The relevant clinical data were reviewed for a recipient of grade 4 portal vein thrombus undergoing reno-portal anastomosis liver transplantation on May 19, 2022. Liver function transaminase and bilirubin gradually normalized within 2 weeks after operation. An elevation of creatinine showed mild functional impairment at Day 5-7 post-operation and then recovered quickly. No portal vein thrombosis, gastrointestinal hemorrhage, ascites and other complications occurred within 2 years post-operation. The survival was excellent during 2-year follow-ups.

Merkel cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin, which is named for its ultrastructure and immunophenotype similar to Merkel cells in the skin. It has been found that the integration of MCC with the oncogenic Merkel cell polyomavirus (MCPyV) may drive tumorigenesis or cause somatic mutations to the development of MCC because of ultraviolet ray-induced DNA damage. However, the pathogenesis of MCC is still unclear. This article introduces the current research progress of the pathogenesis of MCC, hoping to provide theoretical guidance for follow-up researches.

Objective:To evaluate the protective effects of hydrogel implantation in prostate cancer patients for radiotherapy.Methods:A search was performed in PubMed, Web of Science, Cochrane Library, Embase, CNKI and VIP to collect controlled clinical research literature concerning hydrogel implantation in prostate cancer for radiotherapy. The Revman 5.3 software was used to perform meta-analyses of rectal V70, rectal D2 cm 3, rectal toxicity effects and bowel symptoms. Results:The review included ten controlled clinical trials involving 1 360 patients (690 in the hydrogel group and 670 in the control group). The result of Meta-analysis showed that the rectal V70 and rectal D2 cm 3 of prostate cancer patients in the hydrogel group were significantly lower than those in the control group( MD=-4.5, 95% CI -7.11 to -1.90, P<0.001; MD=-19.78, 95% CI -25.92 to -13.63, P<0.001), early and late G1 rectal toxic effects in the hydrogel group were significantly lower than those in the control group ( OR=0.64, 95% CI 0.45-0.90, P=0.01; OR=0.28, 95% CI 0.13-0.60, P=0.001)and the late bowel quality of life in the hydrogel group was significantly improved compared with the control group( MD=5.13, 95% CI 3.29-6.98, P<0.001). However, there were no statistically significant differences in early and late ≥G2 rectal toxic effects( OR=0.46, 95% CI 0.17-1.25, P=0.13; OR=0.44, 95% CI 0.09-2.17, P=0.31)and the early bowel symptoms( MD=2.30, 95% CI -1.31-5.91, P=0.21)between the two groups. Conclusions:Hydrogel implantation inprostate cancer for radiotherapy can reduce rectal V70 and rectal D2 cm 3, lower the early and late G1 rectal toxic effects, and reduce improve the late bowel symptoms.

Objective To report the spontaneous remission and induced remission of phospholipase A2 receptor (PLA2R)-associated idiopathic membranous nephropathy (IMN) in adults,as well as to explore the potential prognostic factors.Methods A total of 120 patients with IMN in Huashan Hospital during 2012 and 2017 were enrolled and their clinical data were collected.Results PLA2R-associated IMN patients accounted for 89.2％ of the IMN patients.Spontaneous remission occurred in 35.5％ of PLA2R-associated IMN patients.The patients with higher serum albumin and lower level of PLA2R antibody were more likely to achieve spontaneous remission (both P ＜ 0.05).Multivariate logistic regression analysis showed that male was an independent risk factor for spontaneous remission in PLA2R-associated IMN patients (OR=0.060,95％CI 0.007-0.493,P=0.009),while higher serum albumin at baseline (OR=1.480,95％ CI 1.144-1.932,P=0.004) and the improvement of serum albumin after 3 months' non-immunosuppressive treatment (OR=2.040,95％CI 1.322-3.151,P=0.001) were independent protective factors for spontaneous remission.About 42.1％ PLA2R-associated IMN patients had received immunosuppressive therapy,with induced remission rate being 70.7％.High serum albumin before treatment was an independent protective factor for induced remission (OR=1.268,95％ CI 1.014-1.585,P=0.038).Conclusions PLA2R-associated IMN accounts for most of the IMN patients,with a spontaneous remission rate of 35.5％,during the follow-up period,which is even higher in patients with higher baseline serum albumin and lower PLA2R antibody titer.Induced remission rate is 70.7％ in patients in need of immunosuppresants.The serum albumin level may be helpful in predicting spontaneous remission and response to immunosuppressive therapy.

Background:Cold storage and ischemia-reperfusion injury of liver grafts are critical for the prognosis of patients undergoing liver transplantation. Establishing a stable cold storage and reperfusion animal model is a fundamental measure for related studies. Aims:To establish a modified isolated perfused rat liver model for comprehensive assessment of liver grafts in studies on preservation of liver grafts before transplantation. Methods:Twelve Sprague-Dawley rats were randomly allocated into two groups. Livers of rats in control group were retrieved and perfused immediately for 90 minutes without preservation. In experimental group,liver grafts underwent a 30-minute warm ischemia followed by 24-hour cold storage before ex vivo perfusion. The perfusate was collected dynamically for monitoring the levels of transaminases,electrolytes and pH value;the portal vein pressure of liver grafts was measured by pressure sensor,and the hepatic hydrogen peroxide (HPO)level was assessed by microprobe for free radicals. The bile production was recorded after the ex vivo perfusion;meanwhile,the levels of malondialdehyde (MDA)and superoxide dismutase (Cu/ Zn SOD),the histopathological changes and apoptosis of hepatocytes of liver grafts were examined. Results:Compared with the control group,the levels of AST and ALT,the portal vein pressure and the HPO level of liver grafts in experimental group were obviously increased throughout the perfusion. Furthermore,the bile production and level of Cu/ Zn SOD of liver grafts in experimental group were significantly decreased. The histopathological injury and hepatocytes apoptosis of liver grafts were milder in control group. Conclusions:The liver function and antioxidant effect were reduced in warm ischemic and cold preserved liver grafts. The modified isolated perfused rat liver model established in this study is useful for monitoring and evaluation of the cold storage and reperfusion injury in liver grafts.

OBJECTIVE:To analyze the differences of inorganic elements in different parts of Saururus chinensis.METHODS:The samples were treated with microwave digestion.The contents of 25 inorganic elements were determined by inductively coupled plasma mass spectrometry (ICP-MS) method:RF power of 1 200 W,cooling gas flow of 14 L/min,auxiliary gas flow of 1.0 L/ min,atomizing air flow of 0.9 L/min,He as collision gas with flow rate of 4.8 mL/min,sampling cone aperture of 1.1 mm,skimmer cone aperture of 0.9 mm,super skimmer cone aperture of 1.0 mm,integral time of 1 s,delay time of 40 s,single hop as scanning mode,repeated for 3 times.The data of principal component analysis and partial least squares discriminant analysis were analyzed with the SIMCA-P 13.0 statistical software.RESULTS:The linear ranges of lithium (Li),beryllium (Be),boron (B),magnesium (Mg),aluminum (Al),titanium (Ti),vanadium (V),chromium (Cr),manganese (Mn),iron (Fe),cobalt (Co),nickel (Ni),copper (Cu),zinc (Zn),gallium (Ga),arsenic (As),cobalt (Sr),cadmium (Cd),tin (Sn),antimony (Sb),barium (Ba),mercury (Hg),thallium (Ti),lead (Pb) and bismuth (Bi) were 0.05-5.0 μg/L(r=0.999 9),0.05-5.0 μg/L(r=0.999 8),0.1-10.0 μg/L(r=0.999 5),1.0-100.0 μg/L(r=0.999 5),1.00-100.0 μg/L(r=0.999 3),0.10-10.0 μg/L(r=0.999 9),0.05-5.0 μg/L (r=0.999 7),0.05-5.0 μg/L(r=0.999 5),0.10-10.0 μg/L(r=0.999 8),1.00-100.0 μg/L(r=0.999 4),0.05-5.0 μg/L(r=0.999 9),0.05-5.0 μg/L(r=0.999 7),0.05-5.0 μg/L(r=0.999 5),0.05-5.0 μg/L(r=0.999 8),0.05-5.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 8),0.05-5.0 μg/L(r=0.999 9),0.05-5.0 μg/L(r=0.999 3),0.05-5.0 μg/L(r=0.999 4),0.05-5.0 μg/L(r=0.999 8),0.1-10.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 7),0.05-5.0 μg/L(r=0.999 4),respectively.The detection limits were no higher than 13.2 ng/L.RSDs of precision,stability and reproducibility tests were all lower than 5.12％.The recoveries ranged 90.18％-123.01％ (RSD were 2.05％-5.79％,n=6).The contents of Sb,Sn,Mn,Cd,Ti,Ba,Co,As,Be,Ga,Ni were higher in aerial part than in rhizome part,while the content of Cr was higher in rhizome part than in aerial part.CONCLUSIONS:Mg,Fe and A1 are abundant in aerial part and rhizome part of S.chinensis.The contents of inorganic elements are significantly different in different parts of S.chinensis.

Recently,the detection of circulating tumor cells(CTCs)in peripheral blood is used in clinical practice as a form of‘ liquid biopsy’. The self-seeding mechanism of CTCs provides a novel approach to explore the growing mechanism of malignant tumor and developing corresponding targeting therapies. A decade ago,the CellSearch system, which can capture and enumerate CTCs,has been validated by Food and Drug Administration( FDA)as an aid for monitoring the relapse of tumor after radical operation in patients with breast,prostate and colorectal cancer. In recent years,although the separation and detection technique of CTCs has been promoted significantly,the clinical significance of CTCs in tumors of digestive system is still under investigation. This article reviewed the research progress of peripheral blood CTCs in digestive system tumors.

OBJECTIVETo evaluate the diagnostic efficacy of IFIR-FIESTA technique in detecting renal artery stenosis in elderly patients.

METHODSTwenty-seven aged patients underwent both IFIR-FIESTA and 3D CE-MRA examinations. The imaging quality and renal artery stenosis grades were evaluated. Kappa test was used to assess the consistency between the two methods. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were calculated in detecting renal artery stenosis.

RESULTSThe images by the two methods were 100% qualified for diagnosis, although the image quality of CE-MRA was significantly better. IFIR-FIESTA and CE-MRA showed excellent consistency in detecting renal artery stenosis. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were 97.1%, 100%, 98.1%, 100%, and 95% in detecting renal artery stenosis, respectively.

CONCLUSIONIFIR-FIESTA is feasible as a routine examination for detecting renal artery stenosis in elderly patients.

Aged ; Aged, 80 and over ; Contrast Media ; Feasibility Studies ; Female ; Humans ; Magnetic Resonance Angiography ; methods ; Male ; Middle Aged ; Renal Artery Obstruction ; diagnosis ; Sensitivity and Specificity

Objective To evaluate the diagnostic efficacy of IFIR-FIESTA technique in detecting renal artery stenosis in elderly patients. Methods Twenty-seven aged patients underwent both IFIR-FIESTA and 3D CE-MRA examinations. The imaging quality and renal artery stenosis grades were evaluated. Kappa test was used to assess the consistency between the two methods. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were calculated in detecting renal artery stenosis. Results The images by the two methods were 100% qualified for diagnosis, although the image quality of CE-MRA was significantly better. IFIR-FIESTA and CE-MRA showed excellent consistency in detecting renal artery stenosis. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were 97.1%, 100%, 98.1%, 100%, and 95%in detecting renal artery stenosis, respectively. Conclusion IFIR-FIESTA is feasible as a routine examination for detecting renal artery stenosis in elderly patients.

Objective To evaluate the diagnostic efficacy of IFIR-FIESTA technique in detecting renal artery stenosis in elderly patients. Methods Twenty-seven aged patients underwent both IFIR-FIESTA and 3D CE-MRA examinations. The imaging quality and renal artery stenosis grades were evaluated. Kappa test was used to assess the consistency between the two methods. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were calculated in detecting renal artery stenosis. Results The images by the two methods were 100% qualified for diagnosis, although the image quality of CE-MRA was significantly better. IFIR-FIESTA and CE-MRA showed excellent consistency in detecting renal artery stenosis. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were 97.1%, 100%, 98.1%, 100%, and 95%in detecting renal artery stenosis, respectively. Conclusion IFIR-FIESTA is feasible as a routine examination for detecting renal artery stenosis in elderly patients.