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
Objectives Salpingectomy and tubal ligation are commonly performed for permanent contraception in women.Salpingectomy has been suggested to reduce the risk of ovarian cancer,but its comparative operative and periopera...Objectives Salpingectomy and tubal ligation are commonly performed for permanent contraception in women.Salpingectomy has been suggested to reduce the risk of ovarian cancer,but its comparative operative and perioperative risks have not been well established.The objective of this study is to compare the peri-and postoperative complications of laparoscopic tubal ligation with those of salpingectomy for permanent contraception.Methods A retrospective review of 49,445 patients who underwent laparoscopic salpingectomy or tubal ligation for permanent contraception between 2017 and 2021 was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program database.Statistical analysis involved t test,chi-square test,and logistic regression analysis with the use of the random forest algorithm.The primary outcomes were perioperative and postoperative complications.Results Of the total cohort,45,307(91.6%)underwent laparoscopic salpingectomy,and 4138(8.4%)received laparoscopic tubal ligation.There were significant differences between the salpingectomy and tubal ligation groups with respect to several demographic characteristics,including age,BMI,minority status,and variations in past medical history.These demographic characteristics were controlled for in the multivariate regression analysis.Salpingectomy had a higher rate of operative and postoperative complications than did tubal ligation(OR=1.78,95%CI:1.46-2.20,p<0.001).Salpingectomy was associated with a greater risk of longer operation time(OR=2.03,95%CI:2.02-2.04,p<0.001),longer hospital stay(OR=5.26,95%CI:4.57-6.09,p<0.001),increased readmission(OR=3.15,95%CI:1.92-5.65,p<0.001),and increased unplanned reoperation(OR=2.42,95%CI:1.32-5.12,p=0.010).In addition,the occurrence rates of organ space surgical site infection(OR=2.68,95%CI:1.21-7.59,p=0.032)and sepsis(OR=3.93,95%CI:1.48-16.02,p=0.020)were significantly greater in the salpingectomy group than in the tubal ligation group.Conclusions Laparoscopic tubal ligation and salpingectomy are both safe and effective procedures for permanent contraception;however,salpingectomy is more likely to be associated with peri-and postoperative complications.These findings may help guide clinical decision-making when selecting the optimal permanent contraception method for women.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
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
BACKGROUND Endoscopic variceal band ligation(EVBL)represents a pivotal treatment in the prophylaxis of esophageal varices bleeding in patients with cirrhosis,but in some cases a single session of EVBL is unable to era...BACKGROUND Endoscopic variceal band ligation(EVBL)represents a pivotal treatment in the prophylaxis of esophageal varices bleeding in patients with cirrhosis,but in some cases a single session of EVBL is unable to eradicate esophageal varices completely,and a control endoscopy after 2-4 weeks is required to assess eradication and/or the need for another band ligation.Liver stiffness measurement(LSM)is being increasingly used as a screening non-invasive tool to predict varices according to Baveno VII criteria.However,to date,there are no instruments able to non-invasively predict the outcome of EVBL.AIM To identify non-invasive predictors of varices eradication(VE)after EVBL through multiparametric ultrasound(US).Secondary aim was to develop a prediction model of successful variceal eradication based on non-invasive parameters.METHODS We prospectively enrolled consecutive cirrhotic patients intolerant or with contraindications to beta-blockers undergoing EVBL for bleeding prophylaxis.Patients underwent multiparametric US with LSM,spleen stiffness measurement(SSM)and dynamic contrastenhanced US(DCE-US)on liver parenchyma and portal vein,at baseline(T0)and one month(T1)after EVBL.Each US parameter and their variations from baseline were correlated with VE evaluated by control endoscopy performed at T1.RESULTS We enrolled 41 patients(median age 64 years,75.6%males).At T128 patients(68.3%)reached VE,whereas 13(31.7%)required a second EVBL.Patients who achieved VE showed a significant decrease in SSM(P=0.018),and a significant increase in peak enhancement,area under the curve and wash-in rate of both liver parenchyma and portal vein after treatment(P<0.001).Statistically significant differences between the two groups of patients were incorporated in a multivariate analysis and used to develop three prediction models.CONCLUSION A multimodal US approach based on DCE-US parameters,LSM and SSM might become a reliable predictor of VE and a useful non-invasive alternative to endoscopy.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
BACKGROUND Cirrhosis-related upper gastrointestinal bleeding(UGIB)poses a fatal risk,and endoscopic ligation as a sole intervention shows inadequate effectiveness.AIM To evaluate the therapeutic efficacy of endoscopic...BACKGROUND Cirrhosis-related upper gastrointestinal bleeding(UGIB)poses a fatal risk,and endoscopic ligation as a sole intervention shows inadequate effectiveness.AIM To evaluate the therapeutic efficacy of endoscopic variceal ligation(EVL)plus pro-pranolol vs EVL monotherapy in patients with cirrhosis complicated with acute UGIB and identify predictors for clinical outcomes.METHODS This study enrolled 99 consecutive patients with cirrhosis presenting with acute UGIB between January 2024 and January 2025.Participants were allocated to either the control group(n=49)receiving EVL alone or(2)the research group(n=50)receiving EVL plus propranolol.Primary outcomes included treatment efficacy,venous blood flow[portal venous flow(PVF)/splenic venous flow(SVF)],and postoperative outcomes(hemostasis time,length of hospital stay,and rebleeding rates).Univariate and multivariate regression analyses were conducted to determine independent predictors of treatment response.RESULTS Compared with the control group,the research group demonstrated significantly better outcomes,including higher overall treatment efficacy,greater reductions in PVF and SVF,shorter hemostasis time and hospital stay,and lower rebleeding rates.Univariate analysis demonstrated significant associations between treatment efficacy and age,cirrhosis duration,Child-Pugh grade,bleeding duration,and treatment approach in patients with cirrhosis complicated with acute UGIB.Multivariate logistic regression identified three independent risk factors for poor outcomes,namely,advanced age(>55 years),prolonged cirrhosis duration(≥4 years),and delayed bleeding intervention(>24 hours).CONCLUSION The EVL plus propranolol regimen demonstrates significant efficacy in treating UGIB in cirrhosis,outperforming EVL alone in improving hemodynamics(PVF/SVF),shortening hemostasis and hospitalization duration,and reducing rebleeding rates.Moreover,advanced age,prolonged disease duration,and longer bleeding times are independent risk factors for poor therapeutic outcomes.展开更多
BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with signifi...BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.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
This study presents an unexpected finding that the cis isomer of β-thio-Asp exhibits higher ligation ac-tivity than the trans isomer.This discovery sheds light on the intricate nature of native chemical ligation and ...This study presents an unexpected finding that the cis isomer of β-thio-Asp exhibits higher ligation ac-tivity than the trans isomer.This discovery sheds light on the intricate nature of native chemical ligation and highlights the importance of factors beyond the steric effects of the side chain in modulating ligation activity.展开更多
BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to...BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to cause serious complications,such as hemorrhage from dislodged ligature rings caused by EBL and hemorrhage from operation-related ulcers resulting from TAI.However,the optimal therapy for mild to moderate type 1 gastric variceal hemorrhage(GOV1)has not been determined.Therefore,the aim of this study was to discover an individualized treatment for mild to moderate GOV1.AIM To compare the efficacy,safety and costs of EBL and TAI for the treatment of mild and moderate GOV1.METHODS A clinical analysis of the data retrieved from patients with mild or moderate GOV1 gastric varices who were treated under endoscopy was also conducted.Patients were allocated to an EBL group or an endoscopic TAI group.The differences in the incidence of varicose relief,operative time,operation success rate,mortality rate within 6 wk,rebleeding rate,6-wk operation-related ulcer healing rate,complication rate and average operation cost were compared between the two groups of patients.RESULTS The total effective rate of the two treatments was similar,but the efficacy of EBL(66.7%)was markedly better than that of TAI(39.2%)(P<0.05).The operation success rate in both groups was 100%,and the 6-wk mortality rate in both groups was 0%.The average operative time(26 min)in the EBL group was significantly shorter than that in the TAI group(46 min)(P<0.01).The rate of delayed postoperative rebleeding in the EBL group was significantly lower than that in the TAI group(11.8%vs 45.1%)(P<0.01).At 6 wk after the operation,the healing rate of operation-related ulcers in the EBL group was 80.4%,which was significantly greater than that in the TAI group(35.3%)(P<0.01).The incidence of postoperative complications in the two groups was similar.The average cost and other related economic factors were greater for the EBL than for the TAI(P<0.01).CONCLUSION For mild to moderate GOV1,patients with EBL had a greater one-time varix eradication rate,a greater 6-wk operation-related ulcer healing rate,a lower delayed rebleeding rate and a lower cost than patients with TAI.展开更多
Carrimycin(CA),sanctioned by China’s National Medical Products Administration(NMPA)in 2019 for treating acute bronchitis and sinusitis,has recently been observed to exhibit multifaceted biological activities,encompas...Carrimycin(CA),sanctioned by China’s National Medical Products Administration(NMPA)in 2019 for treating acute bronchitis and sinusitis,has recently been observed to exhibit multifaceted biological activities,encompassing anti-inflammatory,antiviral,and anti-tumor properties.Despite these applications,its efficacy in sepsis treatment remains unexplored.This study introduces a novel function of CA,demonstrating its capacity to mitigate sepsis induced by lipopolysaccharide(LPS)and cecal ligation and puncture(CLP)in mice models.Our research employed in vitro assays,real-time quantitative polymerase chain reaction(RT-qPCR),and RNA-seq analysis to establish that CA significantly reduces the levels of pro-inflammatory cytokines,namely tumor necrosis factor-alpha(TNF-α),interleukin 1 beta(IL-1β),and interleukin 6(IL-6),in response to LPS stimulation.Additionally,Western blotting and immunofluorescence assays revealed that CA impedes Nuclear Factor Kappa B(NF-κB)activation in LPS-stimulated RAW264.7 cells.Complementing these findings,in vivo experiments demonstrated that CA effectively alleviates LPS-and CLP-triggered organ inflammation in C57BL/6 mice.Further insights were gained through 16S sequencing,highlighting CA’s pivotal role in enhancing gut microbiota diversity and modulating metabolic pathways,particularly by augmenting the production of short-chain fatty acids in mice subjected to CLP.Notably,a comparative analysis revealed that CA’s anti-inflammatory efficacy surpasses that of equivalent doses of aspirin(ASP)and TIENAM.Collectively,these findings suggest that CA exhibits significant therapeutic potential in sepsis treatment.This discovery provides a foundational theoretical basis for the clinical application of CA in sepsis management.展开更多
BACKGROUND The majority of esophageal subepithelial lesions originating from the muscularis propria(SEL-MPs)are benign in nature,although a subset may exhibit malignant characteristics.Conventional endoscopic resectio...BACKGROUND The majority of esophageal subepithelial lesions originating from the muscularis propria(SEL-MPs)are benign in nature,although a subset may exhibit malignant characteristics.Conventional endoscopic resection techniques are time-consuming and lack efficacy for small SEL-MPs.AIM To evaluate the efficacy and safety of ligation-assisted endoscopic submucosal resection(ESMR-L)following unroofing technique for small esophageal SEL-MPs.METHODS From January 2021 to September 2023,17 patients diagnosed with esophageal SEL-MPs underwent ESMR-L following unroofing technique at the endoscopy center of Shenzhen People’s Hospital.Details of clinicopathological characteristics and clinical outcomes were collected and analyzed.RESULTS The mean age of the patients was 50.12±12.65 years.The mean size of the tumors was 7.47±2.83 mm and all cases achieved en bloc resection successfully.The average operation time was 12.2 minutes without any complications.Histopathology identified 2 Lesions(11.8%)as gastrointestinal stromal tumors at very low risk,12 Lesions(70.6%)as leiomyoma and 3 Lesions(17.6%)as smooth muscle proliferation.No recurrence was found during the mean follow-up duration of 14.18±9.62 months.CONCLUSION ESMR-L following roofing technique is an effective and safe technique for management of esophageal SEL-MPs smaller than 20 mm,but it cannot ensure en bloc resection and may require further treatment.展开更多
In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraao...In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.展开更多
The combination of endoscopic ultrasound with endoscopic treatment of type 1 gastric variceal hemorrhage may improve the robustness and generalizability of the findings in future studies.Moreover,the esophageal varice...The combination of endoscopic ultrasound with endoscopic treatment of type 1 gastric variceal hemorrhage may improve the robustness and generalizability of the findings in future studies.Moreover,the esophageal varices should also be included in the evaluation of treatment efficacy in subsequent studies to reach a more convincing conclusion.展开更多
Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a terti...Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a tertiary care center between 2007 and 2018 were included in the study.The records of cases were obtained from the hospital database,retrospectively.Maternal demographic data,morbidities or complications associated with BHGAL surgery,any additional haemostatic interventional or surgical procedures,preoperative admission and lowest postoperative haematocrit-hemoglobin values,blood products given,type of anaesthesia,intensive care unit(ICU)and length of hospital stay were recorded.In cases without surgical sterilization,future fertility and subsequent pregnancy outcomes were assessed for at least two years after operation.Information was obtained through face-to-face or telephone interviews with patients whose long-term fertility and subsequent pregnancy outcomes were assessed.Results:Sixty-eight patients with BHGAL surgery history were included in the study.26 Of 37 cases(70%)that did not undergo surgical sterilization had a desire for pregnancy after the surgery.Six of these cases(23%)were diagnosed with secondary infertility.The fertility rate of these cases was 77%,and subsequent pregnancy was detected in 20 women.A total of 25 pregnancies,including first and second pregnancies,developed,and 15 of these pregnancies resulted in term delivery,six preterm births,one stillbirth,and three abortions.Conclusions:The postoperative pregnancy rate was found to be higher than the rate of women with infertility problems,and this surgery does not seem to adversely affect pregnancy outcomes.This is a tertiary center experience and cohort studies with large patient series are needed.展开更多
BACKGROUND Gastric mesenchymal tumors(GMT)are identified as soft tissue neoplasms that arise from mesenchymal stem cells within the gastrointestinal tract.GMT pri-marily encompass gastric stromal tumors(GST),gastric l...BACKGROUND Gastric mesenchymal tumors(GMT)are identified as soft tissue neoplasms that arise from mesenchymal stem cells within the gastrointestinal tract.GMT pri-marily encompass gastric stromal tumors(GST),gastric leiomyomas,and gastric schwannomas.Although most GMT are benign,there are still potential malignant changes,especially GST.Thus,early surgical intervention is the primary treat-ment for GMT.We have designed a simple endoscopic“calabash”ligation and resection(ECLR)procedure to treat GMT.Its efficacy and safety need to be com-pared with those of traditional endoscopic techniques,such as endoscopic sub-mucosal excavation(ESE).AIM To assess the safety and effectiveness of ECLR in managing small GMT(sGMT)with a maximum diameter≤20 mm by comparing to ESE.METHODS This retrospective analysis involved patients who were hospitalized in our institution between November 2021 and March 2023,underwent endoscopic resection,and received a pathological diagnosis of GMT.Cases with a tumor diameter≤20 mm were chosen and categorized into two cohorts:Study and control groups.The study group was composed of patients treated with ECLR,whereas the control group was composed of those treated with ESE.Data on general clinical characteristics(gender,age,tumor diameter,tumor growth direction,tumor pathological type,and risk grade),surgery-related information(complete tumor resection rate,operation duration,hospitalization duration,hospitalization cost,and surgical complications),and postoperative follow-up were collected for both groups.The aforementioned data were subsequently analyzed and compared.RESULTS Five hundred and eighty-nine individuals were included,with 297 cases in the control group and 292 in the study group.After propensity score matching,the final analysis incorporated 260 subjects in each cohort.The findings indicated that the study group exhibited shorter operation duration and lowered medical expenses relative to the control group.Furthermore,the study group reported less postoperative abdominal pain and had a lower incidence of intraoperative perforation and postoperative electrocoagulation syndrome than the control group.There were no substantial variations observed in other parameters among the two cohorts.CONCLUSION ECLR is a viable and effective approach for managing sGMT.展开更多
Here, we report a new approach of on-resin peptide ligation using C-terminal benzyl ester as the stabilized precursor of thioester, which enables both N-terminal elongation and C-terminal peptide ligation on a Rink Am...Here, we report a new approach of on-resin peptide ligation using C-terminal benzyl ester as the stabilized precursor of thioester, which enables both N-terminal elongation and C-terminal peptide ligation on a Rink Amide resin. On-resin native chemical ligation and auxiliary-assisted peptide ligation were successfully achieved. This method is compatible to both protected and unprotected peptide fragments and has potential application in poor water-soluble peptide ligation.展开更多
Objective The present study aimed to investigate the electrophysiological properties of wide dynamic range （WDR） neurons in spinal dorsal horn of rats with neuropathic pain induced by lumber 5 （L5） spinal nerve li...Objective The present study aimed to investigate the electrophysiological properties of wide dynamic range （WDR） neurons in spinal dorsal horn of rats with neuropathic pain induced by lumber 5 （L5） spinal nerve ligation （SNL） in a large size of samples.Methods Adult Sprague-Dawley rats were divided into normal and SNL groups.Electrophysiological technique was used to record the characteristics of WDR neurons in the spinal dorsal horn.Results Compared with the WDR neurons in normal rats,the WDR neurons in SNL rats showed an increase in excitability,manifested by an enlargement of the receptive field size,an increase in the proportion of neurons that exhibited spontaneous activities,decreases in the Cresponse threshold and latency,and an increase in the C-response duration.In addition,the numbers of A-and C-fiberevoked discharges were smaller in SNL rats than in normal rats.Conclusion The excitability of spinal WDR neurons increased in rats with neuropathic pain induced by L5 SNL.The increase in excitability of WDR neurons may contribute to the development of neuropathic pain.展开更多
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Objectives Salpingectomy and tubal ligation are commonly performed for permanent contraception in women.Salpingectomy has been suggested to reduce the risk of ovarian cancer,but its comparative operative and perioperative risks have not been well established.The objective of this study is to compare the peri-and postoperative complications of laparoscopic tubal ligation with those of salpingectomy for permanent contraception.Methods A retrospective review of 49,445 patients who underwent laparoscopic salpingectomy or tubal ligation for permanent contraception between 2017 and 2021 was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program database.Statistical analysis involved t test,chi-square test,and logistic regression analysis with the use of the random forest algorithm.The primary outcomes were perioperative and postoperative complications.Results Of the total cohort,45,307(91.6%)underwent laparoscopic salpingectomy,and 4138(8.4%)received laparoscopic tubal ligation.There were significant differences between the salpingectomy and tubal ligation groups with respect to several demographic characteristics,including age,BMI,minority status,and variations in past medical history.These demographic characteristics were controlled for in the multivariate regression analysis.Salpingectomy had a higher rate of operative and postoperative complications than did tubal ligation(OR=1.78,95%CI:1.46-2.20,p<0.001).Salpingectomy was associated with a greater risk of longer operation time(OR=2.03,95%CI:2.02-2.04,p<0.001),longer hospital stay(OR=5.26,95%CI:4.57-6.09,p<0.001),increased readmission(OR=3.15,95%CI:1.92-5.65,p<0.001),and increased unplanned reoperation(OR=2.42,95%CI:1.32-5.12,p=0.010).In addition,the occurrence rates of organ space surgical site infection(OR=2.68,95%CI:1.21-7.59,p=0.032)and sepsis(OR=3.93,95%CI:1.48-16.02,p=0.020)were significantly greater in the salpingectomy group than in the tubal ligation group.Conclusions Laparoscopic tubal ligation and salpingectomy are both safe and effective procedures for permanent contraception;however,salpingectomy is more likely to be associated with peri-and postoperative complications.These findings may help guide clinical decision-making when selecting the optimal permanent contraception method for women.
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.
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.
文摘BACKGROUND Endoscopic variceal band ligation(EVBL)represents a pivotal treatment in the prophylaxis of esophageal varices bleeding in patients with cirrhosis,but in some cases a single session of EVBL is unable to eradicate esophageal varices completely,and a control endoscopy after 2-4 weeks is required to assess eradication and/or the need for another band ligation.Liver stiffness measurement(LSM)is being increasingly used as a screening non-invasive tool to predict varices according to Baveno VII criteria.However,to date,there are no instruments able to non-invasively predict the outcome of EVBL.AIM To identify non-invasive predictors of varices eradication(VE)after EVBL through multiparametric ultrasound(US).Secondary aim was to develop a prediction model of successful variceal eradication based on non-invasive parameters.METHODS We prospectively enrolled consecutive cirrhotic patients intolerant or with contraindications to beta-blockers undergoing EVBL for bleeding prophylaxis.Patients underwent multiparametric US with LSM,spleen stiffness measurement(SSM)and dynamic contrastenhanced US(DCE-US)on liver parenchyma and portal vein,at baseline(T0)and one month(T1)after EVBL.Each US parameter and their variations from baseline were correlated with VE evaluated by control endoscopy performed at T1.RESULTS We enrolled 41 patients(median age 64 years,75.6%males).At T128 patients(68.3%)reached VE,whereas 13(31.7%)required a second EVBL.Patients who achieved VE showed a significant decrease in SSM(P=0.018),and a significant increase in peak enhancement,area under the curve and wash-in rate of both liver parenchyma and portal vein after treatment(P<0.001).Statistically significant differences between the two groups of patients were incorporated in a multivariate analysis and used to develop three prediction models.CONCLUSION A multimodal US approach based on DCE-US parameters,LSM and SSM might become a reliable predictor of VE and a useful non-invasive alternative to endoscopy.
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.
文摘BACKGROUND Cirrhosis-related upper gastrointestinal bleeding(UGIB)poses a fatal risk,and endoscopic ligation as a sole intervention shows inadequate effectiveness.AIM To evaluate the therapeutic efficacy of endoscopic variceal ligation(EVL)plus pro-pranolol vs EVL monotherapy in patients with cirrhosis complicated with acute UGIB and identify predictors for clinical outcomes.METHODS This study enrolled 99 consecutive patients with cirrhosis presenting with acute UGIB between January 2024 and January 2025.Participants were allocated to either the control group(n=49)receiving EVL alone or(2)the research group(n=50)receiving EVL plus propranolol.Primary outcomes included treatment efficacy,venous blood flow[portal venous flow(PVF)/splenic venous flow(SVF)],and postoperative outcomes(hemostasis time,length of hospital stay,and rebleeding rates).Univariate and multivariate regression analyses were conducted to determine independent predictors of treatment response.RESULTS Compared with the control group,the research group demonstrated significantly better outcomes,including higher overall treatment efficacy,greater reductions in PVF and SVF,shorter hemostasis time and hospital stay,and lower rebleeding rates.Univariate analysis demonstrated significant associations between treatment efficacy and age,cirrhosis duration,Child-Pugh grade,bleeding duration,and treatment approach in patients with cirrhosis complicated with acute UGIB.Multivariate logistic regression identified three independent risk factors for poor outcomes,namely,advanced age(>55 years),prolonged cirrhosis duration(≥4 years),and delayed bleeding intervention(>24 hours).CONCLUSION The EVL plus propranolol regimen demonstrates significant efficacy in treating UGIB in cirrhosis,outperforming EVL alone in improving hemodynamics(PVF/SVF),shortening hemostasis and hospitalization duration,and reducing rebleeding rates.Moreover,advanced age,prolonged disease duration,and longer bleeding times are independent risk factors for poor therapeutic outcomes.
基金Supported by Scientific Research Fund of China-Japan Friendship Hospital,No.2019-1-QN-53.
文摘BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.
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the CAMS Innovation Fund for Medical Sciences (CIFMS,No.2021-I2M-1-026)the National Key R & D Program of China (No.2018YFE0111400)+5 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 Sciences,the Chinese Academy of Medical SciencesPeking Union Medical College for funding and support
文摘This study presents an unexpected finding that the cis isomer of β-thio-Asp exhibits higher ligation ac-tivity than the trans isomer.This discovery sheds light on the intricate nature of native chemical ligation and highlights the importance of factors beyond the steric effects of the side chain in modulating ligation activity.
基金Supported by the Guizhou Provincial Science and Technology Program,No.[2020]4Y004.
文摘BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to cause serious complications,such as hemorrhage from dislodged ligature rings caused by EBL and hemorrhage from operation-related ulcers resulting from TAI.However,the optimal therapy for mild to moderate type 1 gastric variceal hemorrhage(GOV1)has not been determined.Therefore,the aim of this study was to discover an individualized treatment for mild to moderate GOV1.AIM To compare the efficacy,safety and costs of EBL and TAI for the treatment of mild and moderate GOV1.METHODS A clinical analysis of the data retrieved from patients with mild or moderate GOV1 gastric varices who were treated under endoscopy was also conducted.Patients were allocated to an EBL group or an endoscopic TAI group.The differences in the incidence of varicose relief,operative time,operation success rate,mortality rate within 6 wk,rebleeding rate,6-wk operation-related ulcer healing rate,complication rate and average operation cost were compared between the two groups of patients.RESULTS The total effective rate of the two treatments was similar,but the efficacy of EBL(66.7%)was markedly better than that of TAI(39.2%)(P<0.05).The operation success rate in both groups was 100%,and the 6-wk mortality rate in both groups was 0%.The average operative time(26 min)in the EBL group was significantly shorter than that in the TAI group(46 min)(P<0.01).The rate of delayed postoperative rebleeding in the EBL group was significantly lower than that in the TAI group(11.8%vs 45.1%)(P<0.01).At 6 wk after the operation,the healing rate of operation-related ulcers in the EBL group was 80.4%,which was significantly greater than that in the TAI group(35.3%)(P<0.01).The incidence of postoperative complications in the two groups was similar.The average cost and other related economic factors were greater for the EBL than for the TAI(P<0.01).CONCLUSION For mild to moderate GOV1,patients with EBL had a greater one-time varix eradication rate,a greater 6-wk operation-related ulcer healing rate,a lower delayed rebleeding rate and a lower cost than patients with TAI.
基金supported by the Excellent Young Scholars Cultivation Project of Fujian Medical University Union Hospital in China(No.2022XH031)the National Natural Science Foundation of China(No.82203439)the Natural Science Foundation of Fujian Province(No.2022J01263).
文摘Carrimycin(CA),sanctioned by China’s National Medical Products Administration(NMPA)in 2019 for treating acute bronchitis and sinusitis,has recently been observed to exhibit multifaceted biological activities,encompassing anti-inflammatory,antiviral,and anti-tumor properties.Despite these applications,its efficacy in sepsis treatment remains unexplored.This study introduces a novel function of CA,demonstrating its capacity to mitigate sepsis induced by lipopolysaccharide(LPS)and cecal ligation and puncture(CLP)in mice models.Our research employed in vitro assays,real-time quantitative polymerase chain reaction(RT-qPCR),and RNA-seq analysis to establish that CA significantly reduces the levels of pro-inflammatory cytokines,namely tumor necrosis factor-alpha(TNF-α),interleukin 1 beta(IL-1β),and interleukin 6(IL-6),in response to LPS stimulation.Additionally,Western blotting and immunofluorescence assays revealed that CA impedes Nuclear Factor Kappa B(NF-κB)activation in LPS-stimulated RAW264.7 cells.Complementing these findings,in vivo experiments demonstrated that CA effectively alleviates LPS-and CLP-triggered organ inflammation in C57BL/6 mice.Further insights were gained through 16S sequencing,highlighting CA’s pivotal role in enhancing gut microbiota diversity and modulating metabolic pathways,particularly by augmenting the production of short-chain fatty acids in mice subjected to CLP.Notably,a comparative analysis revealed that CA’s anti-inflammatory efficacy surpasses that of equivalent doses of aspirin(ASP)and TIENAM.Collectively,these findings suggest that CA exhibits significant therapeutic potential in sepsis treatment.This discovery provides a foundational theoretical basis for the clinical application of CA in sepsis management.
基金Supported by the Engineering Training Funds in Shenzhen,No.SYLY201718,No.SYJY201714,and No.SYLY201801Technical Research and Development Project of Shenzhen,No.JCYC20170307100911479,No.JCYJ20190807145617113,No.JCYJ20210324113802006.
文摘BACKGROUND The majority of esophageal subepithelial lesions originating from the muscularis propria(SEL-MPs)are benign in nature,although a subset may exhibit malignant characteristics.Conventional endoscopic resection techniques are time-consuming and lack efficacy for small SEL-MPs.AIM To evaluate the efficacy and safety of ligation-assisted endoscopic submucosal resection(ESMR-L)following unroofing technique for small esophageal SEL-MPs.METHODS From January 2021 to September 2023,17 patients diagnosed with esophageal SEL-MPs underwent ESMR-L following unroofing technique at the endoscopy center of Shenzhen People’s Hospital.Details of clinicopathological characteristics and clinical outcomes were collected and analyzed.RESULTS The mean age of the patients was 50.12±12.65 years.The mean size of the tumors was 7.47±2.83 mm and all cases achieved en bloc resection successfully.The average operation time was 12.2 minutes without any complications.Histopathology identified 2 Lesions(11.8%)as gastrointestinal stromal tumors at very low risk,12 Lesions(70.6%)as leiomyoma and 3 Lesions(17.6%)as smooth muscle proliferation.No recurrence was found during the mean follow-up duration of 14.18±9.62 months.CONCLUSION ESMR-L following roofing technique is an effective and safe technique for management of esophageal SEL-MPs smaller than 20 mm,but it cannot ensure en bloc resection and may require further treatment.
文摘In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.
文摘The combination of endoscopic ultrasound with endoscopic treatment of type 1 gastric variceal hemorrhage may improve the robustness and generalizability of the findings in future studies.Moreover,the esophageal varices should also be included in the evaluation of treatment efficacy in subsequent studies to reach a more convincing conclusion.
文摘Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a tertiary care center between 2007 and 2018 were included in the study.The records of cases were obtained from the hospital database,retrospectively.Maternal demographic data,morbidities or complications associated with BHGAL surgery,any additional haemostatic interventional or surgical procedures,preoperative admission and lowest postoperative haematocrit-hemoglobin values,blood products given,type of anaesthesia,intensive care unit(ICU)and length of hospital stay were recorded.In cases without surgical sterilization,future fertility and subsequent pregnancy outcomes were assessed for at least two years after operation.Information was obtained through face-to-face or telephone interviews with patients whose long-term fertility and subsequent pregnancy outcomes were assessed.Results:Sixty-eight patients with BHGAL surgery history were included in the study.26 Of 37 cases(70%)that did not undergo surgical sterilization had a desire for pregnancy after the surgery.Six of these cases(23%)were diagnosed with secondary infertility.The fertility rate of these cases was 77%,and subsequent pregnancy was detected in 20 women.A total of 25 pregnancies,including first and second pregnancies,developed,and 15 of these pregnancies resulted in term delivery,six preterm births,one stillbirth,and three abortions.Conclusions:The postoperative pregnancy rate was found to be higher than the rate of women with infertility problems,and this surgery does not seem to adversely affect pregnancy outcomes.This is a tertiary center experience and cohort studies with large patient series are needed.
文摘BACKGROUND Gastric mesenchymal tumors(GMT)are identified as soft tissue neoplasms that arise from mesenchymal stem cells within the gastrointestinal tract.GMT pri-marily encompass gastric stromal tumors(GST),gastric leiomyomas,and gastric schwannomas.Although most GMT are benign,there are still potential malignant changes,especially GST.Thus,early surgical intervention is the primary treat-ment for GMT.We have designed a simple endoscopic“calabash”ligation and resection(ECLR)procedure to treat GMT.Its efficacy and safety need to be com-pared with those of traditional endoscopic techniques,such as endoscopic sub-mucosal excavation(ESE).AIM To assess the safety and effectiveness of ECLR in managing small GMT(sGMT)with a maximum diameter≤20 mm by comparing to ESE.METHODS This retrospective analysis involved patients who were hospitalized in our institution between November 2021 and March 2023,underwent endoscopic resection,and received a pathological diagnosis of GMT.Cases with a tumor diameter≤20 mm were chosen and categorized into two cohorts:Study and control groups.The study group was composed of patients treated with ECLR,whereas the control group was composed of those treated with ESE.Data on general clinical characteristics(gender,age,tumor diameter,tumor growth direction,tumor pathological type,and risk grade),surgery-related information(complete tumor resection rate,operation duration,hospitalization duration,hospitalization cost,and surgical complications),and postoperative follow-up were collected for both groups.The aforementioned data were subsequently analyzed and compared.RESULTS Five hundred and eighty-nine individuals were included,with 297 cases in the control group and 292 in the study group.After propensity score matching,the final analysis incorporated 260 subjects in each cohort.The findings indicated that the study group exhibited shorter operation duration and lowered medical expenses relative to the control group.Furthermore,the study group reported less postoperative abdominal pain and had a lower incidence of intraoperative perforation and postoperative electrocoagulation syndrome than the control group.There were no substantial variations observed in other parameters among the two cohorts.CONCLUSION ECLR is a viable and effective approach for managing sGMT.
基金supported by Hunan Provincial Innovation Foundation for Postgraduate (China) (No. CX2017B546)the National Natural Science Foundation of China (No. 21572244)
文摘Here, we report a new approach of on-resin peptide ligation using C-terminal benzyl ester as the stabilized precursor of thioester, which enables both N-terminal elongation and C-terminal peptide ligation on a Rink Amide resin. On-resin native chemical ligation and auxiliary-assisted peptide ligation were successfully achieved. This method is compatible to both protected and unprotected peptide fragments and has potential application in poor water-soluble peptide ligation.
基金supported by the grants from National Natural Science Foundation of China(No. 30600173,81070893)the Key Project of China Ministry of Education(No. 109003)+1 种基金the National Basic Research Development Program(973 Program) of China (No.2007CB512501)Beijing Municipal Commission of Education "Special Grants for Outstanding Ph.D Program Tutors"
文摘Objective The present study aimed to investigate the electrophysiological properties of wide dynamic range （WDR） neurons in spinal dorsal horn of rats with neuropathic pain induced by lumber 5 （L5） spinal nerve ligation （SNL） in a large size of samples.Methods Adult Sprague-Dawley rats were divided into normal and SNL groups.Electrophysiological technique was used to record the characteristics of WDR neurons in the spinal dorsal horn.Results Compared with the WDR neurons in normal rats,the WDR neurons in SNL rats showed an increase in excitability,manifested by an enlargement of the receptive field size,an increase in the proportion of neurons that exhibited spontaneous activities,decreases in the Cresponse threshold and latency,and an increase in the C-response duration.In addition,the numbers of A-and C-fiberevoked discharges were smaller in SNL rats than in normal rats.Conclusion The excitability of spinal WDR neurons increased in rats with neuropathic pain induced by L5 SNL.The increase in excitability of WDR neurons may contribute to the development of neuropathic pain.
