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Outcomes of patients awaiting lung transplantation after the implementation of donation after brain death

《医学前沿（英文）》 2022年 第16卷 第5期   页码 760-765 doi: 10.1007/s11684-021-0899-5

摘要： Voluntary contribution has become the only source of donor lungs in China since 2015. To elaborate the outcomes of patients awaiting lung transplantation (LTx) after the implementation of donation after brain death, we performed a retrospective study that encompassed 205 patients with end-stage lung disease who registered for LTx at Shanghai Pulmonary Hospital from January 1, 2015 to January 1, 2021. A total of 180 patients were enrolled in the study. The median waiting time was 1.25 months. Interstitial lung disease (ILD) (103/180, 57.2%) and chronic obstructive pulmonary disease (COPD) (56/180, 31.1%) were the most common diseases in our study population. The mean pulmonary artery pressure (mPAP) of patients in the died-waiting group was higher than that of the survivors (53.29±21.71 mmHg vs. 42.11±18.58 mmHg, P=0.002). The mortality of patients with ILD (34/103, 33.00%) was nearly twice that of patients with COPD (10/56, 17.86%) while awaiting LTx (P=0.041). In the died-waiting group, patients with ILD had a shorter median waiting time than patients with COPD after being listed (0.865 months vs. 4.720 months, P=0.030). ILD as primary disease and mPAP > 35 mmHg were two significant independent risk factors for waitlist mortality, with hazard ratios (HR) of 3.483 (95% CI 1.311–9.111; P=0.011) and 3.500 (95% CI 1.435–8.536; P=0.006). Hence, LTx is more urgently needed in patients with ILD and pulmonary hypertension.

关键词： lung transplantation     donation after brain death     waitlist    

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The influence of brain death on donor liver and the potential mechanisms of protective intervention

null

《医学前沿（英文）》 2011年 第5卷 第1期   页码 8-14 doi: 10.1007/s11684-011-0109-y

摘要：

Brain-dead donors have become one of the main sources of organs for transplantation in Western countries. The quality of donor organs is closely related to the outcome of the transplantation. Experimental studies have confirmed the inferior graft survival of livers from brain-dead donors compared with those from living donors. Studies conducted in the past 10 years have shown that brain death is associated with effects on the decreased donor organ quality. However, whether the decrease in the viability of donor organs is caused by brain death or by the events before and after brain death remains uncertain. The purpose of this review is to introduce the advances and controversies regarding the influence of brain death on the viability of donor livers and to summarize the mechanisms of the different protective interventions for donor livers.

关键词： brain death     donor liver    

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Experimental study on the establishment and maintenance of brain death model with pigs

ZHANG Shuijun, SHI Jihua, ZHAI Wenlong, SONG Yan, CHEN Shi

《医学前沿（英文）》 2007年 第1卷 第2期   页码 161-166 doi: 10.1007/s11684-007-0030-6

摘要： It remains controversial that after the transplantation of using grafts from brain-dead donors, organs injury and rejection can influence the effects of transplantation. This study sought to explore methods of establishing a stable brain death (BD) model using Bama mini pigs and to maintain the brain-dead state for a comparatively long period to provide a model for investigating changes in brain death. Sixteen anesthetized Bama mini pigs were randomized into a control group ( = 5) and a BD group ( = 11). Intracranial pressure (ICP) was increased in a modified, slow, and intermittent way to establish BD. Respiration and circulation were sustained during the brain-dead state. Hemodynamic changes were monitored during the experiment. In the BD group, 10 pigs met the requirements for brain death and 1 died of cardiopulmonary complications following an increase in ICP. Brain death was maintained for more than 48 hours with artificial life support. During the experiment, the heart rate and blood pressure showed characteristic changes due to increased ICP. Prior to BD being established, a tic reaction inevitably occurred. We used an improved method of increasing ICP to establish a stable BD model. The BD state could be maintained for more than 48 hours with effective respiratory and circulatory support. Disappearance of the tic reaction was considered to be one of the verified indexes for BD via encephalic pressure increase.

关键词： BD     control     Hemodynamic     cardiopulmonary     modified    

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Protein aggregation in association with delayed neuronal death in rat model of brain ischemia

GE Pengfei, FU Shuanglin, LI Wenchen, WANG Chonghao, ZHOU Chuibing, LUO Yinan, LUO Tianfei

《医学前沿（英文）》 2008年 第2卷 第1期   页码 70-74 doi: 10.1007/s11684-008-0013-2

摘要： To investigate the relationship between protein aggregation and delayed neuronal death, we adopted rat models of 20 min ischemia. Brain ischemia was produced using the 2-vessel occlusion (2VO) model in rats Light microscopy, transmission electronic microscopy and Western blot analysis were performed for morphological analysis of neurons, and protein detection. The results showed delayed neuronal death took place at 72 h after ischemia-reperfusion, protein aggregates formed at 4 h after reperfusion and reached the peak at 24 h after reperfusion, and Western blot analysis was consistent with transmission electronic microscopy. We conclude that protein aggregation is one of the important factors leading to delayed neuronal death.
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Autoimmunity in acute ischemic stroke and the role of blood—brain barrier: the dark side or the light

Nikolay V. Tsygan, Alexandr P. Trashkov, Igor V. Litvinenko, Viktoriya A. Yakovleva, Alexandr V. Ryabtsev, Andrey G. Vasiliev, Leonid P. Churilov

《医学前沿（英文）》 2019年 第13卷 第4期   页码 420-426 doi: 10.1007/s11684-019-0688-6

摘要： This article presents a synopsis of the current data on the mechanisms of blood—brain barrier (BBB) alteration and autoimmune response in acute ischemic stroke. Most researchers confirm the relationship between the severity of immunobiochemical changes and clinical outcome of acute ischemic stroke. Ischemic stroke is accompanied by aseptic inflammation, which alters the brain tissue and exposes the co-stimulatory molecules of the immune system and the neuronal antigens. To date, BBB is not considered the border between the immune system and central nervous system, and the local immune subsystems are found within and behind the BBB. BBB disruption contributes to the leakage of brain autoantigens and induction of secondary autoimmune response to neuronal antigens and long-term inflammation. Glymphatic system function is altered and jeopardized both in hemorrhagic and ischemic stroke types. The receptors of innate immunity (toll-like receptor-2 and toll-like receptor-4) are also involved in acute ischemia—reperfusion injury. Immune response is related to the key processes of blood clotting and fibrinolysis. At the same time, the stroke-induced immune activation may promote reparation phenomena in the brain. Subsequent research on the reduction of the acute ischemic brain injury through the target regulation of the immune response is promising.

关键词： stroke     blood–brain barrier     autoimmunity     innate immunity     inflammation     cell death    

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Orlistat induces ferroptosis-like cell death of lung cancer cells

《医学前沿（英文）》 2021年 第15卷 第6期   页码 922-932 doi: 10.1007/s11684-020-0804-7

摘要： Aberrant de novo lipid synthesis is involved in the progression and treatment resistance of many types of cancers, including lung cancer; however, targeting the lipogenetic pathways for cancer therapy remains an unmet clinical need. In this study, we tested the anticancer activity of orlistat, an FDA-approved anti-obesity drug, in human and mouse cancer cells in vitro and in vivo, and we found that orlistat, as a single agent, inhibited the proliferation and viabilities of lung cancer cells and induced ferroptosis-like cell death in vitro. Mechanistically, we found that orlistat reduced the expression of GPX4, a central ferroptosis regulator, and induced lipid peroxidation. In addition, we systemically analyzed the genome-wide gene expression changes affected by orlistat treatment using RNA-seq and identified FAF2, a molecule regulating the lipid droplet homeostasis, as a novel target of orlistat. Moreover, in a mouse xenograft model, orlistat significantly inhibited tumor growth and reduced the tumor volumes compared with vehicle control (P<0.05). Our study showed a novel mechanism of the anticancer activity of orlistat and provided the rationale for repurposing this drug for the treatment of lung cancer and other types of cancer.

关键词： orlistat     ferroptosis     FAF2     lung cancer    

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Cooling strategies and transport theories for brain hypothermia resuscitation

LIU Jing

《能源前沿（英文）》 2007年 第1卷 第1期   页码 32-57 doi: 10.1007/s11708-007-0004-z

摘要： The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen. Unlike skeletal muscles that can survive for hours without oxygen, neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency. With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest, an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain. Meanwhile, the cooling function of the blood flow on the hot tissue will be stopped, while metabolic heat generation in the tissues still keeps running for awhile. Under such adverse situations, the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands. The reason can be attributed to the decreased metabolic requirements of the cold brain tissues, which allows a longer duration for the brain to endure reduced oxygen delivery. It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines, especially in cerebral damage, anoxia, circulatory arrest, respiratory occlusion, etc. However, although brain cooling has been found uniquely significant in clinical practices, the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation. Compared with the expanded trials in clinics, only very limited efforts were made to probe the engineering issues involved, which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation. From the viewpoint of biothermal medical engineering, the major theories and strategies for administering brain cooling can generally be classified into three categories: heat transfer, oxygen transport and cooling strategy. Aiming to provide a complete overview of the brain hypothermia resuscitation, this article comprehensively summarizes the recent progresses made in theoretical, practical and experimental techniques in the area. Particularly, attention is paid to the mathematical models to quantify the heat and oxygen transport inside the cerebral tissues. Typical cooling strategies to effectively lower brain temperature and thus decrease oxygen consumption rate in the cerebral tissues are analyzed. Approaches to deliver oxygen directly to the target tissues are discussed. Meanwhile, some future efforts worth pursuing within the area of brain cooling are suggested.

关键词： mathematical     interruption     hypothermia     metabolic     generation    

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Sudden death due to arrhythmogenic right ventricular cardiomyopathy: Two case reports

CHEN Xinshan, ZHANG Yigu, RAO Guangxun, HUANG Guangzhao

《医学前沿（英文）》 2007年 第1卷 第3期   页码 338-342 doi: 10.1007/s11684-007-0065-8

摘要： Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a kind of primary myocardial disease characterized by the regional or global replacement of right ventricular myocardium by fatty and fibrolipomatous tissues. The ARVC, usually presenting with different clinical manifestations and pathological changes, were mainly seen in young men and is one of the main causes of sudden death in the young. Here two autopsied cases of Chinese men aged 30 and 23 years old who appeared healthy but died suddenly while at work are reported respectively. One of the victims had extensive and severe pathological changes in his heart involving the left ventricular wall as well as the ventricular septum and the right atrium. Not only was there a global fatty and fibrolipomatous tissue replacement of the right ventricular myocardia, but also mild sarcoplasmic coagulation in the myocardium and focal lymphocytic infiltration in the myocardial interstitium of the right ventricular wall. In addition, slight atherosclerosis of the coronary artery and intimal thickening of the sino-atrial node were observed. It is believed that there are no marked differences in the pathological changes of ARVC between Chinese patients and patients from western countries. The etiology and pathogenesis of ARVC could not be explained by a single cause or factor and they are probably related to various congenital and acquired causes or factors.

关键词： sarcoplasmic coagulation     acquired     ventricular myocardium     sino-atrial     autopsied    

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Tramadol reinforces antidepressant effects of ketamine with increased levels of brain-derived neurotrophic

null

《医学前沿（英文）》 2012年 第6卷 第4期   页码 411-415 doi: 10.1007/s11684-012-0226-2

摘要：

Ketamine exerts rapid and robust antidepressant properties in both animal models and depressed patients and tramadol possesses potential antidepressant effects. Brain-derived neurotrophic factor (BDNF) is an important biomarker for mood disorders and tropomyosin-related kinase B (TrkB) is a high affinity catalytic receptor for BDNF. We hypothesized that tramadol pretreatment might reinforce ketamine-elicited antidepressant effects with significant changes in hippocampal BDNF and TrkB levels in rats. Immobility time of rats receiving different treatment in the forced swimming test (FST) was observed. Levels of BDNF and TrkB in hippocampus were measured by enzyme linked immunosorbent assay. Results showed that tramadol (5 mg/kg) administrated alone neither elicited antidepressant effects nor altered BDNF or TrkB level. However, pretreatment with tramadol (5 mg/kg) enhanced the ketamine (10 mg/kg) -elicited antidepressant effects and upregulated the BDNF and TrkB levels in hippocampus. In conclusion, tramadol pretreatment reinforces the ketamine-elicited antidepressant effects, which is associated with the increased levels of BDNF and TrkB in rat hippocampus.

关键词： tramadol     ketamine     antidepressant     brain-derived neurotrophic factor     tropomyosin-related kinase B    

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Various brain-eating amoebae: the protozoa, the pathogenesis, and the disease

《医学前沿（英文）》 2021年 第15卷 第6期   页码 842-866 doi: 10.1007/s11684-021-0865-2

摘要： Among various genera of free-living amoebae prevalent in nature, some members are identified as causative agents of human encephalitis, in which Naegleria fowleri followed by Acanthamoeba spp. and Balamuthia mandrillaris have been successively discovered. As the three dominant genera responsible for infections, Acanthamoeba and Balamuthia work as opportunistic pathogens of granulomatous amoebic encephalitis in immunocompetent and immunocompromised individuals, whereas Naegleria induces primary amoebic meningoencephalitis mostly in healthy children and young adults as a more violent and deadly disease. Due to the lack of typical symptoms and laboratory findings, all these amoebic encephalitic diseases are difficult to diagnose. Considering that subsequent therapies are also affected, all these brain infections cause significant mortality worldwide, with more than 90% of the cases being fatal. Along with global warming and population explosion, expanding areas of human and amoebae activity in some regions lead to increased contact, resulting in more serious infections and drawing increased public attention. In this review, we summarize the present information of these pathogenic free-living amoebae, including their phylogeny, classification, biology, and ecology. The mechanisms of pathogenesis, immunology, pathophysiology, clinical manifestations, epidemiology, diagnosis, and therapies are also discussed.

关键词： free-living amoebae     central nervous system infection     primary amoebic meningoencephalitis     granulomatous amoebic encephalitis    

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Assessing the premature death due to ambient particulate matter in China’s urban areas from 2004 to 2013

Guoxia MA, Jinnan WANG, Fang YU, Xiaomin GUO, Yanshen ZHANG, Chao LI

《环境科学与工程前沿（英文）》 2016年 第10卷 第5期 doi: 10.1007/s11783-016-0849-7

摘要： The number of annual premature deaths attributable to China’s air pollution ranged from 350000 to 520000 from 2004 to 2013, while the figure in 2013 reached 9.9% of total deaths in China. In 2004, the life expectancy potential years of life lost was 69.6 and 1.85 years respectively in contrast to 74.4 and 0.67 years respectively in 2013. The number of PYLL attributable to air pollution in the northern regions is found to be larger than that of the southern regions. The Environmental Burden of Disease (EBD) approach for outdoor air pollution has been used to calculate premature deaths and average potential years of life lost attributable to air pollution in China over the past 10 years with differences between the North and the South of the country being analyzed. The results indicate that: (1) Between 2004 and 2013, annual premature deaths attributable to outdoor air pollution in China ranged from 350000 to 520000. In 2013, deaths resulting from air pollution in China represented 9.9% of the country’s total deaths. (2) In 2004, the average life expectancy of the Chinese population and the number of potential years of life lost (PYLL) attributable to air pollution was 69.6 and 1.85 years respectively as compared to 74.4 and 0.67 years respectively in 2013. (3) The number of the PYLL attributable to air pollution in the northern regions of China is found to be larger than that of the southern regions. The PYLL figures of the northern and southern regions in 2004 were 2.3 and 1.8 years, respectively, with a difference of 0.5 years, as compared to 1.4 and 0.7 years respectively with a difference of 0.7 years in 2013.

关键词： Air pollution     Public health     Premature deaths     Health assessment    

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富含sn-2 DHA脂质对大脑的益处及其酶法合成综述 Review

金俊, 金青哲, 王兴国, Casimir C. Akoh

《工程（英文）》 2020年 第6卷 第4期   页码 424-431 doi: 10.1016/j.eng.2020.02.009

摘要：

大脑中二十二碳六烯酸（DHA, ω-3脂肪酸）的含量与中枢神经系统的正常发育和功能维持高度相关。甘油酯sn-2位上的DHA可以被肠黏膜更好地吸收，从而实现机体对DHA的高效利用。然而，如今人们在饮食中摄入较多的饱和脂肪或富含ω-6脂肪酸的油脂，而摄入较少的DHA，从而导致了部分个体在行为和神经生理学方面的缺陷。为了全面了解DHA对大脑的有益功能，本文系统介绍了天然油脂甘油骨架上DHA的位置分布（sn-2和sn-1,3位）特征，并讨论了DHA补充和通过肠-脑轴传递信息的潜在功能机制。肠-脑轴包含的多条双向信息通道为DHA、肠道菌群和大脑健康的相互作用提供了新的研究思路。为了在日常饮食中摄入更多的sn-2 DHA，我们建议通过更为高效和经济的酯交换制造技术生产富含sn-2 DHA脂质，其中需要解决的关键技术包括强化酶的特异性和优化纯化工艺。这类饮食可满足对sn-2 ω-3脂质有强烈需求的人群，特别是婴儿、儿童、孕妇和哺乳期妇女。

关键词： DHA 和 sn-2 DHA     单甘酯     大脑     肠-脑轴     结构脂质    

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从脑科学到人工智能 Review

范静涛, 方璐, 吴嘉敏, 郭雨晨, 戴琼海

《工程（英文）》 2020年 第6卷 第3期   页码 248-252 doi: 10.1016/j.eng.2019.11.012

摘要：

回顾人工智能（artificial intelligence, AI）的发展历史，我们可以清晰地看到脑科学给AI领域带来的巨大突破，如深度学习。目前，尽管AI及其应用的发展趋势已经超越了人类的预期，但AI与人类智能之间仍然存在着难以逾越的鸿沟。从脑科学到AI、从了解大脑到模拟大脑，在脑科学与AI研究之间建立起一座桥梁已经成为一种迫切需求。为此，我们首先需要通过研究新型脑成像技术来探索脑科学的秘密，建立大脑的动态连接图谱以及将神经科学实验与理论、模型和统计学相结合等。在此基础上，我们将进一步研究新一代AI理论和方法，从而建立起从机器感知和机器学习到机器思维和机器决策的颠覆性模型和工作模式。与此同时，本文还将讨论在脑科学启发新一代AI过程中的一些机遇与挑战。

关键词： 人工智能，脑科学    

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The first avian influenza A (H7N9) viral infection in humans in Zhejiang Province, China: a death report

null

《医学前沿（英文）》 2013年 第7卷 第3期   页码 333-344 doi: 10.1007/s11684-013-0275-1

摘要：

This study reports the first death caused by a novel avian influenza A (H7N9) virus in Zhejiang Province, China. The patient had chronic hepatitis B and history of exposure to poultry. The patient initially complained of diarrhea and influenza-like symptoms on March 7 and 14 respectively. The disease progressed to severe pneumonia, sustained hypoxia, and coagulation abnormalities. The patient died on March 27 because of respiratory failure, multiple organ failure, and disseminated intravascular coagulation without oseltamivir treatment. This H7N9 virus from Zhejiang is highly similar to isolates obtained from Shanghai, Jiangsu, Anhui, etc. Analysis of hemagglutinin, neuramidinase, and matrix genes indicated that the isolates share the same avian origin, have low virulence, and are sensitive to oseltamivir, but are resistant to adamantine. Only the isolate that caused the fatality exhibited substitution of Q226I in the HA gene, which indicates a potentially enhanced human affinity. The secondary transmission rate was 1.6% (2/125). Only two health workers presented with influenza-like symptoms, and they subsequently tested negative for H7N9 RNA. In conclusion, underlying disease, late diagnosis, and untimely antiviral treatment are possible high-risk factors for infections and death caused by the low-pathogenicity avian influenza A (H7N9). Person-to-person transmission of the H7N9 virus was not detected among close contacts, but such transmission should be investigated in the future. Expanding and enhancing surveillance will help in the early discovery and diagnosis of suspected cases, which will reduce the number of severe cases and deaths.

关键词： avian influenza A (H7N9) virus     epidemiology     contacts     person-to-person transmission    

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Clean air captures attention whereas pollution distracts: evidence from brain activities

《环境科学与工程前沿（英文）》 2023年 第18卷 第4期 doi: 10.1007/s11783-024-1801-x

摘要：

● We find air pollution distracts attention and reveal the neurocognitive mechanisms.

关键词： Air pollution     Attention     Disengagement     Performance     Event-related potential    

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标题 作者 时间 类型 操作

Outcomes of patients awaiting lung transplantation after the implementation of donation after brain death

期刊论文

The influence of brain death on donor liver and the potential mechanisms of protective intervention

null

期刊论文

Experimental study on the establishment and maintenance of brain death model with pigs

ZHANG Shuijun, SHI Jihua, ZHAI Wenlong, SONG Yan, CHEN Shi

期刊论文

Protein aggregation in association with delayed neuronal death in rat model of brain ischemia

GE Pengfei, FU Shuanglin, LI Wenchen, WANG Chonghao, ZHOU Chuibing, LUO Yinan, LUO Tianfei

期刊论文

Autoimmunity in acute ischemic stroke and the role of blood—brain barrier: the dark side or the light

Nikolay V. Tsygan, Alexandr P. Trashkov, Igor V. Litvinenko, Viktoriya A. Yakovleva, Alexandr V. Ryabtsev, Andrey G. Vasiliev, Leonid P. Churilov

期刊论文

Orlistat induces ferroptosis-like cell death of lung cancer cells

期刊论文

Cooling strategies and transport theories for brain hypothermia resuscitation

LIU Jing

期刊论文

Sudden death due to arrhythmogenic right ventricular cardiomyopathy: Two case reports

CHEN Xinshan, ZHANG Yigu, RAO Guangxun, HUANG Guangzhao

期刊论文

Tramadol reinforces antidepressant effects of ketamine with increased levels of brain-derived neurotrophic

null

期刊论文

Various brain-eating amoebae: the protozoa, the pathogenesis, and the disease

期刊论文

Assessing the premature death due to ambient particulate matter in China’s urban areas from 2004 to 2013

Guoxia MA, Jinnan WANG, Fang YU, Xiaomin GUO, Yanshen ZHANG, Chao LI

期刊论文

富含sn-2 DHA脂质对大脑的益处及其酶法合成综述

金俊, 金青哲, 王兴国, Casimir C. Akoh

期刊论文

从脑科学到人工智能

范静涛, 方璐, 吴嘉敏, 郭雨晨, 戴琼海

期刊论文

The first avian influenza A (H7N9) viral infection in humans in Zhejiang Province, China: a death report

null

期刊论文

Clean air captures attention whereas pollution distracts: evidence from brain activities

期刊论文