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Mesenteric adipose tissue B lymphocytes promote intestinal injury in severe acute pancreatitis by mediating enteric pyroptosis

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 300-309页

作者： Qing Huang Jia-Wen Liu Hai-Bin Dong Zheng-Jie Wei Jin-Zhe Liu Yu-Tang Ren Xuan Jiang Bo Jiang Department of Gastroenterology Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China

Background:Visceral adipose tissue(VAT)has been linked to the severe acute pancreatitis(SAP)prognosis,although the underlying mechanism remains unclear.It has been reported that pyroptosis worsens SAP.The present study aimed to verify whether mesenteric adipose tissue(MAT,a component of VAT)can cause secondary intestinal injury through the pyroptotic pathway.Methods:Thirty-six male Sprague Dawley(SD)rats were divided into six different groups.Twelve rats were randomly divided into the SAP and control groups.We monitored the changes of MAT and B lymphocytes infiltration in MAT of SAP rats.Twelve SAP rats were injected with MAT B lymphocytes or phosphate buffer solution(PBS).The remaining twelve SAP rats were first injected with MAT B lymphocytes,and then with MCC950(NLRP3 inhibitor)or PBS.We collected blood and tissue samples from pancreas,gut and MAT for analysis.Results:Compared to the control rats,the SAP group showed inflammation in MAT,including higher expression of tumor necrosis factor(TNF-α)and interleukin-6(IL-6),lower expression of IL-10,and histological changes.Flow cytometry analysis revealed B lymphocytes infiltration in MAT but not T lymphocytes and macrophages.The SAP rats also exhibited intestinal injury,characterized by lower expression of zonula occludens-1(ZO-1)and occludin,higher levels of lipopolysaccharide and diamine oxidase,and pathological changes.The expression of NLRP3 and n-GSDMD,which are responsible for pyroptosis,was increased in the intestine of SAP rats.The injection of MAT B lymphocytes into SAP rats exacerbated the inflammation in MAT.The upregulation of pyroptosis reduced tight junction in the intestine,which contributed to the SAP progression,including higher inflammatory indicators and worse histological changes.The administration of MCC950 to SAP+MAT B rats downregulated pyroptosis,which subsequently improved the intestinal barrier and ameliorated inflammatory response of SAP.Conclusions:In SAP,MAT B lymphocytes aggravated local inflammation,and promoted the injury to the int

关键词： Acute pancreatitis Mesenteric adipose tissue B lymphocyte Intestinal barrier Pyroptosis

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Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids:A retrospective study

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 731-739页

作者： Xiao-Wen Sun Jing-Yi Xu Chang-Zhen Zhu Si-Jia Li Lu-Jia Jin Zhi-Dong Zhu Department of Gastrointestinal Surgery Tsinghua University Affiliated Beijing Tsinghua Changgeng HospitalBeijing 102218China Surgical Department Tsinghua University Affiliated Beijing Tsinghua Changgeng HospitalBeijing 102218China

BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in the lower part of the rec-tum.Mixed hemorrhoids bleed easily and recurrently,and this can result in severe anemia.Hence,they may have a negative effect on the health of the patient and surgical treatment is required.Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids.How-ever,most patients experience different degrees of postoperative pain that may cause anxiety.with mixed hemorrhoids post-surgery.METHODS The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively.The basic character-istics of the enrolled patients with mixed hemorrhoids were recorded,and based on the Goligher clinical grading system,the hemorrhoids were classified as grades III or IV.The endpoint of this study was the disappearance of pain in all patients.Quantitative data were presented as mean±SD,such as age,pain score,and QoL score.Student’s t-test was used to compare the groups.RESULTS A total of 164 patients were enrolled.The distribution of the visual analog scale pain scores of all patients at 3,7,14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time.Fourteen days after the operation,the pain had completely disappeared in some patients.Twenty-eight days after the surgery,none of the patients experienced any pain.Comparing the World Health Or-ganization Quality of Life-BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery,we observed that the quality-of-life scores of the patients post-surgery had significantly improved.There were six items that were compared at 14-and 28-d post-surgery.The mean QoL score 28 d after surgery(4.79±0.46)was higher than that at 14 d post-surgery(3.79±0.57).The mean health condition

关键词： Hemorrhoids Mixed hemorrhoids Milligan organ hemorrhoidectomy Postoperative pain Quality of life Anesthesia mode

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Acute upper gastrointestinal bleeding due to portal hypertension in a patient with primary myelofibrosis:A case report

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World Journal of Clinical Cases 2024年第15期12卷 2621-2626页

作者： Yu Chen Bing-Bing Kong He Yin Hao Liu Sheng Wu Ting Xu Department of Emergency Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China Department of Pathology Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China

BACKGROUND Acute upper gastrointestinal bleeding is a common medical emergency that has a 10%hospital mortality rate.According to the etiology,this disease can be divided into acute varicose veins and nonvaricose veins.Bleeding from esophageal varices is a life-threatening complication of portal hypertension.Portal hypertension is a clinical syndrome defined as a portal venous pressure that exceeds 10 mmHg.Cirrhosis is the most common cause of portal hypertension,and thrombosis of the portal system not associated with liver cirrhosis is the second most common cause of portal hypertension in the Western world.Primary myeloproliferative disorders are the main cause of portal venous thrombosis,and somatic mutations in the Janus kinase 2 gene(JAK2 V617F)can be found in approximately 90% of polycythemia vera,50% of essential thrombocyrosis and 50% of primary myelofibrosis.CASE SUMMARY We present a rare case of primary myelofibrosis with gastrointestinal bleeding as the primary manifestation that presented as portal-superior-splenic mesenteric vein thrombosis.Peripheral blood tests revealed the presence of the JAK2 V617F mutation.Bone marrow biopsy ultimately confirmed the diagnosis of myelofibrosis(MF-2 grade).CONCLUSION In patients with acute esophageal variceal bleeding due to portal hypertension and vein thrombosis without cirrhosis,the possibility of myeloproliferative neoplasms should be considered,and the JAK2 mutation test should be performed.

关键词： Acute esophageal variceal bleeding Portal hypertension Myelofibrosis JAK2 V617F mutation Case report

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Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

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Journal of Otology 2024年第1期19卷 19-23页

作者： Sichao Liang Yunshuo Li Zhenping Guo Manlin Lu Xin Li Jia Xu Wenjing Chen Juanjuan Gao Haijin Yi Department of Otolaryngology Head and Neck SurgeryBeijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing102218China

Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

关键词： Modified intratympanic steroid therapy Sudden sensorineural hearing loss Gelfoam Tympanic tube

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In vivo pilot study into superficial microcirculatory characteristics of colorectal adenomas using novel high-resolution magnifying endoscopy with blue laser imaging

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World Journal of Gastrointestinal Endoscopy 2024年第4期16卷 206-213页

作者： Hai-Bin Dong Tao Chen Xiao-Fei Zhang Yu-Tang Ren Bo Jiang Department of Gastroenterology Beijing Tsinghua Changgung HospitalBeijing 102218China Center for Medical Data Science Beijing Tsinghua Changgung HospitalBeijing 102218China

BACKGROUND No studies have yet been conducted on changes in microcirculatory hemody-namics of colorectal adenomas in vivo under endoscopy.The microcirculation of the colorectal adenoma could be observed in vivo by a novel high-resolution magnification endoscopy with blue laser imaging(BLI),thus providing a new insight into the microcirculation of early colon tumors.AIM To observe the superficial microcirculation of colorectal adenomas using the novel magnifying colonoscope with BLI and quantitatively analyzed the changes in hemodynamic parameters.METHODS From October 2019 to January 2020,11 patients were screened for colon adenomas with the novel high-resolution magnification endoscope with BLI.Video images were recorded and processed with Adobe Premiere,Adobe Photoshop and Image-pro Plus software.Four microcirculation parameters:Microcirculation vessel density(MVD),mean vessel width(MVW)with width standard deviation(WSD),and blood flow velocity(BFV),were calculated for adenomas and the surrounding normal mucosa.RESULTS A total of 16 adenomas were identified.Compared with the normal surrounding mucosa,the superficial vessel density in the adenomas was decreased(MVD:0.95±0.18 vs 1.17±0.28μm/μm2,P<0.05).MVW(5.11±1.19 vs 4.16±0.76μm,P<0.05)and WSD(11.94±3.44 vs 9.04±3.74,P<0.05)were both increased.BFV slowed in the adenomas(709.74±213.28 vs 1256.51±383.31μm/s,P<0.05).CONCLUSION The novel high-resolution magnification endoscope with BLI can be used for in vivo study of adenoma superficial microcirculation.Superficial vessel density was decreased,more irregular,with slower blood flow.

关键词： Adenoma Microcirculation High-resolution magnification endoscopy Blue laser imaging

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An Automatic Implementation of Oropharyngeal Swab Sampling for Diagnosing Respiratory Infectious Diseases via Soft Robotic End-Effectors

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Chinese Journal of Mechanical Engineering 2024年第2期37卷 55-67页

作者： Yafeng Cui Wenjie Yu Jingjing Li Qi Shao Ding Weng Guoping Yin Xiaohao Zhang Xinjun Liu Jingying Ye Jiadao Wang Huichan Zhao Department of Mechanical Engineering Tsinghua UniversityBeijing 100084China beijing Huakang Tongbang Technology Company Beijing 102609China Department of Otorhinolaryngology Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China Tianjin Research Institute for Advanced Equipment Tsinghua UniversityTianjin 300300China

The most widely adopted method for diagnosing respiratory infectious diseases is to conduct polymerase chain reaction(PCR)assays on patients’respiratory specimens,which are collected through either nasal or oropharyngeal swabs.The manual swab sampling process poses a high risk to the examiner and may cause false-negative results owing to improper sampling.In this paper,we propose a pneumatically actuated soft end-effector specifically designed to achieve all of the tasks involved in swab sampling.The soft end-effector utilizes circumferential instability to ensure grasping stability,and exhibits several key properties,including high load-to-weight ratio,error tolerance,and variable swab-tip stiffness,leading to successful automatic robotic oropharyngeal swab sampling,from loosening and tightening the transport medium tube cap,holding the swab,and conducting sampling,to snapping off the swab tail and sterilizing itself.Using an industrial collaborative robotic arm,we integrated the soft end-effector,force sensor,camera,lights,and remote-control stick,and developed a robotic oropharyngeal swab sampling system.Using this swab sampling system,we conducted oropharyngeal swab-sampling tests on 20 volunteers.Our Digital PCR assay results(RNase P RNA gene absolute copy numbers for the samples)revealed that our system successfully collected sufficient numbers of cells from the pharyngeal wall for respiratory disease diagnosis.In summary,we have developed a pharyngeal swab-sampling system based on an“enveloping”soft actuator,studied the sampling process,and imple-mented whole-process robotic oropharyngeal swab-sampling.

关键词： Diagnosis Medical robot Soft end-effector Swab-sampling Digital PCR

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Predicting the prognosis of hepatic arterial infusion chemotherapy in hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2380-2393页

作者： Qi-Feng Wang Zong-Wei Li Hai-Feng Zhou Kun-Zhong Zhu Ya-Jing Wang Ya-Qin Wang Yue-Wei Zhang Department of Hepatobiliary Pancreatic Center Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua UniversityBeijing 102218China Department of Hepatobiliary and Pancreatic Surgery Qinghai University Affiliated HospitalXining 810000Qinghai ProvinceChina

Hepatic artery infusion chemotherapy(HAIC)has good clinical efficacy in the treatment of advanced hepatocellular carcinoma(HCC);however,its efficacy varies.This review summarized the ability of various markers to predict the efficacy of HAIC and provided a reference for clinical applications.As of October 25,2023,51 articles have been retrieved based on keyword predictions and HAIC.Sixteen eligible articles were selected for inclusion in this study.Comprehensive literature analysis found that methods used to predict the efficacy of HAIC include serological testing,gene testing,and imaging testing.The above indicators and their combined forms showed excellent predictive effects in retrospective studies.This review summarized the strategies currently used to predict the efficacy of HAIC in middle and advanced HCC,analyzed each marker's ability to predict HAIC efficacy,and provided a reference for the clinical application of the prediction system.

关键词： Hepatocellular carcinoma Hepatic artery infusion chemotherapy Prediction Prognosis Imaging Biomarkers Genomics

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Improving corrosion resistance of additively manufactured WE43 magnesium alloy by high temperature oxidation for biodegradable applications

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Journal of Magnesium and Alloys 2024年第3期12卷 940-953页

作者： Jinge Liu Bangzhao Yin Fei Song Bingchuan Liu Bo Peng Peng Wen Yun Tian Yufeng Zheng Xiaolin Ma Caimei Wang State Key Laboratory of Tribology in Advanced Equipment Beijing100084China Department of Mechanical Engineering Tsinghua UniversityBeijing 100084China Department of Orthopaedics Beijing Tsinghua Changgung HospitalInstitute for Precision MedicineTsinghua UniversityBeijing102218China Department of Orthopaedics Peking University Third HospitalBeijing 100191China Engineering Research Center of Bone and Joint Precision Medicine Ministry of EducationBeijing 100191China School of Materials Science and Engineering Peking UniversityBeijing 100871China beijing AKEC Medical Co. Ltd.Beijing 102200China

Laser powder bed fusion(L-PBF)has been employed to additively manufacture WE43 magnesium(Mg)alloy biodegradable implants,but WE43 L-PBF samples exhibit excessively rapid corrosion.In this work,dense WE43 L-PBF samples were built with the relativity density reaching 99.9%.High temperature oxidation was performed on the L-PBF samples in circulating air via various heating temperatures and holding durations.The oxidation and diffusion at the elevated temperature generated a gradient structure composed of an oxide layer at the surface,a transition layer in the middle and the matrix.The oxide layer consisted of rare earth(RE)oxides,and became dense and thick with increasing the holding duration.The matrix was composed ofα-Mg,RE oxides and Mg_(24)RE_(5) precipitates.The precipitates almost disappeared in the transition layer.Enhanced passivation effect was observed in the samples treated by a suitable high temperature oxidation.The original L-PBF samples lost 40%weight after 3-day immersion in Hank’s solution,and broke into fragments after 7-day immersion.The casted and solution treated samples lost roughly half of the weight after 28-day immersion.The high temperature oxidation samples,which were heated at 525℃ for 8 h,kept the structural integrity,and lost only 6.88%weight after 28-day immersion.The substantially improved corrosion resistance was contributed to the gradient structure at the surface.On one hand,the outmost dense layer of RE oxides isolated the corrosive medium;on the other hand,the transition layer considerably inhibited the corrosion owing to the lack of precipitates.Overall,high temperature oxidation provides an efficient,economic and safe approach to inhibit the corrosion of WE43 L-PBF samples,and has promising prospects for future clinical applications.

关键词： Laser powder bed fusion Biodegradable magnesium alloy High temperature oxidation Corrosion resistance WE43.

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Influence of layer thickness on formation quality,microstructure,mechanical properties,and corrosion resistance of WE43 magnesium alloy fabricated by laser powder bed fusion

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Journal of Magnesium and Alloys 2024年第4期12卷 1367-1385页

作者： Bangzhao Yin Jinge Liu Bo Peng Mengran Zhou Bingchuan Liu Xiaolin Ma Caimei Wang Peng Wen Yun Tian Yufeng Zheng State Key Laboratory of Tribology in Advanced Equipment Beijing100084China Department of Mechanical Engineering Tsinghua UniversityBeijing 100084China Institute for Precision Medicine Tsinghua UniversityBeijing102218China Department of Orthopaedics Peking University Third HospitalBeijing 100191China beijing AKEC Medical Co. Ltd.Beijing 102200China School of Materials Science and Engineering Peking UniversityBeijing 100871China Engineering Research Center of Bone and Joint Precision Medicine Ministry of EducationBeijing 100191China

Laser powder bed fusion(L-PBF)of Mg alloys has provided tremendous opportunities for customized production of aeronautical and medical parts.Layer thickness(LT)is of great significance to the L-PBF process but has not been studied for Mg alloys.In this study,WE43 Mg alloy bulk cubes,porous scaffolds,and thin walls with layer thicknesses of 10,20,30,and 40μm were fabricated.The required laser energy input increased with increasing layer thickness and was different for the bulk cubes and porous scaffolds.Porosity tended to occur at the connection joints in porous scaffolds for LT40 and could be eliminated by reducing the laser energy input.For thin wall parts,a large overhang angle or a small wall thickness resulted in porosity when a large layer thicknesses was used,and the porosity disappeared by reducing the layer thickness or laser energy input.A deeper keyhole penetration was found in all occasions with porosity,explaining the influence of layer thickness,geometrical structure,and laser energy input on the porosity.All the samples achieved a high fusion quality with a relative density of over 99.5%using the optimized laser energy input.The increased layer thickness resulted to more precipitation phases,finer grain sizes and decreased grain texture.With the similar high fusion quality,the tensile strength and elongation of bulk samples were significantly improved from 257 MPa and 1.41%with the 10μm layer to 287 MPa and 15.12%with the 40μm layer,in accordance with the microstructural change.The effect of layer thickness on the compressive properties of porous scaffolds was limited.However,the corrosion rate of bulk samples accelerated with increasing the layer thickness,mainly attributed to the increased number of precipitation phases.

关键词： Magnesium alloy WE43 Laser powder bed fusion Layer thickness Process optimization

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Engineering neuroregenerative microenvironment via aligned hydrogel-assisted magnetic stimulation for complete spinal cord injury repair

Engineered Regeneration

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Engineered Regeneration 2024年第2期5卷 139-152页

作者： Chun-Yi Yang Zhe Meng Zhijun He Pengchao Ma Zhaohui Hou Kunkoo Kim Jingsong Lu Kaiyuan Yang Guihuai Wang Xiumei Wang State Key Laboratory of New Ceramics and Fine Processing Key Laboratory of Advanced Materials of Ministry of EducationSchool of Materials Science and EngineeringTsinghua UniversityBeijing 100084China Department of Neurosurgery Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing102218China

Utilizing biomaterials in tissue engineering has shown considerable promise for tissue regeneration,particularly through delivering multimodel cell-regulatory signals,including the material-related signals and extrinsic stimuli.In this research,we developed a magnetic-responsive aligned nanofiber fibrin hydrogel(MAFG),integrating the structured alignment of nanofibers and the pliability of fibrin hydrogel with an external magnetic field.This design aimed to enhance the regenerative response in spinal cord injury treatment.A medium-strength magnetic field,aligned with the spinal cord,was applied to aid motor function recovery in rats with spinal cord injuries.The use of MAFG in this context not only intensified the effect of the magnetic field but also encouraged the activation and differentiation of native neural stem cells.Furthermore,this method effectively steered macrophage polarization towards a beneficial M2 phenotype,addressing immune dysregulation at the injury site.The parallel application of magnetic field stimulation through MAFG in a spinal cord injury model contributed to the concurrent promotion of neurogenesis,angiogenesis,and immunomodulation,resulting in marked improvement in motor function in rats.This investigation underscores the therapeutic potential of magnetic field stimulation and highlights how aligning this stimulation with the spinal cord can significantly enhance the regenerative milieu at the injury site.

关键词： Angiogenesis Neurogenesis Immunomodulation Magnetic-responsive hydrogel Magnetic stimulation

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