Left ventricular assist device (LVAD) serves as a critical therapeutic option for patients with end-stage heart failure, significantly enhancing survival rates and quality of life. However, LVAD implantation exerts complex and profound effects on right ventricular (RV) function, with RV dysfunction emerging as a key factor influencing the prognosis of LVAD patients. This article systematically reviews the relationship between LVAD and RV function, exploring the importance of RV function in LVAD patients, assessment methods, underlying mechanisms of impact, and strategies for prevention and management. Comprehensive evidence suggests that preoperative evaluation of RV function is crucial for predicting the risk of RV dysfunction, while effective prevention and management rely on preoperative optimization, meticulous intraoperative techniques, rigorous postoperative monitoring, and multidisciplinary collaboration. Furthermore, this review discusses the potential and future directions of emerging technologies, such as improved LVAD designs, biventricular assist devices, gene therapy, and personalized medicine, in ameliorating RV dysfunction. In conclusion, RV function is one of the key determinants of successful LVAD therapy. Through comprehensive assessment, prevention, and management of RV function, coupled with the application of novel technologies, the clinical outcomes of LVAD patients can be further improved.

Objective To investigate the characteristics of KRAS,NRAS,BRAF,and PIK3CA mutations in different colorectal cancer(CRC)metastatic sites and their correlation with prognosis.Methods The mutations of KRAS,NRAS,BRAF,and PIK3CA were detected in 205 cases by using a mutation amplification refractory mutation system(ARMS),and their correlation with clinical fea-tures,metastatic sites,and related prognosis was analyzed.Results The mutation rates of KRAS,NRAS,BRAF,and PIK3CA were 57.1％,4.4％,4.4％and 3.9％,respectively.Mutations of KRAS are increased in women,patients with colorectal cancer,and patients with stage Ⅲ-Ⅳ colorectal cancer.The BRAF mutation rate in right-sided colon cancer was increased(P＜0.05).KRAS mutations were com-monly seen during pulmonary metastasis,while NRAS mutation rates were higher during liver metastasis,and the proportion of peritoneal metastases was higher when BRAF mutated.KRAS and NRAS mutations were identified as elevated risks for lung and liver metastasis in colorectal cancer(CRC)(P＜0.01).BRAF mutation types lead to shorter overall survival(OS)in CRC cases with liver and peritoneal metastasis,whereas KRAS mutations indicate poorer prognosis in lung metastasis.Both KRAS and BRAF mutations are independent prog-nostic indicators of unfavorable outcomes in CRC with lung and liver metastasis,respectively(P＜0.01).Conclusion KRAS,NRAS and BRAF mutations are closely associated with distant metastasis and prognosis in CRC.Clinical practice should routinely assess these mutations to provide critical guidance for treatment decisions.

Objective To compare the efficacy and safety of CT-guided percutaneous radiofrequency ablation(RFA)and cryoablation(CRYO)combined with synchronous biopsy of pulmonary nodules.Methods Totally 62 patients with pulmonary nodules who underwent CT-guided percutaneous ablation with either RFA(n=30)or argon-helium CRYO(n=32)combined with simultaneous biopsy were enrolled,and the regarding postoperative complication rates and 1-year local control outcomes were compared.Results All patients successfully completed both ablation and biopsy procedures.In RFA group,the mean diameter of lesion was(1.43±0.33)cm,and the biopsy positive rate was 90.00%(27/30).Post-biopsy intrapulmonary hemorrhage extent immediately increased by 0.60(0.28,1.63)cm.Hemoptysis,pneumothorax requiring chest tube placement and infectious cavities observed in 2(2/30,6.67%),6(6/30,20.00%)and 4 cases(4/30,13.33%),respectively,and the 1-year local control rate in RFA group was 90.00%(27/30).In CRYO group,the mean diameter of lesion was(1.59±0.34)cm,and the biopsy positive rate was 100%(32/32).Post-biopsy intrapulmonary hemorrhage extent increased by 1.20(0.60,1.83)cm.Hemoptysis occurred in 7 cases(7/32,21.88%),and pneumothorax requiring chest tube placement was noticed in 8 cases(8/32,25.00%),while no infectious cavity was observed.The 1-year local control rate in CRYO group reached 96.88%(31/32).Statistical difference of infectious cavity was found between groups(P＜0.05).Conclusion Simultaneous biopsy during CT-guided percutaneous RFA and CRYO for lung nodules were both efficient and safe,while the former with relative higher incidence of infectious cavity.

B-cell lymphomas account for 70％-80％of non-Hodgkin lymphomas(NHL)and exhibit significant heterogeneity in genetic profiles,phenotypic characteristics,and clinical manifestations,posing substantial challenges for clinical management.The B-cell receptor(BCR)is a transmembrane receptor on the surface of B cells that plays a central regulatory role in B-cell development,activation,and adaptive immune responses.As a core mechanism driving malignant transformation in various B-cell malignancies,aberrant activation of the BCR signaling pathway,plays a pivotal role in B lymphoma pathogenesis.Dysregulated BCR signaling not only promotes tumor cell proliferation,survival,and anti-apoptotic capacity but also accelerates malignant progression.Consequently,researchers are vigorously exploring therapeutic strategies targeting BCR and its downstream pathways,including inhibitors of Bruton's tyrosine kinase(BTK)and PI3K,as well as direct BCR-targeted approaches.The central role of BCR signaling in lymphoma pathogenesis and treatment underscores its potential as a critical focus for future therapeutic development,offering new directions and hope for improved clinical outcomes.

This study explored the effect of the Mycobacterium tuberculosis(Mtb)PE/PPE family protein PE_PGRS37 on the growth of Mycobacterium smegmatis(Ms)and macrophage autophagy during Mtb infection.The pe_pgrs37 gene was amplified from Mtb genome through PCR,and the recombinant vector pAIN-PE_PGRS37 was successfully constructed through homologous recombi-nation.pAIN-PE_PGRS37 and pAIN were integrated into Ms through electroshock to construct pAIN-PGRS37/Ms and pAIN/Ms re-combinant bacteria.Western blotting indicated that the PE_PGRS37 protein was correctly expressed in pAIN-PE_PGRS37/Ms.The re-combinant bacteria were inoculated in 7H9/7H10 medium,and their colony morphology and growth curves were observed.No signifi-cant difference in colony morphology was observed between pAIN-PE_PGRS37/Ms and pAIN/Ms.The growth rate significantly in-creased between 10 and 16 h,and a plateau was reached at 26 h.After infection of U937 cells with pAIN-PE_PGRS37/Ms and pAIN/Ms,macrophage autophagy flow was detected with western blotting and immunofluorescence.In the pAIN-PE_PGRS37/Ms-infected group,compared with the pAIN/Ms-infected group,macrophage LC3-II and p62 protein expression was significantly up-regulated(P<0.001)and inhibited autophagosome and lysosome fusion.The intracellular survival of the recombinant bacteria was detected through colony counting,and pAIN-PE_PGRS37/Ms showed significantly greater survival in macrophages at 12 h,24 h,and 48 h than pAIN/Ms(P<0.05).Our results suggested that PE_PGRS37 protein promotes Mycobacterium survival in macrophages by blocking macro-phage autophagy flow,thus inhibiting macrophage autophagy.

Objective To explore the risk factors and possible preventive measures of delayed postoperative intestinal paralysis(PPOI)in elderly(aged ≥75 years)patients with colorectal cancer.Methods This retrospective study included 333 patients with CRC who underwent laporascopic resection in General Department of Beijing Chaoyang Hospital from June 2016 to August 2023.There were 126 patients were enrolled in PPOI group and 207 patients were enrolled in non-PPOI group.The perioperative clinical characteristics of the patients were compared between PPOI group and non-PPOI group,and the risk factors of PPOI and potential preventive measures for them were investigated usingLogisticregression.Results The incidence of PPOI after laparoscopic surgery in elderly patients with colorectal cancer was 37.84％.The ages of the PPOI group and the non-PPOI group were(82.60±3.587)years and(80.38±3.847)years respectively.The rates of primary enterostomy during the operation were 20.63％and 9.66％,respectively,and the preoperative combined nutritional risks were 53.97％and 20.77％,respectively.The preoperative serum albumin levels were lower,which were(35.32±3.77)g/L and(38.36±3.91)g/L,respectively,and the preoperative hemoglobin levels were(104.47±20.31)g/L and(110.33±20.27)g/L,respectively.The intraoperative blood loss was(140.48±130.65)mland(98.26±56.45)ml,respectively.The patients who received enhanced recovery after surgery(ERAS)measures during the perioperative period were 14.29％and 75.85％,respectively.There was a statistically significant difference between the two groups(P＜0.05).The Logistic analysis showed that the risk factors for elderly patients with PPOI including increased age,preoperative nutritional risk,low preoperative albumin,increased intraoperative blood loss.Moreover,the implementation of ERAS protocols including preoperative nutritional support,multimodal low-opioid anesthesia,gastric tube removal and ground activity early after surgery may be the protective factors of PPOI.Conclusion The risk factors of PPOI for colorectal patients older than 75 years including increased age,preoperative nutritional risk,low preoperative albumin,increased intraoperative blood loss.The ERAS protocols including preoperative nutritional support,multimodal low-opioid anesthesia,gastric tube removal and ground activity early after surgery may be useful to prevent the occurrence of PPOI for elderly patients with colorectal cancer.

Objective To compare the efficacy and safety of CT-guided percutaneous radiofrequency ablation(RFA)and cryoablation(CRYO)combined with synchronous biopsy of pulmonary nodules.Methods Totally 62 patients with pulmonary nodules who underwent CT-guided percutaneous ablation with either RFA(n=30)or argon-helium CRYO(n=32)combined with simultaneous biopsy were enrolled,and the regarding postoperative complication rates and 1-year local control outcomes were compared.Results All patients successfully completed both ablation and biopsy procedures.In RFA group,the mean diameter of lesion was(1.43±0.33)cm,and the biopsy positive rate was 90.00%(27/30).Post-biopsy intrapulmonary hemorrhage extent immediately increased by 0.60(0.28,1.63)cm.Hemoptysis,pneumothorax requiring chest tube placement and infectious cavities observed in 2(2/30,6.67%),6(6/30,20.00%)and 4 cases(4/30,13.33%),respectively,and the 1-year local control rate in RFA group was 90.00%(27/30).In CRYO group,the mean diameter of lesion was(1.59±0.34)cm,and the biopsy positive rate was 100%(32/32).Post-biopsy intrapulmonary hemorrhage extent increased by 1.20(0.60,1.83)cm.Hemoptysis occurred in 7 cases(7/32,21.88%),and pneumothorax requiring chest tube placement was noticed in 8 cases(8/32,25.00%),while no infectious cavity was observed.The 1-year local control rate in CRYO group reached 96.88%(31/32).Statistical difference of infectious cavity was found between groups(P＜0.05).Conclusion Simultaneous biopsy during CT-guided percutaneous RFA and CRYO for lung nodules were both efficient and safe,while the former with relative higher incidence of infectious cavity.

Objective To investigate the characteristics of KRAS,NRAS,BRAF,and PIK3CA mutations in different colorectal cancer(CRC)metastatic sites and their correlation with prognosis.Methods The mutations of KRAS,NRAS,BRAF,and PIK3CA were detected in 205 cases by using a mutation amplification refractory mutation system(ARMS),and their correlation with clinical fea-tures,metastatic sites,and related prognosis was analyzed.Results The mutation rates of KRAS,NRAS,BRAF,and PIK3CA were 57.1％,4.4％,4.4％and 3.9％,respectively.Mutations of KRAS are increased in women,patients with colorectal cancer,and patients with stage Ⅲ-Ⅳ colorectal cancer.The BRAF mutation rate in right-sided colon cancer was increased(P＜0.05).KRAS mutations were com-monly seen during pulmonary metastasis,while NRAS mutation rates were higher during liver metastasis,and the proportion of peritoneal metastases was higher when BRAF mutated.KRAS and NRAS mutations were identified as elevated risks for lung and liver metastasis in colorectal cancer(CRC)(P＜0.01).BRAF mutation types lead to shorter overall survival(OS)in CRC cases with liver and peritoneal metastasis,whereas KRAS mutations indicate poorer prognosis in lung metastasis.Both KRAS and BRAF mutations are independent prog-nostic indicators of unfavorable outcomes in CRC with lung and liver metastasis,respectively(P＜0.01).Conclusion KRAS,NRAS and BRAF mutations are closely associated with distant metastasis and prognosis in CRC.Clinical practice should routinely assess these mutations to provide critical guidance for treatment decisions.

B-cell lymphomas account for 70％-80％of non-Hodgkin lymphomas(NHL)and exhibit significant heterogeneity in genetic profiles,phenotypic characteristics,and clinical manifestations,posing substantial challenges for clinical management.The B-cell receptor(BCR)is a transmembrane receptor on the surface of B cells that plays a central regulatory role in B-cell development,activation,and adaptive immune responses.As a core mechanism driving malignant transformation in various B-cell malignancies,aberrant activation of the BCR signaling pathway,plays a pivotal role in B lymphoma pathogenesis.Dysregulated BCR signaling not only promotes tumor cell proliferation,survival,and anti-apoptotic capacity but also accelerates malignant progression.Consequently,researchers are vigorously exploring therapeutic strategies targeting BCR and its downstream pathways,including inhibitors of Bruton's tyrosine kinase(BTK)and PI3K,as well as direct BCR-targeted approaches.The central role of BCR signaling in lymphoma pathogenesis and treatment underscores its potential as a critical focus for future therapeutic development,offering new directions and hope for improved clinical outcomes.

This study explored the effect of the Mycobacterium tuberculosis(Mtb)PE/PPE family protein PE_PGRS37 on the growth of Mycobacterium smegmatis(Ms)and macrophage autophagy during Mtb infection.The pe_pgrs37 gene was amplified from Mtb genome through PCR,and the recombinant vector pAIN-PE_PGRS37 was successfully constructed through homologous recombi-nation.pAIN-PE_PGRS37 and pAIN were integrated into Ms through electroshock to construct pAIN-PGRS37/Ms and pAIN/Ms re-combinant bacteria.Western blotting indicated that the PE_PGRS37 protein was correctly expressed in pAIN-PE_PGRS37/Ms.The re-combinant bacteria were inoculated in 7H9/7H10 medium,and their colony morphology and growth curves were observed.No signifi-cant difference in colony morphology was observed between pAIN-PE_PGRS37/Ms and pAIN/Ms.The growth rate significantly in-creased between 10 and 16 h,and a plateau was reached at 26 h.After infection of U937 cells with pAIN-PE_PGRS37/Ms and pAIN/Ms,macrophage autophagy flow was detected with western blotting and immunofluorescence.In the pAIN-PE_PGRS37/Ms-infected group,compared with the pAIN/Ms-infected group,macrophage LC3-II and p62 protein expression was significantly up-regulated(P<0.001)and inhibited autophagosome and lysosome fusion.The intracellular survival of the recombinant bacteria was detected through colony counting,and pAIN-PE_PGRS37/Ms showed significantly greater survival in macrophages at 12 h,24 h,and 48 h than pAIN/Ms(P<0.05).Our results suggested that PE_PGRS37 protein promotes Mycobacterium survival in macrophages by blocking macro-phage autophagy flow,thus inhibiting macrophage autophagy.