Organ transplantation has been an important means of rescuing the lives of end-stage patients with organ failure. However, an acute shortage of donor organs has become a common dilemma for organ transplantation all over the world so as to seriously restrict the development of organ transplantation. Many foreign countries have established a relatively mature organ donation system to foster favorable conditions for alleviating a shortage of donor organs. This review summarized the global measures and current domestic efforts of facilitating organ donation to provide theoretical rationales for further optimizing organ donations and transplantation system in China.

Objective:To explore the clinical features and genetic etiology of a patient with adult-onset globoid cell leukodystrophy/Krabbe disease (KD).Methods:A patient who was admitted to the Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology on February 15, 2022 due to exacerbation of right leg weakness for over 4 years was selected as the study subject. Clinical data and results of medical imaging and genetic analysis were analyzed. Candidate variants were verified by family analysis.Results:The patient, a 36-year-old woman, had spasmodic gait as the primary presentation. Cranial magnetic resonance imaging (MRI) revealed symmetrical abnormalities in the bilateral corticospinal tracts, and the activity of β-galactocerebrosidase (GALC) in her white blood cells was significantly decreased. The patient was found to harbor compound heterozygous variants of the GALC gene, namely c.461C>A (p.Pro154His) and c. 1901T>C (p.Leu634Ser). Her mother, sister and nephew were heterozygous carriers of the c. 461C>A (p.Pro154His) variant, whilst her father was heterozygous for the c.1901T>C (p.Leu634Ser) variant. Conclusion:The patient was ultimately diagnosed with adult-onset KD, for which the compound heterozygous variants of the GALC gene may be accountable.

Objective:To analyze and summarize the clinical manifestations, pathological characteristics, treatment, and outcomes of primary malignant melanoma of the esophagus(PMME)in elderly Chinese patients.Methods:A case study of an elderly patient with PMME was conducted at the Department of Gastroenterology in the China-Japan Friendship Hospital.Additionally, literature and case data on elderly PMME cases reported in China up to July 2023 were gathered and analyzed to summarize the epidemiological characteristics, endoscopic manifestations, clinical presentations, diagnosis, treatment, and prognosis of the disease.Results:A comprehensive review of the literature up to July 2023 documented a total of 114 cases of elderly patients with PMME in China, which also included cases from our hospital.Among these cases, there were 68 male patients(59.6%)and 46 female patients(40.4%), ranging in age from 60 to 81 years, with a median age of 65 years.The predominant clinical manifestations observed were dysphagia and choking while eating, followed by chest pain and retrosternal burning sensation.The majority of the lesions were found in the middle and lower segments of the esophagus, predominantly protruding into the lumen, with only 2 cases(1.8%)displaying esophageal mucosal pigmentation.Immunohistochemical analysis revealed that HMB45 was positive in 74 cases(64.9%)and negative in 3 cases(2.6%), while S-100 was positive in 66 cases(57.9%)and negative in 2 cases(1.8%), although data for some patients were not available.Lymph node or distant metastases were present in 45 cases(39.5%), while 38 patients(33.3%)had tumors confined to the esophagus without metastases.Of the 114 patients, 61(53.5%)had a follow-up period ranging from 0.3 to 39 months, with a median follow-up time of 6.75 months.Among the patients who survived during the follow-up period, there were 30 cases(26.3%), with a follow-up time of 1 to 39 months and a median follow-up time of 7.5 months.For the deceased patients, the time from consultation to death ranged from 0.3 to 31 months.Conclusions:Elderly individuals with PMME in China typically present with a gradual onset, nonspecific symptoms, frequent metastasis upon diagnosis, aggressive behavior, and unfavorable outcomes.

Regarding the air quality problems,this article summarized the adverse factors such as trace harmful gases,small particulate matter,and high concentration carbon dioxide that existed in space closed environment,and compared the advantages and disadvantages of physical and chemical treatment methods to improve air quality.The focus was on exploring the improvement benefits of plants method on air quality,and summarizing the research progress in three aspects:absorption of trace harmful gases,release of negative oxygen ions,and absorption of carbon dioxide.The current research problems were pointed out,and the future research directions on using plants to improve the air quality in space closed environment were predicted.

Objective:To investigate the diagnostic and prognostic value of 68Ga-fibroblast activation protein inhibitor (FAPI) PET for hepatobiliary malignancies. Methods:From July 2020 to February 2023, 33 patients (23 males, 10 females; age (55.4±13.5) years) with suspected or confirmed liver or biliary tract malignancies who underwent 68Ga-FAPI PET in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. PET images were evaluated by 3 experienced nuclear medicine physicians, and the results of biopsy or postoperative pathology, clinical and imaging follow-up were used as the gold standard. One-way analysis of variance and least significant difference t test were used to compare the differences among groups. Survival analysis was performed using Kaplan-Meier curves and the log-rank test. Results:Of 33 patients, 14 performed PET for initial diagnosis and staging, and 19 for restaging. There were 14 patients with hepatocellular carcinoma (HCC), 13 patients with cholangiocarcinoma (CCA), and 6 patients with gallbladder carcinoma (GBC). The primary tumor of HCC, CCA and GBC all showed significant 68Ga-FAPI uptake, with no statistically significant difference in SUV max among groups ( F=1.58, P=0.250). The sensitivities of 68Ga-FAPI PET for initial diagnosis and restaging of hepatobiliary malignancies were 14/14 and 15/15, respectively. Compared with conventional imaging, 68Ga-FAPI PET changed the diagnosis and staging in 29.2%(7/24) patients. The treatment strategy was changed in 30.3%(10/33) patients with malignant tumors due to 68Ga-FAPI PET findings. Follow-up showed 22 cases survived and 11 cases died, with the overall survival of 355.56(80.00, 516.97) d, and 1- and 2-year survival rates were 68.2% and 57.9%, respectively. Semi-quantitative 68Ga-FAPI PET parameters such as SUV max, target-liver ratio (TLR), and target-blood ratio (TBR) had no significant prognostic value, but the prognosis of the group without distant metastases diagnosed by 68Ga-FAPI PET was significantly better than that of the group with distant metastasis ( P=0.032). Conclusion:68Ga-FAPI PET has high sensitivity for the diagnosis of hepatobiliary malignancies, which can help guide treatment decisions and prognosis evaluation.

Objective:To assess the feasibility and effectiveness of transnasal ultra-thin gastrointestinal endoscope-guided ileus tube insertion for the treatment of adhesive intestinal obstruction in the elderly.Methods:Randomized controlled trial, a total of 81 elderly patients with adhesive intestinal obstruction were enrolled, with 46 receiving transnasal ultra-thin gastroscope-assisted tube placement(observation group)and 35 receiving conventional transoral gastroscope-assisted tube placement(control group). Tube insertion was carried out.Data on the time needed for tube placement, incidents of oral or nasal bleeding, rates of successful tube placement, physical signs of symptom relief and imaging signs of symptom relief were recorded and compared between the two groups.Results:The symptom remission rate within 3 d was 93.5%(43/46)in the observation group and 88.6%(31/35)in the control group, and the rate for imaging signs of symptom remission was 82.6%(38/46)in the observation group and 74.3%(26/35)in the control group.The differences in symptom remission and imaging signs of symptom remission within 3 d were not statistically significant between the two groups( χ2=0.144, 0.830, all P>0.05). In the observation group, the time needed for tube placement was(15.4±4.2)min, which was significantly shorter than that in the control group(21.3±3.1)min( t=6.984, P<0.01). The rate of successful tube placement was 100% in both groups.In terms of adverse reactions, the observation group had 1 patient with nasal bleeding, 2 with nausea and vomiting, and 1 with a sore throat, with an overall adverse reaction rate of 8.7%(4/46), while the control group had no patient with bleeding, 18 with nausea and vomiting, and 4 with a sore throat, with an overall adverse reaction rate of 62.9%(22/35). There was no statistically significant difference in nasal bleeding(Fisher's exact probability P=0.568)or a sore throat( χ2=1.559, P=0.212), but the differences in the incidence of nausea and vomiting as well as the incidence of total adverse reactions were statistically significant( χ2=23.694, 26.752, both P<0.01)between the two groups. Conclusions:Transnasal ultra-thin gastroscope-assisted tube placement can reduce discomfort such as nausea and vomiting during tube placement, the time needed for the procedure is short with a high success rate, and therefore has very good clinical value, especially for elderly patients.

Objective:To explore the diagnostic value of 68Ga-fibroblast activation protein inhibitor (FAPI) PET for the restaging of patients with colorectal cancer and its impact on treatment strategy. Methods:Patients with colorectal cancer who underwent 68Ga-FAPI PET imaging in the PET Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2020 to June 2021 were retrospectively analyzed. PET images were evaluated by 3 experienced imaging physicians. Biopsy or postoperative pathology, clinical and imaging follow-up results were as the gold standard. The diagnostic value of PET was compared with conventional imaging (CT/MR), and the impact of 68Ga-FAPI PET on guiding treatment was evaluated. χ2 test and Fisher exact test were used to compare the differences between groups. Results:A total of 33 patients were included (17 males, 16 females, age (52.8±12.3) years), of which 24 were finally diagnosed as recurrence/metastases/progression. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 68Ga-FAPI PET in detecting recurrence/metastases/progression of colorectal cancer were 93.9%(31/33), 100%(24/24), 7/9, 92.3%(24/26) and 7/7, respectively. Its accuracy, sensitivity and negative predictive value were significantly higher than those of conventional imaging (64.5%(20/31), 56.5%(13/23) and 7/17; χ2 values: 8.549 and 10.786, all P<0.05). Compared with the clinical or pathological stage before examination, 68Ga-FAPI PET led upstaging to stage Ⅳ in 12 patients (50.0%, 12/24). Of the 31 patients who were correctly diagnosed by 68Ga-FAPI PET, the treatment regimen of 22 patients (71.0%) was changed because of 68Ga-FAPI PET imaging. Conclusion:68Ga-FAPI PET has good diagnostic performance in the restaging of colorectal cancer, which is helpful to further guide clinical treatment strategy.

Objective:To explore the feasibility of statistical parametric mapping (SPM) aided semi-quantitative analysis in 11C-Pittsburgh compound B (PIB) β-amyloid (Aβ) PET imaging acquired by hybrid PET/MR, and evaluate its possibility in assisting the diagnosis or differential diagnosis for cognitive impairment. Methods:From January 2018 to September 2019, 13 Alzheimer′s disease (AD) patients (4 males, 9 females; age (59.2±5.8) years) and 10 vascular cognitive disorders (VCD) patients (9 males, 1 female; age (59.5±11.5) years) who underwent 11C-PIB PET/MR in PET center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. The standardized uptake value ratio (SUVR) of eight key brain regions (cerebral white matter, striatum, thalamus, posterior cingulate gyrus, frontal cortex, posterior parietal cortex, lateral temporal cortex and occipital cortex) to cerebellum cortex were obtained by manual delineation and SPM-aided semi-automatic segmentation with the help of synchronous three-dimensional T 1 weighted imaging (3D T 1WI). Pearson correlation analysis was carried out on the SUVR obtained by the two methods. Independent-sample t test and paired t test were used to analyze the data. Results:There was no significant difference between AD group and VCD group in age and Mini-Mental State Examination (MMSE) score (19.7±4.7 vs 21.7±3.8; t values: 0.095 and 1.098, both P>0.05). Except thalamus( r=0.179, P=0.413), there were good correlations between SUVR obtained by segmentation and delineation in the other 7 key regions ( r values: 0.678-0.893, all P<0.05). The SUVR of 8 key regions obtained by the two methods in AD group was significantly higher than that in VCD group (1.519-2.055 vs 1.105-1.618; t values: 2.799-11.582, all P<0.01). The SUVR of striatum (1.942±0.205), posterior cingulate gyrus (1.915±0.249), frontal lobe (1.983±0.264), parietal lobe (2.008±0.296) and temporal cortex (1.931±0.254) in AD group was significantly higher than that of cerebral white matter (1.746±0.192; t values: 3.793-6.992, all P<0.01). But in VCD group, there was no region with the SUVR higher than that of cerebral white matter. Conclusions:Hybrid PET/MR can acquire the PET and MRI images synchronously, which can realize the accurate brain segmentation and obtain the semi-quantitative data of key brain regions aided by SPM. The method can analyze the characteristics and differences of amyloid imaging in AD and VCD, which is expected to provide an accurate imaging analysis method for the diagnosis and differential diagnosis of cognitive disorders.

Objective To investigate the efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage.Methods From August 2014 to August 2017,91 spontaneous thalamic hemorrhage ruptured into ventricles patients in Affiliated Hospital of the Yangzhou University were enrolled,who were underwent surgical treatment in this retrospective study.The patients were divided into the study group(n =41) and control group(n =50) based on different methods of treatment.The patients in the study group were given with remove visible intraventricular hematoma by neuroendoscopy,followed by External Ventricular Drainage (EVD) combined with urokinase fibrinolysis.The patients in control group were given with EVD combined with urokinase fibrinolysis.The time of postoperative drainage,ICU stay,duration of onset of fever,the number of intracranial infections,and the proportion of Glasgow outcome scale (GOS) (1 to 5) at 6 months postsurgery were compared between two groups.Measurement data were expressed as (Mean ± SD),and t test was used for measurement data.The count data were analyzed by x2 test or nonparametric rank sum test.Results The time of postoperative drainage,the number of intracranial infections,ICU stay in study group were (6.19 ± 1.1) d,5 cases,(2.8 ± 1.6) d,the indexes in control group were (7.06 ± 1.3) d,15 cases,(5.2 ± 2.0) d.The time of postoperative drainage,ICU stay,the number of intracranial infections were superior to those of the control group,and the difference was statistically significant.The proportion of GOS (1 to 5) at 6 months after surgery was 5 cases (12.2％),5 cases (12.2％),10 cases (24.4％),14 cases (34.1％),7 cases (17.1％) in study group,the indexes in control group were 10 cases(20.0％),13 cases (26.0％),11 cases(22.0％),10 cases(20.0％),6 cases(12.0％).The 6-month postoperative GOS of the study group were superior to those of the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Neruendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage can reduce the time of postoperative drainage and the incidence of intracranial infection,shorten the time of ICU stay and improve the functional prognosis of the patients.

Objective To explore the influence of modified radical gastrectomy on glycometabolism in patients with gastric carcinoma and non-obese T2DM.Methods The retrospective study was carried out to analyze the changes of glycometabolism between preoperative and postoperative follow-up in 25 patients with gastric carcinoma and non-obese T2DM.The above parameters included fasting plasma glucose (FPG),2-hour postprandial blood glucose (2 h PBG),glycosylated hemoglobin A1c (HbA1c),fasting insulin (FINS),homeostasis model assessment-insulin resistance (HOMA-IR),fasting glucagon-like peptide-1 (GLP-1),and glucose-dependent insulinotropic polypeptide (GIP).Results At the 6th and 12th month after operation,the related parameters such as FPG,2 h PBG,HbA1c,FINS and HOMA-IR were (7.54±1.44) mmo]/L and (7.17±1.35) mmol/L,(9.97±1.59)mmol/L and (9.47±1.23) mmol/L,(6.46±0.74)％ and (6.31±0.97)％,(7.73±0.98) μIU/ml and (7.44±0.96) μIU/ml,1.10±0.15 and 1.04±0.14 respectively.The above indexes were significantly improved compared with those before operation (P＜O.05).The levels of fasting GLP-1 at 6th and 12th month after operation were (2.27±0.25) pmol/ml and (2.33±0.27) pmol/ml respectively,and there was no significant change compared with those before operation (P＞0.05).On the contrary,the levels of GIP at 6th and 12th month after operation are significantly decreased compared with that before operation,which were (7.23±1.33) pmol/ml and (6.40±1.20) pmol/ml respectively.Conclusion The modified radical gastrectomy can improve T2DM in patients with gastric carcinoma markedly,even curing some patients,which may be related to the decrease of fasting GIP after operation.