The H-K-ATPase (HKA), a potassium-dependent proton transporter in the outer medullary collecting duct (OMCD) plays an important role in acid-base homeostasis. The OMCD contains two HKA isoforms;gastric (HKAα1), domin...The H-K-ATPase (HKA), a potassium-dependent proton transporter in the outer medullary collecting duct (OMCD) plays an important role in acid-base homeostasis. The OMCD contains two HKA isoforms;gastric (HKAα1), dominant under normal dietary conditions (ND), and colonic (HKAα2), induced under a K-free diet (KD). The enzymatic activity (EA) of HKA in the OMCD is incompletely understood. The focus of the present study is elucidating the EA of the HKA in HKAα1 and HKAα2 knockout (KO) mice under ND and KD. KO mice were subjected to ND or KD for 10 days. Ten OMCD tubules were extracted, half placed in potassium-free media (Solution 2), half in potassium-containing media (Solution 3). Fluorescence measurements are based on the hydrolysis of ATP to ADP, coupled with the oxidation of NADH. ADP is determined by a decrease in NADH fluorescence. In K presence, NADH fluorescence of HKAα1 KO mice read 13.5 ± 0.7 ppm for ND and 10.3 ± 0.2 ppm for KD, indicating stimulation of the colonic isoform. HKAα2 KO mice averaged 6.8 ± 0.3 ppm for ND and 5.4 ± 0.3 ppm for KD in solution 2 (p p α2 isoform. A significant difference in ATP production in HKAα2 KO mice is likely due to enhanced EA of H-ATPase under potassium depletion.展开更多
AIM To compare the efficacy,improved quality of life,and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy(SCBAC) or subtotal colonic bypass plus colostomy with antip...AIM To compare the efficacy,improved quality of life,and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy(SCBAC) or subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy(SCBCAC) for the treatment of slow transit constipation.METHODS Between October 2010 and October 2014,aged patients with slow transit constipation who were hospitalized and underwent laparoscopic surgery in our institute weredivided into two groups: the bypass group,15 patients underwent SCBAC,and the bypass plus colostomy group,14 patients underwent SCBCAC. The following preoperative and postoperative clinical data were collected: gender,age,body mass index,operative time,first flatus time,length of hospital stay,bowel movements(BMs),Wexner fecal incontinence scale,Wexner constipation scale(WCS),gastrointestinal quality of life index(GIQLI),numerical rating scale for pain intensity(NRS),abdominal bloating score(ABS),and ClavienDindo classification of surgical complications(CD) before surgery and at 3,6,12,and 24 mo after surgery.RESULTS All patients successfully underwent laparoscopic surgery without open surgery conversion or surgeryrelated death. The operative time and blood loss were significantly less in the bypass group than in the bypass plus colostomy group(P = 0.007). No significant differences were observed in first flatus time,length of hospital stay,or complications with CD > 1 between the two groups. No patients had fecal incontinence after surgery. At 3,6,and 12 mo after surgery,the number of BMs was significantly less in the bypass plus colostomy group than in the bypass group. The parameters at 3,6,12,and 24 mo after surgery in both groups significantly improved compared with the preoperative conditions(P < 0.05),except NRS at 3,6 mo after surgery in both groups,ABS at 12,24 mo after surgery and NRS at 12,24 mo after surgery in the bypass group. WCS,GIQLI,NRS,and ABS significantly improved in the bypass plus colostomy group compared with the bypass group at 3,6,12,and 24 mo after surgery(P < 0.05) except WCS,NRS at 3,6 mo after surgery and ABS at 3 mo after surgery. At 1 year after surgery,a barium enema examination showed that the emptying time was significantly better in the bypass plus colostomy group than in the bypass group(P = 0.007).CONCLUSION Laparoscopic SCBCAC is an effective and safe procedure for the treatment of slow transit constipation in an aged population and can significantly improve the prognosis. Its clinical efficacy is more favorable compared with that of SCBAC. Laparoscopic SCBCAC is a better procedure for the treatment of slow transit constipation in an aged population.展开更多
BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly dev...BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly developed Pringle taping method guided by liver surface in MISRLR.METHODS We retrospectively reviewed 72 cases of MISRLR performed by a single surgeon at two centers from August 2015 to July 2024.Beginning in October 2019,a liver surface-guided encirclement of hepatoduodenal ligament(LSEH)was used for repeat Pringle taping.Perioperative outcomes including Pringle taping success,operative time,blood loss,conversion rate,morbidity,and mortality were assessed.RESULTS Laparoscopic and robotic approaches were used in 63 patients and 9 patients,respectively.The median operative time,blood loss,and hospital stay were 331.5 minutes,70 mL,and 8 days,respectively.Open conversion occurred in two cases(2.8%)due to severe adhesions and right renal vein injury.Clavien-Dindo grade≥III complications occurred in 5.6%of cases with no mortality.Anti-adhesion barriers were used in 54 patients(75.0%).LSEH was attempted in 57 cases,improving Pringle taping success from 33.0%to 91.4%(P<0.001).LSEH succeeded in all patients with prior open liver resection(n=11).Among 6 patients in whom LSEH failed,3 patients(50.0%)had undergone a third liver resection,and 1 patient had a history of distal gastrectomy with choledochoduodenostomy.CONCLUSION The newly developed LSEH technique for Pringle taping in MISRLR was feasible,enhancing safety and reproducibility even in patients with a history of open liver resection.展开更多
In the past oral Caribbean and African cultures,performances by the“griots”reminded the community of its heroic past.In colonial studies,performance is a way for the colonized people to reconnect with its original s...In the past oral Caribbean and African cultures,performances by the“griots”reminded the community of its heroic past.In colonial studies,performance is a way for the colonized people to reconnect with its original soul and language and to become magnificent of creativity like the storyteller Solibo in Chamoiseau’s Solibo Magnifique(Caribbean).In Chamoiseau’s novel,the Black policemen who came to investigate on Solibo’s sudden death during the performance look grotesque.They mimic the French colonizers with their“baton”and their racism at thinking evil of the Black community and they provoke laughter.Mimicry and the irony it conveys,subverts the formerly ironclad authority of the colonial order(Homi K.Bhabha in Location of Culture).The Cameroonian writer Werewere Liking-Gnépo also warns the Africans of the danger of wearing the White Mask of the colonizers(like Fanon in Black Skin,White Masks).She demonstrates in her Song/Novel She will be of Jasper and Coral,that while the African Mask empowers the performer of metaphysical powers,the White Mask of colonialism on the contrary weakens the performer who internalizes his inferiority and becomes complicit of his subjugation.Fortunately,Werewere Liking-Gnépo shows ithat the White Mask of colonialism can be used to mimic the harshness and corruption of the Colonial order and in doing so to bring back regeneration of Africa.展开更多
AIM To elucidate the mechanism of patchouli alcohol(PA) in treatment of rat models of diarrhea-predominant irritable bowel syndrome(IBS-D).METHODS We studied the effects of PA on colonic spontaneous motility using its...AIM To elucidate the mechanism of patchouli alcohol(PA) in treatment of rat models of diarrhea-predominant irritable bowel syndrome(IBS-D).METHODS We studied the effects of PA on colonic spontaneous motility using its cumulative log concentration(3 × 10^(-7) mol/L to 1 × 10^(-4)mol/L). We then determined the responses of the proximal and distal colon segments of rats to the folowing stimuli:(1) carbachol(1 × 10^(-9) mol/L to 1 × 10^(-5) mol/L);(2) neurotransmitter antagonists including N~ω-nitro-l-arginine methyl ester hydrochloride(10μmol/L) and(1 R~*, 2 S~*)-4-[2-Iodo-6-(methylamino)-9 Hpurin-9-yl]-2-(phosphonooxy)bicyclo[3.1.0]hexane-1-methanol dihydrogen phosphate ester tetraammonium salt(1 μmol/L);(3) agonist α,β-methyleneadenosine 5′-triphosphate trisodium salt(100 μmol/L); and(4) single KCl doses(120 mmol/L). The effects of blockers against antagonist responses were also assessed by pretreatment with PA(100 μmol/L) for 1 min. Electrical-field stimulation(40 V, 2-30 Hz, 0.5 ms pulse duration, and 10 s) was performed to observe nonadrenergic, noncholinergic neurotransmitter release in IBS-D rat colon. The ATP level of Kreb's solution was also determined.RESULTS PA exerted a concentration-dependent inhibitory effect on the spontaneous contraction of the colonic longitudinal smooth muscle, and the half maximal effective concentration(EC_(50)) was 41.9 μmol/L. In comparison with the KCl-treated IBS-D group, the contractile response(mg contractions) in the PA + KCl-treated IBS-D group(11.87 ± 3.34) was significantly decreased in the peak tension(P < 0.01). Compared with CCh-treated IBS-D rat colon, the cholinergic contractile response of IBS-D rat colonic smooth muscle(EC_(50) = 0.94 μmol/L) was significantly decreased by PA(EC_(50) = 37.43 μmol/L)(P < 0.05). Lack of nitrergic neurotransmitter release in stress-induced IBS-D rats showed contraction effects on colonic smooth muscle. Pretreatment with PA resulted in inhibitory effect on l-NAME-induced(10 μmol/L) contraction(P < 0.05). ATP might not be the main neurotransmitter involved in inhibitory effects of PA in the colonic relaxation of stressinduced IBS-D rats.CONCLUSION PA application may serve as a new therapeutic approach for IBS-D.展开更多
文摘The H-K-ATPase (HKA), a potassium-dependent proton transporter in the outer medullary collecting duct (OMCD) plays an important role in acid-base homeostasis. The OMCD contains two HKA isoforms;gastric (HKAα1), dominant under normal dietary conditions (ND), and colonic (HKAα2), induced under a K-free diet (KD). The enzymatic activity (EA) of HKA in the OMCD is incompletely understood. The focus of the present study is elucidating the EA of the HKA in HKAα1 and HKAα2 knockout (KO) mice under ND and KD. KO mice were subjected to ND or KD for 10 days. Ten OMCD tubules were extracted, half placed in potassium-free media (Solution 2), half in potassium-containing media (Solution 3). Fluorescence measurements are based on the hydrolysis of ATP to ADP, coupled with the oxidation of NADH. ADP is determined by a decrease in NADH fluorescence. In K presence, NADH fluorescence of HKAα1 KO mice read 13.5 ± 0.7 ppm for ND and 10.3 ± 0.2 ppm for KD, indicating stimulation of the colonic isoform. HKAα2 KO mice averaged 6.8 ± 0.3 ppm for ND and 5.4 ± 0.3 ppm for KD in solution 2 (p p α2 isoform. A significant difference in ATP production in HKAα2 KO mice is likely due to enhanced EA of H-ATPase under potassium depletion.
基金the Medical Science and technology Project of Henan Province,No.2011030031
文摘AIM To compare the efficacy,improved quality of life,and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy(SCBAC) or subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy(SCBCAC) for the treatment of slow transit constipation.METHODS Between October 2010 and October 2014,aged patients with slow transit constipation who were hospitalized and underwent laparoscopic surgery in our institute weredivided into two groups: the bypass group,15 patients underwent SCBAC,and the bypass plus colostomy group,14 patients underwent SCBCAC. The following preoperative and postoperative clinical data were collected: gender,age,body mass index,operative time,first flatus time,length of hospital stay,bowel movements(BMs),Wexner fecal incontinence scale,Wexner constipation scale(WCS),gastrointestinal quality of life index(GIQLI),numerical rating scale for pain intensity(NRS),abdominal bloating score(ABS),and ClavienDindo classification of surgical complications(CD) before surgery and at 3,6,12,and 24 mo after surgery.RESULTS All patients successfully underwent laparoscopic surgery without open surgery conversion or surgeryrelated death. The operative time and blood loss were significantly less in the bypass group than in the bypass plus colostomy group(P = 0.007). No significant differences were observed in first flatus time,length of hospital stay,or complications with CD > 1 between the two groups. No patients had fecal incontinence after surgery. At 3,6,and 12 mo after surgery,the number of BMs was significantly less in the bypass plus colostomy group than in the bypass group. The parameters at 3,6,12,and 24 mo after surgery in both groups significantly improved compared with the preoperative conditions(P < 0.05),except NRS at 3,6 mo after surgery in both groups,ABS at 12,24 mo after surgery and NRS at 12,24 mo after surgery in the bypass group. WCS,GIQLI,NRS,and ABS significantly improved in the bypass plus colostomy group compared with the bypass group at 3,6,12,and 24 mo after surgery(P < 0.05) except WCS,NRS at 3,6 mo after surgery and ABS at 3 mo after surgery. At 1 year after surgery,a barium enema examination showed that the emptying time was significantly better in the bypass plus colostomy group than in the bypass group(P = 0.007).CONCLUSION Laparoscopic SCBCAC is an effective and safe procedure for the treatment of slow transit constipation in an aged population and can significantly improve the prognosis. Its clinical efficacy is more favorable compared with that of SCBAC. Laparoscopic SCBCAC is a better procedure for the treatment of slow transit constipation in an aged population.
文摘BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly developed Pringle taping method guided by liver surface in MISRLR.METHODS We retrospectively reviewed 72 cases of MISRLR performed by a single surgeon at two centers from August 2015 to July 2024.Beginning in October 2019,a liver surface-guided encirclement of hepatoduodenal ligament(LSEH)was used for repeat Pringle taping.Perioperative outcomes including Pringle taping success,operative time,blood loss,conversion rate,morbidity,and mortality were assessed.RESULTS Laparoscopic and robotic approaches were used in 63 patients and 9 patients,respectively.The median operative time,blood loss,and hospital stay were 331.5 minutes,70 mL,and 8 days,respectively.Open conversion occurred in two cases(2.8%)due to severe adhesions and right renal vein injury.Clavien-Dindo grade≥III complications occurred in 5.6%of cases with no mortality.Anti-adhesion barriers were used in 54 patients(75.0%).LSEH was attempted in 57 cases,improving Pringle taping success from 33.0%to 91.4%(P<0.001).LSEH succeeded in all patients with prior open liver resection(n=11).Among 6 patients in whom LSEH failed,3 patients(50.0%)had undergone a third liver resection,and 1 patient had a history of distal gastrectomy with choledochoduodenostomy.CONCLUSION The newly developed LSEH technique for Pringle taping in MISRLR was feasible,enhancing safety and reproducibility even in patients with a history of open liver resection.
文摘In the past oral Caribbean and African cultures,performances by the“griots”reminded the community of its heroic past.In colonial studies,performance is a way for the colonized people to reconnect with its original soul and language and to become magnificent of creativity like the storyteller Solibo in Chamoiseau’s Solibo Magnifique(Caribbean).In Chamoiseau’s novel,the Black policemen who came to investigate on Solibo’s sudden death during the performance look grotesque.They mimic the French colonizers with their“baton”and their racism at thinking evil of the Black community and they provoke laughter.Mimicry and the irony it conveys,subverts the formerly ironclad authority of the colonial order(Homi K.Bhabha in Location of Culture).The Cameroonian writer Werewere Liking-Gnépo also warns the Africans of the danger of wearing the White Mask of the colonizers(like Fanon in Black Skin,White Masks).She demonstrates in her Song/Novel She will be of Jasper and Coral,that while the African Mask empowers the performer of metaphysical powers,the White Mask of colonialism on the contrary weakens the performer who internalizes his inferiority and becomes complicit of his subjugation.Fortunately,Werewere Liking-Gnépo shows ithat the White Mask of colonialism can be used to mimic the harshness and corruption of the Colonial order and in doing so to bring back regeneration of Africa.
基金Supported by the National Natural Science Foundation of China,No.81573715Natural Science Foundation of Guangdong Province,China,No.2015A030313348Science and Technology Program of Guangzhou,China,No.201510010257
文摘AIM To elucidate the mechanism of patchouli alcohol(PA) in treatment of rat models of diarrhea-predominant irritable bowel syndrome(IBS-D).METHODS We studied the effects of PA on colonic spontaneous motility using its cumulative log concentration(3 × 10^(-7) mol/L to 1 × 10^(-4)mol/L). We then determined the responses of the proximal and distal colon segments of rats to the folowing stimuli:(1) carbachol(1 × 10^(-9) mol/L to 1 × 10^(-5) mol/L);(2) neurotransmitter antagonists including N~ω-nitro-l-arginine methyl ester hydrochloride(10μmol/L) and(1 R~*, 2 S~*)-4-[2-Iodo-6-(methylamino)-9 Hpurin-9-yl]-2-(phosphonooxy)bicyclo[3.1.0]hexane-1-methanol dihydrogen phosphate ester tetraammonium salt(1 μmol/L);(3) agonist α,β-methyleneadenosine 5′-triphosphate trisodium salt(100 μmol/L); and(4) single KCl doses(120 mmol/L). The effects of blockers against antagonist responses were also assessed by pretreatment with PA(100 μmol/L) for 1 min. Electrical-field stimulation(40 V, 2-30 Hz, 0.5 ms pulse duration, and 10 s) was performed to observe nonadrenergic, noncholinergic neurotransmitter release in IBS-D rat colon. The ATP level of Kreb's solution was also determined.RESULTS PA exerted a concentration-dependent inhibitory effect on the spontaneous contraction of the colonic longitudinal smooth muscle, and the half maximal effective concentration(EC_(50)) was 41.9 μmol/L. In comparison with the KCl-treated IBS-D group, the contractile response(mg contractions) in the PA + KCl-treated IBS-D group(11.87 ± 3.34) was significantly decreased in the peak tension(P < 0.01). Compared with CCh-treated IBS-D rat colon, the cholinergic contractile response of IBS-D rat colonic smooth muscle(EC_(50) = 0.94 μmol/L) was significantly decreased by PA(EC_(50) = 37.43 μmol/L)(P < 0.05). Lack of nitrergic neurotransmitter release in stress-induced IBS-D rats showed contraction effects on colonic smooth muscle. Pretreatment with PA resulted in inhibitory effect on l-NAME-induced(10 μmol/L) contraction(P < 0.05). ATP might not be the main neurotransmitter involved in inhibitory effects of PA in the colonic relaxation of stressinduced IBS-D rats.CONCLUSION PA application may serve as a new therapeutic approach for IBS-D.
