Background:Ex vivo lung perfusion(EVLP)allows the evaluation of lungs that do not meet standard transplantation criteria.Current procedures do not permit the identification of regional functional deficits.We investiga...Background:Ex vivo lung perfusion(EVLP)allows the evaluation of lungs that do not meet standard transplantation criteria.Current procedures do not permit the identification of regional functional deficits.We investigated the feasibility of assessing lobar gas exchange during EVLP in a swine model.Methods:In five healthy swine,lungs were procured with beating heart and connected to an open-atrium EVLP circuit.Each pulmonary vein was cannulated for lobar perfusate sampling.After baseline assessment,the left inferior bronchus(LIB)and then the left superior bronchus(LSB)were temporarily clamped to simulate localized injury.At each step,perfusate gas analyses from each vein and the left atrium(LA),lung mechanics,pulmonary hemodynamics,and computed tomography(CT)were obtained.Results:At baseline,no differences were observed between LA and lobar samples.Occlusion of LIB and LSB produced up to 95%non-or poorly aerated tissue in the affected lobe,with lobar shunt increasing to 97%[88%–103%](LIB)and 97%[78%–106%](LSB).Corresponding lobar PaO2/FiO2 fell to 47[46–54]and 45[43–67]mm Hg,whereas LA-mixed venous blood maintained higher values(299[188–373]and 349[347–377]mm Hg,respectively).Bronchial occlusions caused overall significant worsening of lung function,including increased pulmonary vascular resistance,and reduction in total air lung volume and normally aerated tissue on CT scan analysis.In Left Inferior Lobe(LIL),histological samples showed significant interstitial congestion and alveolar hemorrhage.Conclusions:Lobar-specific perfusate gas analysis during EVLP provides accurate functional assessment and enables the localization of lung injury,potentially improving graft evaluation before transplantation.展开更多
Background: Traumatic amputations have increased worldwide over the past two decades and are expected to increase by 72% by 2050. Surgical replantation provides superior functional recovery and patient satisfaction bu...Background: Traumatic amputations have increased worldwide over the past two decades and are expected to increase by 72% by 2050. Surgical replantation provides superior functional recovery and patient satisfaction but is limited to specialized centers and restricted by short ischemia times, due to life-over-limb prioritization in patient care. To overcome these limitations, we developed an ex vivo limb perfusion system(EVEP) to extend limb viability and, for the first time, investigate its impact on peripheral nerve regeneration, a key prerequisite for functional recovery following replantation.Methods: Hind limbs of 6 healthy pigs were amputated, and after 2 h of warm ischemia, limbs were either perfused normothermally for 6 h with PerfadexPlus®±medication using in-house developed EVEP or stored statically(4 ℃ vs. room temperature). Perfusion parameters, blood gas analysis, serum markers, cytokine levels, thermal imaging, colloid oncotic pressure, weight gain, joint mobility, peripheral nerve histomorphometric and stereological analyses were performed.Results: Data confirm a valid and reliable EVEP with an optimized perfusion protocol. Comparison of perfusion groups revealed lower serum injury markers in the medication group, which included methylprednisolone treatment. Additionally, the medication group exhibited reduced weight gain and preserved unrestricted joint mobility, but concurrently led to a significant decrease in pro-regenerative cytokine levels associated with Wallerian degeneration(WD).Conclusions: In general, EVEP mitigates ischemia-related damage and facilitates ex vivo induction of WD, a critical prerequisite for nerve regeneration, functional recovery, and prevention of neuroma formation with subsequent phantom pain, by establishing the pro-regenerative environment for WD, which is further amplified by omitting the anti-inflammatory methylprednisolone.展开更多
Successful ex situ conservation of plant populations requires a high degree of genetic representativeness.However,spatially biased sampling in ex situ conservation efforts may fail to capture all wild genetic clusters...Successful ex situ conservation of plant populations requires a high degree of genetic representativeness.However,spatially biased sampling in ex situ conservation efforts may fail to capture all wild genetic clusters for species with range-wide genetic structure.To investigate the extent of spatially biased sampling in living collections and the coverage of wild genetic clusters in plant populations under ex situ conservation worldwide,we combined a global synthesis of ex situ conservation efforts with a case study of an endangered riparian plant species,Myricaria laxiflora.Our analysis of ex situ conservation worldwide revealed that the majority(82.6%)of ex situ populations fail to cover all wild genetic clusters,largely due to spatially biased sampling with low geographic coverage.Our case study of M.laxiflora showed that genetic diversity differed between the ex situ and upstream populations,while it was comparable between ex situ populations and other wild populations.However,current ex situ populations did not cover all wild genetic clusters,as the upstream genetic cluster was previously uncollected.Our study suggests that the failure to cover all wild genetic clusters in ex situ populations is a widespread issue,and ex situ populations with high genetic diversity can also fail to cover all wild genetic clusters.In future ex situ conservation programs,both the importance of high genetic diversity and the high coverage of wild genetic clusters should be prioritized.展开更多
To the Editor:We paid attention to the recent article by Xiao et al.[1].They reviewed a new strategy for expanding the allograft pool,which involves using otherwise-wasted resected liver lobes from patients with large...To the Editor:We paid attention to the recent article by Xiao et al.[1].They reviewed a new strategy for expanding the allograft pool,which involves using otherwise-wasted resected liver lobes from patients with large,symptomatic benign liver tumors as liver transplant donors.Liver transplantation is the ultimate curative treatment for patients with acute or chronic end-stage liver diseases,or malignant liver tumors,but it is restricted due to the limited availability of donor organs.展开更多
Exendin-4(Exe),a glucagon-like peptide-1(GLP-1)receptor agonist,has a protective effect on pancreaticβcells;however,its underlying mechanism is not well understood.In this study,Exendin-4 exhibited a higher antioxida...Exendin-4(Exe),a glucagon-like peptide-1(GLP-1)receptor agonist,has a protective effect on pancreaticβcells;however,its underlying mechanism is not well understood.In this study,Exendin-4 exhibited a higher antioxidant ability and protected MIN6 cells from high glucose-induced oxidative damage by reducing reactive oxygen species(ROS)production(P<0.01),and maintaining mitochondrial function in pancreaticβcells.The beneficial effects of Exendin-4 included increased cell viability(P<0.05)and insulin secretion(P<0.05),as well as improved mitochondrial membrane potential(MMP)(P<0.01)and ATP levels(P<0.05).Additionally,Exendin-4 inhibited lactate dehydrogenase(LDH)activity(P<0.001)and reduced intracellular malondialdehyde(MDA)levels(P<0.01),and boosted the activities of antioxidant enzymes such as superoxide dismutase(SOD)(P<0.01)and catalase(CAT)(P<0.01).Glutaredoxins(Grxs)were identified as glutathione(GSH)-dependent oxidoreductases,and the Grx/GSH system is commonly referred to as the cellular antioxidant system acting in the defense of pancreaticβcells against oxidative stress and the mitochondrial damage.Our findings revealed that Exendin-4 significantly enhanced the protein expression levels of glutaredoxin 1(Grx1),glutaredoxin 2(Grx2)and glutathione reductase(GR)(P<0.05),and improved the GSH/GSSG ratio(P<0.01)and NADPH/NADP+ratio(P<0.05).These results indicate that Exendin-4 improved the function of pancreatic cells under high glucose condition.The underlying mechanism involves increasing the expression levels of key proteins in the glutaredoxin system and inhibiting the dysfunction of the Grx/GSH system,thereby reducing mitochondrial oxidative damage and functional disorders.展开更多
Transcription factor-mediated cell conversion has been reported in the central nervous system of both rodents and nonhuman primates.In particular,glia-to-neuron conversion has been achieved in the brain and spinal cor...Transcription factor-mediated cell conversion has been reported in the central nervous system of both rodents and nonhuman primates.In particular,glia-to-neuron conversion has been achieved in the brain and spinal cord of animal models for neural regeneration and repair.However,whether glia-to-neuron conversion can be used for brain repair in humans needs to be explored.To investigate the use of glia-to-neuron conversion technology in the human brain,we established a long-term ex vivo culture system using human brain tissue that was surgically removed from epileptic patients to test glia-to-neuron conversion directly.We found that neural transcription factors NeuroD1 and Ascl1 both converted human glial cells into neurons.Immunostaining and electrophysiological recordings showed that the glia-converted neurons demonstrated immature properties during the initial 7-14 days of conversion,and then acquired more mature neuronal properties after 21-27 days of conversion.These ex vivo conversion studies in human brain tissue pave the way toward future clinical trials using a transcription factor-based glia-to-neuron conversion approach to treat neurological disorders.展开更多
Cellular immunotherapy has transformed cancer treatment in recent years,with chimeric antigen receptor(CAR)-T cell therapy emerging as one of the most important breakthroughs.Since the first CAR-T products were approv...Cellular immunotherapy has transformed cancer treatment in recent years,with chimeric antigen receptor(CAR)-T cell therapy emerging as one of the most important breakthroughs.Since the first CAR-T products were approved,this therapy has demonstrated remarkable efficacy in hematological malignancies,particularly in relapsed or refractory B-cell cancers.As reported,antiCD19 CAR-T cell therapy has produced remarkable clinical responses in B-cell acute lymphoblastic leukemia(B-ALL)and B-cell lymphomas,with complete remission rates exceeding 80%in many clinical trials.展开更多
Background:Ex vivo liver resection and autotransplantation(ELRA)offers new therapeutic perspectives and possibilities for R0 resection in patients with hepatic alveolar echinococcosis(AE)combined with cavernous transf...Background:Ex vivo liver resection and autotransplantation(ELRA)offers new therapeutic perspectives and possibilities for R0 resection in patients with hepatic alveolar echinococcosis(AE)combined with cavernous transformation of the portal vein(CTPV).Methods:We analyzed 49 hepatic AE patients with CTPV treated at our center from January 2010 to June 2023.We compared the different outcomes with different treatments for the 49 patients:ELRA for 12 and conservative for 9 patients.After propensity score matching,we compared the ELRA treatment outcomes for 12 patients with CTPV and 24 patients without CTPV.Kaplan-Meier analysis was used to compare overall survival,and Cox regression to identify factors influencing postoperative survival.Results:In the ELRA cohort,both CTPV and non-CTPV patients had no intraoperative mortality;90-day mortality rate for both groups was 16.7%(2/12 in CTPV patients and 4/24 in non-CTPV patients).Pleural effusion was the most common postoperative complication.CTPV patients required significantly longer operative time and more intraoperative blood transfusions(P0.05).In the CTPV cohort,patients who underwent ELRA had significantly better long-term survival compared to those who did not receive surgery(72.9%vs.29.6%,P<0.05).Extrahepatic AE disease,rather than CTPV,was identified as an independent risk factor for postoperative survival(P<0.05).Conclusions:ELRA is a safe and effective approach for hepatic AE patients with CTPV,significantly improving long-term survival.CTPV itself does not negatively impact postoperative survival,further emphasizing the benefits of this procedure in this particular population.展开更多
Background:Ex vivo lung perfusion(EVLP)has emerged as a critical technique for lung preservation and evaluation prior to transplantation.While conventional rat EVLP systems utilize closed-loop dual cannulation of pulm...Background:Ex vivo lung perfusion(EVLP)has emerged as a critical technique for lung preservation and evaluation prior to transplantation.While conventional rat EVLP systems utilize closed-loop dual cannulation of pulmonary artery(PA)and vein,the effect of the simplified model using single PA cannulation with passive venous drainage is unknown.Methods:We developed two EVLP models in rats:a semi-closed circuit with PA-only cannulation and left atrial incision for passive venous drainage(SC-EVLP),and a closed circuit employing both arterial and venous cannulation(C-EVLP).Donor lungs were perfused for a defined duration and subsequently orthotopically transplanted.We evaluated pulmonary function parameters,histopathological injury scores,inflammatory cytokine levels,and apoptotic marker expression at the end of perfusion and posttransplantation.Results:Compared to the conventional EVLP,the SC-EVLP group exhibited significantly lower PA pressure and improved dynamic lung compliance throughout perfusion.Although the levels of tumor necrosis factor-αin the perfusate were higher in the SC-EVLP group,other cytokine levels in the perfusate and bronchoalveolar lavage fluid exhibited no significant differences.Pulmonary edema was reduced in the SC-EVLP group,as indicated by a lower lung wet-to-dry ratio.After transplantation,lungs from the SC-EVLP group exhibited lower histological injury scores,reduced apoptosis,and decreased serum cytokine levels,suggesting attenuated inflammation and tissue damage.Conclusions:In a rat model,single PA cannulation with passive venous drainage reduced pulmonary edema during EVLP and reduced lung injury and systemic inflammation after transplantation.展开更多
BACKGROUND Liver transplantation is the only treatment for acute and chronic liver failure,but the global organ shortage has increased reliance on extended criteria donor livers,which are more susceptible to ischemia-...BACKGROUND Liver transplantation is the only treatment for acute and chronic liver failure,but the global organ shortage has increased reliance on extended criteria donor livers,which are more susceptible to ischemia-reperfusion injury.While static cold storage is standard,these grafts often require improved preservation strategies.AIM To summarize the current state of small animal liver machine perfusion(MP),highlight variability in protocols,and emphasize the need for standardization to guide future research.METHODS A comprehensive literature search of PubMed was conducted to identify studies on small animal(rat and mouse)ex vivo liver MP.Only English-language animal studies were included,with no restrictions on publication date.Relevant full-text articles were reviewed,and reference lists were screened to ensure completeness.RESULTS Small animal liver MP provides a cost-effective model to explore dynamic preservation strategies.Rat perfusion studies face challenges including dual-vessel perfusion,maintaining physiological perfusate volumes,and lack of standardized protocols.Open-and closed-circuit setups have distinct advantages and limitations,and experimental designs vary widely across studies.CONCLUSION This review illustrates the wide variability in small animal liver MP protocols and underscores the urgent need for standardization.Addressing these inconsistencies will enhance reproducibility,facilitate comparison across studies,and support the development of optimized liver preservation strategies.展开更多
Analog Relax是一个来自日本的模拟音响制品的品牌,其主脑及设计师Yasushi Yurugi万木康史出生于京都,是一位不折不扣的模拟音色的追随者。因此,他一直提倡“模拟生活”这种由心底而发……那种悠然自得的安逸理念。从大学后投身成为产...Analog Relax是一个来自日本的模拟音响制品的品牌,其主脑及设计师Yasushi Yurugi万木康史出生于京都,是一位不折不扣的模拟音色的追随者。因此,他一直提倡“模拟生活”这种由心底而发……那种悠然自得的安逸理念。从大学后投身成为产品设计师的万木先生,也随波逐流地就职于数码和互联网技术公司,在这个网络世界中,他吸收了多项研发和市场经验。展开更多
The net primary productivity(NPP) is an important indicator for assessing the carbon sequestration capacities of different ecosystems and plays a crucial role in the global biosphere carbon cycle. However, in the cont...The net primary productivity(NPP) is an important indicator for assessing the carbon sequestration capacities of different ecosystems and plays a crucial role in the global biosphere carbon cycle. However, in the context of the increasing frequency, intensity, and duration of global extreme climate events, the impacts of extreme climate and vegetation phenology on NPP are still unclear, especially on the Qinghai-Xizang Plateau(QXP), China. In this study, we used a new data fusion method based on the MOD13A2 normalized difference vegetation index(NDVI) and the Global Inventory Modeling and Mapping Studies(GIMMS) NDVI3g datasets to obtain a NDVI dataset(1982–2020) on the QXP. Then, we developed a NPP dataset across the QXP using the Carnegie-Ames-Stanford Approach(CASA) model and validated its applicability based on gauged NPP data. Subsequently, we calculated 18 extreme climate indices based on the CN05.1 dataset, and extracted the length of vegetation growing season using the threshold method and double logistic model based on the annual NDVI time series. Finally, we explored the spatiotemporal patterns of NPP on the QXP and the impact mechanisms of extreme climate and the length of vegetation growing season on NPP. The results indicated that the estimated NPP exhibited good applicability. Specifically, the correlation coefficient, relative bias, mean error, and root mean square error between the estimated NPP and gauged NPP were 0.76, 0.17, 52.89 g C/(m2·a), and 217.52 g C/(m2·a), respectively. The NPP of alpine meadow, alpine steppe, forest, and main ecosystem on the QXP mainly exhibited an increasing trend during 1982–2020, with rates of 0.35, 0.38, 1.40, and 0.48 g C/(m2·a), respectively. Spatially, the NPP gradually decreased from southeast to northwest across the QXP. Extreme climate had greater impact on NPP than the length of vegetation growing season on the QXP. Specifically, the increase in extremely-wet-day precipitation(R99p), simple daily intensity index(SDII), and hottest day(TXx) increased the NPP in different ecosystems across the QXP, while the increases in the cold spell duration index(CSDI) and warm spell duration index(WSDI) decreased the NPP in these ecosystems. The results of this study provide a scientific basis for relevant departments to formulate future policies addressing the impact of extreme climate on vegetation in different ecosystems on the QXP.展开更多
Crotalaria ferruginea Graham ex Benth.is a commonly used herb among ethnic minorities.Its whole plant is used as medicine for conditions such as heatstroke,tinnitus,hearing loss,phlegm heat cough,gum swelling and pain...Crotalaria ferruginea Graham ex Benth.is a commonly used herb among ethnic minorities.Its whole plant is used as medicine for conditions such as heatstroke,tinnitus,hearing loss,phlegm heat cough,gum swelling and pain,lower back and knee pain,vaginal discharge and infantile malnutrition.Modern pharmaceutical research has found that Crotalaria ferruginea Graham ex Benth.mainly contains flavonoids,steroids,organic acids and terpenes,which have antibacterial,free radical scavenging,antiinflammatory and other effects.Quality control mainly focuses on characteristics,identification,content determination,etc.This article summarizes the recent research progress on the chemical composition,pharmacological effects,quality control and extraction process of Crotalaria ferruginea Graham ex Benth.on the basis of existing Crotalaria ferruginea Graham ex Benth.research reports.展开更多
BACKGROUND Echinococcosis,caused by Echinococcus parasites,includes alveolar echinococcosis(AE),the most lethal form,primarily affecting the liver with a 90%mortality rate without prompt treatment.While radical surger...BACKGROUND Echinococcosis,caused by Echinococcus parasites,includes alveolar echinococcosis(AE),the most lethal form,primarily affecting the liver with a 90%mortality rate without prompt treatment.While radical surgery combined with antiparasitic therapy is ideal,many patients present late,missing hepatectomy opportunities.Ex vivo liver resection and autotransplantation(ELRA)offers hope for such patients.Traditional surgical decision-making,relying on clinical experience,is prone to bias.Machine learning can enhance decision-making by identifying key factors influencing surgical choices.This study innovatively employs multiple machine learning methods by integrating various feature selection techniques and SHapley Additive exPlanations(SHAP)interpretive analysis to deeply explore the key decision factors influencing surgical strategies.AIM To determine the key preoperative factors influencing surgical decision-making in hepatic AE(HAE)using machine learning.METHODS This was a retrospective cohort study at the First Affiliated Hospital of Xinjiang Medical University(July 2010 to August 2024).There were 710 HAE patients(545 hepatectomy and 165 ELRA)with complete clinical data.Data included demographics,laboratory indicators,imaging,and pathology.Feature selection was performed using recursive feature elimination,minimum redundancy maximum relevance,and least absolute shrinkage and selection operator regression,with the intersection of these methods yielding 10 critical features.Eleven machinelearning algorithms were compared,with eXtreme Gradient Boosting(XGBoost)optimized using Bayesian optimization.Model interpretability was assessed using SHAP analysis.RESULTS The XGBoost model achieved an area under the curve of 0.935 in the training set and 0.734 in the validation set.The optimal threshold(0.28)yielded sensitivity of 93.6%and specificity of 90.9%.SHAP analysis identified type of vascular invasion as the most important feature,followed by platelet count and prothrombin time.Lesions invading the hepatic vein,inferior vena cava,or multiple vessels significantly increased the likelihood of ELRA.Calibration curves showed good agreement between predicted and observed probabilities(0.2-0.7 range).The model demonstrated high net clinical benefit in Decision Curve Analysis,with accuracy of 0.837,recall of 0.745,and F1 score of 0.788.CONCLUSION Vascular invasion is the dominant factor influencing the choice of surgical approach in HAE.Machine-learning models,particularly XGBoost,can provide transparent and data-driven support for personalized decision-making.展开更多
Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been propo...Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.展开更多
Although Steen's solution plays a crucial role in maintaining vascular oncotic pressure and reducing pulmonary edema due to its high concentration of human serum albumin during ex vivo lung perfusion(EVLP),it incu...Although Steen's solution plays a crucial role in maintaining vascular oncotic pressure and reducing pulmonary edema due to its high concentration of human serum albumin during ex vivo lung perfusion(EVLP),it incurs high costs and potential immune responses in rat models.In our preliminary research,donor lungs perfused with Steen's solution exhibited significant lung injury post transplantation,likely due to a strong immune response elicited by the high concentration of xenogenic proteins upon reperfusion.This study explores a low-cost and efficient perfusate composition for use in rat EVLP and lung transplant models.The modified perfusate employed in this study uses artificial colloids as the primary component,with an albumin concentration of only 2%,demonstrating comparable physiological parameters,metabolic levels,and pathological changes to those of Steen's solution during EVLP.Moreover,the modified composition exhibited good biocompatibility in transplantation,with minimal lung injury.In summary,the proposed perfusate offers a safer and more economical alternative for establishing rat EVLP and lung transplant models,facilitating the advancement of related research.展开更多
基金supported by“5×1000”2014,devolved to Fondazione IRCCS Ca′Granda Ospedale Maggiore Policlinico“Improvement of perfusion of isolated organs before transplantation through perfusion fluid optimization”and“Implementation of strategies for laboratory animal care,”the Italian Ministry of Health—Current Research IRCCS。
摘要Background:Ex vivo lung perfusion(EVLP)allows the evaluation of lungs that do not meet standard transplantation criteria.Current procedures do not permit the identification of regional functional deficits.We investigated the feasibility of assessing lobar gas exchange during EVLP in a swine model.Methods:In five healthy swine,lungs were procured with beating heart and connected to an open-atrium EVLP circuit.Each pulmonary vein was cannulated for lobar perfusate sampling.After baseline assessment,the left inferior bronchus(LIB)and then the left superior bronchus(LSB)were temporarily clamped to simulate localized injury.At each step,perfusate gas analyses from each vein and the left atrium(LA),lung mechanics,pulmonary hemodynamics,and computed tomography(CT)were obtained.Results:At baseline,no differences were observed between LA and lobar samples.Occlusion of LIB and LSB produced up to 95%non-or poorly aerated tissue in the affected lobe,with lobar shunt increasing to 97%[88%–103%](LIB)and 97%[78%–106%](LSB).Corresponding lobar PaO2/FiO2 fell to 47[46–54]and 45[43–67]mm Hg,whereas LA-mixed venous blood maintained higher values(299[188–373]and 349[347–377]mm Hg,respectively).Bronchial occlusions caused overall significant worsening of lung function,including increased pulmonary vascular resistance,and reduction in total air lung volume and normally aerated tissue on CT scan analysis.In Left Inferior Lobe(LIL),histological samples showed significant interstitial congestion and alveolar hemorrhage.Conclusions:Lobar-specific perfusate gas analysis during EVLP provides accurate functional assessment and enables the localization of lung injury,potentially improving graft evaluation before transplantation.
基金funded by a contract of the German Armed Forces(E/U2ED/LD008/KF558)the German Research Foundation(DFGSPP2014:347346497,447746988 and 347368182,and KFO311 Unloading&Repair:286251789).
摘要Background: Traumatic amputations have increased worldwide over the past two decades and are expected to increase by 72% by 2050. Surgical replantation provides superior functional recovery and patient satisfaction but is limited to specialized centers and restricted by short ischemia times, due to life-over-limb prioritization in patient care. To overcome these limitations, we developed an ex vivo limb perfusion system(EVEP) to extend limb viability and, for the first time, investigate its impact on peripheral nerve regeneration, a key prerequisite for functional recovery following replantation.Methods: Hind limbs of 6 healthy pigs were amputated, and after 2 h of warm ischemia, limbs were either perfused normothermally for 6 h with PerfadexPlus®±medication using in-house developed EVEP or stored statically(4 ℃ vs. room temperature). Perfusion parameters, blood gas analysis, serum markers, cytokine levels, thermal imaging, colloid oncotic pressure, weight gain, joint mobility, peripheral nerve histomorphometric and stereological analyses were performed.Results: Data confirm a valid and reliable EVEP with an optimized perfusion protocol. Comparison of perfusion groups revealed lower serum injury markers in the medication group, which included methylprednisolone treatment. Additionally, the medication group exhibited reduced weight gain and preserved unrestricted joint mobility, but concurrently led to a significant decrease in pro-regenerative cytokine levels associated with Wallerian degeneration(WD).Conclusions: In general, EVEP mitigates ischemia-related damage and facilitates ex vivo induction of WD, a critical prerequisite for nerve regeneration, functional recovery, and prevention of neuroma formation with subsequent phantom pain, by establishing the pro-regenerative environment for WD, which is further amplified by omitting the anti-inflammatory methylprednisolone.
基金supported by National Key Research and Development Program of China(2024YFF1307400)Hubei Provincial Natural Science Foundation and Three Gorges Innovation Development Joint Fund(Grant No.2023AFD195)China Three Gorges Corporation(NBZZ202300130).
摘要Successful ex situ conservation of plant populations requires a high degree of genetic representativeness.However,spatially biased sampling in ex situ conservation efforts may fail to capture all wild genetic clusters for species with range-wide genetic structure.To investigate the extent of spatially biased sampling in living collections and the coverage of wild genetic clusters in plant populations under ex situ conservation worldwide,we combined a global synthesis of ex situ conservation efforts with a case study of an endangered riparian plant species,Myricaria laxiflora.Our analysis of ex situ conservation worldwide revealed that the majority(82.6%)of ex situ populations fail to cover all wild genetic clusters,largely due to spatially biased sampling with low geographic coverage.Our case study of M.laxiflora showed that genetic diversity differed between the ex situ and upstream populations,while it was comparable between ex situ populations and other wild populations.However,current ex situ populations did not cover all wild genetic clusters,as the upstream genetic cluster was previously uncollected.Our study suggests that the failure to cover all wild genetic clusters in ex situ populations is a widespread issue,and ex situ populations with high genetic diversity can also fail to cover all wild genetic clusters.In future ex situ conservation programs,both the importance of high genetic diversity and the high coverage of wild genetic clusters should be prioritized.
摘要To the Editor:We paid attention to the recent article by Xiao et al.[1].They reviewed a new strategy for expanding the allograft pool,which involves using otherwise-wasted resected liver lobes from patients with large,symptomatic benign liver tumors as liver transplant donors.Liver transplantation is the ultimate curative treatment for patients with acute or chronic end-stage liver diseases,or malignant liver tumors,but it is restricted due to the limited availability of donor organs.
基金Supported by Heilongjiang Department of Education Foundation(No.2024-KYYWF-0347 and No.2022-KYYWF-0784)Heilongjiang University Students Innovation and Entrepreneurship Training Program(No.202211230037 and X202311230008)+2 种基金Graduate Student Innovation Fund of Qiqihar Medical University(No.QYYCX2023-08)Construction Project of Dominant Characteristic Disciplines of Qiqihar Medical University(No.QYZDXK-003)Health Commission Foundation of Heilongjiang Province(No.20230202040436)。
摘要Exendin-4(Exe),a glucagon-like peptide-1(GLP-1)receptor agonist,has a protective effect on pancreaticβcells;however,its underlying mechanism is not well understood.In this study,Exendin-4 exhibited a higher antioxidant ability and protected MIN6 cells from high glucose-induced oxidative damage by reducing reactive oxygen species(ROS)production(P<0.01),and maintaining mitochondrial function in pancreaticβcells.The beneficial effects of Exendin-4 included increased cell viability(P<0.05)and insulin secretion(P<0.05),as well as improved mitochondrial membrane potential(MMP)(P<0.01)and ATP levels(P<0.05).Additionally,Exendin-4 inhibited lactate dehydrogenase(LDH)activity(P<0.001)and reduced intracellular malondialdehyde(MDA)levels(P<0.01),and boosted the activities of antioxidant enzymes such as superoxide dismutase(SOD)(P<0.01)and catalase(CAT)(P<0.01).Glutaredoxins(Grxs)were identified as glutathione(GSH)-dependent oxidoreductases,and the Grx/GSH system is commonly referred to as the cellular antioxidant system acting in the defense of pancreaticβcells against oxidative stress and the mitochondrial damage.Our findings revealed that Exendin-4 significantly enhanced the protein expression levels of glutaredoxin 1(Grx1),glutaredoxin 2(Grx2)and glutathione reductase(GR)(P<0.05),and improved the GSH/GSSG ratio(P<0.01)and NADPH/NADP+ratio(P<0.05).These results indicate that Exendin-4 improved the function of pancreatic cells under high glucose condition.The underlying mechanism involves increasing the expression levels of key proteins in the glutaredoxin system and inhibiting the dysfunction of the Grx/GSH system,thereby reducing mitochondrial oxidative damage and functional disorders.
基金supported by the Key Project of Guangzhou City,No.202206060002(to GC)the Guangdong Province Science and Technology Project of China,No.2018B030332001(to GC)+1 种基金the Natural Science Foundation of Guangdong Province of China,No.2020A1515010854(to QW)the Yi-Liang Liu Endowment Fund from Jinan University Education Development Foundation。
摘要Transcription factor-mediated cell conversion has been reported in the central nervous system of both rodents and nonhuman primates.In particular,glia-to-neuron conversion has been achieved in the brain and spinal cord of animal models for neural regeneration and repair.However,whether glia-to-neuron conversion can be used for brain repair in humans needs to be explored.To investigate the use of glia-to-neuron conversion technology in the human brain,we established a long-term ex vivo culture system using human brain tissue that was surgically removed from epileptic patients to test glia-to-neuron conversion directly.We found that neural transcription factors NeuroD1 and Ascl1 both converted human glial cells into neurons.Immunostaining and electrophysiological recordings showed that the glia-converted neurons demonstrated immature properties during the initial 7-14 days of conversion,and then acquired more mature neuronal properties after 21-27 days of conversion.These ex vivo conversion studies in human brain tissue pave the way toward future clinical trials using a transcription factor-based glia-to-neuron conversion approach to treat neurological disorders.
基金supported by Beijing Municipal Science&Technology Commission,Administrative Commission of Zhongguancun Science Park(No.Z241100009024043)S&T Program of Hebei(No.254X9092D)+1 种基金S&T Program of Xiongan New Area(No.XA202501102002K)Beijing Nova Program(No.20220484076)。
摘要Cellular immunotherapy has transformed cancer treatment in recent years,with chimeric antigen receptor(CAR)-T cell therapy emerging as one of the most important breakthroughs.Since the first CAR-T products were approved,this therapy has demonstrated remarkable efficacy in hematological malignancies,particularly in relapsed or refractory B-cell cancers.As reported,antiCD19 CAR-T cell therapy has produced remarkable clinical responses in B-cell acute lymphoblastic leukemia(B-ALL)and B-cell lymphomas,with complete remission rates exceeding 80%in many clinical trials.
基金supported by grants from the Key Project of Xinjiang Uygur Autonomous Region Natural Science Foundation(2022D01D17)the National Natural Science Foundation of China(82360111)。
摘要Background:Ex vivo liver resection and autotransplantation(ELRA)offers new therapeutic perspectives and possibilities for R0 resection in patients with hepatic alveolar echinococcosis(AE)combined with cavernous transformation of the portal vein(CTPV).Methods:We analyzed 49 hepatic AE patients with CTPV treated at our center from January 2010 to June 2023.We compared the different outcomes with different treatments for the 49 patients:ELRA for 12 and conservative for 9 patients.After propensity score matching,we compared the ELRA treatment outcomes for 12 patients with CTPV and 24 patients without CTPV.Kaplan-Meier analysis was used to compare overall survival,and Cox regression to identify factors influencing postoperative survival.Results:In the ELRA cohort,both CTPV and non-CTPV patients had no intraoperative mortality;90-day mortality rate for both groups was 16.7%(2/12 in CTPV patients and 4/24 in non-CTPV patients).Pleural effusion was the most common postoperative complication.CTPV patients required significantly longer operative time and more intraoperative blood transfusions(P0.05).In the CTPV cohort,patients who underwent ELRA had significantly better long-term survival compared to those who did not receive surgery(72.9%vs.29.6%,P<0.05).Extrahepatic AE disease,rather than CTPV,was identified as an independent risk factor for postoperative survival(P<0.05).Conclusions:ELRA is a safe and effective approach for hepatic AE patients with CTPV,significantly improving long-term survival.CTPV itself does not negatively impact postoperative survival,further emphasizing the benefits of this procedure in this particular population.
基金Key Science and Technology Program of Shaanxi Province,Grant/Award Number:2024SF2-GJHX-45National Natural Science Foundation of China,Grant/Award Number:82472191The Natural Science Foundation of Shaanxi Province,Grant/Award Number:2024JC-ZDXM-49。
摘要Background:Ex vivo lung perfusion(EVLP)has emerged as a critical technique for lung preservation and evaluation prior to transplantation.While conventional rat EVLP systems utilize closed-loop dual cannulation of pulmonary artery(PA)and vein,the effect of the simplified model using single PA cannulation with passive venous drainage is unknown.Methods:We developed two EVLP models in rats:a semi-closed circuit with PA-only cannulation and left atrial incision for passive venous drainage(SC-EVLP),and a closed circuit employing both arterial and venous cannulation(C-EVLP).Donor lungs were perfused for a defined duration and subsequently orthotopically transplanted.We evaluated pulmonary function parameters,histopathological injury scores,inflammatory cytokine levels,and apoptotic marker expression at the end of perfusion and posttransplantation.Results:Compared to the conventional EVLP,the SC-EVLP group exhibited significantly lower PA pressure and improved dynamic lung compliance throughout perfusion.Although the levels of tumor necrosis factor-αin the perfusate were higher in the SC-EVLP group,other cytokine levels in the perfusate and bronchoalveolar lavage fluid exhibited no significant differences.Pulmonary edema was reduced in the SC-EVLP group,as indicated by a lower lung wet-to-dry ratio.After transplantation,lungs from the SC-EVLP group exhibited lower histological injury scores,reduced apoptosis,and decreased serum cytokine levels,suggesting attenuated inflammation and tissue damage.Conclusions:In a rat model,single PA cannulation with passive venous drainage reduced pulmonary edema during EVLP and reduced lung injury and systemic inflammation after transplantation.
摘要BACKGROUND Liver transplantation is the only treatment for acute and chronic liver failure,but the global organ shortage has increased reliance on extended criteria donor livers,which are more susceptible to ischemia-reperfusion injury.While static cold storage is standard,these grafts often require improved preservation strategies.AIM To summarize the current state of small animal liver machine perfusion(MP),highlight variability in protocols,and emphasize the need for standardization to guide future research.METHODS A comprehensive literature search of PubMed was conducted to identify studies on small animal(rat and mouse)ex vivo liver MP.Only English-language animal studies were included,with no restrictions on publication date.Relevant full-text articles were reviewed,and reference lists were screened to ensure completeness.RESULTS Small animal liver MP provides a cost-effective model to explore dynamic preservation strategies.Rat perfusion studies face challenges including dual-vessel perfusion,maintaining physiological perfusate volumes,and lack of standardized protocols.Open-and closed-circuit setups have distinct advantages and limitations,and experimental designs vary widely across studies.CONCLUSION This review illustrates the wide variability in small animal liver MP protocols and underscores the urgent need for standardization.Addressing these inconsistencies will enhance reproducibility,facilitate comparison across studies,and support the development of optimized liver preservation strategies.
基金supported by the National Natural Science Foundation of China (U2243227)。
摘要The net primary productivity(NPP) is an important indicator for assessing the carbon sequestration capacities of different ecosystems and plays a crucial role in the global biosphere carbon cycle. However, in the context of the increasing frequency, intensity, and duration of global extreme climate events, the impacts of extreme climate and vegetation phenology on NPP are still unclear, especially on the Qinghai-Xizang Plateau(QXP), China. In this study, we used a new data fusion method based on the MOD13A2 normalized difference vegetation index(NDVI) and the Global Inventory Modeling and Mapping Studies(GIMMS) NDVI3g datasets to obtain a NDVI dataset(1982–2020) on the QXP. Then, we developed a NPP dataset across the QXP using the Carnegie-Ames-Stanford Approach(CASA) model and validated its applicability based on gauged NPP data. Subsequently, we calculated 18 extreme climate indices based on the CN05.1 dataset, and extracted the length of vegetation growing season using the threshold method and double logistic model based on the annual NDVI time series. Finally, we explored the spatiotemporal patterns of NPP on the QXP and the impact mechanisms of extreme climate and the length of vegetation growing season on NPP. The results indicated that the estimated NPP exhibited good applicability. Specifically, the correlation coefficient, relative bias, mean error, and root mean square error between the estimated NPP and gauged NPP were 0.76, 0.17, 52.89 g C/(m2·a), and 217.52 g C/(m2·a), respectively. The NPP of alpine meadow, alpine steppe, forest, and main ecosystem on the QXP mainly exhibited an increasing trend during 1982–2020, with rates of 0.35, 0.38, 1.40, and 0.48 g C/(m2·a), respectively. Spatially, the NPP gradually decreased from southeast to northwest across the QXP. Extreme climate had greater impact on NPP than the length of vegetation growing season on the QXP. Specifically, the increase in extremely-wet-day precipitation(R99p), simple daily intensity index(SDII), and hottest day(TXx) increased the NPP in different ecosystems across the QXP, while the increases in the cold spell duration index(CSDI) and warm spell duration index(WSDI) decreased the NPP in these ecosystems. The results of this study provide a scientific basis for relevant departments to formulate future policies addressing the impact of extreme climate on vegetation in different ecosystems on the QXP.
摘要Crotalaria ferruginea Graham ex Benth.is a commonly used herb among ethnic minorities.Its whole plant is used as medicine for conditions such as heatstroke,tinnitus,hearing loss,phlegm heat cough,gum swelling and pain,lower back and knee pain,vaginal discharge and infantile malnutrition.Modern pharmaceutical research has found that Crotalaria ferruginea Graham ex Benth.mainly contains flavonoids,steroids,organic acids and terpenes,which have antibacterial,free radical scavenging,antiinflammatory and other effects.Quality control mainly focuses on characteristics,identification,content determination,etc.This article summarizes the recent research progress on the chemical composition,pharmacological effects,quality control and extraction process of Crotalaria ferruginea Graham ex Benth.on the basis of existing Crotalaria ferruginea Graham ex Benth.research reports.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01D17State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia,No.SKL-HIDCA-2024-2.
摘要BACKGROUND Echinococcosis,caused by Echinococcus parasites,includes alveolar echinococcosis(AE),the most lethal form,primarily affecting the liver with a 90%mortality rate without prompt treatment.While radical surgery combined with antiparasitic therapy is ideal,many patients present late,missing hepatectomy opportunities.Ex vivo liver resection and autotransplantation(ELRA)offers hope for such patients.Traditional surgical decision-making,relying on clinical experience,is prone to bias.Machine learning can enhance decision-making by identifying key factors influencing surgical choices.This study innovatively employs multiple machine learning methods by integrating various feature selection techniques and SHapley Additive exPlanations(SHAP)interpretive analysis to deeply explore the key decision factors influencing surgical strategies.AIM To determine the key preoperative factors influencing surgical decision-making in hepatic AE(HAE)using machine learning.METHODS This was a retrospective cohort study at the First Affiliated Hospital of Xinjiang Medical University(July 2010 to August 2024).There were 710 HAE patients(545 hepatectomy and 165 ELRA)with complete clinical data.Data included demographics,laboratory indicators,imaging,and pathology.Feature selection was performed using recursive feature elimination,minimum redundancy maximum relevance,and least absolute shrinkage and selection operator regression,with the intersection of these methods yielding 10 critical features.Eleven machinelearning algorithms were compared,with eXtreme Gradient Boosting(XGBoost)optimized using Bayesian optimization.Model interpretability was assessed using SHAP analysis.RESULTS The XGBoost model achieved an area under the curve of 0.935 in the training set and 0.734 in the validation set.The optimal threshold(0.28)yielded sensitivity of 93.6%and specificity of 90.9%.SHAP analysis identified type of vascular invasion as the most important feature,followed by platelet count and prothrombin time.Lesions invading the hepatic vein,inferior vena cava,or multiple vessels significantly increased the likelihood of ELRA.Calibration curves showed good agreement between predicted and observed probabilities(0.2-0.7 range).The model demonstrated high net clinical benefit in Decision Curve Analysis,with accuracy of 0.837,recall of 0.745,and F1 score of 0.788.CONCLUSION Vascular invasion is the dominant factor influencing the choice of surgical approach in HAE.Machine-learning models,particularly XGBoost,can provide transparent and data-driven support for personalized decision-making.
摘要Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.
摘要Although Steen's solution plays a crucial role in maintaining vascular oncotic pressure and reducing pulmonary edema due to its high concentration of human serum albumin during ex vivo lung perfusion(EVLP),it incurs high costs and potential immune responses in rat models.In our preliminary research,donor lungs perfused with Steen's solution exhibited significant lung injury post transplantation,likely due to a strong immune response elicited by the high concentration of xenogenic proteins upon reperfusion.This study explores a low-cost and efficient perfusate composition for use in rat EVLP and lung transplant models.The modified perfusate employed in this study uses artificial colloids as the primary component,with an albumin concentration of only 2%,demonstrating comparable physiological parameters,metabolic levels,and pathological changes to those of Steen's solution during EVLP.Moreover,the modified composition exhibited good biocompatibility in transplantation,with minimal lung injury.In summary,the proposed perfusate offers a safer and more economical alternative for establishing rat EVLP and lung transplant models,facilitating the advancement of related research.