stream Ion Focusing Electrospray Ionization-Time of Flight Mass Spectrometry(AJS-TOF-MS/MS),and the sources of impurities were identified combined with forced degradation experiments,the prescription and the production process of various manufacturers.Results Ornidazole and its known impurities were well separated under the chromatographic conditions.The structures of five unknown impurities were inferred,and the sources of the impurities were identified.Conclusion This study provides a reference for impurity analysis,quality control,and overall evaluation of ornidazole API and injection.