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Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

World Journal of transplantation 2024年第1期14卷 84-95页

作者： Muhammed Mubarak Amber Raza Rahma Rashid Fnu Sapna Shaheera Shakeel department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

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Pyrotinib and chrysin synergistically potentiate autophagy in HER2-positive breast cancer

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Signal Transduction and Targeted Therapy 2024年第1期9卷 295-307页

作者： Xiaoxiao Liu Xing Zhang Zhiying Shao Xiaorong Zhong Xin Ding Liang Wu Jie Chen Ping He Yan Cheng Kunrui Zhu Dan Zheng Jing Jing Ting Luo Institute for Breast Health Medicine Cancer CenterBreast CenterWest China HospitalSichuan University610041 ChengduSichuanChina department of Radiation Oncology Cancer CenterAffiliated Hospital of Xuzhou Medical UniversityJiangsu Center for the Collaboration and Innovation of Cancer BiotherapyCancer InstituteXuzhou Medical University221000 XuzhouChina department of Orthopedics Trauma and Reconstructive SurgeryUniversity Hospital RWTH AachenAachen 52074Germany Cancer Institute Xuzhou Medical University221000 XuzhouJiangsuChina Division of nephrology and transplantation Department of Internal MedicineUniversity Medical Center Rotterdam Erasmus MCRotterdam 3015 GDThe Netherlands Institute for Breast Health Medicine Department of General SurgeryBreast CenterWest China HospitalSichuan University610041 ChengduSichuanChina Institute for Breast Health Medicine West China HospitalSichuan University610041 ChengduSichuanChina

Human epidermal growth factor receptor 2(HER2)-positive breast cancer(BC)has been the most challenging subtype of BC,consisting of 20%of BC with an apparent correlation with poor *** that pyrotinib,a new HER2 inhibitor,has led to dramatic improvements in prognosis,the efficacy of pyrotinib monotherapy remains largely restricted due to its acquired ***,identifying a new potential antitumor drug in combination with pyrotinib to amplify therapeutic efficacy is a pressing ***,we reported a novel combination of pyrotinib with chrysin and explored its antitumor efficacy and the underlying mechanism in HER2-positive *** determined that pyrotinib combined with chrysin yielded a potent synergistic effect to induce more evident cell cycle arrest,inhibit the proliferation of BT-474 and SK-BR-3 BC cells,and repress in vivo tumor growth in xenograft mice *** may be attributed to enhanced autophagy induced by endoplasmic reticulum ***,the combined treatment of pyrotinib and chrysin induced ubiquitination and glucose-6-phosphate dehydrogenase(G6PD)degradation by upregulating zinc finger and BTB/POZ domain-containing family protein 16(ZBTB16)in tumorigenesis of ***,we identified that miR-16-5p was a potential upstream regulator of ZBTB16,and it showed a significant inverse correlation with *** of miR-16-5p overexpression by restoring ZBTB16 significantly potentiated the overall antitumor efficacy of pyrotinib combined with chrysin against HER2-positive ***,these findings demonstrate that the combined treatment of pyrotinib and chrysin enhances autophagy in HER2-positive BC through an unrecognized miR-16-5p/ZBTB16/G6PD axis.

关键词： HER2 synergistic Together

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Application and management of continuous glucose monitoring in diabetic kidney disease

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World Journal of Diabetes 2024年第4期15卷 591-597页

作者： Xin-Miao Zhang Quan-Quan Shen Geriatric Medicine center Department of EndocrinologyZhejiang Provincial People's Hospital(Affiliated People's HospitalHangzhou Medical College)Hangzhou 310014Zhejiang ProvinceChina Urology and nephrology center Department of NephrologyZhejiang Provincial People’s Hospital(Affiliated People’s HospitalHangzhou Medical College)Hangzhou 310014Zhejiang ProvinceChina

Diabetic kidney disease(DKD)is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease(ESKD).Wide glycemic var-iations,such as hypoglycemia and hyperglycemia,are broadly found in diabetic patients with DKD and especially ESKD,as a result of impaired renal *** is essential to monitor glycemia for effective management of *** A1c(HbA1c)has long been considered as the gold standard for monitoring glycemia for>3 ***,assessment of HbA1c has some bias as it is susceptible to factors such as anemia and liver or kidney *** glucose monitoring(CGM)has provided new insights on glycemic assessment and *** directly measures glucose level in interstitial fluid,reports real-time or retrospective glucose concentration,and provides multiple glycemic *** avoids the pitfalls of HbA1c in some contexts,and may serve as a precise alternative to estimation of mean glucose and glycemic *** studies have demonstrated the merits of CGM for precise monitoring,which allows fine-tuning of glycemic management in diabetic ***,CGM technology has the potential for better glycemic monitoring in DKD *** research is needed to explore its application and management in different stages of DKD,including hemodialysis,peritoneal dialysis and kidney transplantation.

关键词： Diabetic kidney disease Continuous glucose monitoring Glycemic monitoring Hemodialysis Peritoneal dialysis Kidney transplantation

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Exome sequencing identifies a likely causative variant in 53%of families with ciliopathy-related features on renal ultrasound after excluding NPHP1 deletions

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Genes & Diseases 2024年第5期11卷 40-43页

作者： Konstantin Deutsch Verena Klambt Thomas M.Kitzler Tilman Jobst-Schwan Ronen Schneider Florian Buerger Steve Seltzsam Sherif El Desoky Jameela A.Kari Farkhanda Hafeez Maria Szczepanska Loai A.Eid Hazem S.Awad Muna Al-Saffar Neveen A.Soliman Velibor Tasic Camille Nicolas-Frank Kirollos Yousef Luca M.Schierbaum Sophia Schneider Abdul Halawi Izzeldin Elmubarak Katharina Lemberg Shirlee Shril Shrikant M.Mane Nancy Rodig Friedhelm Hildebrandt Division of nephrology Department of PediatricsBoston Children’s HospitalHarvard Medical SchoolBostonMA 02215USA department of Pediatric Gastroenterology Nephrology and Metabolic DiseasesCharite Universitatsmedizin BerlinBerlin 13353Germany Berlin Institute of Health at Charitee Universitatsmedizin Berlin BIH Biomedical Innovation AcademyBIH Charite Clinician Scientist ProgramBerlin 10178Germany department of nephrology and Hypertension FriedrichAlexander-Universitat Erlangen-NurnbergErlangen 91054Germany department of Pediatrics Faculty of Medicine King Abdulaziz UniversityPediatric Nephrology Center of ExcellenceKing Abdulaziz University HospitalJeddah 21589Saudi Arabia department of Pediatric nephrology The Children’s Hospital and Institute of Child HealthLahore 54000Pakistan department of Pediatrics Faculty of Medical Sciences in ZabrzeMedical University of Silesia in KatowiceKatowice 40-752Poland Dubai hospital and Al-Jalila Children’s Specialty hospital Kidney Center of ExcellenceDubai 4545United Arab Emirates department of Genetics and Genomics UAE UniversityAbu Dhabi 15551United Arab Emirates department of Pediatrics Division of Genetics and GenomicsBoston Children’s HospitalHarvard Medical SchoolBostonMA 02215USA department of Pediatrics Center of Pediatric Nephrology and TransplantationKasr Al Ainy School of MedicineCairo UniversityCairo 11562Egypt Egypt center for Research and Regenerative Medicine(ECRRM) Cairo 11511Egypt Medical Faculty Skopje University Children’s HospitalSkopje 1000North Macedonia department of Genetics Yale University School of MedicineNew HavenCT 06520USA

Nephronophthisis-related ciliopathies(NPHP-RC)represent one of the most common causes of chronic kidney disease in the first three decades of life and are characterized by a broad genetic and clinical heterogeneity.1 To date,more than 90 genes have been identified that cause autosomalrecessive NPHP-RC if mutated,accounting for up to 60%of cases.1 Among these,homozygous deletions of NPHP1 are the most common *** genes localize to primary cilia,basal bodies,or the centrosome and lead to a primary ciliary disruption if mutated,thereby causing a broad phenotypical spectrum.1 Patients that suffer from NPHP-RC can either have an isolated renal phenotype,such as polyuria,polydipsia,decreased urinary concentration ability,and secondary enuresis due to loss of tubular function,or present with extrarenal symptoms including retinal degeneration,cerebellar vermis hypoplasia,or hepatic *** are often diagnosed in early adolescence,reaching end-stage renal disease before 25 years of age,but early onset and rapidly progressive forms of NPHP-RC also exist.1 Renal ultrasound indicates kidneys of normal or reduced renal length with increased echogenicity and corticomedullary cysts.

关键词： degeneration urinary likely

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Renal Transplant Artery Stenosis: Clinical Manifestations, Diagnosis and Treatment

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Open Journal of nephrology 2024年第2期14卷 262-274页

作者： Rihab Dkhissi Latifa Driouch Naima Ouzeddoun Loubna Benamar Tarik Bouattar department of nephrology-Dialysis-Renal transplantation IbnSina Hospital Mohammed V University Rabat Morocco

Introduction: Renal transplant artery stenosis (RTAS) is a common and early complication of renal transplantation, which can lead to severe post-transplant hypertension, as well as significant morbidity and mortality, particulary graft loss. The aim of this study is to determine the prevalence, clinico-radiological characteristics and evaluate the outcomes of luminal angioplasty as a first-line treatment for RTAS, through the analysis of medical records of 27 kidney transplant patients. Material and Methods: This is a retrospective, single-center, and descriptive study conducted at the nephrology department of the Ibn-Sina hospital in Rabat, including 27 renal transplant patients with RTAS during the period from 1998 to 2023. All patients with clinically suspected RTAS and confirmed by Doppler ultrasound of the transplanted renal artery were included in the study. Results: The mean age of donors was 48.66 ± 13.55 years, with a female predominance (65%). The donor was deceased in 15% of cases. The mean age of the recipients was 39 ± 16 years with a male-to-female ratio of 4.4. The median onset of RTAS was 3.6 ± 3.4 months after renal transplantation. Seven patients (26%) had high blood pressure (HBP) before their transplantation. Six patients (22%) had hypertriglyceridemia and 7 patients (26%) had pure hypercholesterolemia. The main clinical signs were worsening of preexisting HBP, de novo HBP and acute renal failure (ARF). Stenosis was confirmed by renal Doppler ultrasound in all patients. It was severe in 63%, with a stenosis degree greater than 70%. Six patients underwent angioplasty, resulting in the stabilization of graft function with a nadir of 15 mg/l creatinine and blood pressure control with dual therapy in 5 patients. No graft loss cases were noted. Conclusion: RTAS is a significant vascular complication of renal transplantation that predicts unfavorable outcomes for both the patient and the graft. Early diagnosis is crucial to successfully restore graft f

关键词： RTAS Post Transplant Hypertension Graft Function Luminal Angioplasty

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Liver transplantation for colorectal liver metastasis:the exception,not the rule

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 857-860页

作者： Diamantis I.Tsilimigras Anargyros Bakopoulos Timothy M.Pawlik1 Timothy M.Pawlik department of Surgery Division of Surgical OncologyThe Ohio State UniversityWexner Medical Center and James Comprehensive Cancer CenterColumbusOHUSA department of Surgery Laiko University HospitalNational and Kapodistrian University of AthensAthensGreece department of Surgery Attikon University HospitalNational and Kapodistrian University of AthensAthensGreece

Approximately half of individuals diagnosed with colorectal cancer(CRC)will develop colorectal liver metastasis(CRLM)during the course of their disease(1,2).Liver resection is the only potentially curative treatment for patients with CRLM,yet less than 20%of individuals are candidates for resection due to the extent or location of liver disease,underlying liver function and/or presence of extrahepatic metastases(1,2).In addition,the oncologic benefit of liver resection for CRLM is limited by recurrence rates than can be as high as 70%(3).Liver transplantation(LT)for CRLM was initially proposed as an alternative treatment strategy in the early 1990s but was abandoned due to the initial poor outcomes(3,4).The concept of transplantation for CRLM was later revisited in the 2000s by a group in Oslo,Norway that reported promising results in the SECA-I pilot study(5).Since the completion of the SECA-I study,the Norwegian group has also published other promising data from the SECA-II study(6).In addition,other notable outcomes have been reported in the RAPID study(7),as well as another study from specialized centers in North America(8),both of which have revitalized the concept of LT for CRLM.

关键词： Liver transplantation(LT) colorectal cancer(CRC) liver metastasis colorectal liver metastasis(CRLM)

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Integrated bulk and single-cell transcriptome data identify clinically relevant cell populations in clear cell renal cell carcinoma

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Genes & Diseases 2024年第1期11卷 42-45页

作者： Pingbao Zhang Pu Zhang Jun Gao Xiaosong Li Chengcheng Wei Weihui Liu QingLiu He Yuan Zhang department of Urology Zhongshan HospitalFudan UniversityShanghai 200032China department of Urology Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China department of Liver Surgery and transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghai 200032China Clinical Molecular Medicine Testing center The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China department of Urology The Second Affiliated Hospital of Fujian Medical UniversityQuanzhouFujian 362000China department of nephrology Sichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuan 610072China

Renal cell carcinoma,which consists of three main histological subtypes,namely,clear cell renal cell carcinoma(ccRCC),papillary RCC(pRCC),and chromophobe RCC(chRCC),accounts for most kidney cancer *** accounts for approximately 85%of all RcC cases,1 and it is a malignant tumor with multiple molecular features and a poor *** have shown that ccRCC is one of the most immune and vaso-invasive cancer types.2 Considering that ccRCC is not sensitive to either radiotherapy or chemotherapy,targeted therapies.

关键词： chemotherapy cancer cases

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Pros and cons of live kidney donation in prediabetics: A critical review and way forward

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World Journal of transplantation 2024年第1期14卷 12-31页

作者： Muhammad Abdul Mabood Khalil Nihal Mohammed Sadagah Jackson Tan Furrukh Omair Syed Vui Heng Chong Salem H Al-Qurashi center of Renal Diseases and transplantation King Fahad Armed Forces Hospital JeddahJeddah 23311Saudi Arabia department of nephrology RIPAS Hospital Brunei DarussalamBrunei Muara BA1710Brunei Darussalam Division of Gastroenterology and Hepatology Department of MedicineRaja Isteri Pengiran Anak Saleha HospitalBandar Seri Begawan BA1710Brunei Darussalam

There is shortage of organs,including kidneys,*** with deceased kidney transplantation,there is a significant rise in live kidney *** prevalence of prediabetes(PD),including impaired fasting glucose and impaired glucose tolerance,is on the rise across the *** teams frequently come across prediabetic kidney donors for *** are at risk of diabetes,chronic kidney disease,cardiovascular events,stroke,neuropathy,retinopathy,dementia,depression and nonalcoholic liver disease along with increased risk of all-cause ***,most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up *** is lack of prospective long-term studies to know about the real risk of complications after ***,there are variations in recommendations from various guidelines across the globe for donations in prediabetics,leading to more confusion among *** increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and *** review focuses on pathophysiological changes of PD in kidneys,potential complications of PD,other risk factors for development of type 2 diabetes,a review of guidelines for kidney donation,the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.

关键词： Live kidney donation Prediabetes Impaired fasting glucose Impaired glucose tolerance Review

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Genitourinary tumors and liver transplantation: A comprehensive review

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World Journal of transplantation 2024年第3期14卷 52-58页

作者： Vibor Sesa Hrvoje Silovski Nikolina Basic-Jukic Iva Kosuta Maja Sremac Anna Mrzljak department of Gastroenterology and Hepatology University Hospital Center ZagrebZagreb 10000Croatia department of Hepatobiliary Surgery and transplantation University Hospital Center ZagrebZagreb 10000Croatia department of Medicine School of MedicineZagreb 10000Croatia department of nephrology Arterial hypertensionDialysis and TransplantationUniversity Hospital Center ZagrebZagreb 10000Croatia department of Intensive Care Medicine University Hospital Center ZagrebZagreb 10000Croatia

Liver transplantation is as a crucial therapeutic option for patients with end-stage liver disease,but the persistent organ shortage emphasizes a need to explore unconventional donor sources,including individuals with a history of *** review investigates the viability of liver donation from individuals with current or past genitourinary malignancies,focusing on renal,prostate and urinary bladder *** rising incidence of urogenital malignancies among potential donors is thought to result from increasing donor *** of transmission risks reveals low rates of donor-derived cancer transmission,partic-ularly for early-stage renal and prostate *** with a history of genitourinary malignancy pose complex challenges regarding post-transplant immunosuppression and cancer ***,the evidence suggests acceptable outcomes can be achieved with careful patient selection and tailored management *** for pre-transplant evaluation and post-transplant surveillance are discussed,highlighting the need for individualized approaches in this patient *** prospective studies are warranted to refine guidelines and optimize outcomes in liver transplantation for patients with genitourinary malignancies.

关键词： Liver transplantation Genitourinary malignancies Donor-transmitted cancer Malignancy recurrence Immunosuppression

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The Impact of Finerenone on Changes in Pulse Wave Velocity, Arterial Pressure and Heart Related Deaths in Hemodialysis Patients—Study Perspective

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Open Journal of nephrology 2024年第2期14卷 216-225页

作者： Ljiljana Fodor Duric Bozidar Vujicic Tonko Gulin Matko Gulin School of Medicine University Catholica Croatica Zagreb Croatia department for nephrology and Arterial Hypertension Medikol Polyclinic Zagreb Croatia department for nephrology Dialysis and Kidney Transplantation Clinical Hospital Center Rijeka Faculty of Medicine University of Rijeka Rijeka Croatia department for nephrology and Dialysis Clinical Hospital Center Sisters of Charity Zagreb Croatia Faculty of Medicine University of Zagreb Zagreb Croatia department for Radiology Clinical Hospital Center Sisters of Charity Zagreb Croatia

The description in the abstract lacks clear logic and a comprehensive summary of this study, so please revise and improve it according to the design theme and main content of this study, and describe it in the order of (research background), purpose/aim, method, results and conclusions. The introduction of the abstract and preface is rather lengthy, but the summary of the whole study and the presentation of the research background are not perfect (mainly because the logic of the context is not clear and orderly), so it will appear a bit messy. Hope to be able to modify (this has been mentioned in the preliminary opinion). Cardiovascular events (CVE) pose a significant threat to individuals with end-stage renal disease (ESRD), yet these patients are often excluded from cardiovascular clinical trials, leaving prognostic factors associated with CVE in ESRD patients largely unexplored. Recent human studies have demonstrated elevated circulating aldosterone levels in ESRD patients, correlating with left ventricular hypertrophy. Additionally, animal models have shown improvements in uremic cardiomyopathy with spironolactone therapy, prompting interest in assessing the efficacy of spironolactone or eplerenone in reducing mortality and improving cardiovascular function in dialysis patients. Clinicians have historically been cautious about prescribing mineralocorticoid receptor antagonists (MRAs) to congestive heart failure patients with chronic kidney disease (CKD) due to hyperkalemia risk. However, the emergence of finerenone, a novel MR antagonist with a favorable safety profile and lower hyperkalemia risk, has renewed interest in MRA therapy in this population. Heart disease, including coronary artery disease, hypertension, and left ventricular failure, is alarmingly prevalent in dialysis patients, contributing significantly to elevated mortality rates compared to the general population. Arterial stiffness, as indicated by pulse wave velocity (PWV), progressively worsens

关键词： Cardiovascular Risk Factors Finerenone Arterial Stiffness Heart Related Deaths Hemodialysis Patients

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