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The application of real-time indocyanine green fluorescence cholangiography in laparoscopic living donor left lateral sectionectomy

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 575-585,I0001页

作者： Lu Lu Wen-Wei Zhu Cong-Huan Shen Yi-Feng Tao Zheng-Xin Wang Jin-Hong Chen Lun-Xiu Qin Hepatobiliary Surgery center Department of General SurgeryHuashan HospitalFudan UniversityShanghaiChina Liver Transplantation center Department of General SurgeryHuashan HospitalFudan UniversityShanghaiChina

Background:The judgment of the division point of the bile duct has always been one of the difficulties of laparoscopic left lateral sectionectomy(LLLS).The purpose of this study was to assess the effects of indocyanine green(ICG)fluorescence cholangiography during LLLS on the occurrence of biliary complications in both donors and *** optimal dose and injection time of ICG were also ***:This is a retrospective cohort *** October 2016 to December 2022,the clinical data of 103 donors who underwent LLLS and relevant recipients were retrospectively *** to whether ICG fluorescence cholangiography was used,they were divided into a non-ICG group(n=46)and an ICG group(n=57).Biliary complications were observed and the optimal dose and injection time of ICG were ***:Three donors in the non-ICG group suffered from bile *** grafts had multiple bile duct openings and biliary complications were observed in the relevant recipients who received these grafts in the non-ICG *** recipients had bile leakage,and the other two had biliary *** was no biliary complications both in donors and recipients in the ICG *** fluorescence intensity of the liver was 108.1±17.6 at a dose of 0.004 mg/kg 90 minutes after injection,significantly weaker than that at 0.05 mg/kg 30 minutes(200.3±17.6,P=0.001)and 90 minutes after injection(140.2±15.4,P=0.001).The fluorescence intensity contrast value at a dose of 0.004 mg/kg was stronger than that at 0.05 mg/kg,both measured 90 minutes after injection(0.098±0.032 vs.0.078±0.022,P=0.021).Conclusions:ICG fluorescence cholangiography is safe and feasible in *** reduces biliary complications in both donors and *** optimal ICG dose was 0.004 mg/kg,and 90 minutes after injection was the best observation *** fluorescence cholangiography is recommended for routine use in LLLS.

关键词： Laparoscopic living donor hepatectomy(LLDH) living donor liver transplantation(LDLT) real-time indocyanine green fluorescence cholangiography(real-time ICG fluorescence cholangiography)

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Endoscopic features and treatments of gastric cystica profunda

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World Journal of Gastroenterology 2024年第7期30卷 673-684页

作者： Zi-Han Geng Yan Zhu Pei-Yao Fu Yi-Fan Qu Wei-Feng Chen Xia Yang Ping-Hong Zhou Quan-Lin Li Endoscopy center and Endoscopy Research Institute Zhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND Gastric cystica profunda(GCP)represents a rare condition characterized by cystic dilation of gastric glands within the mucosal and/or submucosal *** is often linked to,or may progress into,early gastric cancer(EGC).AIM To provide a comprehensive evaluation of the endoscopic features of GCP while assessing the efficacy of endoscopic treatment,thereby offering guidance for diagnosis and *** This retrospective study involved 104 patients with GCP who underwent endoscopic *** demographic and clinical data,regular patient followups were conducted to assess local *** Among the 104 patients diagnosed with GCP who underwent endoscopic resection,12.5%had a history of previous gastric *** primary site predominantly affected was the cardia(38.5%,n=40).GCP commonly exhibited intraluminal growth(99%),regular presentation(74.0%),and ulcerative mucosa(61.5%).The leading endoscopic feature was the mucosal lesion type(59.6%,n=62).The average maximum diameter was 20.9±15.3 mm,with mucosal involvement in 60.6%(n=63).Procedures lasted 73.9±57.5 min,achieving complete resection in 91.3%(n=95).Recurrence(4.8%)was managed via either surgical intervention(n=1)or through endoscopic resection(n=4).Final pathology confirmed that 59.6%of GCP cases were associated with *** analysis indicated that elderly males were more susceptible to GCP associated with ***,multivariate analysis identified lesion morphology and endoscopic features as significant risk *** analysis demonstrated no statistically significant difference in recurrence between GCP with and without EGC(P=0.72).CONCLUSION The findings suggested that endoscopic resection might serve as an effective and minimally invasive treatment for GCP with or without EGC.

关键词： Gastric cystica profunda Early gastric cancer Endoscopic features Endoscopic resection Endoscopy

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Self-assembly multifunctional DNA tetrahedron for efficient elimination of antibiotic-resistant bacteria

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Aggregate 2024年第1期5卷 204-215页

作者： Tiantian Wu Yu Fu Shuang Guo Yanqiang Shi Yuxin Zhang Zhijin Fan Bin Yang Baoquan Ding Yuhui Liao Molecular Diagnosis and Treatment center for Infectious Diseases Dermatology HospitalSouthern Medical UniversityGuangzhouChina CAS Key Laboratory of Nanosystem and Hierarchical Fabrication CAS Center for Excellence in NanoscienceNational Center for Nanoscience and TechnologyBeijingChina Longgang District Central hospital of Shenzhen ShenzhenChina

Antibiotic resistance is a major challenge in the clinical treatment of bacterial infectious ***,we constructed a multifunctional DNA nanoplatform as a versatile carrier for bacteria-specific delivery of clinical antibiotic ciprofloxacin(CIP)and classic nanoantibiotic silver nanoparticles(AgNP).In our rational design,CIP was efficiently loaded in the self-assembly double-bundle DNA tetrahedron through intercalation with DNA duplex,and single-strand DNA-modified AgNP was embedded in the cavity of the DNA tetrahedron through *** the site-specific assembly of targeting aptamer in the well-defined DNA tetrahedron,the bacteria-specific dual-antibiotic delivery system exhibited excellent combined bactericidal *** enhanced antibiotic accumulation through breaking the out membrane of bacteria,the antibiotic delivery system effectively inhibited biofilm formation and promoted the healing of infected wounds in *** DNAbased antibiotic delivery system provides a promising strategy for the treatment of antibiotic-resistant infections.

关键词： antibiotic resistance anti-infection therapy biofilm DNA nanotechnology targeted delivery

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Mesenchymal stromal cells modulate unfolded protein response and preserve β-cell mass in type 1 diabetes

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BIOCELL 2024年第7期48卷 1115-1126页

作者： SIYUAN LIU YUAN ZHAO YU YU DOU YE QIAN WANG ZHAOYAN WANG ZUO LUAN Department of Pediatrics The Sixth Medical CenterChinese PLA General HospitalBeijing100037China

Introduction:Transplantation of mesenchymal stromal cells(MSCs)is a promising therapy for type 1 diabetes(T1D).However,whether the infused MSCs affect the endoplasmic reticulum stress or subsequent unfolded protein response inβcells remains ***:To investigate this,we induced early-onset T1D in non-obese diabetic mice using ***,T1D mice were randomly assigned to receive either MSCs or phosphate-buffered *** observed the in vivo homing of MSCs and assessed their effectiveness by analyzing blood glucose levels,body weight,histopathology,pancreatic protein expression,and serum levels of cytokines,proinsulin,and ***:Infused MSCs were found in the lungs,liver,spleen,and pancreas of T1D *** exhibited various effects,including reducing blood glucose levels,regulating immunity,inhibiting inﬂammation,increasingβ-cell areas,and reducing the expression of key proteins in the unfolded protein response *** serum proinsulin and C-peptide levels were signiﬁcantly higher in the MSCs treatment group than in the T1D model ***,there was no signiﬁcant difference in the biomarker ofβ-cell endoplasmic reticulum stress,the ratio of fasting serum proinsulin to C-peptide,between the two ***:Ourﬁndings reveal that MSCs infusion does not alleviate endoplasmic reticulum stress inβcells directly but modulates the unfolded protein response pathway to preserveβ-cell mass and function in T1D mice.

关键词： Type 1 diabetes Mesenchymal stromal cells Endoplasmic reticulum stress Unfolded protein response Non-obese diabetic mice

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Incidence and predictors of futile recanalisation after endovascular therapy in acute vertebrobasilar artery occlusion patients:insight from the ANGEL-ACT registry

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Stroke & Vascular Neurology 2024年第3期9卷 289-294,I0248-I0250页

作者： Dapeng Sun Xinguang Yang Xiaochuan Huo Raynald- Baixue Jia Xu Tong Anxin Wang Ning Ma Feng Gao Dapeng Mo Zhongrong Miao Interventional Neuroradiology Department of NeurologyBeijing Tiantan HospitalCaptial Medical UniversityBeijingChina Department of Neurology Sun Yat-Sen Memorial HospitalGuangzhouGuangdongChina Cerebrovascular Disease Department Neurological Disease CenterBeijing Anzhen HospitalCapital Medical UniversityBeijingChina China National Clinical Research center for Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina

Objectives To identify the occurrence rate and predictors of futile recanalisation after endovascular therapy(EVT)for acute vertebrobasilar artery occlusion(VBAO).Methods Participants of the Endovascular Treatment Key Technique and Emergency Workflow Improvement of Acute Ischaemic Stroke(ANGEL-ACT)registry were selected for the *** recanalisation was defined as patients did not achieve a 90-day good outcome(modified Rankin Scale≤3)despite successful recanalisation(modified Treatment in Cerebral Ischaemia Scale≥2b)after the *** logistic regression analysis was conducted to find independent predictors of futile recanalisation in VBAO patients undergoing *** Three hundred and fifteen patients with VBAO who achieved successful recanalisation after EVT were included in current analysis,of whom,155(49.2%)suffered futile recanalisation,and 160 achieved effective *** the multivariable analysis,we found admission National Institutes of Health Stroke Scale(NIHSS)≥19(OR 4.81,95%CI 2.76 to 8.39,p<0.001),platelet-lymphocyte ratio(PLR)≥162.2(OR 1.93,95%CI 1.14 to 3.27,p=0.001),onset-to-puncture time(OTP)≥334min(OR 2.15,95%CI 1.25 to 3.68,p=0.005)and use of general anesthesia(GA)(OR 1.87,95%CI 1.09 to 3.22,p=0.024)were associated with futile *** Futile recanalisation after EVT occurred 49.2%of VBAO patients in the ANGEL-ACT ***≥19,PLR≥162.2,OTP≥334min and use of GA were independent predictors of futile recanalisation.

关键词： patients anesthesia occlusion

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Efficacy of a Nutritional Cream Intervention to Treat Depression in Rescuers:A Randomized Controlled Trial

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Biomedical and Environmental Sciences 2024年第7期37卷 754-761页

作者： Qiao Wang Hengyu Luan Chunyan Li Rufang Gong Qiongxuan Li Jiayi Deng Xiaoyong Sai Department of Statistics and Epidemiology The Graduate School of the Chinese PLA General HospitalBeijing 100853China Comprehensive Internal Medicine Western Medical Branch of PLA General HospitalBeijing 100144China Department of Respiratory The First Medical Center of PLA General HospitalBeijing 100853China Department of Pharmacy Intravenous Admixture Services(PIVAS) The First Medical Center of PLA General HospitalBeijing 100853China

Objective To explore the effectiveness of a nutritional intervention in rescuers who screened positive for *** A randomized controlled trial design was *** June to August,2022,4,460 rescuers were screened using the Self-Rating Depression Scale(SDS),and 1,615 positive cases were ***-one volunteers were recruited and randomly divided into a nutritional intervention group and a control *** intervention group received health education and nutritional intervention(a compound paste therapy primarily composed of red roses and Seville orange flowers),while the control group received psychological *** scores were assessed before and after the *** There was a statistically significant decline in SDS scores in the nutritional intervention group after the intervention(P<0.05).Furthermore,the SDS scores of the intervention group were significantly lower than those of the control group,both before and after the intervention(P<0.05).No severe adverse reactions were observed during safety *** The nutritional intervention effectively reduced the depression scores in *** nutritional intervention is recommended for rescuers who initially screen positive for depression.

关键词： Nutritional intervention Rescuers Depression Randomized controlled trial

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Sedation reversal trends at outpatient ambulatory endoscopic center vs in-hospital ambulatory procedure center using a triage protocol

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 413-423页

作者： Saqib Walayat Peter Stadmeyer Azfar Hameed Minahil Sarfaraz Paul Estrada Mark Benson Anurag Soni Patrick Pfau Paul Hayes Brittney Kile Toni Cruz Deepak Gopal Department of Gastroenterology University of IllinoisPeoriaIL 61605United States Department of Gastroenterology University of WisconsinMadisonWI 53792United States Department of Internal Medicine Texas Health DentonDentonTX 76201United States Department of Internal Medicine Allama Iqbal Medical CollegeLahore 042Pakistan Department of Gastroenterology Texas Tech University Health Services CenterEl PasoTX 79911United States Department of Gastroenterology and Hepatology University of WisconsinMadisonWI 53705United States Finance Business Partners UW Health University of WisconsinMadisonWI 53792United States UW Health Digestive Health center Endoscopy University of WisconsinMadisonWI 53792United States Division of Gastroenterology and Hepatology Department of MedicineUniversity of Wisconsin Hospitals and ClinicsMadisonWI 53705United States

BACKGROUND Routine outpatient endoscopy is performed across a variety of outpatient settings.A known risk of performing endoscopy under moderate sedation is the potential for over-sedation,requiring the use of reversal *** needs to be reported on rates of reversal across different outpatient *** academic tertiary care center utilizes a triage tool that directs higher-risk patients to the in-hospital ambulatory procedure center(APC)for their ***,we report data on outpatient sedation reversal rates for endoscopy performed at an inhospital APC vs at a free-standing ambulatory endoscopy digestive health center(AEC-DHC)following risk stratification with a triage *** To observe the effect of risk stratification using a triage tool on patient outcomes,primarily sedation reversal *** We observed all outpatient endoscopy procedures performed at AEC-DHC and APC from April 2013 to September *** were stratified to their respective sites using a triage *** evaluated each procedure for which sedation reversal with flumazenil and naloxone was *** and characteristics recorded include patient age,gender,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,procedure type,and reason for sedation *** There were 97366 endoscopic procedures performed at AEC-DHC and 22494 at the APC during the study *** these,17 patients at AEC-DHC and 9 at the APC underwent sedation reversals(0.017%vs 0.04%;P=0.06).Demographics recorded for those requiring reversal at AEC-DHC vs APC included mean age(53.5±21 vs 60.4±17.42 years;P=0.23),ASA class(1.66±0.48 vs 2.22±0.83;P=0.20),BMI(27.7±6.7 kg/m^(2) vs 23.7±4.03 kg/m^(2);P=0.06),and female gender(64.7%vs 22%;P=0.04).The mean doses of sedative agents and reversal drugs used at AEC-DHC vs APC were midazolam(5.9±1.7 mg vs 8.9±3.5 mg;P=0.01),fentanyl(147.1±49.9μg vs 188.9±74.1μg;P=0.10),flumazenil(0.3±0.18μg vs 0.17±0.17μg;P=0.13)and naloxo

关键词： Ambulatory care Conscious sedation Endoscopy Colonoscopy Risk assessment Risk factors

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Transmembrane serine protease 4 expression in the prognosis of radical resection for biliary tract cancer

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2555-2564页

作者： Yoshiyuki Shibata Takeshi Sudo Sho Tazuma Naoki Tanimine Takashi Onoe Yosuke Shimizu Atsushi Yamaguchi Kazuya Kuraoka Shinya Takahashi Hirotaka Tashiro Department of Surgery National Hospital Organization Kure Medical Center and Chugoku Cancer CenterHiroshima 737-0023Japan Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterHiroshima 737-0023Japan Department of Diagnostic Pathology National Hospital Organization Kure Medical Centerand Chugoku Cancer CenterHiroshima 737-0023Japan Department of Surgery Graduate School of Biochemical and Health ScienceHiroshima UniversityHiroshima 734-8551Japan

BACKGROUND Recent advancements in biliary tract cancer(BTC)treatment have expanded beyond surgery to include adjuvant therapy,yet the prognosis remains *** prognostic biomarkers could enhance the assessment of patients who have undergone radical resection for *** To determine transmembrane serine protease 4(TMPRSS4)utility as a prognostic biomarker of radical resection for *** Medical records of patients who underwent radical resection for BTC,excluding intrahepatic cholangiocarcinoma,were retrospectively *** associations between TMPRSS4 expression and clinicopathological factors,overall survival,and recurrence-free survival were *** Among the 85 patients undergoing radical resection for BTC,46(54%)were *** TMPRSS4-positive group exhibited significantly higher preoperative carbohydrate antigen 19-9(CA19-9)values and greater lymphatic invasion than the TMPRSS4-negative group(P=0.019 and 0.039,respectively).Postoperative overall survival and recurrence-free survival were significantly worse in the TMPRSS4-positive group(median survival time:25.3 months vs not reached,P<0.001;median survival time:28.7 months vs not reached,P=0.043,respectively).Multivariate overall survival analysis indicated TMPRSS4 positivity,pT3/T4,and resection status R1 were independently associated with poor prognosis(P=0.032,0.035 and 0.030,respectively).TMPRSS4 positivity correlated with preoperative CA19-9 values≥37 U/mL and pathological tumor size≥30 mm(P=0.016 and 0.038,respectively).CONCLUSION TMPRSS4 is a potential prognostic biomarker of radical resection for BTC.

关键词： Biliary tract cancer Biomarker Prognosis Radical resection Transmembrane serine protease 4

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Predicting hepatocellular carcinoma: A new non-invasive model based on shear wave elastography

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World Journal of Gastroenterology 2024年第25期30卷 3166-3178页

作者： Dong Jiang Yi Qian Yi-Jun Gu Ru Wang Hua Yu Hui Dong Dong-Yu Chen Yan Chen Hao-Zheng Jiang Bi-Bo Tan Min Peng Yi-Ran Li Department of Ultrasound Eastern Hepatobiliary Surgery HospitalThe Third Affiliated Hospital of Naval Medical UniversityShanghai 200433China Department of Pathology Shanghai Eastern Hepatobiliary Surgery HospitalThird Affiliated Hospital of Naval Medical UniversityShanghai 200433China Department of College of Art and Science Case Western Reserve UniversityClevelandOH 44106United States Ultrasound Diagnosis PLA Naval Medical CenterShanghai 200437China

BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)*** To develop a 2D-SWE-based predictive model for preoperative identification of *** A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery *** patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory *** logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for *** factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%*** model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.

关键词： Shear wave elastography Predicting model Microvascular invasion Antiviral treatment Hepatocellular carcinoma

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A rare case of hepatic vein-portal vein fistula with hepatolithiasis presenting as cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 538-540页

作者： Wei Li Wen Lin Le Xiao General Surgery center The General Hospital of Western Theater CommandChengdu 610083China

To the Editor: We sincerely applaud the work by Tang et al., in which they described caudate lobe-sparing subtotal hepatectomy as treatment for intrahepatic arterioportal fistulas [ 1 ]. Compared to intrahepatic arterioportal fistulas, portal vein-hepatic vein fistulas are rarely reported. Patients typically lack clinical symptoms such as hyperammonemia, cholestatic jaundice, and hypoglycemia, unless the shunt becomes relatively large [ 2, 3 ]. Herein, we describe partial hepatectomy as a treatment for cases of left portal vein-middle hepatic vein fistulas.

关键词： hepatic clinical

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