ABSTRACT Migrasomes, newly discovered vesicular organelles, hold promise as diagnostic biomarkers and therapeutic targets in various diseases. However, the exploration of their clinical value remains hindered by the complexity of enriching and analyzing low concentrations of migrasomes in body fluids. To address this issue, a magnetic‐assisted strategy was devised for screening aptamers specific to migrasomes, with the identified aptamer then being utilized for the specific isolation of migrasomes derived from clinical plasma. Initially, lipid‐affinity magnetic nanoparticles were prepared and employed in a Magnetic‐Systematic Evolution of Ligands by Exponential Enrichment (Mag‐SELEX) process to identify aptamers that specifically target migrasomes. An optimal aptamer, Apt_B3, with a dissociation constant (Kd) of 251.9 nM, was successfully identified. This aptamer was subsequently utilized to construct the magnetic aptamer probe system, enabling the precise and rapid capture of migrasomes from plasma within 15 min. Our strategy exhibited exceptional separation efficiency, confirming its reliability and enhanced performance compared to traditional methods such as density gradient centrifugation. Clinical samples were then analyzed to validate the potential role of migrasome‐derived tumor biomarkers in lung adenocarcinoma. These findings underscore the promising applicability of our strategy for studying migrasomes in clinical disease diagnosis.

Diarrhea is usually observed in newborn Hu lambs, while severe diarrhea may lead to the stunted growth and even death in lambs, necessitating the common practice of antibiotic administration to newborns. In order to explore the application of the effective probiotics and/or prebiotic treatment in animal feed to lessen the recline on antibiotics, 27 newborn of Hu lambs were equally allocated into three groups: control group (Con), probiotics group (Pro) receiving Lactiplantibacillus plantarum N-1 (LPN-1), and synbiotics group (Syn) receiving LPN-1 combined with isomaltose-oligosaccharide (IMO), and raised till 60 days of age. Compared with the Con, the incidence of severe diarrhea was lower in both two treatment groups, accompanied by a significant reduction in terramycin administration frequency (P < 0.05). The daily feed intake in newborns significantly increased after probiotics or synbiotics treatment (P < 0.05), leading to the substantial increment in average daily gain by 48.28

BACKGROUND AND AIMS:Acute-on-chronic liver failure (ACLF) is driven by systemic inflammation and immune dysregulation. This study aims to characterize the immune landscape in ACLF and identify potential therapeutic targets. APPROACH AND RESULTS:We employed single-cell RNA sequencing, vision spatial sequencing, bulk RNA sequencing, and bioinformatics analysis to profile immune cells in ACLF livers compared to acute liver failure, decompensated cirrhosis, and controls. ACLF livers exhibited a distinct immune signature with increased neutrophils, particularly CCL4 + subsets, which drive unresolved inflammation by recruiting additional neutrophils and inflammatory CD14 + S100A9 + monocytes. Resident KCs were reduced, and monocytes differentiated into TREM2 + macrophages with an M1-like pro-inflammatory phenotype, exacerbating inflammation. Additionally, lymphoid cells showed significant dysfunction, with reduced NK cells and relatively expanded T cells exhibiting diminished cytotoxicity or pro-inflammatory cytokine production. Cell-cell communication analysis identified the ANXA1-FPR1 axis as a key interaction between T cells and myeloid cells, serving as a negative feedback mechanism to dampen inflammation. Plasma and hepatic ANXA1 levels were elevated in ACLF patients, correlating with disease severity. In the preclinical model, the ANXA1 peptide Ac2-26 improved liver function, reduced inflammation, and promoted macrophage polarization from M1 to M2. In vitro, Ac2-26 inhibited CCL4-mediated monocyte chemotaxis and M1 polarization, effects partially blocked by the FPR1 inhibitor Randialic acid B. Mechanically, Ac2-26 activated AMPK and inhibited mTOR signaling. CONCLUSIONS:Our findings provide a comprehensive immune profile in ACLF and highlight ANXA1 as a potential therapeutic target for resolving immune dysregulation and improving outcomes in ACLF.

The aim of the present study was to develop and validate a spleen ultrasound-based radiomics nomogram for non-invasive differentiation between myelofibrosis (MF) and liver cirrhosis. A total of 90 patients (40 patients with MF and 50 with cirrhosis) were enrolled, and randomly divided into training (n=72) and validation (n=18) sets. Ultrasound radiomics features were extracted from spleen images using PyRadiomics, and feature selection was performed using the least absolute shrinkage and selection operator and Boruta algorithms. Multivariate logistic regression combining radiomics features and clinical parameters was used to construct the nomogram model. Two radiomics features (wavelet.HHL_glcm_ClusterShade and original_glszm_GrayLevelNonUniformity) were selected. When combined with direct bilirubin and glutamic-oxalacetic transaminase levels, the nomogram achieved an area under the curve of 0.958 [95% confidence interval (CI), 0.912-1.0] in the training set and 0.750 (95% CI, 0.487-1.0) in the validation set, with sensitivities of 93.8 and 100%, specificities of 87.5 and 60%, and accuracies of 80.3 and 71.4%, respectively. In conclusion, the spleen ultrasound-based radiomics nomogram demonstrated promising performance for differentiating MF from liver cirrhosis, providing a potential non-invasive tool for early diagnosis and clinical decision-making.

Background: Urinary tract infection (UTI) is the most common infection requiring empiric antibiotic treatment. Due to the increased antibiotic resistance of uropathogens and their regional variation, monitoring pathogen distribution and antimicrobial susceptibility is important to ensure effective antibiotic therapy. This retrospective study analyzed the 3-year-long uropathogen profiles and their resistance from a single tertiary general hospital (single-center) and 28 hospitals (multi-center) to provide data allowing guidance for appropriate empiric antimicrobial treatment for UTI. Methods: A total of 26,108 non-repetitive clinical urine isolates from the single-center during 2017-2019 and the multi-center in 2018 were collected, the pathogen and antimicrobial resistance profiles were analyzed. Results: Escherichia coli, Enterococcus faecium, Klebsiella pneumoniae, Enterococcus faecalis, and Pseudomonas aeruginosa were the top five bacterial pathogens for both the multi-center and single-center, while the proportion of Candida albicans was higher in the single-center. E. coli was the most resistant species, with resistance rates exceeding 50% for 13/30 of the antibiotics tested, even exceeding 80% for ampicillin, nalidixic acid and piperacillin. Particularly, the resistance rates of E. coli to cefazolin were 62.7% in the multi-center while exceeding 90% in the single-center. Similarly, the resistance rates of K. pneumoniae were approximately 40% similar to 60% to 16/29 of the antibiotics tested in the single-center, compared to 30% similar to 50% in the multi-center. In enterococci, E. faecium showed the resistance rates exceeding 90% for 6/10 of the antibiotics tested, while E. faecalis was highly resistant to erythromycin (> 66%) and tetracycline (> 81%). The main fungal pathogens were C. albicans, Candida tropicalis, and Candida glabrata, with the highest resistance rates exceeding 30% for C. tropicalis to fluconazole, itraconazole and voriconazole. The main extended-spectrum beta lactamase (ESBL)-producing isolates were E. coli (86.3%) and K. pneumoniae (11.3%), with resistance rates exceeding 60% for cephalosporins, sulfonamides, quinolones and tetracycline in the single-center. Conclusion: Escherichia coli, E. faecium, K. pneumoniae, E. faecalis, P. aeruginosa and C. albicans were the main uropathogens in the southwestern region of China, while E. coli and E. faecium showed the highest antibiotic resistance. The high resistance of ESBL-producing isolates to cephalosporins, sulfonamides, quinolones and tetracycline in the tertiary general hospital suggests a greater challenge to their antibiotic administration and timely ESBL test, and the empirical antimicrobial therapy should greatly consider the updated local characteristics of the uropathogen resistance, and be more cautious in the tertiary general hospital where patients are more likely to harbor higher resistant pathogens.

MicroRNAs (miRNAs) are found ubiquitously in biological cells and play a pivotal role in regulating the expression of numerous target genes. Therapies centered around miRNAs are emerging as a promising strategy for disease treatment, aiming to intervene in disease progression by modulating abnormal miRNA expressions. The accurate prediction of miRNA-drug resistance (MDR) is crucial for the success of miRNA therapies. Computational models based on deep learning have demonstrated exceptional performance in predicting potential MDRs. However, their effectiveness can be compromised by errors in the data acquisition process, leading to inaccurate node representations. To address this challenge, we introduce the GAM-MDR model, which combines the graph autoencoder (GAE) with random path masking techniques to precisely predict potential MDRs. The reliability and effectiveness of the GAM-MDR model are mainly reflected in two aspects. Firstly, it efficiently extracts the representations of miRNA and drug nodes in the miRNA-drug network. Secondly, our designed random path masking strategy efficiently reconstructs critical paths in the network, thereby reducing the adverse impact of noisy data. To our knowledge, this is the first time that a random path masking strategy has been integrated into a GAE to infer MDRs. Our method was subjected to multiple validations on public datasets and yielded promising results. We are optimistic that our model could offer valuable insights for miRNA therapeutic strategies and deepen the understanding of the regulatory mechanisms of miRNAs. Our data and code are publicly available at GitHub:https://github.com/ZZCrazy00/GAM-MDR.

Since the migrasome concept was first proposed in 2015, extensive research has been conducted on these novel organelles, which grow on retracted fibers at the posterior end of migrating cells. Recently, molecular markers, biological functions, and clinical values based on the initial formation mechanism of migrasomes have emerged. Additionally, researchers are recognizing the significant role that migrasomes play in the pathological and diagnostic processes of clinical diseases. In this review, we summarize recent advances in the biology and clinical application of migrasomes and provide a comprehensive view of the prospective challenges surrounding their clinical application.

Background: The cardiotoxicity induced by human epidermal growth factor receptor-2 (HER-2) inhibitors in patients with breast cancer has been reported widely. However, these data sources were largely limited to fewer patients in clinical trials and case reports, lacking more comprehensive analysis from real-world data. Methods: The cases diagnosed with breast cancer from January 2004 to December 2021 were extracted from the FDA adverse event database and further divided into 3 groups (the HER-2 inhibitor group, the positive control group, and the control group). The association between HER-2 inhibitors and cardiovascular adverse events was evaluated using the reporting odds ratio (ROR), a disproportionality method. Results: A total of 167,639 breast cancer patients were included, including 18,615 cases in the HER-2 inhibitor drug group, 2568 cases in the positive control group, and 146,456 cases in the control group. A total of 2529 cases (13.5%) treated with HER-2 inhibitors experienced cardiovascular adverse events, mainly reported by health professionals (81.5%). The disproportionality analysis showed that cardiomyopathy was observed in all HER-2 inhibitors except trastuzumab deruxtecan. Trastuzumab-related CVAEs were most frequently reported (N =2075), and the median time was 80.50 days (IQR: 8.00 to 206.75 days). Conclusion: Based on real-world data analysis, our study demonstrated a significant association between HER-2 inhibitors and cardiovascular toxicity. Cardiac function in patients with breast cancer should be monitored early during anti-HER therapy, especially within six months.

Growing evidence suggests that polyphenols could mitigate type 2 diabetes mellitus (T2DM). The glucose-regulatory effects of protein-bound polyphenols, however, have been rarely studied. In this study, macrogenomic and metabolomic analyses were applied to investigate the modulation of myofibrillar protein-chlorogenic acid (MP-CGA) complexes on T2DM rats from the gut microbiota perspective. Results showed that MP-CGA improved hyperglycemia and hyperlipidemia, decreased intestinal inflammation, and reduced intestinal barrier injury. MP-CGA reconstructed gut microbiota in T2DM rats, elevating the abundance of probiotics Bacteroides, Akkermansia, and Parabacteroides while suppressing opportunistic pathogens Enterococcus and Staphylococcus. MP-CGA significantly elevated the concentrations of intestinal metabolites like butyric acid that positively regulate T2DM and reduced the secondary bile acids contents. Therefore, MP-CGA modulated the gut microbiota and related metabolites to maintain stable blood glucose in T2DM rats, providing new insights into the application of protein-polyphenol complexes in foods.

The increased global incidence of chronic metabolic diseases,a vital threat to human health and a burden on our healthcare systems,includes a series of clinical metabolic syndromes such as obesity,diabetes,hypertension,and dyslipidemia.One of the well-known probiotic microorganisms,Lactiplantibacillus plantarum plays an important role in promoting human health,including inhibiting the occurrence and development of a variety of chronic metabolic diseases.The present study provides an overview of the preventive and therapeutic effects of L.plantarum on diabetes,obesity,non-alcoholic fatty liver disease,kidney stone disease,and cardiovascular diseases in animal models and human clinical trials.Ingesting L.plantarum demonstrated its ability to reduce inflammatory and oxidative stress levels by regulating the production of cytokines and short-chain fatty acids（SCFAs）,the activity of antioxidant enzymes,and the balance of intestinal microbial communities to alleviate the symptoms of chronic metabolic diseases.Furthermore,updated applications and technologies of L.plantarum in food and biopharmaceutical industries are also discussed.Understanding the characteristics and functions of L.plantarum will guide the development of related probiotic products and explore the modulatory benefit of L.plantarum supplementations on the prevention and treatment of multiple chronic metabolic diseases.

Background Prevention, screening, and early treatment are the aims of postoperative delirium management. The scoring system is an objective and effective tool to stratify potential delirium risk for patients undergoing cardiac surgery. Methods Patients who underwent cardiac surgery between January 1, 2012, and January 1, 2019, were enrolled in our retrospective study. The patients were divided into a derivation cohort (n = 45,744) and a validation cohort (n = 11,436). The AD predictive systems were formulated using multivariate logistic regression analysis at three time points: preoperation, ICU admittance, and 24 h after ICU admittance. Results The prevalence of AD after cardiac surgery in the whole cohort was 3.6% (2,085/57,180). The dynamic scoring system included preoperative LVEF ≤ 45%, serum creatinine > 100 µmol/L, emergency surgery, coronary artery disease, hemorrhage volume > 600 mL, intraoperative platelet or plasma use, and postoperative LVEF ≤ 45%. The area under the receiver operating characteristic curve (AUC) values for AD prediction were 0.68 (preoperative), 0.74 (on the day of ICU admission), and 0.75 (postoperative). The Hosmer‒Lemeshow test indicated that the calibration of the preoperative prediction model was poor ( P = 0.01), whereas that of the pre- and intraoperative prediction model ( P = 0.49) and the pre, intra- and postoperative prediction model ( P = 0.35) was good. Conclusions Using perioperative data, we developed a dynamic scoring system for predicting the risk of AD following cardiac surgery. The dynamic scoring system may improve the early recognition of and the interventions for AD.

Aims: As the impact of inclisiran in stroke prevention in atherosclerotic cardiovascular disease (ASCVD) patients or those at high risk of ASCVD is still unclear, we conducted a systematic review and meta-analysis of randomized controlled trials (RCT) to quantify the effectiveness of inclisiran in stroke prevention in these patients.Methods: Literature research was conducted in four electronic databases (PubMed, EMBASE, Web of Science, CENTRAL) and two clinical trials registers (ClinicalTrials.gov, WHO ICTRP) from the inception of the study to 17 October 2022, and was updated by the end of the study on 5 January 2023. Two authors independently screened the studies, extracted the data, and assessed the bias. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). The intervention effect was estimated by calculating risk ratio (RR), weighted mean difference (WMD), and 95% confidence interval (CI) with R 4.0.5. Sensitivity analysis by changing meta-analysis model was also performed to test the robustness of the pooled results. If this was not possible, a descriptive analysis was conducted.Results: Four RCTs (n = 3,713 patients) were rated as high-risk bias. Meta-analysis of three RCTs (ORION-9, ORION-10, and ORION-11) showed that inclisiran reduced myocardial infarction (MI) risk by 32% (RR = 0.68, 95%CI = 0.48–0.96) but did not reduce stroke (RR = 0.92, 95%CI = 0.54–1.58) and major cardiovascular events (MACE) (RR = 0.81, 95%CI = 0.65–1.02) risk. Sensitivity analysis results were stable. Safety was similar to the placebo group but had frequent injection-site reactions (RR = 6.56, 95%CI = 3.83–11.25), which were predominantly mild or moderate. A descriptive analysis of one RCT (ORION-5) was conducted due to different study designs, and suggested that inclisiran might be given semiannually from the beginning.Conclusion: Inclisiran is not beneficial for stroke or MACE prevention in ASCVD or patients at high risk of ASCVD but is associated with the reduction of MI. Given the limited number and quality of the available studies and the lack of a standardized definition for cardiovascular events, further studies are essential for confirming the results.

目的:分析左旋多巴联合司来吉兰或普拉克索治疗帕金森病的真实世界临床给药剂量情况,为合理用药提供参考.方法:基于全国30个三甲医院随机抽取的2014-2019年的帕金森患者用药真实世界处方数据,筛选帕金森病治疗药物,根据实际用药情况分为单用左旋多巴、左旋多巴+司来吉兰、左旋多巴+普拉克索3组的处方数据,分析不同方案中左旋多巴的给药剂量,以及小剂量左旋多巴(≤400.00 mg·d-1)处方占比.结果:左旋多巴+司来吉兰组的左旋多巴等效日剂量与左旋多巴+普拉克索组(P＜0.01)、左旋多巴组(P＜0.01)差异均有统计学意义,左旋多巴+普拉克索组与左旋多巴组的左旋多巴等效日剂量差异并无统计学意义(P=0.76).不同年龄段、年份和地区的左旋多巴等效日剂量有一定差异,小剂量左旋多巴处方占比呈逐年增加.结论:帕金森患者联合使用司来吉兰时可能需要减少左旋多巴用药剂量,而普拉克索的联合使用不需要调整左旋多巴的应用剂量.

Probiotics have gained tremendous attention as an alternative to antibiotics, while synbiotics may exhibit a greater growth promoting effect than their counterpart probiotics due to the prebiotics’ promotion on the growth and reproduction of probiotics. The objective of this study was to investigate the influence of Lactiplantibacillus plantarum N-1 and its synbiotic with oligomeric isomaltose on the growth performance and meat quality of Hu sheep. Hu sheep (0–3 days old) were fed with water, probiotics of N-1, or synbiotics (N-1 and oligomeric isomaltose) daily in three pens for 60 days and regularly evaluated to measure growth performance and collect serum (five lambs per group). Longissimus thoracis (LT) and biceps brachii (BB) muscle tissues were collected for the analysis of pH value, color, texture, nutrients, mineral elements, amino acids, volatile compounds, and antioxidant capacity. The results showed that dietary supplementation of N-1 tended to improve growth performance and meat quality of Hu sheep, while the synergism of N-1 with oligomeric isomaltose significantly improved their growth performance and meat quality (p < 0.05). Both the dietary supplementation of N-1 and synbiotics (p < 0.05) increased the body weight and body size of Hu sheep. Synbiotic treatment reduced serum cholesterol and improved LT fat content by increasing the transcription level of fatty acid synthase to enhance fat deposition in LT, as determined via RT-qPCR analysis. Moreover, synbiotics increased zinc content and improved LT tenderness by decreasing shear force and significantly increased the levels of certain essential (Thr, Phe, and Met) and non-essential (Asp, Ser, and Tyr) amino acids of LT (p < 0.05). Additionally, synbiotics inhibited the production of carbonyl groups and TBARS in LT and thus maintained antioxidant stability. In conclusion, it is recommended that the use of synbiotics in livestock breeding be promoted to improve sheep production and meat quality.

Background and purposeBreast cancer is a rapidly raising healthcare problem worldwide. DESTINY-Breast04 demonstrated that trastuzumab deruxtecan (T-Dxd) had a survival advantage comparing to the physician's choice of chemotherapy for patients with HER2-low metastatic breast cancer. But at the same time, this expensive novel treatment also brought an economic burden. This study assessed the cost-effectiveness of T-Dxd based on results of DESTINY-Breast04 from the perspective of Chinese healthcare system.Materials and methodsA three-state partitioned-survival model [progression-free survival (PFS), progressive disease (PD) and death] based on data from DESTINY-Breast04 and Chinese healthcare system was used to estimate the incremental cost-effectiveness ratio (ICER) of T-Dxd vs. the physician's choice of chemotherapy for HER2-low metastatic breast cancer. Costs, quality-adjusted life-years (QALYs) and the ICER in terms of 2022 US$ per QALY gained were calculated for both hormone receptor–positive cohort and all patients. One-way and probabilistic sensitivity analyses were performed to assess the model robustness.ResultsCompared with the physician's choice of chemotherapy, T-Dxd increased costs by $104,168.30, while gaining 0.31 QALYs, resulting in an ICER of $336,026.77 per QALY in all patients. The costs of T-Dxd and the utility of PFS were the crucial factors in determining the ICER. In the hormone receptor–positive cohort, the ICER was lower than that in all patients, with the ICER of $274,905.72 per QALY. The ICER was much higher than the commonly accepted willingness-to-pay threshold ($357,96.83 per QALY).ConclusionT-Dxd as second- or subsequent-line treatment is not a cost-effective treatment option for HER2-low metastatic breast cancer from the perspective of the Chinese healthcare system.

Background: Bevacizumab biosimilars are slowly making their way into cancer treatment, but the data on their efficacy and safety in cancer patients are still poor. We systematically summarized the current evidence for the efficacy and safety of bevacizumab biosimilars in patients with advanced non-small cell lung cancer (NSCLC) or metastatic colorectal cancer (CRC). Methods: This review searched CNKI, VIP, PubMed, Medline (Ovid), Embase, and Cochrane Library (Ovid) for randomized controlled trials of bevacizumab biosimilars treated in adults with advanced NSCLC or metastatic CRC. A pairwise meta-analysis and a Bayesian network meta-analysis based on the random-effect model were performed to summarize the evidence. We rated the certainty of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation framework. Results: Ten eligible trials with a total of 5526 patients were included. Seven trials (n = 4581) were for the NSCLC population, while three trials (n = 945) were for patients with CRC. According to the pairwise meta-analysis, the efficacy (objective response rate: risk ratio (RR) 0.98 [0.92-1.04], p = 0.45; progression-free survival: hazard ratio (HR) 1.01 [0.92-1.10], p = 0.85; and overall survival: HR 1.06 [0.94-1.19], p = 0.35) and safety (incidence of grade 3-5 adverse events: odds ratio (OR) 1.03 [0.91-1.16], p = 0.65) of bevacizumab biosimilars performed no significant difference with reference biologics in patients with NSCLC as well as metastatic CRC patients (objective response rate: RR 0.97 [0.87-1.09], p = 0.60; overall survival: HR 0.94 [0.70-1.25], p = 0.66; incidence of grade 3-5 adverse events: OR 0.78 [0.59-1.02], p = 0.73). Network estimates displayed 7 types of bevacizumab biosimilars in the medication regime of NSCLC patients who had no significant difference among each other in terms of efficacy and safety. The certainty of the evidence was assessed as low to moderate. Three types of biosimilars were found to be clinically equivalent to each other in the patients with CRC, which were evaluated with very low to moderate certainty. Conclusion: In patients with advanced NSCLC or metastatic CRC, the efficacy and safety of bevacizumab biosimilars were found to be comparable with those of reference biologics and each other.

The dominance of antibodies in diagnostics has gradually changed following the discovery of aptamers in the early 1990s. Aptamers offer inherent advantages over traditional antibodies, including higher specificity, higher affinity, smaller size, greater stability, ease of manufacture, and low immunogenicity, rendering them the best candidates for point-of-care testing (POCT). In the past 20 years, the research community and pharmaceutical companies have made great efforts to promote the development of aptamer technology. Macugen® (pegaptanib) was the first aptamer drug approved by the US Food and Drug Administration (FDA), and various aptamer-based diagnostics show great promise in preclinical research and clinical trials. In this review, we introduce recent literature, ongoing clinical trials, commercial reagents of aptamer-based diagnostics, discuss the FDA regulatory mechanisms, and highlight the prospects and challenges in translating these studies into viable clinical diagnostic tools.

BACKGROUND Red blood cell transfusion is common and associated with adverse outcomes for cardiac surgery, while present blood conservation guidelines have not been fully implemented until now. This study evaluated our comprehensive blood conservation program after quality management and explored its impact on blood transfusion and outcomes in patients undergoing cardiopulmonary bypass (CPB). METHODS We retrospectively compared blood transfusions and outcomes of patients from 2 different periods, before and after initiation of the quality management of the comprehensive blood conservation program. The comprehensive program included restrictive transfusion protocols, conventional ultrafiltration, cell salvage, residual pump blood ultrafiltration, and a modified minimal extracorporeal circulation system. A 1:1 propensity score matching and subgroup analysis were conducted. RESULTS There were 3977 pairs. A significant decrease of red blood cell transfusion was observed before vs after the comprehensive blood conservation program during CPB (28.4% vs 18.6%, P < .001), in the operation (40.7% vs 34.3%, P < .001), and after the operation (6.2% vs 4.3%, P < .001). Also reduced were 30-day mortality and some major complications. Subgroup analysis showed that the comprehensive blood conservation program was more beneficial for patients aged >60 years, male, and with a medium-risk European System for Cardiac Operative Risk Evaluation (EuroSCORE) of score 3 to 5. CONCLUSIONS The comprehensive blood conservation program during CPB is safe and effective in adult cardiac operations, reducing blood use, with no adverse outcomes. For patients who are older, male, and have a EuroSCORE of 3 to 5, blood transfusion should be more cautious. (C) 2022 by The Society of Thoracic Surgeons

Mycobacterium tuberculosis complex (MTBC), the main cause of TB in humans and animals, is an extreme example of genetic homogeneity, whereas it is still nevertheless separated into various lineages by numerous typing methods, which differ in phenotype, virulence, geographic distribution, and host preference. The large sequence polymorphism (LSP), incorporating region of difference (RD) and H37Rv-related deletion (RvD), is considered to be a powerful means of constructing phylogenetic relationships within MTBC. Although there have been many studies on LSP already, focusing on the distribution of RDs in MTBC and their impact on MTB phenotypes, a crumb of new lineages or sub-lineages have been excluded and RvDs have received less attention. We, therefore, sampled a dataset of 1,495 strains, containing 113 lineages from the laboratory collection, to screen for RDs and RvDs by structural variant detection and genome assembly, and examined the distribution of RvDs in MTBC, including RvD2, RvD5, and cobF region. Consistent with genealogical delineation by single nucleotide polymorphism (SNP), we identified 125 RDs and 5 RvDs at the species, lineage, or sub-lineage levels. The specificities of RDs and RvDs were further investigated in the remaining 10,218 strains, suggesting that most of them were highly specific to distinct phylogenetic groups, could be used as stable genetic markers in genotyping. More importantly, we identified 34 new lineage or evolutionary branch specific RDs and 2 RvDs, also demonstrated the distribution of known RDs and RvDs in MTBC. This study provides novel details about deletion events that have occurred in distinct phylogenetic groups and may help to understand the genealogical differentiation.

目的 通过文献计量及可视化分析,了解2011年以来《医药导报》载文情况的动态变化,为作者投稿和该刊的高质量发展提供参考.方法 计算机检索2011-2021年"中国生物医学文献数据库"中收录来源为《医药导报》的相关文章.运用文献计量学方法对年载文量、基金论文、发文地区、作者、作者单位、关键词和文章引用情况等进行统计分析,并通过CiteSpace(5.8.R3)软件进行可视化分析.结果 共纳入文章5365篇,共涉及作者13 477名.文章来源范围广,基金论文占比稳步提升.优质作者团队凸显,合作力度有所提升.文章主题广泛,紧跟医药信息发展趋势.结论 《医药导报》知名度和学术水平稳步提升,学术影响力逐渐扩大,向国内一流、国际有影响力的学术期刊迈进.