Despite a record setting number of heart transplants performed annually,the national donor shortage continues to plague transplant teams across the United States.Here we describe the barriers to adaptation of numerous...Despite a record setting number of heart transplants performed annually,the national donor shortage continues to plague transplant teams across the United States.Here we describe the barriers to adaptation of numerous“non-traditional”orthotopic heart transplant donor characteristics including donors with hepatitis C virus,those meeting criteria for donation after cardiac death,donors with coronavirus disease 19 infection,donors with the human immunodeficiency virus,and grafts with left ventricular systolic dysfunction.Our center’s objective was to increase our transplant volume by expanding our donor pool from“traditional”donors to these“non-traditional”donors.We detail how medical advances such as certain laboratory studies,pharmacologic interventions,and organ care systems have allowed our center to expand the donor pool thereby increasing transplantation volume without adverse effects on outcomes.展开更多
In the past half century, the mean summertime temperature in China has increased, with nights warm- ing more than days. Using surface station observations, we show that the frequency of extreme heat-stress events in C...In the past half century, the mean summertime temperature in China has increased, with nights warm- ing more than days. Using surface station observations, we show that the frequency of extreme heat-stress events in China, caused by extremely hot and humid days as well as by heatwaves lasting for a few days, has increased over the period from 1951 to 1994 When humidity is high, hot weather can cause heat stress in humans. The increased heatrstress trend may pose a public health problem展开更多
It was demonstrated that xanthine oxidoreductase (XOR), during ischemia, catalyzes the formation of nitric oxide (NO) from nitrite (NO_2^-) and this NO_2^--derived NO protects the isolated perfused rat heart against t...It was demonstrated that xanthine oxidoreductase (XOR), during ischemia, catalyzes the formation of nitric oxide (NO) from nitrite (NO_2^-) and this NO_2^--derived NO protects the isolated perfused rat heart against the damaging effects of ischemia-reperfusion (I/R) when conventional nitric oxide synthase (NOS) -dependent NO production is impaired. Liver is one of the organs with the highest XOR concentration. This study was designed to determine whether NO_2^--derived NO by XOR protects liver against I/R injury in vivo. For its minute amounts and active reactivity, NO can not be detected directly in real time in vivo by this time. We have to prove the above hypothesis indirectly. METHODS:Wistar rats were pretreated with saline, NOS inhibitor L-NAME (10 mg/kg intravenously), XOR inhibitor allopurinol (1.5 mg/kg orally), L-NAME +allopurinol and NO scavenger carboxy-PTIO (0.6 mg/kg intravenously) respectively (12 animals per group). And then, they were subjected to total liver ischemia for 40 minutes followed by reperfusion. Blood samples and liver tissues were obtained for analysis after 3 hours of reperfusion. Survival was also investigated. RESULTS:Allopurinol-treated animals exhibited further increased serum alanine aminotransferase (ALT) levels and liver myeloperoxidase (MPO) activities, but further decreased liver adenosine triphosphate (ATP) stores after I/R compared to saline-treated counterparts (830.5±108.3 U/L, 56.5±11.0 U/mg protein and 1.93±0.47 μmol/g vs. 505.8± 184.2 U/L, 41.5±10.2 U/mg protein and 3.05±0.55 μmol/g respectively, P<0.01, P<0.05 and P<0.01 respectively). The hepatocyte injury was further exacerbated and the overall survival rate was significantly decreased after I/R in animals given by allopurinol compared to those pretreated by saline (P<0.05). L-NAME and allopurinol co-treated animals exhibited more severe liver injury (P<0.05 and P<0.01) and a further decreased overall survival rate (P<0.05) compared to L-NAME or allopurinol alone-treated counterparts, but they were not diff展开更多
In 2019, an investigation by the U.S. House of Representatives revealed major infant food conglomerates had products with high levels of arsenic, lead, cadmium, and mercury, posing concerns for infants’ vulnerability...In 2019, an investigation by the U.S. House of Representatives revealed major infant food conglomerates had products with high levels of arsenic, lead, cadmium, and mercury, posing concerns for infants’ vulnerability to the neurotoxic effects of these metals. Trends of laboratory-detected heavy metals were analyzed in children aged zero to five from 1999-2020, providing insights on heavy metal contamination in infant food products. Utilizing National Health and Nutrition Examination Survey (NHANES) data, mean heavy metal levels in children were calculated, considering gender, race, and income-to-poverty ratio as proxies for assessing associations with increasing heavy metal rates in infant food. Findings indicated an overall decrease in mean concentrations over time, though remaining elevated. Black children exhibited higher lead levels than the overall average, while the Asian subgroup displayed higher levels of total blood mercury and cadmium levels. Lack of internal standards in regulatory bodies, particularly the FDA, exacerbates the issue, with no legally enforceable guidelines or strict maximum levels for heavy metals in infant foods. Urgent FDA interventions are needed, addressing contamination at the sources of raw materials, implementing transparent and extensive product testing, and comprehensive manufacturer labeling to inform consumers about elevated heavy metal levels in infant products.展开更多
BACKGROUND Recent studies in non-colorectal malignancy have associated T resident memory(T_(RM)) cells with improved patient survival. It is unknown if T_(RM) plays a role in colorectal cancer(CRC).AIM To examine the ...BACKGROUND Recent studies in non-colorectal malignancy have associated T resident memory(T_(RM)) cells with improved patient survival. It is unknown if T_(RM) plays a role in colorectal cancer(CRC).AIM To examine the potential role of T_(RM) cells in providing immunogenicity in CRC stratified by microsatellite instability(MSI) and BRAF status.METHODS Patients with known MSI and BRAF mutation status were eligible for inclusion in this study. CRC tumour sections stained with haematoxylin and eosin were microscopically reviewed and the images scanned prior to assessment for location of invading edge and core of tumour. Sequential sections were prepared for quantitative multiplex immunohistochemistry(IHC) staining. Opal Multiplex IHC staining was performed with appropriate positive and negative controls and imaged using a standard fluorescent microscope fitted with a spectral scanning camera(Mantra) in conjunction with Mantra snap software. Images were unmixed and annotated in in Form 2.2.0. Statistical analysis was performed using Graphpad Prism Version 7 and Stata Version 15.RESULTS Seventy-two patients with known MSI and BRAF status were included in the study. All patients were assessed for MSI by IHC and high resolution capillary electrophoresis testing and 44 of these patients successfully underwent quantitative multiplex IHC staining. Overall, there was a statistically significant increase in CD8+ T_(RM) cells in the MSI(BRAF mutant and wild type) group over the microsatellite stable(MSS) group. There was a statistically significant difference in CD8+ T_(RM) between high level MSI(MSI-H):BRAF mutant [22.57, 95% confidence interval(CI): 14.31-30.84] vs MSS [8.031(95%CI: 4.698-11.36)], P = 0.0076 and MSI-H:BRAF wild type [16.18(95%CI: 10.44-21.93)] vs MSS [8.031(95%CI: 4.698-11.36)], P = 0.0279. There was no statistically significant difference in CD8 T cells(both CD8+CD103-and CD8+CD103+T_(RM)) between MSI-H: BRAF mutant and wild type CRC.CONCLUSION This study has shown that CD8+ T_(RM) are found in greater abun展开更多
BACKGROUND Pancreatic acinar cell carcinoma(PACC)is a rare tumor.Up to 45%of PACCs have alterations in the DNA damage repair pathway and 23%harbor rearrangements in the BRAF or RAF1 genes.We present a PACC case with a...BACKGROUND Pancreatic acinar cell carcinoma(PACC)is a rare tumor.Up to 45%of PACCs have alterations in the DNA damage repair pathway and 23%harbor rearrangements in the BRAF or RAF1 genes.We present a PACC case with a germline BRCA2 likely pathogenic variant(LPV)to highlight the impact of genomic testing on treatment decisions and patient outcomes.In our larger case series,we provide clinic-based information on additional 10 PACC patients treated in our center.CASE SUMMARY A 70-year-old male was diagnosed with advanced PACC.At presentation,he was cachectic with severe arthralgia despite prednisolone and a skin rash that was later confirmed to be panniculitis.He was treated with modified FOLFIRINOX(mFFX)with the knowledge of the germline BRCA2 LPV.Following 11 cycles of mFFX,a computed tomography(CT)scan demonstrated significant tumor response in the pancreatic primary and hepatic metastases,totaling 70%from baseline as per Response Evaluation Criteria in Solid Tumors.Resolution of the skin panniculitis was also noted.We identified two additional PACCs with druggable targets in our case series.Our data contribute to practical evidence for the value of germline and somatic profiling in the management of rare diseases like PACC.CONCLUSION This patient and others in our larger case series highlight the importance of genomic testing in PACC with potential utility in personalized treatment.展开更多
文摘Despite a record setting number of heart transplants performed annually,the national donor shortage continues to plague transplant teams across the United States.Here we describe the barriers to adaptation of numerous“non-traditional”orthotopic heart transplant donor characteristics including donors with hepatitis C virus,those meeting criteria for donation after cardiac death,donors with coronavirus disease 19 infection,donors with the human immunodeficiency virus,and grafts with left ventricular systolic dysfunction.Our center’s objective was to increase our transplant volume by expanding our donor pool from“traditional”donors to these“non-traditional”donors.We detail how medical advances such as certain laboratory studies,pharmacologic interventions,and organ care systems have allowed our center to expand the donor pool thereby increasing transplantation volume without adverse effects on outcomes.
文摘In the past half century, the mean summertime temperature in China has increased, with nights warm- ing more than days. Using surface station observations, we show that the frequency of extreme heat-stress events in China, caused by extremely hot and humid days as well as by heatwaves lasting for a few days, has increased over the period from 1951 to 1994 When humidity is high, hot weather can cause heat stress in humans. The increased heatrstress trend may pose a public health problem
文摘It was demonstrated that xanthine oxidoreductase (XOR), during ischemia, catalyzes the formation of nitric oxide (NO) from nitrite (NO_2^-) and this NO_2^--derived NO protects the isolated perfused rat heart against the damaging effects of ischemia-reperfusion (I/R) when conventional nitric oxide synthase (NOS) -dependent NO production is impaired. Liver is one of the organs with the highest XOR concentration. This study was designed to determine whether NO_2^--derived NO by XOR protects liver against I/R injury in vivo. For its minute amounts and active reactivity, NO can not be detected directly in real time in vivo by this time. We have to prove the above hypothesis indirectly. METHODS:Wistar rats were pretreated with saline, NOS inhibitor L-NAME (10 mg/kg intravenously), XOR inhibitor allopurinol (1.5 mg/kg orally), L-NAME +allopurinol and NO scavenger carboxy-PTIO (0.6 mg/kg intravenously) respectively (12 animals per group). And then, they were subjected to total liver ischemia for 40 minutes followed by reperfusion. Blood samples and liver tissues were obtained for analysis after 3 hours of reperfusion. Survival was also investigated. RESULTS:Allopurinol-treated animals exhibited further increased serum alanine aminotransferase (ALT) levels and liver myeloperoxidase (MPO) activities, but further decreased liver adenosine triphosphate (ATP) stores after I/R compared to saline-treated counterparts (830.5±108.3 U/L, 56.5±11.0 U/mg protein and 1.93±0.47 μmol/g vs. 505.8± 184.2 U/L, 41.5±10.2 U/mg protein and 3.05±0.55 μmol/g respectively, P<0.01, P<0.05 and P<0.01 respectively). The hepatocyte injury was further exacerbated and the overall survival rate was significantly decreased after I/R in animals given by allopurinol compared to those pretreated by saline (P<0.05). L-NAME and allopurinol co-treated animals exhibited more severe liver injury (P<0.05 and P<0.01) and a further decreased overall survival rate (P<0.05) compared to L-NAME or allopurinol alone-treated counterparts, but they were not diff
文摘In 2019, an investigation by the U.S. House of Representatives revealed major infant food conglomerates had products with high levels of arsenic, lead, cadmium, and mercury, posing concerns for infants’ vulnerability to the neurotoxic effects of these metals. Trends of laboratory-detected heavy metals were analyzed in children aged zero to five from 1999-2020, providing insights on heavy metal contamination in infant food products. Utilizing National Health and Nutrition Examination Survey (NHANES) data, mean heavy metal levels in children were calculated, considering gender, race, and income-to-poverty ratio as proxies for assessing associations with increasing heavy metal rates in infant food. Findings indicated an overall decrease in mean concentrations over time, though remaining elevated. Black children exhibited higher lead levels than the overall average, while the Asian subgroup displayed higher levels of total blood mercury and cadmium levels. Lack of internal standards in regulatory bodies, particularly the FDA, exacerbates the issue, with no legally enforceable guidelines or strict maximum levels for heavy metals in infant foods. Urgent FDA interventions are needed, addressing contamination at the sources of raw materials, implementing transparent and extensive product testing, and comprehensive manufacturer labeling to inform consumers about elevated heavy metal levels in infant products.
文摘BACKGROUND Recent studies in non-colorectal malignancy have associated T resident memory(T_(RM)) cells with improved patient survival. It is unknown if T_(RM) plays a role in colorectal cancer(CRC).AIM To examine the potential role of T_(RM) cells in providing immunogenicity in CRC stratified by microsatellite instability(MSI) and BRAF status.METHODS Patients with known MSI and BRAF mutation status were eligible for inclusion in this study. CRC tumour sections stained with haematoxylin and eosin were microscopically reviewed and the images scanned prior to assessment for location of invading edge and core of tumour. Sequential sections were prepared for quantitative multiplex immunohistochemistry(IHC) staining. Opal Multiplex IHC staining was performed with appropriate positive and negative controls and imaged using a standard fluorescent microscope fitted with a spectral scanning camera(Mantra) in conjunction with Mantra snap software. Images were unmixed and annotated in in Form 2.2.0. Statistical analysis was performed using Graphpad Prism Version 7 and Stata Version 15.RESULTS Seventy-two patients with known MSI and BRAF status were included in the study. All patients were assessed for MSI by IHC and high resolution capillary electrophoresis testing and 44 of these patients successfully underwent quantitative multiplex IHC staining. Overall, there was a statistically significant increase in CD8+ T_(RM) cells in the MSI(BRAF mutant and wild type) group over the microsatellite stable(MSS) group. There was a statistically significant difference in CD8+ T_(RM) between high level MSI(MSI-H):BRAF mutant [22.57, 95% confidence interval(CI): 14.31-30.84] vs MSS [8.031(95%CI: 4.698-11.36)], P = 0.0076 and MSI-H:BRAF wild type [16.18(95%CI: 10.44-21.93)] vs MSS [8.031(95%CI: 4.698-11.36)], P = 0.0279. There was no statistically significant difference in CD8 T cells(both CD8+CD103-and CD8+CD103+T_(RM)) between MSI-H: BRAF mutant and wild type CRC.CONCLUSION This study has shown that CD8+ T_(RM) are found in greater abun
文摘BACKGROUND Pancreatic acinar cell carcinoma(PACC)is a rare tumor.Up to 45%of PACCs have alterations in the DNA damage repair pathway and 23%harbor rearrangements in the BRAF or RAF1 genes.We present a PACC case with a germline BRCA2 likely pathogenic variant(LPV)to highlight the impact of genomic testing on treatment decisions and patient outcomes.In our larger case series,we provide clinic-based information on additional 10 PACC patients treated in our center.CASE SUMMARY A 70-year-old male was diagnosed with advanced PACC.At presentation,he was cachectic with severe arthralgia despite prednisolone and a skin rash that was later confirmed to be panniculitis.He was treated with modified FOLFIRINOX(mFFX)with the knowledge of the germline BRCA2 LPV.Following 11 cycles of mFFX,a computed tomography(CT)scan demonstrated significant tumor response in the pancreatic primary and hepatic metastases,totaling 70%from baseline as per Response Evaluation Criteria in Solid Tumors.Resolution of the skin panniculitis was also noted.We identified two additional PACCs with druggable targets in our case series.Our data contribute to practical evidence for the value of germline and somatic profiling in the management of rare diseases like PACC.CONCLUSION This patient and others in our larger case series highlight the importance of genomic testing in PACC with potential utility in personalized treatment.
