Background： Human Cytomegalovirus（HCMV） infections can be found throughout the body, especially in epithelial tissue. Animal model was established by inoculation of HCMV（strain AD-169） or coinoculation with Hepat...Background： Human Cytomegalovirus（HCMV） infections can be found throughout the body, especially in epithelial tissue. Animal model was established by inoculation of HCMV（strain AD-169） or coinoculation with Hepatitis E virus（HEV） into the ligated sacculus rotundus and vermiform appendix in living rabbits. The specimens were collected from animals sacrificed 1 and a half hours after infection.Results： The virus was found to be capable of reproducing in these specimens through RT-PCR and Western-blot.Severe inflammation damage was found in HCMV-infected tissue. The viral protein could be detected in high amounts in the mucosal epithelium and lamina propria by immunohistochemistry and immunofluorescense.Moreover, there are strong positive signals in lymphocytes, macrophages, and lymphoid follicles. Quantitative statistics indicate that lymphocytes among epithlium cells increased significantly in viral infection groups.Conclusions： The results showed that HCMV or HEV ＋ HCMV can efficiently infect in rabbits by vivo ligated intestine loop inoculation. The present study successfully developed an infective model in vivo rabbit ligated intestinal Loop for HCMV pathogenesis study. This rabbit model can be helpful for understanding modulation of the gut immune system with HCMV infection.展开更多
AIM:To evaluate the effects of estrogen(E2) on systemic and splanchnic hyperdynamic circulation in portal hypertensive rats.METHODS:Fifty castrated female Sprague-Dawley rats were divided into five groups:sham operati...AIM:To evaluate the effects of estrogen(E2) on systemic and splanchnic hyperdynamic circulation in portal hypertensive rats.METHODS:Fifty castrated female Sprague-Dawley rats were divided into five groups:sham operation(SO),partial portal vein ligation(PPVL) + placebo(PLAC),PPVL + E2,PPVL + ICI and PPVL + E2 + ICI. Hemodynamic measurements were performed using ultrasonography. Mesenteric arteriole contractility in response to norepinephrine was determined using a vessel perfusion system. Oxidative stress in the mesenteric artery was investigated by in situ detection of the superoxide anion(O2) and hydrogen peroxide(H2O2) concentrations.RESULTS:Treatment with E2 resulted in a significant decrease of portal pressure(P < 0.01) and portal venous inflow(P < 0.05),and higher systemic vascular resistance(P < 0.05) and splanchnic arteriolar resistance(P < 0.01) in PPVL + E2 rats compared to PPVL+ PLAC rats. In the mesenteric arterioles of PPVL +E2 rats,the dose-response curve was shifted left,and the EC50was decreased(P < 0.01). E2 reduced O2 production and H2O2concentration in the mesenteric artery. However,ICI182,780 reversed the beneficial effects of E2,therefore,the systemic and splanchnic hyperdynamic circulation were more deteriorated in ICI182,780-treated rats.CONCLUSION:Treatment with estrogen improved the systemic and splanchnic hyperdynamic circulation in PPVL rats,in part due to the alleviation of oxidative stress.展开更多
Summary： In order to investigate whether Yinchenhao decoction （YCHD） attenuates hepatic fibro- genesis in the bile duct ligation （BDL） model via recovering and restoring the self-regulation and bal- ance of the r...Summary： In order to investigate whether Yinchenhao decoction （YCHD） attenuates hepatic fibro- genesis in the bile duct ligation （BDL） model via recovering and restoring the self-regulation and bal- ance of the renin-angiotensin system （RAS）, 33 specific-pathogen-free （SPF） male Sprague-Dawley rats with common BDL and scission were randomly divided into five groups as follows： G1, the sham group （n=4）; G2, BDL 7-day group （n=5）; G3, BDL＋YCHD 430 mg/mL （n=8）; G4, BDL＋losartan 0.65 mg/mL （ARB group, n=8）; G5, model group （BDL without any treatment, n=8）. YCHD and losartan （10 mL.kgl.day-1） were given by gastric gavage for 16 days following BDL in G3 and G4 groups, respec- tively. The effect of YCHD on liver fibrosis and the detailed molecular mechanisms were assessed by liver function including total bilirubin （TBIL）, direct bilirubin （DBIL）, indirect bilirubin （IDBIL）, alanine aminotransferase （ALT）, and aspartate aminotransferase （AST）. Histological changes were ob-. served by transmission electron microscopy （TEM） and Masson trichrome staining. Western blotting was used to detect the protein expression level of the renin-angiotensin system （RAS） components in- cluding angiotensin converting enzyme （ACE）, angiotensin II type 1 receptor （AT1R）, ACE2, angio- tensin II （Ang II） as well as transforming growth factor 131 （TGF131）. The experimental data were ana- lyzed by principle component analytical method of pattern recognition. The results showed that bio- chemically, serum TBIL, DBIL, IDBIL, ALT and AST levels were markedly increased following BDL as compared with the sham group （P〈0.05）. Serum TBIL, IDBIL and DBIL levels in G3 group were dramatically decreased as compared with G5 and G4 groups （P〈0.05）. Serum AST level in G3 was sig- nificantly lowered than in G5 group （P〈0.05）, but there was no significant difference in ALT among G3, G4 and G5 groups （P〉0.05）. Histologically, livers in G3 group showed less hepatocytes necrosis, less bile duct hyperplasia and less collagen formation than in G4 and G5 groups. The protein expression lev- els of ACE2, ACE, Ang II, AT1R and TGF131 in G2, G3 and G4 groups were significantly higher than in sham group （P〈0.05）, and lower than in G5 group （P〈0.05）. However, the differences among G2, G3 and G4 groups were not significant （P〉0.05）. ACE2 protein expression in G3 group was significantly higher than in G2 group （P〈0.05） and there was no significant difference in comparison with G4 group （P〉0.05）. Moreover, the protein expression of TGF131 in G3 group was significantly lower than in G5 and G4 groups （P〈0.05）. Our findings suggest that the antifibrotic effects of YCHD may be associated with the decreased classical RAS pathway components and TGFI31 downexpression so as to recover and rebuild self-regulation of the RAS by elevating the protein expression of ACE2.展开更多
AIM: To evaluate in bile duct ligated rats whether there were progressive alterations of renal function without changes in histopathology. METHODS: Male Wistar rats were submitted to sham-surgery or bile duct ligation...AIM: To evaluate in bile duct ligated rats whether there were progressive alterations of renal function without changes in histopathology. METHODS: Male Wistar rats were submitted to sham-surgery or bile duct ligation (BDL) and divided according to the post-procedure time (2, 4 and 6-wk). To determine renal function parameters, rats wereplaced in metabolic cages and, at the end of the experiment, blood and urine samples were obtained. Histology and hydroxyproline content were analyzed in liver and renal tissue. RESULTS: Rats with 2 wk of BDL increased free water clearance (P = 0.02), reduced urinary osmolality (P = 0.03) and serum creatinine (P = 0.01) in comparison to the sham group. In contrast, rats at 6 wk of BDL showed features of HRS, including signif icant increase in serum creatinine and reductions in creatinine clearance, water excretion and urinary sodium concentration. Rats with 4 wk of BDL exhibited an intermediate stage of renal dysfunction. Progressive hepatic f ibrosis according to post-procedure time was confirmed by histology. The increased levels of liver hydroxyproline contrasted with the absence of structural changes in the kidney, as assessed by histology and unchanged hydroxyproline content in renal tissue. CONCLUSION: Our data show that BDL produced progressive renal dysfunction without structural changes in the kidney, characterizing HRS. The present model will be useful to understand the pathophysiology of HRS.展开更多
AIM: To investigate the mechanisms of liver growth and atrophy after portal vein ligation (PVL) and its effects on tumor growth. METHODS: Mice were subjected to PVL, partial hepatectomy, or sham surgery. The morpholog...AIM: To investigate the mechanisms of liver growth and atrophy after portal vein ligation (PVL) and its effects on tumor growth. METHODS: Mice were subjected to PVL, partial hepatectomy, or sham surgery. The morphological alterations, activation of transcription factors, and expression of cytokines and growth factors involved in liver regeneration were evaluated. In a separate set of experiments, murine colorectal carcinoma cells were injected via the portal vein and the effect of each operation on liver tumor growth was studied. RESULTS: Liver regeneration after PVL and partial hepatectomy were very similar. In ligated lobes, various cytokines, transcription factors and regulatory factors were signifi cantly upregulated compared to nonligated lobes after PVL. Atrophy in ligated lobes was a result of early necrosis followed by later apoptosis. Tumor growth was signifi cantly accelerated in ligated compared to non-ligated lobes.CONCLUSION: Tumor growth was accelerated in ligated liver lobes and appeared to be a result of increased growth factor expression.展开更多
BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different tre...BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.AIM To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation(RPH).METHODS A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group(n=50)and the treatment group(n=50)by rolling the dice.The procedure for prolapse and hemorrhoids(PPH)was adopted in the control group,while polidocanol foam injection+RPH was adopted in the treatment group.The therapeutic effects,operation time,wound healing time,hospital stay,pain situation(24 hours post-operative pain score,first defecation pain score),quality of life(QOL),incidence of complications(post-operative hemorrhage,edema,infection),incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.RESULTS Compared with the control group,the total effective rate of treatment group was higher,and the difference was significant(P<0.05).The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group(P<0.05).The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group(P<0.05).After surgery,the QOL scores of the two groups decreased,with the treatment group having higher scores than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications in the treatment group was lower,and the difference was significant(P<0.05);However,there was no significant difference in the incidence of postoperative bleeding between the two groups(P>0.05);There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups(P>0.05).CONCLUSION For patients with mixed hemorrhoids,the therapeutic effect achieved by using polidocanol injection combined with RPH was better.The wounds of the patients healed faster,the postoperative pain was milder,QOL improved,and the incidence of complications was lower,and the short-term and long-term prognosis was good.展开更多
BACKGROUND Colonic diverticular bleeding(CDB)is a leading cause of lower gastrointestinal hemorrhage that has a high risk of recurrence.The endoscopic clipping and endoscopic band ligation(EBL)methods are widely used ...BACKGROUND Colonic diverticular bleeding(CDB)is a leading cause of lower gastrointestinal hemorrhage that has a high risk of recurrence.The endoscopic clipping and endoscopic band ligation(EBL)methods are widely used for hemostasis in patients with CDB.Endoscopic detachable snare ligation(EDSL)has also become an increasingly common treatment option.The data remain inconsistent regarding the comparative efficacy of these endoscopic therapies in achieving initial hemostasis and reduction of early and late rebleeding rates.AIM To study the effectiveness and complications of endoscopic clipping,EBL,and EDSL for CDB.METHODS We conducted a systematic search of PubMed/MEDLINE,Scopus,Web of Science,Embase,Google Scholar,and the Cochrane database for clinical trials to find studies that reported CDB and endoscopic clipping,EBL,or EDSL as treatment methods.The pooled estimates of initial hemostasis,early and late rebleeding,and the need for transarterial embolization or surgery between these groups were calculated.RESULTS We analyzed 28 studies with 5224 patients.Of these,4526 had active CDB and required one of the three endoscopic interventions.The pooled prevalence of early rebleeding was 23.5%,10.7%,and 10.6%in the endoscopic clipping,EBL,and EDSL groups,respectively.Patients who underwent endoscopic clipping had a significantly higher rate of early rebleeding compared to those who received EBL[odds ratio(OR)=3.76(95%CI:2.13-6.63)]and EDSL(OR=3.30,95%CI:1.28-8.53).There was no difference in the initial hemostasis between the three groups.The pooled prevalence of late rebleeding was 27.2%in the clipping,followed by 13.8%in the EBL and 2.7%in the EDSL group.Compared to 2.6%in the EBL group,4.0%of patients who received endoscopic clipping subsequently underwent surgery or transarterial embolization.These results were consistent in the network meta-analysis.Based on the ranking of the indirect comparison of modalities,the snare technique was better at achieving initial hemostasis and had a lower late rebleeding rate.CONCLUSION The findings of this direct and indirect pairwise comparison suggest that EDSL is superior to endoscopic clipping and EBL in achieving initial hemostasis and lowering the rate of late rebleeding in patients with CDB.展开更多
For the treatment method of esophageal subepithelial lesions originating from the muscularis propria,conventional endoscopic resection techniques are timeconsuming and lack efficacy for small subepithelial lesions ori...For the treatment method of esophageal subepithelial lesions originating from the muscularis propria,conventional endoscopic resection techniques are timeconsuming and lack efficacy for small subepithelial lesions originating from the muscularis propria.Lu et al presented an exploration of the effectiveness and safety of ligation-assisted endoscopic submucosal resection,aiming to provide a minimally invasive method for treatment.We discussed and analyzed this study from the aspects of sample screening,clinical pathological characteristics,casecontrol analysis,and follow-up data.展开更多
Most Aloe species are used as new food or functional food ingredient.Even though widely known for its health benefits,the anti-inflammatory effects and underlying mechanisms of Aloin(Alo),an anthraquinone compound iso...Most Aloe species are used as new food or functional food ingredient.Even though widely known for its health benefits,the anti-inflammatory effects and underlying mechanisms of Aloin(Alo),an anthraquinone compound isolated from plant species of the genus Aloe,remain unidentified.Here,we investigated the protective effects of Alo against cecal ligation and puncture(CLP)-induced sepsis and microflora in mice.Alo significantly improved CLP-induced sepsis and the survival rate of septic mice,downregulated the expression of proinflammatory factors,and decreased the infiltration of inflammatory cells in tissues.Alo upregulated the proportion of peritoneal macrophages,reduced the number of peritoneal bacteria,decreased the content of short-chain fatty acids and bile acids in the abdominal cavity,and suppressed Toll-like receptor(TLR)-2/4/nuclear factor kappa-B(NF-κB)/NOD-like receptor thermal protein domain associated protein 3(NLRP3)/Caspase-1/3/8 signaling.Furthermore,Alo altered the composition of the microbiome and promoted the growth of Lactobacillus,which showed a stronger anti-inflammatory effect.Whole-genome analysis identified the genes Saa3,Il10,Fpr1,and Eif4a1 associated with the protective effects of Alo in mice with CLP-induced sepsis.Overall,our results provide novel insights into the therapeutic potential and mechanism of action of Alo in the treatment of sepsis.展开更多
Biodegradable magnesium(Mg)materials offer significant advantages in trauma care due to their degradable nature and superior mechanical properties.This study reports the first successful use of degradable Mg clips in ...Biodegradable magnesium(Mg)materials offer significant advantages in trauma care due to their degradable nature and superior mechanical properties.This study reports the first successful use of degradable Mg clips in damage control surgery for pelvic fractures,addressing challenges associated with severe hemorrhage and high mortality rates(30-70%).A 57-year-old male patient with pelvic fractures and traumatic shock underwent open reduction and internal fixation with Mg clips.At a six-month follow-up,imaging confirmed fracture healing,clip degradation,and no signs of rebleeding or infection,highlighting their effectiveness in precise hemorrhage control.Unlike traditional titanium clips,Mg clips degrade over time,eliminating the need for removal and reducing infection risks.This innovative approach combines Mg clips with conventional gauze packing,offering a more effective and safer alternative for managing pelvic trauma.Future large-scale clinical trials are necessary to validate these findings and establish Mg clips as a global standard for pelvic fracture treatment.Their portability and functionality hold promise for advancing emergency trauma care.展开更多
Background: Plexiform neurofibromas(PNF) are highly vascular tumors with the potential for significant growth.Surgical removal of giant PNF is often challenging because of intraoperative hemorrhage.This study proposed...Background: Plexiform neurofibromas(PNF) are highly vascular tumors with the potential for significant growth.Surgical removal of giant PNF is often challenging because of intraoperative hemorrhage.This study proposed and evaluated an innovative surgical approach involving FENCY ligation and the role of preoperative embolization in the resection of giant PNF.Methods: This was a retrospective,interventional,and sequential case series conducted in a plastic and reconstructive surgery unit.We summarized all patients with PNF who underwent resection at our center between2019 and 2024.Surgical case notes from 11 patients with giant PNF who underwent FENCY ligation were reviewed,including three patients who received preoperative embolization.All patients participated in structured telephone interviews.Patient demographics,surgical safety,postoperative recovery,and patient satisfaction were evaluated.Results: Among 456 patients with 494 PNF who underwent surgical resection,we categorized the procedures into median,large,and giant PNF subgroups.To illustrate comprehensive perioperative and surgical approaches,we analyzed seven female and four male patients with giant PNF.The median maximum tumor diameter at the time of surgery was 30.4 cm(range,11.5–55.6 cm).Most PNF were located on the face(63.6%),followed by the back(18.2%),buttocks(18.2%),upper limbs(9.1%),and neck(9.1%).The median intraoperative hemorrhage volume was 366 m L(range,10–2 034 m L),And the median hospital stay was 17 days(range,14–33 days).The mean follow-up duration was 2.5 years(range,0.4–5.5 years).No severe complications were observed,except for one case of infection.Conclusion: PNF resection,particularly giant PNF resection,is a high-risk treatment option.Comprehensive evaluation,perioperative preparation,and surgical techniques are required to ensure efficacy and safety.FENCY ligation and preoperative embolization can be used to resect giant PNF in multiple complex regions with satisfactory outcomes.展开更多
By investigating 17 peptide arylthioesters that were previously challenging to produce,this study reveals a clear correlation between increased ligation activity and decreased pKa values of their corresponding arylthi...By investigating 17 peptide arylthioesters that were previously challenging to produce,this study reveals a clear correlation between increased ligation activity and decreased pKa values of their corresponding arylthiols.The observed differences are attributed to variations in thioester bond strength and steric hindrance.These insights have led to the development of an improved one-pot chemical protein synthesis approach that leverages the reactivity differences between peptide arylthioesters with C-terminal Ala-SPh(4-NO_(2))and Ala-S-Ph(2,6-diCH_(3)).This approach eliminates the need for thiol-thioester exchange and additive removal steps while enabling in situ desulfurization,thereby significantly simplifying the protein synthesis process.展开更多
BACKGROUND In hemorrhoidal disease,despite the existence of numerous treatment options to alleviate symptoms,surgical intervention continues to be the gold standard.The advantages and disadvantages of many methods hav...BACKGROUND In hemorrhoidal disease,despite the existence of numerous treatment options to alleviate symptoms,surgical intervention continues to be the gold standard.The advantages and disadvantages of many methods have been shown in numerous studies However,only a few studies have compared the effectiveness of combined methods.AIM To compare the results of a coloproctology clinic that switched to the Doppler-guided hemorrhoidal artery ligation(DG-HAL)+Ferguson hemorrhoidectomy(FH)technique from the FH in the treatment of hemorrhoidal disease.METHODS In this retrospective cohort,data from a total of 45 patients who underwent DG-HAL+FH(n=24)and FH(n=21)for grade III hemorrhoidal disease between 2020 and 2022 were analyzed.Demographic and clinical data,surgical duration,intraoperative blood loss,hospital stay,postoperative analgesic consumption,pain scores using the Visual Analog Scale(VAS),complications,time to return to normal activities,and the recurrence rate were compared in both groups.RESULTS The study included 45 patients,with 75.6%(n=34)male and 24.4%(n=11)female.The rate of intraoperative blood loss was higher in the FH group(P<0.05).The VAS scores and postoperative complication rates were similar in both groups.The need for postoperative analgesics was lower in the DG-HAL+FH group(2 vs 4 days,P<0.05),while the FH group showed a shorter time to return to normal activities(9.5 vs 6.0 days,P=0.02).The recurrence rate(16.7%vs 0%)and Clavien–Dindo Score-1 complications(20.8%vs 9.5%,P=0.29)were higher in the DG-HAL+FH group but were insignificant.CONCLUSION Our study revealed that the addition of the DG-HAL to classical hemorrhoidectomy caused less intraoperative bleeding and a lower postoperative analgesia requirement.展开更多
Acute lung injury(ALI)is a significant complication of sepsis,characterized by high morbidity,mortality,and poor prognosis.Neutrophils,as critical intrinsic immune cells in the lung,play a fundamental role in the deve...Acute lung injury(ALI)is a significant complication of sepsis,characterized by high morbidity,mortality,and poor prognosis.Neutrophils,as critical intrinsic immune cells in the lung,play a fundamental role in the development and progression of ALI.During ALI,neutrophils generate neutrophil extracellular traps(NETs),and excessive NETs can intensify inflammatory injury.Research indicates that Taohe Chengqi decoction(THCQD)can ameliorate sepsis-induced lung inflammation and modulate immune function.This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients,seeking to provide novel perspectives and interventions for clinical treatment.The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture(CLP)-induced ALI mouse model.Furthermore,THCQD diminished neutrophil and macrophage infiltration,inflammatory responses,and the production of pro-inflammatory cytokines,including interleukin-1β(IL-1β),IL-6,and tumor necrosis factorα(TNF-α).Notably,subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro.Moreover,THCQD significantly decreased the expression of peptidyl arginine deiminase 4(PAD4)protein,and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4.PAD4 overexpression partially reversed THCQD’s inhibitory effects on PAD4.These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.展开更多
The term subepithelial lesions encompasses a wide array of pathology of which numerous benign and malignant pathologies are grouped.A subset of these lesions are termed gastric mesenchymal tumours of which some have i...The term subepithelial lesions encompasses a wide array of pathology of which numerous benign and malignant pathologies are grouped.A subset of these lesions are termed gastric mesenchymal tumours of which some have innate malignant potential.Currently there is various guidance on the recommended approach to the investigation and management of these lesions and there exists multiple methods of resection.Lin et al have developed and proposed a new method of resection of these gastric mesenchymal tumours within the field of endoscopy,a procedure they have termed endoscopic calabash ligation and resection.This editorial aims to outlay the current landscape for gastric mesenchymal tumours with regards to the various guidelines and resection techniques while comparing Lin et al’s new technique to those that are already established in the field of endoscopy.Advancements in endoscopy that maintain or improve patient outcomes compared to the gold standard approach are exciting developments.Lin et al’s study suggests that their technique is comparable in regard to patient outcomes while simultaneously being more efficient in its use of hospital resources including procedural time.Whilst the data and analysis proposed in the study is promising,there are areas that need to be addressed before advocating the procedure for widespread use.However,with further studies and analysis this may be foreseeable in the future.展开更多
BACKGROUND Routinely separating the ligamentum teres uteri(LTU)intraoperatively remains an unresolved issue for female children undergoing surgery for indirect inguinal hernia(IIH).AIM To identify the effect of LTU pr...BACKGROUND Routinely separating the ligamentum teres uteri(LTU)intraoperatively remains an unresolved issue for female children undergoing surgery for indirect inguinal hernia(IIH).AIM To identify the effect of LTU preservation in laparoscopic high hernia sac ligation(LHSL)in children with IIH.METHODS The participants were 100 female children with unilateral IIH admitted from April 2022 to January 2024 to the Pediatric Surgery Department of Zhangzhou Municipal Hospital of Fujian Province.They were categorized based on LTU retention into the control group(n=45 cases),which underwent LTU ligation intraoperatively,and the experimental group(55 cases),which had the LTU preserved intraoperatively.All children underwent LHSL.RESULTS This study comparatively analyzed the operation time,hospitalization time,blood loss,postoperative recurrence rate,and complications(repeated pain in the inguinal region,foreign body sensation in the inguinal region,bloody exudation at the inguinal incision,and incision infection),which were all comparable between the two groups.CONCLUSION The above results indicate that LTU preservation during LHSL exerts certain therapeutic benefits for children with IIH.LTU preservation does not increase hospitalization time,blood loss,postoperative recurrence rate,and complications,which is safe and feasible,compared with conventional LTU ligation.LHSL with LTU preservation should be performed if conditions permit,which is worth popularizing.展开更多
BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)is a procedure used for patients with initially unresectable colorectal liver metastases(CRLM).However,the procedure has bee...BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)is a procedure used for patients with initially unresectable colorectal liver metastases(CRLM).However,the procedure has been reported to be associated with high morbidity and mortality.Laparoscopic ALPPS has recently been reported as a minimally invasive technique that reduces perioperative risks.AIM To assess the safety and feasibility of full laparoscopic ALPPS in patients with CRLM.METHODS A retrospective analysis was conducted on all consecutive patients with CRLM who underwent full laparoscopic ALPPS at the Sixth Affiliated Hospital of Sun Yat-sen University between March 2021 and July 2024.RESULTS Fifteen patients were included,13 with synchronous liver metastases.Nine patients had more than five liver tumors,with the highest count being 22.The median diameter of the largest lesion was 2.8 cm on preoperative imaging.No extrahepatic metastases were observed.RAS mutations were detected in nine patients,and 14 underwent preoperative chemotherapy.The median increase in future liver remnant volume during the interstage interval was 47.0%.All patients underwent R0 resection.Overall complication rates were 13.3%(stage 1)and 53.3%(stage 2),while major complication rates(Clavien-Dindo≥IIIa)were 13.3%(stage 1)and 33.3%(stage 2).No mortality occurred in either stage.The median hospital stay after stage 2 was 10 days.CONCLUSION Full laparoscopic ALPPS for CRLM is safe and feasible,with the potential for reduced morbidity and mortality,offering radical resection opportunities for patients with initially unresectable CRLM.展开更多
Kupffer cells(KCs),the liver resident macrophages accounting for 80-90%of the total population of fixed tissue macrophages in the body,not only play a key role in host defense via removing particulate materials from t...Kupffer cells(KCs),the liver resident macrophages accounting for 80-90%of the total population of fixed tissue macrophages in the body,not only play a key role in host defense via removing particulate materials from the portal circulation,but may also contribute to the pathogenesis of various liver diseases.We have previously demonstrated that KCs play an important role in controlling portal hypertension and hepatocellular injury via releasing thromboxane A_(2)(TXA_(2))in early fibrosis induced by one-week bile duct ligation(BDL).Production of TXA_(2) is controlled by cytosolic phospholipase A_(2)(cPLA_(2))that is activated by the interaction of entothelin-1(ET-1)with its G-protein coupled ET receptor B(ETBR).However,the signaling pathways that contribute to the ET-1-induced activation of cPLA_(2) and production of TXA_(2) in KCs in the normal healthy or injured livers are not yet clear,which are investigated in the present study using isolated KCs from one-week BDL or sham rats.The pharmacological inhibition of cPLA_(2) or chelation of intracellular calcium abrogated the ET-1 induction of TXA_(2) from KCs.Compared to those from sham rats,KCs from BDL animals displayed a significantly enhanced responsiveness of p38 MAPK to ET-1,increased ETBR and Gai subunit but decreased Gaq and Ga11 expression.Inhibition of ERK1/2 or Gq signaling abrogated significantly the ET-1 induction of TXA_(2) in sham KCs but only slightly in BDL KCs.In contrast,inhibition of p38 MAPK and Gi signaling markedly attenuated the ET-1 induction of TXA_(2) in BDL KCs but had no effect in sham KCs.Lastly,inhibition of PLC or PKC abrogated ET-1 induction of TXA_(2) in KCs from both sham and BDL groups.The hepatic stress(such as BDL)induces significant modifications in the receptor and intermediates of ET-1 signaling in KC and subsequently alters ET-1 signaling mechanisms,particularly a shift from Gq induced signaling to Gi induced signaling,in the activation of cPLA_(2) and production of TXA_(2) in response to ET-1.展开更多
基金supported by the National Natural Science Foundation of China(31272515,31472165,31330076)
文摘Background： Human Cytomegalovirus（HCMV） infections can be found throughout the body, especially in epithelial tissue. Animal model was established by inoculation of HCMV（strain AD-169） or coinoculation with Hepatitis E virus（HEV） into the ligated sacculus rotundus and vermiform appendix in living rabbits. The specimens were collected from animals sacrificed 1 and a half hours after infection.Results： The virus was found to be capable of reproducing in these specimens through RT-PCR and Western-blot.Severe inflammation damage was found in HCMV-infected tissue. The viral protein could be detected in high amounts in the mucosal epithelium and lamina propria by immunohistochemistry and immunofluorescense.Moreover, there are strong positive signals in lymphocytes, macrophages, and lymphoid follicles. Quantitative statistics indicate that lymphocytes among epithlium cells increased significantly in viral infection groups.Conclusions： The results showed that HCMV or HEV ＋ HCMV can efficiently infect in rabbits by vivo ligated intestine loop inoculation. The present study successfully developed an infective model in vivo rabbit ligated intestinal Loop for HCMV pathogenesis study. This rabbit model can be helpful for understanding modulation of the gut immune system with HCMV infection.
文摘AIM:To evaluate the effects of estrogen(E2) on systemic and splanchnic hyperdynamic circulation in portal hypertensive rats.METHODS:Fifty castrated female Sprague-Dawley rats were divided into five groups:sham operation(SO),partial portal vein ligation(PPVL) + placebo(PLAC),PPVL + E2,PPVL + ICI and PPVL + E2 + ICI. Hemodynamic measurements were performed using ultrasonography. Mesenteric arteriole contractility in response to norepinephrine was determined using a vessel perfusion system. Oxidative stress in the mesenteric artery was investigated by in situ detection of the superoxide anion(O2) and hydrogen peroxide(H2O2) concentrations.RESULTS:Treatment with E2 resulted in a significant decrease of portal pressure(P < 0.01) and portal venous inflow(P < 0.05),and higher systemic vascular resistance(P < 0.05) and splanchnic arteriolar resistance(P < 0.01) in PPVL + E2 rats compared to PPVL+ PLAC rats. In the mesenteric arterioles of PPVL +E2 rats,the dose-response curve was shifted left,and the EC50was decreased(P < 0.01). E2 reduced O2 production and H2O2concentration in the mesenteric artery. However,ICI182,780 reversed the beneficial effects of E2,therefore,the systemic and splanchnic hyperdynamic circulation were more deteriorated in ICI182,780-treated rats.CONCLUSION:Treatment with estrogen improved the systemic and splanchnic hyperdynamic circulation in PPVL rats,in part due to the alleviation of oxidative stress.
基金supported by grants from the National Natural Science Foundation of China(No.81102692)the Natural Science Foundation of Hubei Province,China(No.JX6B09)the Fundamental Research Funds for the Central Universities,China(No.2015QN203)
文摘Summary： In order to investigate whether Yinchenhao decoction （YCHD） attenuates hepatic fibro- genesis in the bile duct ligation （BDL） model via recovering and restoring the self-regulation and bal- ance of the renin-angiotensin system （RAS）, 33 specific-pathogen-free （SPF） male Sprague-Dawley rats with common BDL and scission were randomly divided into five groups as follows： G1, the sham group （n=4）; G2, BDL 7-day group （n=5）; G3, BDL＋YCHD 430 mg/mL （n=8）; G4, BDL＋losartan 0.65 mg/mL （ARB group, n=8）; G5, model group （BDL without any treatment, n=8）. YCHD and losartan （10 mL.kgl.day-1） were given by gastric gavage for 16 days following BDL in G3 and G4 groups, respec- tively. The effect of YCHD on liver fibrosis and the detailed molecular mechanisms were assessed by liver function including total bilirubin （TBIL）, direct bilirubin （DBIL）, indirect bilirubin （IDBIL）, alanine aminotransferase （ALT）, and aspartate aminotransferase （AST）. Histological changes were ob-. served by transmission electron microscopy （TEM） and Masson trichrome staining. Western blotting was used to detect the protein expression level of the renin-angiotensin system （RAS） components in- cluding angiotensin converting enzyme （ACE）, angiotensin II type 1 receptor （AT1R）, ACE2, angio- tensin II （Ang II） as well as transforming growth factor 131 （TGF131）. The experimental data were ana- lyzed by principle component analytical method of pattern recognition. The results showed that bio- chemically, serum TBIL, DBIL, IDBIL, ALT and AST levels were markedly increased following BDL as compared with the sham group （P〈0.05）. Serum TBIL, IDBIL and DBIL levels in G3 group were dramatically decreased as compared with G5 and G4 groups （P〈0.05）. Serum AST level in G3 was sig- nificantly lowered than in G5 group （P〈0.05）, but there was no significant difference in ALT among G3, G4 and G5 groups （P〉0.05）. Histologically, livers in G3 group showed less hepatocytes necrosis, less bile duct hyperplasia and less collagen formation than in G4 and G5 groups. The protein expression lev- els of ACE2, ACE, Ang II, AT1R and TGF131 in G2, G3 and G4 groups were significantly higher than in sham group （P〈0.05）, and lower than in G5 group （P〈0.05）. However, the differences among G2, G3 and G4 groups were not significant （P〉0.05）. ACE2 protein expression in G3 group was significantly higher than in G2 group （P〈0.05） and there was no significant difference in comparison with G4 group （P〉0.05）. Moreover, the protein expression of TGF131 in G3 group was significantly lower than in G5 and G4 groups （P〈0.05）. Our findings suggest that the antifibrotic effects of YCHD may be associated with the decreased classical RAS pathway components and TGFI31 downexpression so as to recover and rebuild self-regulation of the RAS by elevating the protein expression of ACE2.
基金FAPEMIG (Funda■o de Amparo à Pesquisa do Estado de Minas Gerais)CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico)PRONEX (Grupos de Excelência)
文摘AIM: To evaluate in bile duct ligated rats whether there were progressive alterations of renal function without changes in histopathology. METHODS: Male Wistar rats were submitted to sham-surgery or bile duct ligation (BDL) and divided according to the post-procedure time (2, 4 and 6-wk). To determine renal function parameters, rats wereplaced in metabolic cages and, at the end of the experiment, blood and urine samples were obtained. Histology and hydroxyproline content were analyzed in liver and renal tissue. RESULTS: Rats with 2 wk of BDL increased free water clearance (P = 0.02), reduced urinary osmolality (P = 0.03) and serum creatinine (P = 0.01) in comparison to the sham group. In contrast, rats at 6 wk of BDL showed features of HRS, including signif icant increase in serum creatinine and reductions in creatinine clearance, water excretion and urinary sodium concentration. Rats with 4 wk of BDL exhibited an intermediate stage of renal dysfunction. Progressive hepatic f ibrosis according to post-procedure time was confirmed by histology. The increased levels of liver hydroxyproline contrasted with the absence of structural changes in the kidney, as assessed by histology and unchanged hydroxyproline content in renal tissue. CONCLUSION: Our data show that BDL produced progressive renal dysfunction without structural changes in the kidney, characterizing HRS. The present model will be useful to understand the pathophysiology of HRS.
文摘AIM: To investigate the mechanisms of liver growth and atrophy after portal vein ligation (PVL) and its effects on tumor growth. METHODS: Mice were subjected to PVL, partial hepatectomy, or sham surgery. The morphological alterations, activation of transcription factors, and expression of cytokines and growth factors involved in liver regeneration were evaluated. In a separate set of experiments, murine colorectal carcinoma cells were injected via the portal vein and the effect of each operation on liver tumor growth was studied. RESULTS: Liver regeneration after PVL and partial hepatectomy were very similar. In ligated lobes, various cytokines, transcription factors and regulatory factors were signifi cantly upregulated compared to nonligated lobes after PVL. Atrophy in ligated lobes was a result of early necrosis followed by later apoptosis. Tumor growth was signifi cantly accelerated in ligated compared to non-ligated lobes.CONCLUSION: Tumor growth was accelerated in ligated liver lobes and appeared to be a result of increased growth factor expression.
文摘BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.AIM To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation(RPH).METHODS A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group(n=50)and the treatment group(n=50)by rolling the dice.The procedure for prolapse and hemorrhoids(PPH)was adopted in the control group,while polidocanol foam injection+RPH was adopted in the treatment group.The therapeutic effects,operation time,wound healing time,hospital stay,pain situation(24 hours post-operative pain score,first defecation pain score),quality of life(QOL),incidence of complications(post-operative hemorrhage,edema,infection),incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.RESULTS Compared with the control group,the total effective rate of treatment group was higher,and the difference was significant(P<0.05).The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group(P<0.05).The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group(P<0.05).After surgery,the QOL scores of the two groups decreased,with the treatment group having higher scores than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications in the treatment group was lower,and the difference was significant(P<0.05);However,there was no significant difference in the incidence of postoperative bleeding between the two groups(P>0.05);There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups(P>0.05).CONCLUSION For patients with mixed hemorrhoids,the therapeutic effect achieved by using polidocanol injection combined with RPH was better.The wounds of the patients healed faster,the postoperative pain was milder,QOL improved,and the incidence of complications was lower,and the short-term and long-term prognosis was good.
文摘BACKGROUND Colonic diverticular bleeding(CDB)is a leading cause of lower gastrointestinal hemorrhage that has a high risk of recurrence.The endoscopic clipping and endoscopic band ligation(EBL)methods are widely used for hemostasis in patients with CDB.Endoscopic detachable snare ligation(EDSL)has also become an increasingly common treatment option.The data remain inconsistent regarding the comparative efficacy of these endoscopic therapies in achieving initial hemostasis and reduction of early and late rebleeding rates.AIM To study the effectiveness and complications of endoscopic clipping,EBL,and EDSL for CDB.METHODS We conducted a systematic search of PubMed/MEDLINE,Scopus,Web of Science,Embase,Google Scholar,and the Cochrane database for clinical trials to find studies that reported CDB and endoscopic clipping,EBL,or EDSL as treatment methods.The pooled estimates of initial hemostasis,early and late rebleeding,and the need for transarterial embolization or surgery between these groups were calculated.RESULTS We analyzed 28 studies with 5224 patients.Of these,4526 had active CDB and required one of the three endoscopic interventions.The pooled prevalence of early rebleeding was 23.5%,10.7%,and 10.6%in the endoscopic clipping,EBL,and EDSL groups,respectively.Patients who underwent endoscopic clipping had a significantly higher rate of early rebleeding compared to those who received EBL[odds ratio(OR)=3.76(95%CI:2.13-6.63)]and EDSL(OR=3.30,95%CI:1.28-8.53).There was no difference in the initial hemostasis between the three groups.The pooled prevalence of late rebleeding was 27.2%in the clipping,followed by 13.8%in the EBL and 2.7%in the EDSL group.Compared to 2.6%in the EBL group,4.0%of patients who received endoscopic clipping subsequently underwent surgery or transarterial embolization.These results were consistent in the network meta-analysis.Based on the ranking of the indirect comparison of modalities,the snare technique was better at achieving initial hemostasis and had a lower late rebleeding rate.CONCLUSION The findings of this direct and indirect pairwise comparison suggest that EDSL is superior to endoscopic clipping and EBL in achieving initial hemostasis and lowering the rate of late rebleeding in patients with CDB.
文摘For the treatment method of esophageal subepithelial lesions originating from the muscularis propria,conventional endoscopic resection techniques are timeconsuming and lack efficacy for small subepithelial lesions originating from the muscularis propria.Lu et al presented an exploration of the effectiveness and safety of ligation-assisted endoscopic submucosal resection,aiming to provide a minimally invasive method for treatment.We discussed and analyzed this study from the aspects of sample screening,clinical pathological characteristics,casecontrol analysis,and follow-up data.
基金supported by the National Natural Science Foundation of China(81803547)the Natural Science Foundation of Fujian Province,China(2021J01204)Fujian Provincial Regional Development Project(2021N3005)。
文摘Most Aloe species are used as new food or functional food ingredient.Even though widely known for its health benefits,the anti-inflammatory effects and underlying mechanisms of Aloin(Alo),an anthraquinone compound isolated from plant species of the genus Aloe,remain unidentified.Here,we investigated the protective effects of Alo against cecal ligation and puncture(CLP)-induced sepsis and microflora in mice.Alo significantly improved CLP-induced sepsis and the survival rate of septic mice,downregulated the expression of proinflammatory factors,and decreased the infiltration of inflammatory cells in tissues.Alo upregulated the proportion of peritoneal macrophages,reduced the number of peritoneal bacteria,decreased the content of short-chain fatty acids and bile acids in the abdominal cavity,and suppressed Toll-like receptor(TLR)-2/4/nuclear factor kappa-B(NF-κB)/NOD-like receptor thermal protein domain associated protein 3(NLRP3)/Caspase-1/3/8 signaling.Furthermore,Alo altered the composition of the microbiome and promoted the growth of Lactobacillus,which showed a stronger anti-inflammatory effect.Whole-genome analysis identified the genes Saa3,Il10,Fpr1,and Eif4a1 associated with the protective effects of Alo in mice with CLP-induced sepsis.Overall,our results provide novel insights into the therapeutic potential and mechanism of action of Alo in the treatment of sepsis.
基金supported by grants from the Integrated Traditional Chinese and Western Medicine Guidance Project for General Hospitals of Shanghai Municipal Health Commission(ZXXT-202311)the National Key R&D Program of China(No.2023YFC2416800)+1 种基金the National Natural Science Foundation of China(No.52201300)the Fundamental Research Funds for the Central Universities(No.2232024D-34).
文摘Biodegradable magnesium(Mg)materials offer significant advantages in trauma care due to their degradable nature and superior mechanical properties.This study reports the first successful use of degradable Mg clips in damage control surgery for pelvic fractures,addressing challenges associated with severe hemorrhage and high mortality rates(30-70%).A 57-year-old male patient with pelvic fractures and traumatic shock underwent open reduction and internal fixation with Mg clips.At a six-month follow-up,imaging confirmed fracture healing,clip degradation,and no signs of rebleeding or infection,highlighting their effectiveness in precise hemorrhage control.Unlike traditional titanium clips,Mg clips degrade over time,eliminating the need for removal and reducing infection risks.This innovative approach combines Mg clips with conventional gauze packing,offering a more effective and safer alternative for managing pelvic trauma.Future large-scale clinical trials are necessary to validate these findings and establish Mg clips as a global standard for pelvic fracture treatment.Their portability and functionality hold promise for advancing emergency trauma care.
基金supported by grants from the National Natural Science Foundation of China (grant nos.82472579,82172228,and 82202470)Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center (grant no.2023ZZ02023)+2 种基金Shanghai Clinical Research Center of Plastic and Reconstructive Surgery supported by the Science and Technology Commission of Shanghai Municipality (grant no.22MC1940300)Project of Biobank (grant no.YBKA202204) from Shanghai Ninth People’s Hospital of Shanghai Jiao Tong University School of MedicineCross-Disciplinary Research Fund of Shanghai Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (grant no.JYJC202407)。
文摘Background: Plexiform neurofibromas(PNF) are highly vascular tumors with the potential for significant growth.Surgical removal of giant PNF is often challenging because of intraoperative hemorrhage.This study proposed and evaluated an innovative surgical approach involving FENCY ligation and the role of preoperative embolization in the resection of giant PNF.Methods: This was a retrospective,interventional,and sequential case series conducted in a plastic and reconstructive surgery unit.We summarized all patients with PNF who underwent resection at our center between2019 and 2024.Surgical case notes from 11 patients with giant PNF who underwent FENCY ligation were reviewed,including three patients who received preoperative embolization.All patients participated in structured telephone interviews.Patient demographics,surgical safety,postoperative recovery,and patient satisfaction were evaluated.Results: Among 456 patients with 494 PNF who underwent surgical resection,we categorized the procedures into median,large,and giant PNF subgroups.To illustrate comprehensive perioperative and surgical approaches,we analyzed seven female and four male patients with giant PNF.The median maximum tumor diameter at the time of surgery was 30.4 cm(range,11.5–55.6 cm).Most PNF were located on the face(63.6%),followed by the back(18.2%),buttocks(18.2%),upper limbs(9.1%),and neck(9.1%).The median intraoperative hemorrhage volume was 366 m L(range,10–2 034 m L),And the median hospital stay was 17 days(range,14–33 days).The mean follow-up duration was 2.5 years(range,0.4–5.5 years).No severe complications were observed,except for one case of infection.Conclusion: PNF resection,particularly giant PNF resection,is a high-risk treatment option.Comprehensive evaluation,perioperative preparation,and surgical techniques are required to ensure efficacy and safety.FENCY ligation and preoperative embolization can be used to resect giant PNF in multiple complex regions with satisfactory outcomes.
基金CAMS Innovation Fund for Medical Sciences(CIFMS,No.2021-I2M-1-026)the National Key R&D Program of China(No.2018YFE0111400)+6 种基金the NIH Research Project Grant Program(No.R01 EB025892)the National Natural Science Foundation of China(the Training Program of the Major Research Plan,No.91853120)the National Major Scientific and Technological Special Project of China(Nos.2018ZX09711001-005 and 2018ZX09711001-013)the State Key Laboratory of Bioactive Substance and Function of Natural Medicines,Institute of Materia Medicathe Biomedical High Performance Computing Platform,Chinese Academy of Medical Sciencesthe Chinese Academy of Medical SciencesPeking Union Medical College for funding and support.
文摘By investigating 17 peptide arylthioesters that were previously challenging to produce,this study reveals a clear correlation between increased ligation activity and decreased pKa values of their corresponding arylthiols.The observed differences are attributed to variations in thioester bond strength and steric hindrance.These insights have led to the development of an improved one-pot chemical protein synthesis approach that leverages the reactivity differences between peptide arylthioesters with C-terminal Ala-SPh(4-NO_(2))and Ala-S-Ph(2,6-diCH_(3)).This approach eliminates the need for thiol-thioester exchange and additive removal steps while enabling in situ desulfurization,thereby significantly simplifying the protein synthesis process.
文摘BACKGROUND In hemorrhoidal disease,despite the existence of numerous treatment options to alleviate symptoms,surgical intervention continues to be the gold standard.The advantages and disadvantages of many methods have been shown in numerous studies However,only a few studies have compared the effectiveness of combined methods.AIM To compare the results of a coloproctology clinic that switched to the Doppler-guided hemorrhoidal artery ligation(DG-HAL)+Ferguson hemorrhoidectomy(FH)technique from the FH in the treatment of hemorrhoidal disease.METHODS In this retrospective cohort,data from a total of 45 patients who underwent DG-HAL+FH(n=24)and FH(n=21)for grade III hemorrhoidal disease between 2020 and 2022 were analyzed.Demographic and clinical data,surgical duration,intraoperative blood loss,hospital stay,postoperative analgesic consumption,pain scores using the Visual Analog Scale(VAS),complications,time to return to normal activities,and the recurrence rate were compared in both groups.RESULTS The study included 45 patients,with 75.6%(n=34)male and 24.4%(n=11)female.The rate of intraoperative blood loss was higher in the FH group(P<0.05).The VAS scores and postoperative complication rates were similar in both groups.The need for postoperative analgesics was lower in the DG-HAL+FH group(2 vs 4 days,P<0.05),while the FH group showed a shorter time to return to normal activities(9.5 vs 6.0 days,P=0.02).The recurrence rate(16.7%vs 0%)and Clavien–Dindo Score-1 complications(20.8%vs 9.5%,P=0.29)were higher in the DG-HAL+FH group but were insignificant.CONCLUSION Our study revealed that the addition of the DG-HAL to classical hemorrhoidectomy caused less intraoperative bleeding and a lower postoperative analgesia requirement.
基金supporteded by the National Natural ScienceFoundation of China(Nos.82374183,82405092,82204991,82274246,and 82374341)the Planned Science TechnologyProjectofGuangzhouCity(Nos.2023A03J0419and2023A03J0420)+3 种基金the General Project of Natural Science Foundationof Guangdong Province(No.2023A1515011090)Hong KongScholars Program 2024(No.XJ2024005)the Basic and AppliedBasic Research Foundation of Guangdong Province(No.2021A151510809)the Project of Administration of TraditionalChinese Medicine of Guangdong Province of China(No.20223013).
文摘Acute lung injury(ALI)is a significant complication of sepsis,characterized by high morbidity,mortality,and poor prognosis.Neutrophils,as critical intrinsic immune cells in the lung,play a fundamental role in the development and progression of ALI.During ALI,neutrophils generate neutrophil extracellular traps(NETs),and excessive NETs can intensify inflammatory injury.Research indicates that Taohe Chengqi decoction(THCQD)can ameliorate sepsis-induced lung inflammation and modulate immune function.This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients,seeking to provide novel perspectives and interventions for clinical treatment.The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture(CLP)-induced ALI mouse model.Furthermore,THCQD diminished neutrophil and macrophage infiltration,inflammatory responses,and the production of pro-inflammatory cytokines,including interleukin-1β(IL-1β),IL-6,and tumor necrosis factorα(TNF-α).Notably,subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro.Moreover,THCQD significantly decreased the expression of peptidyl arginine deiminase 4(PAD4)protein,and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4.PAD4 overexpression partially reversed THCQD’s inhibitory effects on PAD4.These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.
文摘The term subepithelial lesions encompasses a wide array of pathology of which numerous benign and malignant pathologies are grouped.A subset of these lesions are termed gastric mesenchymal tumours of which some have innate malignant potential.Currently there is various guidance on the recommended approach to the investigation and management of these lesions and there exists multiple methods of resection.Lin et al have developed and proposed a new method of resection of these gastric mesenchymal tumours within the field of endoscopy,a procedure they have termed endoscopic calabash ligation and resection.This editorial aims to outlay the current landscape for gastric mesenchymal tumours with regards to the various guidelines and resection techniques while comparing Lin et al’s new technique to those that are already established in the field of endoscopy.Advancements in endoscopy that maintain or improve patient outcomes compared to the gold standard approach are exciting developments.Lin et al’s study suggests that their technique is comparable in regard to patient outcomes while simultaneously being more efficient in its use of hospital resources including procedural time.Whilst the data and analysis proposed in the study is promising,there are areas that need to be addressed before advocating the procedure for widespread use.However,with further studies and analysis this may be foreseeable in the future.
基金Supported by the Startup Fund for Scientific Research,Fujian Medical University,No.2021QH1262.
文摘BACKGROUND Routinely separating the ligamentum teres uteri(LTU)intraoperatively remains an unresolved issue for female children undergoing surgery for indirect inguinal hernia(IIH).AIM To identify the effect of LTU preservation in laparoscopic high hernia sac ligation(LHSL)in children with IIH.METHODS The participants were 100 female children with unilateral IIH admitted from April 2022 to January 2024 to the Pediatric Surgery Department of Zhangzhou Municipal Hospital of Fujian Province.They were categorized based on LTU retention into the control group(n=45 cases),which underwent LTU ligation intraoperatively,and the experimental group(55 cases),which had the LTU preserved intraoperatively.All children underwent LHSL.RESULTS This study comparatively analyzed the operation time,hospitalization time,blood loss,postoperative recurrence rate,and complications(repeated pain in the inguinal region,foreign body sensation in the inguinal region,bloody exudation at the inguinal incision,and incision infection),which were all comparable between the two groups.CONCLUSION The above results indicate that LTU preservation during LHSL exerts certain therapeutic benefits for children with IIH.LTU preservation does not increase hospitalization time,blood loss,postoperative recurrence rate,and complications,which is safe and feasible,compared with conventional LTU ligation.LHSL with LTU preservation should be performed if conditions permit,which is worth popularizing.
基金Supported by Natural Science Foundation of Guangdong Province of China,No.2024A1515012862.
文摘BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)is a procedure used for patients with initially unresectable colorectal liver metastases(CRLM).However,the procedure has been reported to be associated with high morbidity and mortality.Laparoscopic ALPPS has recently been reported as a minimally invasive technique that reduces perioperative risks.AIM To assess the safety and feasibility of full laparoscopic ALPPS in patients with CRLM.METHODS A retrospective analysis was conducted on all consecutive patients with CRLM who underwent full laparoscopic ALPPS at the Sixth Affiliated Hospital of Sun Yat-sen University between March 2021 and July 2024.RESULTS Fifteen patients were included,13 with synchronous liver metastases.Nine patients had more than five liver tumors,with the highest count being 22.The median diameter of the largest lesion was 2.8 cm on preoperative imaging.No extrahepatic metastases were observed.RAS mutations were detected in nine patients,and 14 underwent preoperative chemotherapy.The median increase in future liver remnant volume during the interstage interval was 47.0%.All patients underwent R0 resection.Overall complication rates were 13.3%(stage 1)and 53.3%(stage 2),while major complication rates(Clavien-Dindo≥IIIa)were 13.3%(stage 1)and 33.3%(stage 2).No mortality occurred in either stage.The median hospital stay after stage 2 was 10 days.CONCLUSION Full laparoscopic ALPPS for CRLM is safe and feasible,with the potential for reduced morbidity and mortality,offering radical resection opportunities for patients with initially unresectable CRLM.
基金This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases Grant(DK-38201).
文摘Kupffer cells(KCs),the liver resident macrophages accounting for 80-90%of the total population of fixed tissue macrophages in the body,not only play a key role in host defense via removing particulate materials from the portal circulation,but may also contribute to the pathogenesis of various liver diseases.We have previously demonstrated that KCs play an important role in controlling portal hypertension and hepatocellular injury via releasing thromboxane A_(2)(TXA_(2))in early fibrosis induced by one-week bile duct ligation(BDL).Production of TXA_(2) is controlled by cytosolic phospholipase A_(2)(cPLA_(2))that is activated by the interaction of entothelin-1(ET-1)with its G-protein coupled ET receptor B(ETBR).However,the signaling pathways that contribute to the ET-1-induced activation of cPLA_(2) and production of TXA_(2) in KCs in the normal healthy or injured livers are not yet clear,which are investigated in the present study using isolated KCs from one-week BDL or sham rats.The pharmacological inhibition of cPLA_(2) or chelation of intracellular calcium abrogated the ET-1 induction of TXA_(2) from KCs.Compared to those from sham rats,KCs from BDL animals displayed a significantly enhanced responsiveness of p38 MAPK to ET-1,increased ETBR and Gai subunit but decreased Gaq and Ga11 expression.Inhibition of ERK1/2 or Gq signaling abrogated significantly the ET-1 induction of TXA_(2) in sham KCs but only slightly in BDL KCs.In contrast,inhibition of p38 MAPK and Gi signaling markedly attenuated the ET-1 induction of TXA_(2) in BDL KCs but had no effect in sham KCs.Lastly,inhibition of PLC or PKC abrogated ET-1 induction of TXA_(2) in KCs from both sham and BDL groups.The hepatic stress(such as BDL)induces significant modifications in the receptor and intermediates of ET-1 signaling in KC and subsequently alters ET-1 signaling mechanisms,particularly a shift from Gq induced signaling to Gi induced signaling,in the activation of cPLA_(2) and production of TXA_(2) in response to ET-1.
