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Blood metal concentrations and cardiac structure and function in total joint arthroplasty patients

World Journal of Orthopedics 2024年第8期15卷 773-782页

作者： Peter C Brennan Stephanie M Peterson Thomas J O'Byrne Mariana L Laporta Cody C Wyles Paul J Jannetto Garvan C Kane Maria Vassilaki Hilal Maradit Kremers department of Orthopedic Surgery Mayo ClinicRochesterMN 55905United States department of Quantitative Health Sciences Mayo ClinicRochesterMN 55905United States department of Anesthesiology and Perioperative Medicine Mayo ClinicRochesterMN 55905United States department of laboratory Medicine and Pathology Mayo ClinicRochesterMN 55905United States department of Cardiovascular Diseases Mayo ClinicRochesterMN 55905United States

BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)*** To determine the association of commonly used implant metals with echocardiographic measures in TJA *** The study comprised 110 TJA patients who had a recent history of high chromium,cobalt or titanium *** underwent two-dimensional,three-dimensional,Doppler and speckle-strain transthoracic echocardiography and a blood draw to measure metal *** and sex-adjusted linear and logistic regression models were used to examine the association of metal concentrations(exposure)with echocardiographic measures(outcome).RESULTS Higher cobalt concentrations were associated with increased left ventricular end-diastolic volume(estimate 5.09;95%CI:0.02-10.17)as well as left atrial and right ventricular dilation,particularly in men but no changes in cardiac *** titanium concentrations were associated with a reduction in left ventricle global longitudinal strain(estimate 0.38;95%CI:0.70 to 0.06)and cardiac index(estimate 0.08;95%CI,-0.15 to-0.01).CONCLUSION Elevated cobalt and titanium concentrations may be associated with structural and functional cardiac changes in some *** studies are warranted to better understand the systemic effects of metals in TJA patients.

关键词： Total joint arthroplasty Metal-on-metal Cardiotoxicity Heart failure Echocardiography Cobalt

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Resveratrol as an Anti-inflammatory Agent in Coronary Artery Disease:A Systematic Review, Meta-Analysis and Meta-Regression

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Chinese Journal of Integrative Medicine 2024年第10期30卷 927-937页

作者： Vito A.Damay Ignatius Ivan department of Cardiovascular Medicine Universitas Pelita Harapan Jakarta Varices clinic

Background: Resveratrol is a non-flavonoid polyphenol that shows promise in reducing proinflammatory factors and maintaining endothelial function, which hints at its potential role in slowing atherosclerosis and preventing acute coronary events. Objective: To study the cardioprotective effects of resveratrol on inflammatory mediators and endothelial function in patients with coronary artery disease(CAD). Methods: A thorough search was conducted in databases(Cochrane Library, Pro Quest, Pub Med, LILACS, Science Direct, Springer, Taylor&Francis, CNKI, Wanfang, and Weipu) until September 24, 2023. The vasopro-inflammatory mediators, endothelial function and outcomes related to cardiovascular events were observed. Titles and abstracts were assessed, and bias was evaluated with Cochrane Ro B 2.0. Heterogeneity of results was explored by metaregression, certainty of evidence was assessed by the GRADE system, and conclusive evidence was enhanced by trial sequence analysis. Results: Ten randomized controlled trials and 3 animal studies investigated resveratrol's impact on inflammatory mediators and endothelial function. In primary prevention studies, meta-analysis showed a significant reduction(95% CI: –0.73 to –0.20; P=0.0005) in tumor necrosis factor-α(TNF-α) expression with resveratrol, demonstrating a dose-dependent relationship. No significant difference was observed in interleukin-6(IL-6) expression with P=0.58 for primary prevention and P=0.57 for secondary prevention. Vascular endothelial nitric oxide synthase(e NOS) expression was significantly increased after resveratrol pre-treatment following CAD events. Secondary prevention studies yielded no significant results; however, meta-regression identified associations between age, hypertension, and lower doses with the extent of TNF-α alterations. High certainty of evidence supported TNF-α reduction, while evidence for IL-6 reduction and e NOS elevation was deemed low. Conclusions: Resveratrol reduces TNF-α in individ

关键词： anti-inflammation coronary artery disease nitric oxide resveratrol systematic review

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Radiofrequency ablation versus microwave ablation for colorectal liver metastases:long-term results of a retrospective cohort surgical experience

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 759-770,I0001页

作者： Ali Gunduz Sarioglu Chase J.Wehrle Ege Akgun Arturan Ibrahimli James F.Bena Eren Berber department of Endocrine Surgery Cleveland ClinicClevelandOHUSA department of General Surgery Cleveland ClinicClevelandOHUSA department of Quantitative Health Sciences Cleveland ClinicClevelandOHUSA

Background:Ablation is an alternative treatment modality for selected patients with colorectal liver metastases(CRLMs).Although initially widely performed via radiofrequency ablation(RFA),more recently,microwave ablation(MWA)is being preferred due to its perceived superiority in creating the ablation *** aim of this study is to compare the long-term efficacy of these two modalities performed ***:Patients undergoing surgical liver ablation from 2005-2023 at a tertiary center by a single surgeon for CRLM were included in a retrospective institutional review board-approved *** were compared using Wilcoxon,Chi-square,Kaplan-Meier,and Cox multivariate regression *** data are presented as median(interquartile range).Results:There were a total of 242 *** RFA was done in 121 patients with 303 lesions and laparoscopic MWA in 121 patients with 300 *** was no difference between the groups regarding operative time(161 vs.147 minutes,respectively,P=0.4),perioperative morbidity(3%vs.8%,respectively,P=0.2)or hospital stay(1 vs.1 day,P=0.05).Local recurrence(LR)per lesion with at least 1 year of imaging follow-up was 29%in the RFA and 13%in the MWA group(P<0.001).Based on univariate survival analysis,tumor size,blood vessel proximity,ablation margin,and ablation modality were independent predictors of *** control these variables,direct matching was *** cohort included 189 ***-Meier analysis of these cohorts showed increased LR-free survival in the MWA group *** RFA group(P=0.005).Conclusions:This large study confirms our initial observation that local tumor control rate is better after MWA ***.

关键词： Colorectal cancer liver metastasis liver ablation radiofrequency ablation(RFA) microwave ablation(MWA) local recurrence(LR)

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Comparison of fungal vs bacterial infections in the medical intensive liver unit:Cause or corollary for high mortality?

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World Journal of Hepatology 2024年第3期16卷 379-392页

作者： Sarah Khan Hanna Hong Stephanie Bass Yifan Wang Xiao-Feng Wang Omar T Sims Christine E Koval Aanchal Kapoor Christina C Lindenmeyer department of Internal Medicine Cleveland ClinicClevelandOH 44195United States Cleveland clinic Lerner College of Medicine Cleveland ClinicClevelandOH 44195United States department of Pharmacy Cleveland ClinicClevelandOH 44195United States department of Quantitative Health Sciences/Biostatistics Section Cleveland ClinicClevelandOH 44195United States department of Gastroenterology Hepatology and NutritionCleveland ClinicClevelandOH 44195United States department of Infectious Disease Cleveland ClinicClevelandOH 44195United States department of Critical Care Medicine Cleveland ClinicClevelandOH 44195United States

BACKGROUND Due to development of an immune-dysregulated phenotype,advanced liver disease in all forms predisposes patients to sepsis acquisition,including by opportunistic pathogens such as *** data exists on fungal infection within a medical intensive liver unit(MILU),particularly in relation to acute on chronic liver *** To investigate the impact of fungal infections among critically ill patients with advanced liver disease,and compare outcomes to those of patients with bacterial *** From our prospective registry of MILU patients from 2018-2022,we included 27 patients with culture-positive fungal infections and 183 with bacterial *** compared outcomes between patients admitted to the MILU with fungal infections to bacterial *** was extracted through chart *** All fungal infections were due to Candida species,and were most frequently blood *** among patients with fungal infections was significantly worse relative to the bacterial cohort(93%vs 52%,P<0.001).The majority of the fungal cohort developed grade 2 or 3 acute on chronic liver failure(ACLF)(90%vs 64%,P=0.02).Patients in the fungal cohort had increased use of vasopressors(96%vs 70%,P=0.04),mechanical ventilation(96%vs 65%,P<0.001),and dialysis due to acute kidney injury(78%vs 52%,P=0.014).On MILU admission,the fungal cohort had significantly higher Acute Physiology and Chronic Health Evaluation(108 vs 91,P=0.003),Acute Physiology Score(86 vs 65,P=0.003),and Model for End-Stage Liver Disease-Sodium scores(86 vs 65,P=0.041).There was no significant difference in the rate of central line use preceding culture(52%vs 40%,P=0.2).Patients with fungal infection had higher rate of transplant hold placement,and lower rates of transplant;however,differences did not achieve statistical *** Mortality was worse among patients with fungal infections,likely attributable to severe ACLF *** studies examinin

关键词： Fungal Infection Sepsis Acute on chronic liver failure Intensive care

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Standardization is needed in reporting risk and outcomes of machine perfusion in liver transplantation

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 709-714页

作者： Chase J.Wehrle Charles Miller Koji Hashimoto Andrea Schlegel Transplantation Center Department of SurgeryDigestive Disease InstituteCleveland ClinicClevelandOHUSA department of Immunology Lerner Research InstituteCleveland ClinicClevelandOHUSA

We congratulate Yamamoto et *** their study“Impact of Portable Normothermic Machine Perfusion for Liver Transplantation from Adult Deceased Donors”(1).The surge of interest in normothermic machine perfusion(NMP)in the United States(US)has generated considerable *** authors present generally exciting results from their single-center analysis of 541 liver *** these,469 were from donors after brain dead(DBD);58(12.4%)received NMP and 411 static cold storage(SCS,87.6%).Seventy-two transplants were from donors after circulatory death(DCD);52(72.2%)received NMP(device-to-donor)vs.20 SCS(27.8%).

关键词： Liver transplantation machine perfusion normothermic machine perfusion(NMP) transplantation viability assessment

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Bioinspired 3D flexible devices and functional systems

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National Science Review 2024年第3期11卷 271-295页

作者： Xu Cheng Zhangming Shen Yihui Zhang Applied Mechanics laboratory Department of Engineering Mechanics Tsinghua University laboratory of Flexible Electronics Technology Tsinghua University

Flexible devices and functional systems with elaborated three-dimensional(3D) architectures can endow better mechanical/electrical performances, more design freedom, and unique functionalities, when compared to their two-dimensional(2D) counterparts. Such 3D flexible devices/systems are rapidly evolving in three primary directions, including the miniaturization, the increasingly merged physical/artificial intelligence and the enhanced adaptability and capabilities of heterogeneous *** challenges exist in this emerging research area, such as relatively poor controllability in the locomotion of soft robotic systems, mismatch of bioelectronic interfaces, and signal coupling in multi-parameter sensing. By virtue of long-time–optimized materials, structures and processes, natural organisms provide rich sources of inspiration to address these challenges, enabling the design and manufacture of many bioinspired 3D flexible devices/systems. In this Review, we focus on bioinspired 3D flexible devices and functional systems, and summarize their representative design concepts, manufacturing methods, principles of structure-function relationship and broad-ranging applications. Discussions on existing challenges, potential solutions and future opportunities are also provided to usher in further research efforts toward realizing bioinspired 3D flexible devices/systems with precisely programmed shapes,enhanced mechanical/electrical performances, and high-level physical/artificial intelligence.

关键词： bioinspired designs biomimetic 3D structures 3D flexible electronics 3D functional systems direct 3D manufacture 2D-to-3D assembly

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Micelle-directed self-assembly of single-crystal-like mesoporous stoichiometric oxides for high-performance lithium storage

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National Science Review 2024年第4期11卷 195-205页

作者： Yanhua Wan Changyao Wang Xingmiao Zhang Yang Yin Mengmeng Liu Bing Ma Linlin Duan Yuzhu Ma Wei Zhang Changlin Zheng Dongliang Chao Fei Wang Yongyao Xia Wei Li department of Chemistry Laboratory of Advanced Materials Shanghai Key Laboratory of Molecular Catalysis and Innovative Materials State Key Laboratory of Molecular Engineering of Polymers College of Chemistry and Materials ScienceFudan University State Key laboratory of Surface Physics and department of Physics Fudan University

Due to their uncontrollable assembly and crystallization process,the synthesis of mesoporous metal oxide single crystals remains a formidable ***,we report the synthesis of single-crystal-like mesoporous Li2TiSiO5by using soft micelles as *** key lies in the atomic-scale self-assembly and step-crystallization processes,which ensure the formation of single-crystal-like mesoporous Li2TiSiO5microparticles via an oriented attachment growth mechanism under the confinement of an in-situ formed carbon *** mesoporous Li2TiSiO5anode achieves a superior rate capability(148 mAh g-1at5.0 A g-1) and outstanding long-term cycling stability(138 mAh g-1after 3000 cycles at 2.0 A g-1) for lithium storage as a result of the ultrafast Li+diffusion caused by penetrating mesochannels and nanosized crystal frameworks（5-10 nm）.In comparison,bulk Li2TiSiO5exhibits poor rate capability and cycle performance due to micron-scale diffusion *** method is very simple and reproducible,heralding a new way of designing and synthesizing mesoporous single crystals with controllable frameworks and chemical functionalities.

关键词： mesoporous materials micelles single-crystal-like Li2TiSiO5 lithium-ion batteries

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Does ischemia-free machine perfusion lead to early allograft dysfunction (EAD) free liver transplantation?

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 678-680页

作者： Hani M.Wadei Kristopher P.Croome Division of Kidney and Pancreas Transplant Department of TransplantMayo ClinicJacksonvilleFLUSA Division of Transplant Surgery Department of TransplantMayo ClinicJacksonvilleFLUSA

Normothermic machine perfusion(NMP)is an innovative technique used in solid organ transplantation that involves perfusing the organ with specialized solution or leukocyte depleted red blood cells at near-normal body temperature aiming at mimicking physiological conditions,and providing optimal conditions for organ preservation which leads to reduced risk of ischemia reperfusion injury(IRI)when compared to the standard static cold storage(SCS)(1).One of the key advantages of NMP is its ability to assess the quality of the organ in real-time and assessment of the organ performance prior to *** continuously monitoring parameters such as blood flow,oxygen consumption,and lactate production,clinicians can evaluate the viability of the organ and make more informed decisions about its suitability for *** real-time assessment can help reduce the risk of transplanting organs that may not function optimally or have a higher likelihood of complications ***,NMP may expand the pool of donor organs by allowing for the use of organs that may have been deemed marginal or unsuitable for transplantation using traditional methods(1,2).

关键词： Early allograft dysfunction(EAD) normothermic machine perfusion(NMP) liver transplant outcomes

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Toward less invasive coloproctology: The future is out there

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World Journal of Gastroenterology 2024年第3期30卷 199-203页

作者： Sameh Hany Emile Jonathan Ragheb department of Colorectal Surgery Cleveland Clinic FloridaWestonFL 33331United States department of Gastroenterology and Hepatology Cleveland Clinic FloridaWestonFL 33331United States

Medical care has undergone remarkable improvements over the past few *** of the most important innovative breakthroughs in modern medicine is the advent of minimally and less invasive *** trend towards employing less invasive treatment has been vividly shown in the field of gastroenterology,particularly *** to foregut interventions,colorectal surgery has shifted towards a minimally invasive ***,including both medical and surgical management of colorectal diseases,has undergone a remarkable paradigm *** treatment of both benign and malignant colorectal conditions has gradually transitioned towards more conservative and less inva-sive *** interesting paradigm shift was the trend to avoid the need for radical resection of rectal cancer altogether in patients who showed complete response to neoadjuvant *** trend of adopting less invasive appro-aches to treat various colorectal conditions does not seem to be stopping soon as further research on novel,more effective and safer methods is ongoing.

关键词： Toward Less invasive Minimally invasive Coloproctology Future Colorectal surgery

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The genomic and immunogenomic landscape of mechanics pathway informs clinical prognosis and response to mechanotherapy

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Science China(Life Sciences) 2024年第8期67卷 1549-1562页

作者： Peidong Zhang Peiwei Li Muya Tang Ryan CGimple Liang Huang Jing Yue Qiuhong Shen Yiwei Du Qian Zhang Zhengnan Yang Haihuai He Kailin Yang Linjie Zhao Shengtao Zhou department of Obstetrics and Gynecology Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOEState Key Laboratory of BiotherapyWest China Second HospitalSichuan University and Collaborative Innovation CenterChengdu 610041China Physician Scientist Training Program Department of MedicineWashington University School of MedicineSt.Louis 63110USA department of Neurosurgery State Key Laboratory of BiotherapyWest China HospitalSichuan University and Collaborative Innovation CenterChengdu 610041China department of Radiation Oncology Taussig Cancer CenterCleveland ClinicCleveland 44106USA

Mechanics shape cell and tissue plasticity and maintain their *** cancers,mechanical signals regulate cancer hallmarks via mechanotransduction pathways,such as proliferation,metastasis and metabolic ***,comprehensive characterization of mechanotransduction pathway genes and their clinical relevance across different cancer types remains ***,we systematically portrayed the alterations of mechanotransduction pathway genes across 31 cancer types using The Cancer Genome Atlas(TCGA)*** the cancer types could be categorized into 6 subtypes based upon the transcriptional pattern of mechanics pathway *** subtype has its own unique molecular expression pattern,mutation landscapes,immune infiltrates,and patient clinical *** further found that the responses of two subtypes of cancers,one with the optimal outcome and the other with the worst prognosis,to a classical mechanotherapeutic agent(Fasudil,RhoA/ROCK inhibitor)were totally different,indicating that our cancer stratification system based upon mechanotransduction pathway genes could inform clinical responses of patients to mechanotherapeutic ***,our study provides a novel pan-cancer landscape of the mechanotransduction pathways and underscores its potential clinical significance in the prediction of clinical prognosis and therapeutic responses to mechanotherapy among cancer patients.

关键词： pan-cancer cancer mechanics multi-omics immunology

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