Background/Aims: The shortage of donor liver hinders the development of liver transplantation. This study aimed to clarify the poor outcomes of functionally marginal liver grafts (FMLs) and provide evidence for the improvement of ischemia-free liver transplantation (IFLT) after FML transplantation. Methods: Propensity score matching was used to control for confounding factors. The outcomes of the control group and FML group were compared to demonstrate the negative impact of FMLs on liver transplantation patients. We compared the clinical improvements of the different surgical types. To elucidate the underlying mechanism, we conducted bioinformatic analysis based on transcriptome and single-cell profiles. Results: FMLs had a significantly greater hazard ratio (HR: 1.969, P=0.018) than did other marginal livers. A worse 90-day survival (Mortality: 12.3% vs. 5.0%, P=0.007) was observed in patients who underwent FML transplantation. Patients who received FMLs had a significant improvement in overall survival after IFLT (Mortality: 10.4% vs 31.3%, P=0.006). Pyroptosis and inflammation were inhibited in patients who underwent IFLT. The infiltration of natural killer cells was lower in liver grafts from these patients. Bulk transcriptome profiles revealed a positive relationship between IL-32 and Caspase 1 (R=0.73, P=0.01) and between IL-32 and Gasdermin D (R=0.84, P=0.0012). Conclusions FML is a more important negative prognostic parameter than other marginal liver parameters. IFLT might ameliorate liver injury in FMLs by inhibiting the infiltration of NK cells, consequently leading to the abortion of IL-32, which drives pyroptosis in monocytes and macrophages.

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Objective: To investigate the dose-response relationship between hemoglobin concentration and preterm birth, during pregnancy. Methods: With Zhuang ethnicity, a total of 12 780 pregnant women and their infants that admitted to Wuming、Pingguo、Jingxi、Debao、Longan and Tiandong hospitals, were recruited, in Guangxi Zhuang Autonomous Region, from January 2015 to December 2017. Non-conditional logistic regression method was used to analyze the effect of anemia on preterm birth during pregnancy. Dose-response relationship between hemoglobin concentration and preterm birth was explored, using the restrictive cubic spline model. Results: After excluding 2 053 pregnant women with hypertension or aged 35 years and over, results from the non-conditional logistic regression analysis showed that the risk of preterm birth in the anemia group was 1.29 times (OR=1.29, 95%CI: 1.04-1.59, P=0.019) of the non-anemia group in the first trimester. Data from the restricted cubic sample showed that there appeared nonlinear "L" dose-response relationship between hemoglobin concentration and preterm birth in the first trimester and "U" shape in the third trimester (non-linearity test P<0.001). Conclusion There appeared nonlinear dose-response relationship between the hemoglobin concentration and preterm birth, both in the first and third trimesters.

BACKGROUND:Lumbar fusion surgery as an important and effective means of treating degenerative diseases is widely used in clinical application for almost a century. However, long-term clinical evidence showed that lumbar fusion also brought some problems, such as the loss of waist flexibility, complications of donor site, fusion segment motion loss and accelerating the adjacent segment degeneration. In recent years, the theory of spinal dynamic stabilization had spread widely, and a variety of non-fusion surgery is becoming more broadly used in treatment of lumbar degenerative disease. OBJECTIVE:To review the application of non-fusion surgery in the treatment of lumbar degenerative diseases and explain application perspectives and experiences. METHODS:Databases including PubMed and CNKI were retrieved to col ect clinical application and views about non-fusion internal fixation in the treatment of lumbar degenerative diseases from 2007 to 2016. The key words were“lumbar, non-fusion, bone fusion, dynamic stabilization, adjacent segment degeneration”. RESULTS AND CONCLUSION:Thirty papers were included in the final analysis after screening by two independent researchers. We summarized the lumbar non-fusion technology, including artificial nucleus replacement, total disc replacement and posterior lumbar dynamic stabilization device. The philosophy of these new technologies is to provide stability and physiological activity, reducing the abnormal stress that leads to adjacent segment degeneration. These methods can be applied to the step of treatment of lumbar degenerative diseases and to reduce the fusion of diseased segments. Simultaneously, it is needed to strictly grasp the indications for surgery, to identify the cause of the pain caused by low back pain and lumbar spine instability, and to select the most suitable non-fusion device for individual treatment.

Purpose To investigate estrogen receptor ( ER ) , progesterone receptor ( PR ) expression in PTEN-deficient endometrial carcinoma and to analysis the relationship of PTEN, ER and PR protein expression with histological grade, pathological staging and muscle invasive. Methods Immunohistochemistry EnVision was used to detect the expression of PTEN, ER and PR protein in 100 ca-ses of endometrial carcinoma. Results The rate of PTEN-deficient endometrial carcinoma was 52. 0% (52/100). The expression rate of ER, PR protein on PTEN-deficient endometrial carcinoma was 15. 4% (8/52), 19. 2% (10/52), respectively. And the expression rate of ER, PR protein on PTEN over-expression endometrial carcinoma was 72. 7% (8/11), 63. 6% (7/11), respectively. The rate of PTEN, ER and PR expression types shown PTEN-ER-PR- was 42. 0% (42/100), which was higher than other types (P <0. 05). Different PTEN, ER and PR expression types were well correlated with histological grade and pathological staging (P<0. 05), but not with muscle invasive. Conclusion Combined detection of PTEN, ER and PR may have an important reference value for prog-nosis and treatment of endometrial carcinoma.

Purpose To explore the clinical value of ultrasound in charactering brain anomalies in open spina bifida at 11-13+6 weeks of gestation.Materials and Methods Abdominal and transvaginal ultrasound was performed in 125 cases of normal fetus and 4 cases of confirmed open spina bifida at 11-13+6 weeks of gestation to compare the morphology of intracranial translucency (IT), diencephalon and midbrain.Results Fetal IT was readily recognized in all 125 normal cases, with diencephalons and midbrain showing number 8 shape. In 4 cases of open spina bifida, fetal IT cannot be identified, and the expected 8 shape of diencephalon and midbrain was distorted.Conclusion Fetal brain characteristics including intracranial translucency and the shape of diencephalon and midbrain in 11-13+6 weeks gestation are valuable ultrasound screening indicators for open spina bifida.

Objective To stduy the expression of PTEN ,P27 and BAG-1 in endometrial carcinoma ,and to analysis the clinical significance .Methods The expression of PTEN ,P27 and BAG-1 in 102 cases of endometrial carcinoma ,90 cases of endometrial hy-perplasia and 44 cases of normal endometrium tissue were detected by immunohistochemistry .Results PTEN and P27 in endome-trial carcinoma and hyperplasia tissue showed lower expression ,BAG-1 showed high expression in them .The expression of PTEN and BAG-1 were well correlated to histology degree and muscular infiltration .BAG-1 expression also had a well correlated to clinical stage .In this study ,we had not find a correlated between the expression of P27 and clinical and pathology characteristic of patien . PTEN expression had a Pearson relevance to P27 or BAG-1 expression ,but there was no correlation between P27 and BAG-1 .Con-clusion PTEN and P27 in endometrial carcinoma and hyperplasia tissue showed lower expression ,BAG-1 showed high expression in them .PTEN ,P27 and BAG-1 might play a role in the development of endometrial cancer .

Objective to investigate the efficacy of moxibustion treatment to rheumatoid arthritis(RA) patients and the impact to blood levels of rheumatoid factor(RF) ,C reactive protein(CRP) ,and interleukin-6(IL-6) .Methods RA patients were divided in-to treatment group and comfort group .The two groups were treated by moxibustion and sham-moxibustion for 2 courses ,respec-tievely .Results Overall clinical efficacy rate was higher in treatment group than in comfort group(P<0 .01) .The arthralgia ,ar-throcele ,tenderness and its degrees ,and morning stiffness time were significant improved in both groups(P<0 .05) ,and the indexes were better in treatment group than comfort group(P<0 .05) .The blood levels of RF ,IL-6 and CRP were reduced after treatment in both groups(P<0 .05) ,and which of treatment group reduced more than those of comfort group(P<0 .05) .Conclusion Moxi-bustion treatment can significantly improve clinical outcomes of RA and markedly reduce the blood levels of RF ,IL-6 and CRP of RA patients .

BACKGROUND:cells under mechanical stimulation can achieve their biological functions by converting mechanical signals into chemical signals through certain signal transduction mechanism. As the fibrous framework throughout a cell, cytoskeleton is one of the critical components in this process.
OBJECTIVE:Through systemical y analyzing the role of the cytoskeleton in mechanical signal transduction, to provide a potential therapeutic target for the clinical treatment of cytoskeleton related diseases.
METHODS:In order to search relevant articles about the mechanics mechanism of signal transduction of cytoskeleton from PubMed and CNKI databases (from 1990 to 2012), a computer-based search was performed, using the key words of“cytoskeleton, microtubules, microfilaments, intermediate filaments, mechanical stimulation, signal transduction”in English and Chinese, respectively. After eliminating literatures which were irrelevant to research purpose or containing a similar content, 48 articles were chosen for further analysis.
RESULTS AND CONCLUSION:Mechanical stimulation plays an important role in cellproliferation, development and apoptosis. With the gradual understanding of the biological function of cytoskeleton, people have found that cytoskeleton is one of the critical components in the process of the mechanical signal transduction. After getting mechanical stimulation, cytoskeleton can be reorganized through Rho, protein kinase C, integrin and mitogen-activated protein kinase signaling pathways, then converting the mechanical stimulation to chemical signals and finishing its biological functions final y.

OBJECTIVETo compare the radiation injuries of the temporomandibular joint (TMJ) following three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).

METHODSThirty-nine NPC patients without previous radiotherapy underwent 3D-CRT and another 32 received IMRT in our institute. The distance between the 2 dens incisivus medialis (DDIM) and LENT SOMA criteria were employed to evaluate TMJ injuries, clinical outcomes, and the performance-to-price ratios.

RESULTSThe short-term local response rates were similar between the two groups (P=0.878). The mean radiation doses of the TMJ were significantly higher in 3D-CRT group than in IMRT group (57.06 vs 40.90 Gy, P<0.001). The DDIM showed significant changes in 3D-CRT groups after the radiotherapy (P<0.05). No significant difference was found in the TMJ injuries between the two groups according to the SOMA criteria (P>0.05).

CONCLUSIONRadiation injuries of the TMJ are tolerable in both 3D-CRT and IMRT groups, and 3D-CRT is a more economic choice for patients who can not afford IMRT.

Carcinoma ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiation Injuries ; etiology ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; adverse effects ; methods ; Radiotherapy, Intensity-Modulated ; adverse effects ; methods ; Temporomandibular Joint ; injuries