Objective To explore the method for establishing a pig left lung orthotopic transplantation model. Methods A total of 4 male Yorkshire pigs weighing (40.0±2.5) kg underwent surgical procedures, including anesthesia, tracheal intubation, donor lung procurement, and recipient lung transplantation. Histological morphology and blood gas analysis of the transplanted lungs were assessed 2 hours after reperfusion to evaluate the histological changes and function of the transplanted lungs. Results The pigs underwent left lung in situ transplantation, effectively simulating conditions relevant to human lung transplantation. Two hours after the transplantation, arterial blood gas analysis showed that arterial partial pressure of oxygen was 155.4-178.6 mm Hg, arterial partial pressure of carbon dioxide was 53.1-62.4 mm Hg, and the oxygenation index was 310.8-357.2 mm Hg. Hematoxylin and eosin staining indicated a low degree of pulmonary edema and minimal cellular infiltration. Conclusion The pig left lung orthotopic transplantation model possesses strong operability and stability. Researchers can replicate this model according to the described methods and further conduct basic research and explore clinical translational applications.

Supercooling preservation technology, as a groundbreaking innovation in the field of organ preservation, significantly reduces the metabolic rate of cells and inhibits ice crystal formation by placing organs in a low-temperature environment near or below the freezing point. This technology extends the preservation time of organs and maintains their biological activity. Compared with the traditional low-temperature preservation at 4 °C, supercooling preservation effectively avoids cell damage and the accumulation of metabolic products, demonstrating significant advantages in the preservation of cells, tissues and organs. In recent years, important progress has been made in the optimization of cryoprotectants, the application of antifreeze proteins, the improvement of vitrification technology, and the development of nanotechnology-based rewarming techniques. These advancements provide new pathways to address the challenges of toxicity, ice crystal formation and uneven rewarming rates during supercooling preservation. This review summarizes the basic principles of supercooling preservation, the application of key technologies, and their practical effects in organ transplantation. It also analyzes the challenges of toxicity and rewarming efficiency, aiming to provide theoretical support and research directions for the future optimization of organ low-temperature preservation technology and its clinical application.

Objective:To explore the value of the deep learning model based on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI in preoperatively predicting vessels completely encapsulating tumor clusters (VETC) in hepatocellular carcinoma (HCC).Methods:This study adopted a case-control design to retrospectively analyze 420 patients with HCC confirmed by postoperative pathology who underwent Gd-EOB-DTPA enhanced MRI between June 2016 and March 2023. A total of 420 patients were divided into a training set ( n=305) from the First Affiliated Hospital of Soochow University and an external validation set ( n=115) from Affiliated Nantong Hospital 3 of Nantong University. Based on postoperative pathological findings, patients were stratified into VETC-positive and VETC-negative groups. The training set comprised 161 VETC-positive cases and 144 VETC-negative cases, while the external validation set included 55 VETC-positive cases and 60 VETC-negative cases. Tumor regions of interest in arterial, portal venous, and hepatobiliary phases were manually delineated using ITK-SNAP software. Pre-trained Vgg19, Densenet121, and Vision Transformer (ViT) models were employed for transfer learning, extracting deep learning features from each image. Feature data were processed using FAE software, and 12 logistic regression models (arterial phase, portal venous phase, hepatobiliary phase, and combined three-phase models) were constructed to select the optimal deep learning model. Independent predictors in clinical characteristics were identified through univariate and multivariate logistic analyses to establish a clinical model for predicting VETC pattern. Subsequently, a clinical-deep learning fusion model was developed by integrating these clinical predictors with the optimal deep learning features. Model performance in predicting VETC-positive HCC was evaluated using receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA). Results:In the external validation set, the area under the curve (AUC) of the Vgg19 model in the arterial phase, portal venous phase, hepatobiliary phase, and combined three-phase, respectively were 0.799,0.756,0.789,0.821, which were higher than those of Densenet121 (AUC: 0.544,0.581,0.544,0.583) and ViT (AUC: 0.740,0.752,0.785,0.767) model. The three-phase combined Vgg19 model achieved the highest AUC of 0.821 (95% CI 0.746-0.897). Multivariate logistic regression identified alpha-fetoprotein level ( OR=1.826,95% CI 1.069-3.120, P=0.028) and tumor diameter ( OR=1.329,95% CI 1.206-1.466, P<0.001) as independent predictors of VETC-positive HCC, forming the clinical model with an AUC of 0.789 (95% CI 0.703-0.859). The clinical-deep learning fusion model further achieved the AUC of 0.825 (95% CI 0.749-0.900). Calibration curves confirmed high concordance between predicted and actual probabilities for the three-phase Vgg19 model, while DCA revealed greater net clinical benefit for the combined Vgg19 and fusion models compared with the clinical model alone. Conclusions:The deep learning model based on Gd-EOB-DTPA enhanced MRI can be used to predict VETC of HCC preoperatively, among which the three-phase combined Vgg19 model and the clinical-deep learning model provide high predictive value.

Objective:A nomogram model for predicting double positivity of microvascular invasion (MVI) and vascular endothelial-to-mesenchymal transition (VETC) in patients with hepatocellular carcinoma (HCC) was constructed and its predictive performance was evaluated.Methods:A retrospective analysis was conducted on 326 HCC patients who were treated at the Third People's Hospital of Nantong and the First Affiliated Hospital of Soochow University from January 2013 to June 2023, including 240 males and 86 females, with an average age of (58.7±9.0) years. The 326 patients were randomly divided into a training set ( n=228) and a test set ( n=98) at a ratio of 7: 3 using the random number table method. The training set was divided into a double-positive group ( n=54) and a control group ( n=174) based on whether the HCC patients were double positive for MVI and VETC. Univariate and multivariate logistic regression analyses were performed to identify the influencing factors of double positivity of microvascular invasion in HCC patients, and a nomogram for predicting double positivity of microvascular invasion patterns was constructed based on the multivariate. The predictive performance and clinical net benefit of the nomogram were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis. Results:There were statistically significant differences in alpha-fetoprotein, gamma-glutamyl transferase, and phosphatidylinositol proteoglycan between the two groups (all P<0.05). Multivariate logistic regression analysis showed that LI-RADS category ( OR=8.58, 95% CI: 1.87-39.38), intratumoral hemorrhage ( OR=2.16, 95% CI: 1.14-4.07), and intratumoral arteries ( OR=2.59, 95% CI: 1.19-5.64) were all influencing factors of double positivity of microvascular invasion patterns in HCC patients (all P<0.05). Based on the multivariate results, a nomogram was constructed. In the training set, the area under the ROC curve for predicting double positivity of microvascular invasion patterns in HCC patients was 0.769 (95% CI: 0.720-0.814). In the test set, the area under the ROC curve for predicting double positivity of microvascular invasion patterns in HCC patients was 0.756 (95% CI: 0.622-0.850). The calibration curve showed a good fit between the predicted model and the ideal curve. Decision curve analysis showed that the clinical applicability was good when the threshold was 0.01-0.80 in the training set and 0.01-0.65 in the test set. Conclusion:The nomogram model based on LI-RADS category, intratumoral hemorrhage, and intratumoral arteries can effectively predict double positivity of microvascular invasion patterns in HCC patients and has good clinical applicability.

[Objective]To evaluate the feasibility of animal model of simulated adenoid hypertrophy by combining animal model of allergic rhinitis and chronic pharyngitis from the perspective of predictive validity.[Methods]Forty SD rats were randomly divided into blank group,model control group,montelukast group and traditional Chinese medicine(TCM)group,with 10 rats in each group.The model control group,montelukast group and TCM group all established rat model of allergic rhinitis and the rat model of chronic pharyngitis was also established in the same time,which combined the simulated adenoid hypertrophy rat model,while the blank group was replaced the equivalent amount of 0.9%sodium chloride solution.After molding,the montelukast group was gavaged with montelukast sodium particles,the TCM group was gavaged with Yunpi Huatan Tongqiao Decoction,model control group and blank group received equal amount of 0.9%sodium chloride solution,the course of treatment would all be 8 weeks.After molding and after the course of treatment,the symptom performance of model animals was assessed by animal behavioral score and the eosinophil percentage(EOS%),interleukin-4(IL-4),immunoglobulin E(IgE)and hypoxia-inducible factor-1α(HIF-1α)levels in blood serum and nasopharyngeal mucosal tissues were tested,and the pathomorphological changes of nasal and pharyngeal mucosa were observed by hematoxylin-eosin(HE)staining.[Results]After molding,the levels of animal behavioral score,EOS%,serum and tissue IL-4,IgE,and HIF-1α level in model control group,montelukast group and TCM group were significantly upregulated compared with blank group(P<0.01),and the nasal and pharyngeal mucosa showed different degrees of disease-related histopathological changes.After treatment,the levels of each index in montelukast group and TCM group were lower compared with that before treatment,and were also lower than that in model control group,all differences were statistically significant(P<0.05,P<0.01),and the histopathological damage was relieved than before the treatment.[Conclusion]The simulated rat model is similar to adenoid hypertrophy in terms of symptom manifestations and pathological changes,and effective drugs used clinically have similar efficacy in simulated rat models.In terms of predictive validity,the animal model of simulated adenoid hypertrophy can be made by combining animal model of allergic rhinitis and chronic pharyngitis,but it still needs further exploration and improvement.

Objective To observe the clinical efficacy of Melastoma dodecandrum(MD)nasal irrigation in the treatment of chronic sinusitis in children.Methods A total of 63 children with chronic sinusitis,treated at Lishui Hospital of Traditional Chinese Medicine from January to June 2022 were selected as the study subjects.They were divided into control group(n=33)and treatment group(n=30)by a random number table method.The control group received nasal irrigation with 2.3％ hypertonic saline,while the treatment group received nasal irrigation with MD.The clinical efficacy,Lund-Mackay score of sinus CT,levels of interleukin(IL)-6,IL-8,and tumor necrosis factor(TNF)-α in the nasal irrigation fluid,and safety were compared between two groups.Results After 3 months of treatment,the effective rate of treatment group was higher than that of control group(P＜0.05).After treatment,the CT Lund-Mackay scores for both groups of children decreased,with treatment group showing a better improvement(P＜0.05).Levels of IL-6,IL-8,and TNF-α in the nasal irrigation fluid of both groups were significantly reduced(P＜0.05).Conclusion MD nasal irrigation can effectively treat chronic sinusitis in children,the clinical total effective rate,IL-6,IL-8 inflammatory factors and sinus CT Lund-Mackay score improvement are better than 2.3％hypertonic physiological seawater,and safety is good.

Objective:To compare the effect of repeated transcranial magnetic stimulation (rTMS) targeting the M1 hand area, the M1 lower limb area, or the sciatic nerve on the motor functioning and ability in the activities of daily living of persons after a spinal cord injury (SCI).Methods:This was a retrospective analysis of data describing 86 hospitalized SCI patients. They were divided into four groups based on where the rTMS was applied: an M1 hand area group ( n=22), an M1 lower limb area group ( n=20), a sciatic nerve group ( n=24), and a control group ( n=20) who never received rTMS. In addition to conventional medication and rehabilitation training, the M1 hand area group, the M1 lower limb area group and the sciatic nerve group received 10Hz rTMS over the named area for 4 weeks. Before and after the treatment, the Spinal Cord Independence Measure (SCIM) total scores, SCIM indoor activity (SCIM12) sub-scores, Modified Barthel Index (MBI) scores, and lower extremity motor (LEMS) scores were compared among the four groups. Results:After the treatment, the average SCIM, SCIM12, MBI, and LEMS scores had improved significantly in all four groups. The average SCIM [10.00(4.00, 24.75] and MBI scores [12.00(6.75, 31.50)] of the M1 hand area group were then significantly better than the control group′s averages [3.50(0.00, 9.50) and 7.50(1.25, 17.75)]. There was also significantly greater improvement in the average LEMS score of the M1 hand area group [2.00(0.00, 10.00)] compared with both the sciatic nerve group [0.00(0.00, 2.00)] and the control group [0.00(0.00, 1.75)].Conclusions:High-frequency rTMS stimulation of the M1 hand area significantly promotes the recovery of lower limb motor function and self-care ability after an SCI. It is more effective than stimulating the M1 lower limb area or the sciatic nerve.

Objective To investigate the clinical effects of different right lung volume reduction techniques when the donor lung is oversized and mismatched with the recipient. Methods Clinical data of 10 recipients who underwent right lung volume reduction lung transplantation at the First Affiliated Hospital of Xi'an Jiaotong University from October 2022 to June 2024 were collected, including gender, age, primary disease type, and type of transplantation. A retrospective analysis was performed on postoperative complications within 90 days, duration of mechanical ventilation, hospital stay, and survival status to explore the impact of different volume reduction techniques on the survival rate of lung transplant recipients. Results A total of 10 right lung volume reduction recipients were included in this study, with 2 cases of upper lobe reduction, 7 cases of middle lobe reduction, and 1 case of lower lobe reduction. Three recipients developed airway complications (one each with upper, middle, and lower lobe reduction). The 30-day survival rate was 90% and the 1-year survival rate was 70%. One recipient with upper lobe reduction died of septic shock during the perioperative period, one with lower lobe reduction died of airway anastomotic fistula 2 months after surgery, and one with middle lobe reduction died of renal insufficiency 1 year after surgery. All 7 recipients with middle lobe reduction successfully passed the perioperative period, with one case of airway anastomotic stenosis (1/7). The average duration of mechanical ventilation was 71 hours, and the average hospital stay was 26 days. The 30-day survival rate was 7/7, and the 1-year survival rate was 6/7. Conclusions Middle lobe reduction in right lung transplantation surgery has the advantages of low incidence of airway complications, good safety, and minimal loss of lung function, and may be a better right lung volume reduction option with potential for application.

OBJECTIVE: To explore the clinical presentation and genetic etiology of a case with Xeroderma pigmentosum in conjunct with basal cell carcinoma and melanoma. METHODS: A male patient with Xeroderma pigmentosum treated at Xinxiang Central Hospital in October 2022 was selected as study subject. Whole exome sequencing (WES) was carried out. Candidate variants were verified by Sanger sequencing of his family members. This study was approved by the Ethics Committee of the hospital (Ethics No.: 2021-167). RESULTS: Magnetic resonance imaging showed that the patient has a solid soft tissue mass in the anterior and lower part of his right eyeball and a small nodule on the left nasal wing. Histopathological biopsy showed that the periocular tumor was basal cell carcinoma in conjunct with malignant melanoma, and the nasal wing tumor was basal cell carcinoma. WES and Sanger sequencing revealed that he has harbored compound heterozygous variants of the XPC gene, namely c.2391delT (p.F797Lfs*11) and IVS1+1G>A, which were inherited from his father and mother, respectively. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variants were rated as likely pathogenic (PVS1+PM2_Supporting+PM3) and pathogenic (PVS1+PM2_Supporting+PM3+PP5), respectively. The c.2391delT variant was unreported previously. Bioinformatic analysis suggests that it could significantly affect the tertiary structure of XPC protein. CONCLUSION The c.2391delT(p.F797Lfs*11) and IVS1+1G>A compound heterozygous variants probably underlay the pathogenesis in this patient. The detection of the novel variant has enriched the mutational spectrum of the XPC gene.
Humans ; Male ; Xeroderma Pigmentosum/genetics* ; Basal Cell Carcinoma/genetics* ; DNA-Binding Proteins/genetics* ; Melanoma/genetics* ; Mutation ; Skin Neoplasms/genetics* ; Middle Aged ; Exome Sequencing ; Pedigree

After continuous development and improvement, lung transplantation has become the preferred means to treat a variety of benign end-stage lung diseases. However, the field of lung transplantation still faces many challenges, including shortage of donor resources, preservation and maintenance of donor lungs, and postoperative complications. Lung tissue samples removed after lung transplantation are excellent clinical resources for the study of benign end-stage lung disease and perioperative complications of lung transplantation. However, at present, the collection, storage and utilization of tissue samples after lung transplantation are limited to a single study, and unified technical specifications have not been formed. Based on the construction plan of the biobank for lung transplantation in the First Affiliated Hospital of Xi'an Jiaotong University, this study reviewed the practical experience in the collection, storage and utilization of lung transplant tissue samples in the aspects of ethical review, staffing, collection process, storage method, quality control and efficient utilization, in order to provide references for lung transplant related research.