Vision transformer network discovers the prognostic value of pancreatic cancer pathology sections via interpretable risk scores.

Pathological sections hold rich diagnostic information, yet their prognostic potential is underutilized. This study leverages deep learning to predict outcomes, advancing precision oncology of pathological sections with focus on pancreatic cancer. We analyzed H&E-stained whole section images of 125 cases from public databases as well as 28 real-world patients with pancreatic cancer and precancerous lesions.

European Society of Intensive Care Medicine Clinical Practice Guideline on fluid therapy in adult critically ill patients: Part 3-fluid removal at de-escalation phase.

Purpose: This is the third of three parts of the clinical practice guideline from the European Society of Intensive Care Medicine (ESICM) on fluid management in adult critically ill patients. This part addresses fluid removal in the de-escalation phase of shock management.

Methods: This guideline was formulated by an international panel of clinical experts, methodologists, and patient representatives.

Use of extracorporeal membrane oxygenation in adult trauma patients with refractory acute cardiopulmonary failure: guideline from the Chinese society of extracorporeal life support 2025.

Background: Adult trauma patients with refractory acute cardiopulmonary failure suffer from high morbidity and mortality. In the past decade, a growing body of researches has shown survival benefits of extracorporeal membrane oxygenation (ECMO) in trauma patients who fail to respond to optimal damage control resuscitation (DCR), and there is an opportunity to formulate clinical practice guidelines to guide clinicians in implementing trauma ECMO at the bedside.

Methods: The Chinese Society of Extracorporeal Life Support (CSECLS) convened a domestic panel of interdisciplinary experts to develop this guideline, adhering to the principles of the World Health Organization (WHO) Manual for Guideline Development and the policy of conflict of interest.

FTO O-GlcNAcylation promotes TRIM21-mediated FTO ubiquitination degradation to sustain the negative feedback control of macrophage inflammation.

Introduction: The fat mass and obesity-associated protein (FTO), a key RNA N-methyladenosine (mA) demethylase, has been highlighted for its important role in inflammatory response. Emerging evidences link the O-GlcNAcylation to numerous human diseases, particularly inflammation. However, the specific role and underlying mechanism of FTO O-GlcNAcylation in inflammation remain elusive.

Mechanisms of Acute Kidney Injury-Chronic Kidney Disease Transition: Unraveling Maladaptive Repair and Therapeutic Opportunities.

Acute kidney injury (AKI) causes damage to the renal epithelium, initiating a reparative process intended to restore renal function. Although effective repair can result in the complete recovery of kidney function, this process is frequently incomplete. In instances where repair is unsuccessful, the kidney experiences maladaptive alterations that may progressively result in chronic kidney disease (CKD), a phenomenon referred to as failed repair.

Enhancing Swallowing Function in Tracheotomy Patients with Subglottic Oxygen Flow: A Randomized Self-Controlled Crossover Trial.

To investigate the effect of oxygen airflow administered through a subglottic suction tube on the swallowing function of stroke patients with tracheotomies. This study used randomized self-controlled cross-over design. A total of 20 patients with dysphagia following tracheotomy related to stroke were enrolled.

Nonlinear association between estimated plasma volume status and acute kidney injury in acute pancreatitis patients.

Background: Acute pancreatitis (AP), a severe pancreatic inflammatory condition, with a mortality rate reaching up to 40%. Recently, AP shows a steadily elevating prevalence, which causes the greater number of hospital admissions, imposing the substantial economic burden. Acute kidney injury (AKI) complicates take up approximately 15% of AP cases, with an associated mortality rate of 74.

Cidofovir Treatment for Prevention of BK Virus-Associated Hemorrhagic Cystitis in Pediatric Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation.

Objective: In this prospective observational study, we aim to investigate the role of cidofovir (CDV) as prophylactic treatment in preventing BK virus (BKV)-associated hemorrhagic cystitis (HC) in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).

Methods: This study enrolled 28 patients who received prophylactic treatment with CDV following allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and 25 Allo-HSCT patients who received conventional supportive care, which included hydration and analgesics, from January 2020 to January 2022. Patients in the CDV prophylactic treatment group received intravenous injections of CDV at a dose of 1 mg/kg once a week for 4 weeks.

Dendrobine attenuates sepsis-associated acute kidney injury by promoting PINK1/PARKIN-mediated mitophagy.

Sepsis-associated acute kidney injury (SA-AKI) is a severe condition with high mortality rates and a lack of specific treatments. Dendrobine (DEN) has shown diverse pharmacological effects across different diseases. Nonetheless, its impact on SA-AKI remains unexplored.

Diabetic Kidney Disease: Disease Progression Driven by Positive Feedback Loops and Therapeutic Strategies Targeting Pathogenic Pathways.

Diabetic kidney disease (DKD) is a major complication of diabetes mellitus, with its pathogenesis intricately regulated by dynamic feedback mechanisms. This comprehensive review systematically analyzes the hierarchical feedback networks driving DKD progression, spanning from systemic interactions to molecular cross-talks. We reveal that self-amplifying positive feedback loops dominate the disease process, manifested through three key dimensions: (1) The systemic triad of hyperglycemia-hypertension-proteinuria establishes a vicious cycle accelerating renal dysfunction; (2) Cellular homeostasis collapse through cross-amplified cell death modalities (apoptosis, pyroptosis, ferroptosis) and cell cycle dysregulation; (3) Molecular cascades centered on AGE/RAGE signaling that fuel chronic inflammation and fibrotic transformation.

Study on the synthesis and biological activity of kojic acid triazol thiosemicarbazide Schiff base derivatives.

A series of kojic acid triazol thiosemicarbazide Schiff base derivatives were designed and synthesised. Evaluation on the inhibition of tyrosinase activity showed that these compounds possessed potent inhibit tyrosinase activity, and the compound (IC = 0.94 μM) exhibited the best inhibitory effect.

Renal replacement therapy modalities and techniques in intensive care units: An international survey.

Background And Hypothesis: Up to 14 % of critically ill patients receive renal replacement therapy (RRT) during their ICU stay and are treated with intermittent hemodialysis (IHD) or one of the continuous renal replacement therapy (CRRT) techniques. The choice of a modality (IHD or CRRT) and technique (continuuous veno-venous -hemodialysis (CVVHD), -hemofiltration (CVVH), or - hemodiafiltration (CVVHDF)), and the way it is delivered, may have an impact on outcomes but only few studies addressed this question. We aimed to survey the availability, settings, and clinicians' preferences regarding RRT modalities and techniques in critically ill patients.

A novel conditioning regimen involving haploid immune cell infusion combined with umbilical cord blood transplantation for the treatment of juvenile myelomonocytic leukemia.

Juvenile myelomonocytic leukemia (JMML) is a rare and highly malignant hematological tumor that occurs in children. Allogeneic hematopoietic stem cell transplantation remains the primary treatment for the vast majority of children with JMML. However, busulfan-based myeloablative conditioning regimens do not effectively solve the problem of low survival and high recurrence rates after transplantation.

European Society of Intensive Care Medicine (ESICM) 2025 clinical practice guideline on fluid therapy in adult critically ill patients: part 2-the volume of resuscitation fluids.

Objective: This European Society of Intensive Care Medicine (ESICM) guideline provides evidence-based recommendations on the volume of early resuscitation fluid for adult critically ill patients.

Methods: An international panel of experts developed the guideline, focusing on fluid resuscitation volume in adult critically ill patients with circulatory failure. Using the PICO format, questions were formulated, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to assess evidence and formulate recommendations.

Atherogenic index of plasma as a novel predictor for acute kidney injury and disease severity in acute pancreatitis: a retrospective cohort study.

Background: The atherogenic index of plasma (AIP) can be used to reveal atherosclerosis. This study evaluated the AIP's efficacy in predicting the prognosis of acute kidney injury (AKI) and severity of acute pancreatitis (AP).

Methods: This retrospective cohort study recruited AP cases from the First College of Clinical Medical Science of China Three Gorges University between January 2019 and October 2023, including 1470 patients.

TIMP2-mediated mitochondrial fragmentation and glycolytic reprogramming drive renal fibrogenesis following ischemia-reperfusion injury.

Acute kidney injury (AKI) triggers renal structural and functional abnormalities through inflammatory and fibrotic signaling pathways, ultimately progressing to chronic kidney disease (CKD). The mechanisms underlying AKI-to-CKD transition are complex, with hypoxia, mitochondrial dysfunction, and metabolic reprogramming as critical contributors. Public data analysis demonstrated significant upregulation of tissue inhibitors of metalloproteinases (Timp2) in renal biopsy tissues of CKD patients.

Heteroatom-Based Ligand Engineering of Metal Organic Frameworks for Efficient and Robust Electrochemical Water Oxidation.

Metal-organic frameworks (MOFs) are promising catalysts for the electrochemical oxygen evolution reaction (OER) due to their high surface area, tunable pore structures, and abundant active sites. Ligand engineering is an important strategy to optimize their performance. Here, we report the synthesis of NiFe-MOFs based on three different ligands: 1,4-terephthalic acid (BDC), 2,4-thiophene dicarboxylic acid (TDC), and 2,5-furandicarboxylic acid (FDC), to investigate the effects of heteroatom-based aromatic rings on OER performance.

Progression and perspectives in disease modeling for Juvenile myelomonocytic leukemia.

Juvenile myelomonocytic leukemia (JMML) is a rare myeloproliferative neoplasm occurring in infants and young children. JMML has been shown to be resistant to all conventional cytotoxic chemotherapy drugs, and current curative therapies still rely on hematopoietic stem cell transplantation, which carries a high risk of relapse post-transplantation. This underscores the urgent need for novel treatment strategies.

Boosting the circularly polarized luminescence of pyrene-tiaraed pillararenes through mechanically locking.

Attributed to their unique dynamic planar chirality, pillar[n]arenes, particularly pillar[5]arenes, have evolved as promising platforms for diverse applications such as circularly polarized luminescence (CPL) emitters. However, due to the unit flipping and swing, the achievement of excellent CPL performances of pillar[5]arenes in solution state remains a formidable challenge. To deal with this key issue, a mechanically locking approach has been successfully developed, leading to boosted dissymmetry factor (g) values of pyrene-tiaraed pillar[5]arenes up to 0.

Dual-responsive renal injury cells targeting nanoparticles for vitamin E delivery to treat ischemia reperfusion-induced acute kidney injury.

Ischemia/reperfusion (I/R) is an important inducer of acute kidney injury (AKI), and triggers the generation of reactive oxygen species (ROS) and the expression of matrix metalloproteinase 2 (MMP2), exacerbating kidney damage. Given the immense potential of vitamin E (VitE) as a natural fat-soluble antioxidant in kidney protection, we designed the nanoparticles (NPs) that could dual respond to ROS and MMP2, aiming to accurately deliver VitE to renal injury cells. The NPs utilized Gel-SH as a sensitive receptor for MMP2 and diselenide as a sensitive receptor for ROS, while PEG modification enhanced biocompatibility and prevented phagocytosis mediated by the mononuclear phagocyte system.

Exploring the role and therapeutic potential of lipid metabolism in acute kidney injury.

Acute kidney injury (AKI) is a prevalent condition, yet no specific treatment is available. Extensive research has revealed the pivotal role of lipid-related alterations in AKI. Lipid metabolism plays an essential role in the sustenance of the kidneys.

Association between hyperglycemia at ICU admission and postoperative acute kidney injury in patients undergoing cardiac surgery: Analysis of the MIMIC-IV database.

Background: This study aimed to explore the correlation between hyperglycemia at intensive care unit (ICU) admission and the incidence of acute kidney injury (AKI) in patients after cardiac surgery.

Methods: We conducted a retrospective cohort study, in which clinical data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Adults (≥18 years) in the database who were admitted to the cardiovascular intensive care unit after cardiac surgery were enrolled.

Decitabine-based treatment strategy improved the outcome of HSCT in JMML: a retrospective cohort study.

Introduction: Pre-HSCT disease control, suboptimal long-term prognosis, and a high recurrence incidence (RI) continue to pose significant challenges for hematopoietic stem cell transplantation (HSCT) in juvenile myelomonocytic leukemia (JMML) patients.

Methods: This retrospective cohort study assessed the effectiveness of a decitabine (DAC)-based protocol in JMML patients undergoing HSCT. The pre-HSCT treatment includes initial and bridging treatment.