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Biomedicines Jun 2024In this study, a mixed porcine-human bioengineered liver (MPH-BEL) was used in a preclinical setup of extracorporeal liver support devices as a treatment for a model of...
In this study, a mixed porcine-human bioengineered liver (MPH-BEL) was used in a preclinical setup of extracorporeal liver support devices as a treatment for a model of post-resection liver failure (PRLF). The potential for human clinical application is further illustrated by comparing the functional capacity of MPH-BEL grafts as assessed using this porcine PRLF model with fully human (FH-BEL) grafts which were perfused and assessed in vitro. BEL grafts were produced by reseeding liver scaffolds with HUVEC and primary porcine hepatocytes (MPH-BEL) or primary human hepatocytes (FH-BEL). PRLF was induced by performing an 85% liver resection in domestic white pigs and randomized into the following three groups 24 h after resection: standard medical therapy (SMT) alone, SMT + extracorporeal circuit (ECC), and SMT + MPH-BEL. The detoxification and metabolic functions of the MPH-BEL grafts were compared to FH-BEL grafts which were perfused in vitro. During the 24 h treatment interval, INR values normalized within 18 h in the MPH-BEL therapy group and urea synthesis increased as compared to the SMT and SMT + ECC control groups. The MPH-BEL treatment was associated with more rapid decline in hematocrit and platelet count compared to both control groups. Histological analysis demonstrated platelet sequestration in the MPH-BEL grafts, possibly related to immune activation. Significantly higher rates of ammonia clearance and metabolic function were observed in the FH-BEL grafts perfused in vitro than in the MPH-BEL grafts. The MPH-BEL treatment was associated with improved markers of liver function in PRLF. Further improvement in liver function in the BEL grafts was observed by seeding the biomatrix with human hepatocytes. Methods to reduce platelet sequestration within BEL grafts is an area of ongoing research.
PubMed: 38927479
DOI: 10.3390/biomedicines12061272 -
Biomedicines Jun 2024Chronic hepatitis B (CHB) constitutes a major global public health issue, affecting millions of individuals. Despite the implementation of robust vaccination programs,... (Review)
Review
Chronic hepatitis B (CHB) constitutes a major global public health issue, affecting millions of individuals. Despite the implementation of robust vaccination programs, the hepatitis B virus (HBV) significantly influences morbidity and mortality rates. CHB emerges as one of the leading causes of hepatocellular carcinoma (HCC), introducing a major challenge in the effective management of CHB patients. Therefore, it is of utmost clinical importance to diligently monitor individuals with CHB who are at high risk of HCC development. While various prognostic scores have been developed for surveillance and screening purposes, their accuracy in predicting HCC risk may be limited, particularly in patients under treatment with nucleos(t)ide analogues. The PAGE-B model, incorporating age, gender, and platelet count, has exhibited remarkable accuracy, validity, and reliability in predicting HCC occurrence among CHB patients receiving HBV treatment. Its predictive performance stands out, whether considered independently or in comparison to alternative HCC risk scoring systems. Furthermore, the introduction of targeted adjustments to the calculation of the PAGE-B score might have the potential to further improve its predictive accuracy. This review aims to evaluate the efficacy of the PAGE-B score as a dependable tool for accurate prediction of the development of HCC in CHB patients. The evidence discussed aims to provide valuable insights for guiding recommendations on HCC surveillance within this specific population.
PubMed: 38927467
DOI: 10.3390/biomedicines12061260 -
Zhongguo Shi Yan Xue Ye Xue Za Zhi Jun 2024To investigate the risk factors of pulmonary infection in patients with acute leukemia (AL) after chemotherapy.
OBJECTIVE
To investigate the risk factors of pulmonary infection in patients with acute leukemia (AL) after chemotherapy.
METHODS
A total of 294 patients with AL were collected and divided into infection group (=93) and control group (=201) according to whether the pulmonary infection occurred after chemotherapy. Analyze the correlation between sociodemographic data (sex, age, BMI), clinical data (disease type, ECOG score, invasive procedure, underlying disease, hormone therapy, empirical use of antibiotics, prognosis stratification, chemotherapy intensity, primitive cell count, white blood cell count, neutrophil count, duration of granulocyte deficiency, platelet count, hemoglobin, and albumin and pulmonary infection after chemotherapy. COX regression method was used to analyze the risk factors of pulmonary infection in AL patients after chemotherapy.
RESULTS
Among 294 patients with AL, 11 died within 30 days after pulmonary infection. There were statistically significant differences in age, smoking history, ECOG score, invasive procedure, hormone therapy, empirical use of antibiotics, prognosis stratification, chemotherapy intensity, primitive cell count, neutrophil count, duration of granulocyte deficiency, platelet count, hemoglobin, albumin and fasting blood glucose between the 2 groups ( <0.05). COX regression analysis showed that smoking history, invasive procedure, unexperienced use of antibiotics, poor prognosis, long duration of granulocytopenia, low platelet level and low albumin were high risk factors for pulmonary infection in AL patients after chemotherapy ( <0.05).
CONCLUSION
Smoking, invasive procedures, unexperienced use of antibiotics, poor prognosis, long duration of granulodeficiency, low platelet levels and low albumin are risk factors for pulmonary infection in AL patients after chemotherapy.
Topics: Humans; Risk Factors; Leukemia; Prognosis; Acute Disease; Male; Female
PubMed: 38926991
DOI: 10.19746/j.cnki.issn.1009-2137.2024.03.043 -
Zhongguo Shi Yan Xue Ye Xue Za Zhi Jun 2024To investigate the effects of mild SARS-CoV-2 infection on hematological parameters of adult blood donors and the suitability of apheresis platelet donation, the changes...
OBJECTIVE
To investigate the effects of mild SARS-CoV-2 infection on hematological parameters of adult blood donors and the suitability of apheresis platelet donation, the changes of the hematological parameters in blood donors with mild infection of the SARS-CoV-2 Omicron variant strain were evaluated.
METHODS
Seventy-two blood donors with mild COVID-19 symptoms who donated consecutive apheresis platelets for 3 times from December 2022 to January 2023, 42 cases among which were included in the infection-positive group, and 30 cases in the suspected infection group. Forty-two donors un-vaccinated against SARS-CoV-2, un-infected, and donated three consecutive apheresis platelets from October to November 2022 were included in the control group. The changes of blood routine testing in the positive group and the suspected infection group were retrospectively compared before (Time1) and after (Time2 and Time3) the onset of symptoms, three consecutive times (Time1, Time2, Time3) in the control group by repeated measures analysis of variance. The Bayesian discriminant method was used to establish a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not.
RESULTS
Simple effect of the number times of tests in the positive and suspected infection groups was significant( =6.98, < 0.001, partial η=0.79, =4.31, < 0.001, partial η=0.70). The positive group and the suspected infection group had lower RBC, HCT, and HGB, and higher PLT and PCT at Time2 compared to Time1 and Time3( < 0.05). The positive group and the suspected infection group showes RDW-CV and RDW-SD at Time3 higher than Time1 and Time2 ( < 0.001). The simple effect of the number times of tests in the control group was not significant ( =0.96, =0.55, partial η=0.34). The difference of the whole blood count parameters in the control group for three times was not statistically significant ( >0.05). We established a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not. The equation had an eigenvalue of 0.22, a canonical correlation of 0.43 (χ=27.81, < 0.001), and an analysis accuracy of 72.9%.
CONCLUSION
The hematological indicators of RBC, HCT, HGB, PLT, PCT, RDW-CV and RDW-SD in blood donors who had infected with mild COVID-19 showed dynamic changes. The discriminant equation for whether they are infected recently with COVID-19 has a high accuracy rate.
Topics: Humans; COVID-19; Blood Donors; SARS-CoV-2; Plateletpheresis; Blood Platelets; Retrospective Studies; Platelet Count; Adult; Male
PubMed: 38926984
DOI: 10.19746/j.cnki.issn.1009-2137.2024.03.036 -
Zhongguo Shi Yan Xue Ye Xue Za Zhi Jun 2024To analyze the efficacy and influencing factors of cyclosporine (CsA) alone in the treatment of children with acquired aplastic anemia (AA).
OBJECTIVE
To analyze the efficacy and influencing factors of cyclosporine (CsA) alone in the treatment of children with acquired aplastic anemia (AA).
METHODS
The clinical data of children diagnosed with AA and treated with CsA alone from January 1, 2016 to December 31, 2020 in the Children's Hospital of Chongqing Medical University were collected, and the efficacy and influencing factors of CsA treatment were evaluated.
RESULTS
Among the 119 patients, there were 62 male and 57 female, with a median age of 7 years and 1 month. There were 45 cases of very severe AA (VSAA), 47 cases of severe AA (SAA), and 27 cases of non-severe AA (NSAA). At 6 months after treatment, the efficacy of VSAA was lower than that of SAA and NSAA, and there was a statistical difference ( < 0.01). 6 cases died early, 16 cases relapsed, 2 cases progressed to AML and ALL. The results of univariate analysis showed that the high proportion of lymphocyte in the bone marrow at 6 months was an adverse factor for the efficacy of CsA, while high PLT count was a protective factor ( =0.008, =0.002). The ROC curve showed that the cut-off values of PLT count and the proportion of bone marrow lymphocyte at 6 months were 16.5×10 /L, 68.5%, respectively. Multivariate analysis showed that the high proportion of lymphocyte in bone marrow at 6 months was an independent adverse factor for IST ( =0.020, =0.062), and high PLT count was a protective factor ( =0.044, =1.038). At 3 months of treatment, CsA response and NSAA were the risk factor for recurrence ( =0.001, 0.031).
CONCLUSION
The efficacy of NSAA was higher than that of SAA and VSAA after 6 months of treatment with CsA alone. A high PLT count at the initial diagnosis was a good factor for the effectiveness of CsA, and a high proportion of bone marrow lymphocyte was an unfavorable factor. CsA response at 3 months and NSAA were risk factors for recurrence.
Topics: Humans; Anemia, Aplastic; Cyclosporine; Female; Male; Child; Treatment Outcome; Platelet Count; Immunosuppressive Agents; Child, Preschool; Adolescent; Bone Marrow
PubMed: 38926977
DOI: 10.19746/j.cnki.issn.1009-2137.2024.03.029 -
Zhongguo Shi Yan Xue Ye Xue Za Zhi Jun 2024To evaluate the clinical and prognostic value of prothrombin time (PT) and activated partial thromboplastin time (APTT) in newly diagnosed patients with multiple myeloma...
OBJECTIVE
To evaluate the clinical and prognostic value of prothrombin time (PT) and activated partial thromboplastin time (APTT) in newly diagnosed patients with multiple myeloma (MM).
METHODS
The clinical data of 116 newly diagnosed MM patients in the Second Hospital and Third Hospital of Shanxi Medical University from October 2014 to March 2022 were analyzed retrospectively, and the patients were divided into two groups: normal PT and APTT group and prolonged PT or APTT group. The differences in sex, age, classification, staging, bleeding events, laboratory indicators [including hemoglobin (Hb), platelet count (PLT), serum calcium, serum albumin (ALB), lactate dehydrogenase (LDH), serum creatinine and β-microglobulin], and cytogenetic characteristics between the two groups of patients were compared. The effect of prolonged PT or APTT on survival of patients with MM was analyzed.
RESULTS
Compared with patients in normal PT and APTT group, patients in prolonged PT or APTT group were more likely to experience bleeding events (=5.087, =0.024), with lower ALB levels (=4.962, =0.026) and PLT levels (=4.309, =0.038), and higher serum calcium levels (=5.056, =0.025). The positive rates of del17p, del13q and 1q21+ in prolonged PT or APTT group were higher than those in normal PT and APTT group, but the difference was not statistically significant ( >0.05). K-M survival analysis showed that the prolonged PT or APTT group had a shorter median progression-free survival (PFS) ( =0.032) and overall survival (OS) ( =0.032). Multivariate Cox analysis showed that prolonged PT or APTT (=2.116, 95% :1.025-4.372, =0.043) and age ≥65 years (=2.403, 95% : 1.195-4.836, =0.014) were independent risk factor for OS in newly diagnosed MM patients. However, prolonged PT or APTT had no significant effect on PFS of newly diagnosed MM patients (=1.162, 95% : 0.666-2.026, =0.597).
CONCLUSION
Newly diagnosed MM patients with prolonged PT or APTT have worse clinical indicators, shorter PFS and OS. Prolonged PT or APTT is an independent risk factor for OS in MM patients.
Topics: Humans; Multiple Myeloma; Partial Thromboplastin Time; Prognosis; Retrospective Studies; Prothrombin Time; Male; Female; Middle Aged
PubMed: 38926971
DOI: 10.19746/j.cnki.issn.1009-2137.2024.03.023 -
Surgical Case Reports Jun 2024The safety of laparoscopic hepatectomy for inherited coagulation disorders is unclear; however, the safety of open hepatectomy has been reported in several studies....
BACKGROUND
The safety of laparoscopic hepatectomy for inherited coagulation disorders is unclear; however, the safety of open hepatectomy has been reported in several studies. Herein, we report the first case of a laparoscopic hepatectomy for a patient with von Willebrand Disease (VWD).
CASE PRESENTATION
A 76-year-old male with a history of chronic hepatitis C and VWD type 2B was advised surgical resection of a 4 cm hepatocellular carcinoma in segment 7 of the liver. The patient was diagnosed with VWD in his 40 s due to gastrointestinal bleeding caused by gastric erosion. The von Willebrand factor (VWF) ristocetin cofactor activity was 30%, and VWF large multimer deficiency and increased ristocetin-induced platelet agglutination were observed. The preoperative platelet count was reduced to 3.5 × 10/μL; however, preoperative imaging findings had no evidence of liver cirrhosis, such as any collateral formations and splenomegaly. The indocyanine green retention rate at 15 min was 10%, and his Child-Pugh score was 5 (classification A). Perioperatively, VWF/factor VIII was administered in accordance with our institutional protocol. A laparoscopic partial hepatectomy of the right posterior segment was performed. The most bleeding during surgery occurred during the mobilization of the right lobe of the liver due to inflammatory adhesion between the retroperitoneum and the tumor. Bleeding during parenchymal transection was controlable. The duration of hepatic inflow occlusion was 65 min. The surgical duration was 349 min, and the estimated blood loss was 2150 ml. Four units of red blood cells and fresh frozen plasma were transfused at the initiation of parenchymal transection, and 10 units of platelets were transfused at the end of the parenchymal transection. On postoperative day 1, the transection surface drainage fluid became hemorrhagic, and emergency contrast-enhanced computed tomography showed extravasation in the greater omentum. Percutaneous transcatheter arterial embolization of the omental branch of the right gastroepiploic artery was performed. No further postoperative interventions were required. The patient was discharged on postoperative day 14.
CONCLUSION
The indications for laparoscopic hepatectomy in patients with VWD should be carefully considered, and an open approach may still be the standard approach for patients with VWD.
PubMed: 38926208
DOI: 10.1186/s40792-024-01960-4 -
The Prostate Jun 2024The diagnostic accuracy of suspicious lesions that are classified as PI-RADS 3 in multiparametric prostate magnetic-resonance imaging (mpMRI) is controversial. This...
BACKGROUND
The diagnostic accuracy of suspicious lesions that are classified as PI-RADS 3 in multiparametric prostate magnetic-resonance imaging (mpMRI) is controversial. This study aims to assess the predictive capacity of hematological inflammatory markers such as neutrophil-lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), and systemic immune-response index (SIRI) in detecting prostate cancer in PI-RADS 3 lesions.
METHODS
276 patients who underwent mpMRI and subsequent prostate biopsy after PI-RADS 3 lesion detection were included in the study. According to the biopsy results, the patients were distributed to two groups as prostate cancer (PCa) and no cancer (non-PCa). Data concerning age, PSA, prostate volume, PSA density, PI-RADS 3 lesion size, prostate biopsy results, monocyte counts (10/L), lymphocyte counts (10/L), platelet counts (10/L), neutrophils count (10/L) were recorded from the complete blood count. From these data; PIV value is obtained by monocyte × neutrophil × platelet/lymphocyte, NLR by neutrophil/lymphocyte, and SIRI by monocyte number × NLR.
RESULTS
Significant variations in neutrophil, lymphocyte, and monocyte levels between PCa and non-PCa patient groups were detected (p = 0.009, p = 0.001, p = 0.005 respectively, p < 0.05). NLR, PIV, and SIRI exhibited significant differences, with higher values in PCa patients (p = 0.004, p = 0.001, p < 0.001 respectively, p < 0.05). The area under curve of SIRI was 0.729, with a cut-off value of 1.20 and with a sensitivity 57.70%, and a specificity of 68.70%.
CONCLUSION
SIRI outperformed NLR and PIV in detecting PCa in PI-RADS 3 lesions, showcasing its potential as a valuable biomarker. Implementation of this parameter to possible future nomograms has the potential to individualize and risk-stratify the patients in prostate biopsy decision.
PubMed: 38926140
DOI: 10.1002/pros.24762 -
Discovery Medicine Jun 2024Genetic mutations play a crucial role in the development and progression of myelodysplastic syndromes (MDS), impacting the immune microenvironment and influencing the...
BACKGROUND
Genetic mutations play a crucial role in the development and progression of myelodysplastic syndromes (MDS), impacting the immune microenvironment and influencing the choice of treatment regimen, as well as the efficacy and prognosis of patients. The objective of this study was to examine variations in hematological and immunological characteristics associated with common gene mutations in MDS patients and establish a foundation for the precise treatment of MDS.
METHODS
The hematological, immunological, and other clinical features of 71 recently diagnosed MDS patients from January 1, 2019, to July 31, 2023, were retrospectively analyzed. These patients were categorized based on their gene mutations, and the variances in hematological and immunological characteristics among distinct groups were compared.
RESULTS
Hematological variances were observed among different gene mutation groups. Specifically, platelet counts in the splicing factor 3B subunit 1 () mutation group were notably higher compared to the wild-type group ( = 0.009). Conversely, in the additional sex combs like 1 () mutation groups, monocyte ratios were significantly elevated in comparison to the wild-type group ( = 0.046), and in the ten-eleven translocation 2 () mutation group, lymphocyte ratios were significantly lower ( = 0.022). Additionally, the leukocyte ( = 0.005), neutrophil ratio ( = 0.002), and lymphocyte ratio ( = 0.001) were significantly higher in the Runt-related transcription factor 1 () mutation group. Regarding immunological distinctions, the Natural Killer (NK) cell ratio demonstrated a significant increase in the mutation group ( = 0.005). Moreover, the mutation group exhibited a significantly higher Interleukin-8 (IL-8) level ( = 0.017). In contrast, the U2 small nuclear RNA auxiliary factor 1 () group displayed significantly lower levels of IL-1β ( = 0.033), IL-10 ( = 0.033), and Tumour Necrosis Factor-α (TNF-α) ( = 0.009).
CONCLUSION
Distinct variations exist in the immune microenvironment of MDS associated with different genetic mutations. Further studies are imperative to delve into the underlying mechanisms that drive these differences.
Topics: Humans; Myelodysplastic Syndromes; Mutation; Female; Male; Middle Aged; Aged; RNA Splicing Factors; Retrospective Studies; Adult; Dioxygenases; Aged, 80 and over; DNA-Binding Proteins; Phosphoproteins; Killer Cells, Natural; Core Binding Factor Alpha 2 Subunit; Platelet Count; Repressor Proteins
PubMed: 38926115
DOI: 10.24976/Discov.Med.202436185.119 -
Anticancer Research Jul 2024There is limited evidence regarding the systemic treatment of retroperitoneal soft-tissue sarcoma, and the current Japanese guidelines fail to make definitive...
BACKGROUND/AIM
There is limited evidence regarding the systemic treatment of retroperitoneal soft-tissue sarcoma, and the current Japanese guidelines fail to make definitive suggestions. Here, we report our experience with combination chemotherapy of mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) in this population.
PATIENTS AND METHODS
We retrospectively reviewed the records of eight patients (three male and five female) who received MAID for pathologically diagnosed metastatic unresectable retroperitoneal sarcoma (either leiomyosarcoma or pleomorphic sarcoma) between October 2019 and January 2022. Treatment efficacy, tolerability (need for dose reduction), and safety profiles were evaluated and summarized.
RESULTS
At initiation, the median age was 56.0 years, and the body mass index was 20.0 kg/cm Six patients had Eastern Cooperative Oncology Group performance status scores of 0. The net clinical benefit was a partial response in three (37.5%) patients, stable disease in four (50.0%), and progressive disease in one (12.5%). During the median 90.8 weeks of follow-up, disease in five patients progressed, resulting in a median progression-free survival of 48.4 weeks, and five deaths occurred, resulting in an overall survival of 95.1 weeks. Commonly observed adverse events were neutropenia (eight patients), anemia (eight patients), and decreased platelet count (seven patients), which led to dose reduction (60-80%) in six patients.
CONCLUSION
MAID combination therapy may be an acceptable option for advanced retroperitoneal sarcoma; however, its benefits must be carefully assessed owing to its not insignificant toxicity.
Topics: Humans; Male; Female; Middle Aged; Ifosfamide; Doxorubicin; Antineoplastic Combined Chemotherapy Protocols; Retroperitoneal Neoplasms; Sarcoma; Mesna; Aged; Dacarbazine; Retrospective Studies; Adult
PubMed: 38925814
DOI: 10.21873/anticanres.17137