Liver transplantation is the standard therapy for end-stage liver disease, but the long-standing shortage of donor livers has constrained its advancement. The use of standard donor criteria expansion partially alleviates the supply-demand imbalance but increases postoperative complication risks. Extracorporeal mechanical perfusion mitigates ischemia-reperfusion injury, extends preservation time, and enables functional assessment and partial repair of the liver under ex vivo settings. Current clinical evidence confirms that short-term mechanical perfusion positively improves outcomes, but it still has limitations in terms of functional evaluation and deep repair. Therefore, the exploration of prolonged mechanical perfusion has possibilities for the restoration of organ function. The concept of "organ medicine" has enabled the breakthrough application of mechanical perfusion technology, originating from organ transplantation, to multiple disciplines, such as organ research, education, and therapy. Additionally, advancements in transforming research results and industrial upgrading are anticipated to develop into a strategic technology for a new round of medical revolution and industrial transformation.

Liver transplantation is the standard therapy for end-stage liver disease, but the long-standing shortage of donor livers has constrained its advancement. The use of standard donor criteria expansion partially alleviates the supply-demand imbalance but increases postoperative complication risks. Extracorporeal mechanical perfusion mitigates ischemia-reperfusion injury, extends preservation time, and enables functional assessment and partial repair of the liver under ex vivo settings. Current clinical evidence confirms that short-term mechanical perfusion positively improves outcomes, but it still has limitations in terms of functional evaluation and deep repair. Therefore, the exploration of prolonged mechanical perfusion has possibilities for the restoration of organ function. The concept of "organ medicine" has enabled the breakthrough application of mechanical perfusion technology, originating from organ transplantation, to multiple disciplines, such as organ research, education, and therapy. Additionally, advancements in transforming research results and industrial upgrading are anticipated to develop into a strategic technology for a new round of medical revolution and industrial transformation.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Background and purpose:The evaluation of treatment response is one of the most important building blocks in determining the best strategy for the management of malignant tumors. In lymphoma and several solid cancer types, PET/CT-based response evaluation has been shown to be valuable, especially in visualizing the effect of the targeted treatment, which induces tumor activity changes not necessarily followed by tumor shrinkage. This study aimed to evaluate the role of18F-FDG PET/CT in the monitoring of response to sorafenib treatment in radioiodine-refractory differentiated thyroid cancer (RR-DTC) patients; and to compare the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) with the European Organization for Research and Treatment of Cancer (EORTC) criteria.Methods:This was a single-center retrospective analysis of 14 patients with RR-DTC treated with sorafenib in the period from Dec. 2011 to Dec. 2014. A Wilcoxon signed-rank sum test was used to assess the differences in percentage changes between the sum of diameter and ∑SUVmax. These values of responses were statistically compared using the chi-square test (Fisher’s exact test). The differences in PFS between response categories according to either RECIST 1.1 or the EORTC criteria were evaluated using the Wilcoxon signed-rank sum test. The Spearman rank correlation coefficient was estimated between PFS and either morphologic (RECIST 1.1) or metabolic response (EORTC criteria) categories.Results:There was an agreement between the RECIST 1.1 and EORTC criteria in 10 of the 14 patients (χ2=2.345,P=0.424). The remaining 4 patients with SD in-cluded 2 patients with PMR and 2 patients with PMD. Differences in PFS among different response categories according to either RECIST 1.1 (χ2=8.571,P=0.003) or EORTC criteria (χ2=8.781,P=0.003) were statistically significant. Correlations were found between PFS and either morphologic (r=0.741,P=0.002) or metabolic (r=0.816,P=0.0004) response criteria. Conclusion:18F-FDG PET/CT imaging is of value in the monitoring of response to sorafenib in patients with RR-DTC. Although RECIST 1.1 and EORTC criteria agree in 71.4% patients, PET-based metabolic response criteria seems to be more accurate in predicting therapeutic outcome and may be more suitable than morphologic response criteria for the eval-uation of response to targeted therapy.

Objective To compare signal characteristics and image qualities of MR diffusion-weighted imaging (DWI)at 1.5T and 3.0T in patients with the complex adnexal masses.Methods Magnetic resonance imaging including routine MRI and DWI(b=0 s/mm2 ,400 s/mm2 , 600 s/mm2 ,800 s/mm2 ,1 000 s/mm2 )of 1.5T (50 patients with 31 benign and 1 9 malignant lesions )and 3.0T (53 patients with 29 benign and 24 malignant lesions )were performed in 103 patients with histopathologically proved adnexal masses.The optimal b value was analyzed,and the apparent diffusion coefficient (ADC)value and signal intensity (SI)value and contrast to noise ratio (CNR)of solid and cystic components in adnexal masses from both 1.5T and 3.0T MR were respectively compared statistically.Results The 800 s/mm2 was the optimal b value in demonstrating adnexal masses at 1.5T and 3.0T.The CNR of solid and cystic components in adnexal masses were significantly higher at 3.0T than at 1.5T on all b values(all P =0.000).The difference in ADC value of solid lesions between 1.5T and 3.0T on all b values DWI had no statistically significant (all P >0.05),nor did the difference in SI value of solid lesions as well as ADC value of cystic lesions on b800 DWI(P >0.05).Conclusion MR diffusion-weighted imaging at 3.0T compared with 1.5T has quantitative and qualitative advantages of evaluating for adnexal masses,while the 800 s/mm2 is the optimal b value for both of them.

Objective To evaluate the effect of sevoflurane pretreatment on the inflammatory response during renal ischemia-reperfusion (I/R) in rats.Methods Thirty pathogen-free male Sprague-Dawley rats,aged 12-14 weeks,weighing 220-260 g,were randomized into 3 groups (n =10 each) using a random number table:sham operation group (group S),I/R group and sevoflurane pretreatment group (group SP).Renal I/R was induced by clamping the left renal pedicle for 45 min followed by reperfusion in I/R and SP groups.In group S inhalation of 3％ sevoflurane in O2 was started at 30 min before I/R and maintained throughout the experiment.Venous blood samples were taken at 3 h of reperfusion for determination of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The animals were then sacrificed and the left kidneys were removed for microscopic examination and for measurement of the content of tumor necrosis factor-apha (TNF-α),interleukin-6 (IL-6) and intercellular cell adhesion molecule-1 (ICAM-1) in renal tissues (by ELISA).Results Compared with group S,the serum BUN and Cr concentrations,severity of necrosis of renal proximal convoluted tubules (0 =normal,4 =necrosis of whole segment of proximal convoluted tubules),and contents of TNF-α,IL-6 and ICAM-1 were significantly increased in I/R and SP groups (P ＜ 0.05).Compared with group I/R,the serum BUN and Cr concentrations,severity of necrosis of renal proximal convoluted tubules,and contents of TNF-α,IL-6 and ICAM-1 were significantly decreased in SP group (P ＜ 0.05).Conclusion Sevoflurane pretreatment can protect kidney against I/R injury by inhibiting the inflammatory responses in the renal tissues of rats.

Objective To compare the cost-effectiveness of intervention protocols with or without rehabilitation approaches for burn patients.To explore the pros and cons of the two treatment programs,especially in terms of efficacy.Methods Data on 164 burn patients hospitalized in four hospitals in Hunan Province were collected and compared in terms of the therapeutic interventions employed,the direct medical costs and the effects obtained at the end of the first two months of hospitalization.The patients were divided into an early rehabilitation therapy group and a control group,based on the interventions they received.Results The average total direct medical cost of the early rehabilitation group was significantly lower than that of the control group [((￥)59 380.80 ±196.87) versus ((￥)67 471.62 ±217.23)].The average Vancouver scar scale (VSS) results in the early rehabilitation group were significantly better than those of the controls,but their Zung's Self-rating Anxiety Scale and Barthel index scores were not.The average cost-effectiveness ratio (C/E) of the early rehabilitation group as judged by these scores was lower than that of the control group.Conclusion Early rehabilitation can improve the therapy of burns patients and reduce subsequent expenditures.It is a cost-effective approach to treating burns patients.

OBJECTIVE: To compare the cost-effect of 2 therapeutic regimens and to find out a better therapeutic regimen with reasonable price and better effect, hoping to improve the quality of burn patients and reduce the waste of medical resources. METHODS: We collected 1017 burn patients from Hunan and Sichuan, and divided them into a research group (the moist exposed burn therapy group) and a control group (the escharectomy and grafting group). We analyzed the cost and effect of the 2 groups from general condition, direct medical cost during treatment and curative effect. RESULTS: The average total cost of the research group [93633.71 (82260.79, 107576.34) yuan] was significantly lower than the control group [175077.93 (131433.23, 228918.83) yuan] (P<0.05). The total effective rate of the research group was higher (97.28%) than that in the control group (92.89%) (P<0.05). The cost-effect of the research group (962.52) was better than that of the control group (1884.79). CONCLUSION Cost-effect analysis is objective and direct in the evaluation of different treatments. The moist exposed burn therapy is a better and cheaper therapeutic regimen.
Adolescent ; Adult ; Burns ; economics ; surgery ; therapy ; China ; Cost-Benefit Analysis ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult