Objective
To investigate the biliary complications and recovery of liver function after liver transplantation from citizen’s deceased donors (DCD) versus standard criteria donors (SCD).
Method
The clinical data of 269 patients who underwent orthotopic liver transplantation from January 2009 to December 2016 at the Fuzhou General Hospital were collected. 197 livers were from SCD and 72 from DCD. Propensity score matching (PSM) was used to compare the biliary complications and recovery of liver function after liver transplantation in the two groups.
Results
PSM matched 61 pairs of patients. There were 10 (16.4%) and 8 (13.1%) biliary complications in the DCD and the SCD groups, respectively, with no significant difference between them (P>0.05). The recovery of liver function was significantly delayed in the DCD group when compared with the SCD group. The levels of ALT, AST, GGT and AKP in the DCD group were significant different on the postoperative first, third, fifth, seventh and fourteenth day (P<0.05). At 30 days after surgery, there was no significant difference in liver function between the two groups.
Conclusions
Liver grafts from DCD had a significant impact on the recovery of liver function. When compared with the SCD group, the DCD group recovered significantly slower in liver function. There was no significant increase in the incidence of biliary complications.
Key words:
Liver transplantation; Donation after citizen’s deceased; Standard criteria donors; Liver function; Biliary complications; Propensity score matching(PSM)
Pembrolizumab plus Lenvatinib is regarded as a significant treatment option for advanced unresectable hepatocellular carcinoma (HCC). This study aims to meticulously monitor and identify adverse events (AEs) related to this combined therapy, enhance patient safety, and offer evidence-based recommendations for the appropriate use of these drugs. We gathered adverse drug reactions (ADRs)-related data from the FAERS database for HCC patients who received Pembrolizumab, both alone and in combination with Lenvatinib from the first quarter of 2014 to the fourth quarter of 2023. ADRs signal detection was performed using the ROR, PRR, BCPNN, MHRA, and MGPS methods. We gathered data on 459 and 358 AEs from patients with HCC treated with pembrolizumab alone and in combination with lenvatinib, respectively. Using four signal quantification techniques, we identified 50 and 38 distinct AEs, which were classified into 15 different System organ class (SOC) categories. Notably, the most common AEs associated with pembrolizumab were gastrointestinal disorders and hepatobiliary disorders. In both patient groups, the most frequently reported AEs were hepatic encephalopathy, blood bilirubin increased and diarrhea. We also observed some unexpected significant AEs, such as dehydration, skin ulcers, and intestinal perforation. The countries reporting the highest number of AEs were the United States, followed by China, France, and Japan. The median onset time for AEs related to pembrolizumab alone and its combination with lenvatinib was 80.5 days (interquartile range 20.0–217.3 days) and 77.5 days (interquartile range 19.7–212.3 days), respectively. This study offers new insights into the monitoring and management of ADRs in HCC patients receiving pembrolizumab alone or in combination with lenvatinib. It is crucial to closely monitor the safety of this treatment regimen in HCC patients to avoid serious AEs.
Because of the anomalous points distributed in the image, gene chip is hard to be distinguished effectively in fact. This article offers some arithmetic of image processing by VB such as increasing contrast, self-adapt thresholds, two-values and searching for spares and disperse templet which can distinguish all kinds of gene chip quickly, well and truly.
Objective: To analyse the clinical manifestation,diagnosis,emergency treatment and nursing care of aortic dissection(AD) retrospectively.Method: 80 Cases with AD hospitalized in our hospital in recent 10 years were analyzed.Result: The onset manifestations is varied,but the chest pain is the most.The diagnostic sensitivity of X-ray,Echocardiography,CT and Magnetic resonance imaging(MRI) are also difference.To control the hypertension and to relieve severe pain actively is the key to the emergency therapy.The main issues of emergency nursing care are careful observation of disease development,to prevent the accident,to enhance the mental nursing.Conclusion: The effective emergency treatment can improve its outcome,include to diagnosis promptly,to effectively control hypertension and relieve the severe pain actively,perfect nursing care,careful observation of disease development,to prevent the accident,to enhance the mental nursing.
Objective To analyze the clinic effect of Patients With ST-Elevation Acute Myocardial Infarction(STEAMI)treated with clopidogrel plus aspirin and low molecular heparin,incidence of cardiac event,ST-segment resolution(STR)and the clinical manifestation and prognosis.Methods 236 case with STEAMI,were divided into two groups:combined treatment group(CTG)(n=120)and control group(CG)(n=116).The CTG was administrated standard dose of aspirin,clopidogrel and low molecular heparin.The CG received aspirin and low molecular heparin treatment.STR,the bleeding and clotting hemostatic function of pretreatment and 3 months after treatment were observed.The incidence of cardiac event,STR and bleeding side effect of two groups after treatment were compared.The clinical manifestation and prognosis in STR group and without STR group were compared.Results The clinical effect of STEAMI with clopidogrel,aspirin and low molecular heparin is improved than the control group.Before the treatment with intravenous thrombolysis,the groups with the dose 300 mg of clopidogrel,the incidence of Spontaneous STR is higher than the groups without clopidogrel,and Spontaneous STR after acute STEAMI is associated with favorable outcomes.The incidence of cardiac event of two groups had no significant difference.But The incidence of STR is higher in the treatment group than control group(p0.01).The group with STR than the groups without STR,the difference is very significant(p0.01),including length of in-hospital days,left ventricular ejection fraction(%),atrial fibrillation,malignant ventricular arrhythmia,peak creatine kinase-isoenzyme MB,peak troponin I.The bleeding side effect is also no significant difference,and both need no drug withdrawal.Conclusion The combine treatment with clopidogrel,aspirin and low molecular heparin on acute coronary syndrome can improve the clinical outcome;can be in effect to relieve complaint of STEAMI.Can cut down the incidence of cardiac event,and the combine treatment is safe.STR may be a prognosis factor of patient with STEAMI.
High recurrence rate in HCC is the primary cause of the poor prognosis after hepatectomy. Therefore, in this study, we aimed to construct a gene signature for predicting the recurrence rate in HCC. The mRNA expression profiles and clinical information of HCC patients from GEO and TCGA databases were used, and ferroptosis-related gene list was obtained from the FerrDb database. We identified 39 ferroptosis-related genes (FDEGs) that were differentially expressed between HCC samples and normal tissues from the GSE14520 dataset. The univariate and multivariate Cox regression analyses were employed to construct a prognostic signature. Seven FDEGs (MAPK9, SLC1A4, PCK2, ACSL3, STMN1, CDO1, and CXCL2) were included to construct a risk model, which was validated in the TCGA dataset. Patients in high-risk groups exhibited a significantly poor prognosis compared with patients in low-risk groups in both the training set (GSE14520 cohort) and the validation set (TCGA cohort). Multivariate cox regression analyses demonstrated that the 7-gene signature was an independent risk factor for RFS in HCC patients. KEGG analysis showed that FDEGs were mainly enriched in Ferroptosis, Hepatocellular carcinoma pathway, and MAPK signaling pathway. GSEA analysis suggested that the high-risk group was correlated with multiple oncogenic signatures and invasive-related pathways. These results indicated that this risk model can accurately predict recurrence after hepatectomy and offer novel research directions for personalized treatment in HCC patients.
Small nuclear ribonucleoprotein Sm D1 (SNRPD1), one of the crucial genes encoding core spliceosome components, was abnormally highly expressed in multiple types of tumors. In this study, we investigated the diagnostic and prognostic significance of SNRPD1 in hepatocellular carcinoma (HCC). The investigation of datasets from GEO and TCGA databases revealed that SNRPD1 expression in HCC was significantly higher than adjacent normal liver tissues, which was validated by immunohistochemistry (IHC). Both GO, KEGG analysis showed that the SNRPD1 co-expressed genes mainly enriched in Cell division, Nuclear import, mRNA splicing via spliceosome, Ribosome, Cell cycle, etc. Survival analysis from the GSE14520 dataset and 154 HCC cohorts exhibited a significant association of high SNRPD1 expression with poor overall survival and recurrence-free survival. ROC analysis showed that the abnormally high SNRPD1 mRNA expression has diagnostic significance in distinguishing between HCC and normal liver tissue (AUC = 0.819). Gene set enrichment analysis (GSEA) demonstrated that the high expression of SNRPD1 might regulate HCC tumorigenesis and progression by affecting the cell cycle, mismatch repair, DNA replication, and RNA degradation, etc. The luciferase report assay revealed that SNRPD1 was the direct target gene of miR-100 manifested by decreased SNRPD1 expression and luciferase activity in the HCC cells upon miR-100 overexpression. Finally, SNRPD1 may as an oncogene affecting the progression of HCC through regulates the mTOR pathway and autophagy.
Gastric cancer is considered to be one of the most common causes of cancer death worldwide due to its high recurrence and metastasis rates. The molecule 23,24-Dihydrocucurbitacin E (DHCE) is a cucurbitacin-derived tetracyclic triterpenoid compound that has anti-tumor activity, but the exact mechanism remains to be elucidated. This research aimed to explore the effects of DHCE on human gastric cancer cells and the possible mechanisms. The results showed that DHCE suppressed proliferation, migration, and invasion of gastric cancer cells, as well as induced apoptosis and G2/M phase arrest. Mechanistically, the potential targets and pathways of DHCE were predicted using database screening and verified using a molecular docking study, fluorescence staining, and Western blot. The results indicated that DHCE obviously inhibited the kinase activity of ERK2 via targeting its ATP-binding domain, destroyed F-actin microfilament, and reduced the expression levels of Ras, p-c-Raf, ERK, p-ERK, and MMP9 proteins. Collectively, our study demonstrated that DHCE suppressed gastric cancer cells' proliferation, migration, and invasion through targeting ERK2 and disrupting the Ras/Raf/ERK/MMP9 signaling pathway. These properties make DHCE a promising candidate drug for the further design and development of novel and effective Ras/Raf/ERK/MMP9 pathway inhibitors for treating gastric cancer.
Allium is a common functional vegetable with edible and medicinal value. Allium plants have a special spicy taste, so they are often used as food and seasoning in people’s diets. As a functional food, Allium also has abundant biological activities, some of which are used as drugs to treat diseases. By consuming Allium on a daily basis, people can receive active compounds of natural origin, thereby improving their health status and reducing the likelihood of disease. Steroidal saponins are important secondary metabolites of Allium, which are formed by the steroidal aglycone group and sugar. Steroidal saponins have various physiological activities, such as hypoglycemic, antiplatelet aggregation, anti-inflammatory, antitumor, antimicrobial, and enzyme activity inhibition, which is one of the key reasons why Allium has such significant health benefits. The structural diversity and rich biological activities of steroidal saponins make Allium important plants for both food and medicine. In this paper, the chemical structures, biological activities, and structure–activity relationships of steroidal saponins isolated from Allium are reviewed, and the biosynthetic pathways of some key compounds are proposed as well, to provide a molecular reference basis based on secondary metabolites for the health value of Allium.
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