Efficacy of transjugular intrahepatic portosystemic shunts in treating cirrhotic esophageal-gastric variceal bleeding

BACKGROUND Esophageal-gastric variceal bleeding(EGVB)represents a severe complication among patients with cirrhosis and often culminates in fatal outcomes.Interven-tional therapy,a rapidly developing treatment modality over the past few years,has found widespread application in clinical practice due to its minimally inva-sive characteristics.However,whether transjugular intrahepatic portosystemic shunt(TIPS)treatment has an impact on patient prognosis remains controversial.METHODS A retrospective study was conducted on ninety-two patients presenting with cirrhotic EGVB who were admitted to our hospital between September 2020 and September 2022.Based on the different modes of treatment,the patients were assigned to the study group(TIPS received,n=50)or the control group(per-cutaneous transhepatic varices embolization received,n=42).Comparative ana-lyses were performed between the two groups preoperatively and one month postoperatively for the following parameters:Varicosity status;hemodynamic parameters[portal vein flow velocity(PVV)and portal vein diameter(PVD);platelet count(PLT);red blood cell count;white blood cell count(WBC);and hepatic function[albumin(ALB),total bilirubin(TBIL),and aspartate transaminase(AST)].The Generic Quality of Life Inventory-74 was utilized to assess quality of life in the two groups,and the 1-year postoperative rebleeding and survival rates were compared.RESULTS Following surgical intervention,there was an improvement in the incidence of varicosity compared to the preoperative status in both cohorts.Notably,the study group exhibited more pronounced enhancements than did the control group(P<0.05).PVV increased,and PVD decreased compared to the preoperative values,with the study cohort achieving better outcomes(P<0.05).PLT and WBC counts were elevated postoperatively in the two groups,with the study cohort displaying higher PLT and WBC counts(P<0.05).No differences were detected between the two groups in terms of serum ALB,TBIL,or AST levels either preoperatively or postoperatively(P<0.05).Postoperative scores across all dimensions of life quality surpassed preoperative scores,with the study cohort achieving higher scores(P<0.05).At 22.00%,the one-year postoperative rebleeding rate in the study cohort was significantly lower than that in the control group(42.86%;P<0.05);conversely,no marked difference was obser-ved in the 1-year postoperative survival rate between the two cohorts(P>0.05).CONCLUSION TIPS,which has demonstrated robust efficacy in managing cirrhotic EGVB,remarkably alleviates varicosity and improves hemodynamics in patients.This intervention not only results in a safer profile but also contributes significantly to a more favorable prognosis.

Enterococcus faecalis provides protection during scavenging in carrion crow (Corvus corone)

The gut microbiota significantly influences host physiology and provides essential ecosystem services.While diet can affect the composition of the gut microbiota,the gut microbiota can also help the host adapt to specific dietary habits.The carrion crow(Corvus corone),an urban facultative scavenger bird,hosts an abundance of pathogens due to its scavenging behavior.Despite this,carrion crows infrequently exhibit illness,a phenomenon related to their unique physiological adaptability.At present,however,the role of the gut microbiota remains incompletely understood.In this study,we performed a comparative analysis using 16S rRNA amplicon sequencing technology to assess colonic content in carrion crows and 16 other bird species with different diets in Beijing,China.Our findings revealed that the dominant gut microbiota in carrion crows was primarily composed of Proteobacteria(75.51%)and Firmicutes(22.37%).Significant differences were observed in the relative abundance of Enterococcus faecalis among groups,highlighting its potential as a biomarker of facultative scavenging behavior in carrion crows.Subsequently,E.faecalis isolated from carrion crows was transplanted into model mice to explore the protective effects of this bacterial community against Salmonella enterica infection.Results showed that E.faecalis down-regulated the expression of pro-inflammatory cytokines tumor necrosis factor alpha(TNF-α),interferon gamma(IFN-γ),and interleukin 6(IL-6),prevented S.enterica colonization,and regulated the composition of gut microbiota in mice,thereby modulating the host’s immune regulatory capacity.Therefore,E.faecalis exerts immunoregulatory and anti-pathogenic functions in carrion crows engaged in scavenging behavior,offering a representative case of how the gut microbiota contributes to the protection of hosts with specialized diets.

Correlation between serum markers and transjugular intrahepatic portosystemic shunt prognosis in patients with cirrhotic ascites

BACKGROUND Individuals with refractory ascites in the context of liver cirrhosis typically face an adverse prognosis.The transjugular intrahepatic portosystemic shunt(TIPS)is an efficacious intervention,but there is a lack of reliable tools for postoperative pro-gnosis assessment.Previously utilized clinical biochemical markers,such as the serum albumin concentration(Alb),sodium(Na+)concentration,and serum creatinine(Scr),have limited predictive value.Therefore,the quest for novel,specific biomarkers to evaluate the post-TIPS prognosis in patients with liver cirrhosis and refractory ascites holds significant practical importance.A retrospective analysis was conducted on 75 patients with liver cirrhosis and refractory ascites who underwent TIPS at our institution from August 2019 to August 2021.These patients were followed up regularly for two years,and the death toll was meticulously documented.The patients were allocated into a survival group(n=45 patients)or a deceased group(n=30 patients)based on their prognosis status.The clinical data of the two groups were collected,and Child-Pugh scores and MELD scores were calculated for analysis.Spearman correlation analysis was carried out to evaluate the correlation of prognosis with Child-Pugh grade,MELD score,and Cys C level.Additionally,a multiple-factor analysis utilizing the Cox proportional hazard model was used to identify independent risk factors affecting the post-TIPS prognosis of patients with liver cirrhosis and refractory ascites.The receiver operating characteristic curve(ROC)ascertained the predictive value of the Cys C concen-tration,Child-Pugh grade,and MELD score for the prognosis of liver cirrhosis with refractory ascites in post-TIPS patients.RESULTS During a 2-year follow-up period,among 75 patients with liver cirrhosis and refractory ascites who underwent TIPS treatment,30 patients(40.00%)passed away.The deceased cohort exhibited heightened aspartate aminotrans-ferase,alanine aminotransferase,total bilirubin,Scr,prothrombin time,Cys C,international normalized ratio,Child-Pugh,and MELD scores compared to those of the survival cohort,while Alb and Na+levels were attenuated in the deceased group(P<0.05).Spearman analysis revealed moderate to high positive correlations between prognosis and Child-Pugh score,MELD score,and Cys C level(r=0.709,0.749,0.671,P<0.05).Multivariate analysis using the Cox proportional hazard model demonstrated that the independent risk factors for post-TIPS prognosis in patients with liver cirrhosis and refractory ascites were Cys C(HR=3.802;95%CI:1.313-11.015),Child-Pugh(HR=3.030;95%CI:1.858-4.943),and MELD(HR=1.222;95%CI:1.073-1.393)scores.ROC analysis confirmed that,compared to those of the classic prognostic models for Child-Pugh and MELD scores,the predictive accuracy of Cys C for post-TIPS prognosis in patients with liver cirrhosis and refractory ascites was slightly lower.This analysis yielded sensitivity and specificity values of 83.33%and 82.22%,respectively.The area under the curve value at this juncture was 0.883,with an optimal cutoff value set at 1.95 mg/L.CONCLUSION Monitoring the serum Cys C concentration is valuable for assessing the post-TIPS prognosis in patients with liver cirrhosis and refractory ascites.Predictive models based on serum Cys C levels,as opposed to Scr levels,are more beneficial for evaluating the condition and prognosis of patients with ascites due to cirrhosis.

Baseline hepatocyte ballooning is a risk factor for adverse events in patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease

BACKGROUND Although many studies have investigated the impact of chronic hepatitis B virus(HBV)infection and nonalcoholic fatty liver disease(NAFLD)on liver disease,few have investigated the relationship between nonalcoholic steatohepatitis(NASH)defined by liver pathology and the prognosis of chronic HBV infection.Most patients were followed up for a short time.This study aimed to further explore the impact of NAFLD and the pathological changes confirmed by liver pathology in patients with chronic HBV infection.AIM To study the effect of NAFLD confirmed using liver pathology on the outcomes of long-term serious adverse events[cirrhosis,hepatocellular carcinoma(HCC),and death]in patients with chronic hepatitis B(CHB)virus infection.METHODS We enrolled patients with chronic hepatitis B virus(HBV)infection who underwent liver biopsy at the Third People’s Hospital of Zhenjaing Affiliated Jiangsu University between January 2005 and September 2020.Baseline clinical and pathological data on liver pathology and clinical data at the end of follow-up were collected.Propensity score matching(PSM)was used to balance baseline parameters,Kaplan-Meier(K-M)survival analysis was used to evaluate the risk of clinical events,and Cox regression was used to analyze the risk factors of events.RESULTS Overall,456 patients with chronic HBV infection were included in the study,of whom 152(33.3%)had histologically confirmed NAFLD.The median follow-up time of the entire cohort was 70.5 mo.Thirty-four patients developed cirrhosis,which was diagnosed using ultrasound during the follow-up period.K-M survival analysis showed that NAFLD was not significantly associated with the risk of cirrhosis(log-rank test,P>0.05).Patients with CHB with fibrosis at baseline were more prone to cirrhosis(log-rank test,P=0.046).After PSM,multivariate analysis showed that diabetes mellitus,ballooning deformation(BD),and platelet(PLT)were independent risk factors for cirrhosis diagnosed using ultrasound(P<0.05).A total of 10 patients(2.2%)developed HCC,and six of these patients were in the combined NAFLD group.K-M survival analysis showed that the cumulative risk of HCC in the NAFLD group was significantly higher(log-rank test,P<0.05).Hepatocyte ballooning,and severe liver fibrosis were also associated with an increased risk of HCC(log-rank test,all P<0.05).Cox multivariate analysis revealed that hepatocyte ballooning,liver fibrosis,and diabetes mellitus were independent risk factors for HCC.CONCLUSION There was no significant correlation between chronic HBV infection and the risk of cirrhosis in patients with NAFLD.Diabetes mellitus,BD,and PLT were independent risk factors for liver cirrhosis.Patients with chronic HBV infection and NASH have an increased risk of HCC.BD,liver fibrosis,and diabetes mellitus are independent risk factors for HCC.

Corrosion resistance of bioinspired DNA-induced Ca-P coating on biodegradable magnesium alloy

Bioinspired coatings with decreased corrosion rate and enhanced bond strength are at the core of future clinic applications on degradable magnesium(Mg)-based implants.The hybrid of organic and inorganic compounds offers a strategy to fabricate biodegradable,biocompatible and compact coatings on biomedical Mg alloys.Hereby,a comparison with and without DNA addition was made on the corrosion resistance and adhesion strength of Ca-P coatings fabricated on AZ31 alloy via hydrothermal deposition.The morphology,chemical composition,and crystallographic structure of the coatings were investigated by means of SEM,EDS and FTIR as well as XRD before and after corrosion tests.Corrosion resistance was evaluated via potentiodynamic polarization curves,electrochemical impedance spectroscopy(EIS)and hydrogen evolution tests in Hank’s solution.Results show that the coatings are mainly characterized by tricalcium phosphate(TCP),dicalcium phosphate anhydrous(DCPA)and calcium-deficient hydroxyapatite(CDHA).The presence of DNA leads to the formation of Ca-P coating with improved corrosion resistance and adhesion strength.Additionally,the formation mechanism for DNA-induced Ca-P coating is proposed.The DNA-induced Ca-P coating exhibits a promising future for controlling the corrosion rate of biodegradable Mg alloys.©2019 Published by Elsevier B.V.on behalf of Chongqing University.

Is simultaneous presence of IgG4-positive plasma cells and giantcell hepatitis a coincidence in autoimmune hepatitis?A case report

BACKGROUND The immune-mediated invasion of IgG4-positive plasma cells in the liver is found in some autoimmune hepatitis.Giant-cell hepatitis(GCH)is a very rare pathological feature in adults,and the clinical characteristics of the simultaneous appearance of the two pathological phenomena are not clear.CASE SUMMARY A 68-year-old woman was hospitalized with fatigue,poor appetite,and yellow urine for 20 d.Liver function tests and immunological indexes were significantly abnormal and accompanied by elevated serum IgG4 levels.Liver pathology revealed severe inflammation of the interface between the portal tract and hepatocytes,portal area inflammation,plasma cell infiltration,formation of rosette cells,IgG4-positive plasma cells>10/high-power field,IgG4/IgG>40%,and multinucleated liver cell swelling.IgG4-related autoimmune hepatitis(AIH)combined with GCH was diagnosed,and methylprednisolone was administered at 40 mg/day.Two weeks later,the clinical symptoms disappeared,and the liver function and immunological indicators were significantly improved.Methylprednisolone was reduced at a rate of 4–8 mg per week to 8 mg/day for maintenance.A second liver biopsy 48 wk later indicated that liver inflammation and fibrosis were significantly improved.IgG4-positive plasma cells and GCH were not detected.A literature search was conducted to analyze articles reporting similar pathological phenomena.CONCLUSION AIH with simultaneous IgG4-positive plasma cell infiltration and GCH,liver inflammation,and fibrosis is possibly more severe than typical AIH but sensitive to corticosteroids.

Flexible GPBi-CG Method for Nonsymmetric Linear Systems

We present a flexible version of GPBi-CG algorithm which allows for the use of a different preconditioner at each step of the algorithm. In particular, a result of the flexibility of the variable preconditioner is to use any iterative method. For example, the standard GPBi-CG algorithm itself can be used as a preconditioner, as can other Krylov subspace methods or splitting methods. Numerical experiments are conducted for flexible GPBi-CG for a few matrices including some nonsymmetric matrices. These experiments illustrate the convergence and robustness of the flexible iterative method.

Nonsolvent-induced phase separation-derived TiO_(2) nanotube arrays/porous Ti electrode as high-energy-density anode for lithium-ion batteries

TiO_(2) nanotube arrays,growing on three-dimensional(3 D)porous Ti membrane,were synthesized using a facile nonsolvent-induced phase separation and anodization process.The length of those three-dimensional nanotube arrays could be tuned by prolonging the anodizing time.When the anodizing time is 8 h,the three-dimensional TiO_(2) nanotube arrays/porous Ti electrode exhibits well cycling stability and ultra-high specific capacity,which is used in lithium-ion batteries,attributed to the high utilization rate of the substrate and the high growth intensity of the active materials.Three-dimensional TiO_(2) nano tube arrays/porous Ti electrode,at 100μA·cm^(-2) with 8 h anodizing time,shows a typical discharge plateau at 1.78 V and exhibits the specific capacity with 2126.7μAh·cm^(-2),The novel nanotube arrays@3 D porous architecture effectively shortens the electron/ion transmission path,which could pave way for optimizing the design of highperformance anode materials for next-generation energy storage system.

Tuning dual three-dimensional porous copper/graphite composite to achieve diversified utilization of copper current collector for lithium storage

Graphite anode materials are widely used in commercial lithium-ion batteries;however, the long electron/ion transportation path restricted its high energy storage. In this experiment, we designed a copper/graphite composite with a dual three-dimensional(3 D) continuous porous structure combining used nonsolvent-induced phase separation and heat treatment, in which a large amount of graphite is embedded in the 3 D porous copper/carbon architecture. In the novel structure, not only the electron and Li^(+) transmission performances are improved, but also the space of current collector is fully utilized. Meanwhile,carbonized polyacrylonitrile network stabilizes the interface between graphite and copper matrix. The obtained copper/graphite composite anode has an initial discharge capacity of 524.6 mAh·g^(-1), a holding capacity of350 mAh·g^(-1) and excellent cycle stability(299.3 mAh·g^(-1) after 180 cycles at 0.1 C rate), exhibiting good electrochemical performance. The experimental results show that the mass loading of the copper/graphite composite electrode material is about 4.39 mg·cm^(-2). We also envisage replacing graphite with other high-capacity active materials to fill the current collector, which can provide a reference for the future development of next-generation advanced electrodes.

Association between 5α-reductase inhibitors therapy and incidence, cancer-specific mortality,and progression of prostate cancer: evidence from a meta-analysis

5a-reductase inhibitors(5-ARI)are widely employed for the treatment of benign prostatic hyperplasia.It has been noted that 5-ARI exhibit the potential to attenuate the risk of prostate cancer,but consistent agreement has not been achieved.Moreover,the effect of 5-ARI on cancer-specific mortality and progression of prostate cancer remains unclear.Therefore,the goal of the current meta-analysis was to elucidate the impact of 5-ARI on the incidence and progression of prostate cancer.We searched for all studies assessing the effect of 5-ARI on risk of prostate cancer in PubMed,Embase,Medline,and Cochrane Library databases.Pooled relative risk(RR)and corresponding 95%confidence intervals(CIs)were accepted to evaluate the association between 5-ARI and the risk of prostate cancer.Synthetic results implied that subjects who accepted 5-ARI compared with the placebo group experienced a distinctly weakened overall incidence of prostate cancer(RR=0.74;95%C l:0.66-0.82;P<0.001).Subgroup analyses further revealed that 5-ARI reduction of the incidence of prostate cancer was limited to low-grade(Gleason score 2-6;RR=0.68;95%C l:0.57-0.81;P<0.001)and intermediate-grade tumors(Gleason score 7;RR=0.81;95%C l:0.67-0.97;P=0.023),but not high-grade tumors(Gleason score>7;RR=1.19;95%Cl:0.98-1.43;P=0.069).The results also showed that 5-ARI treatment did not significantly alter prostate cancer-specific mortality(RR=1.0;95%C l:0.95-1.05;P=0.916).In addition,it was worth noting that 5-ARI treatment acted in a protective role that presented a dramatic benefit to delay the progression of low-risk tumors(RR=0.58;95%C l:0.43-0.78;P<0.001).

Synthesis of Rod-like NiO-Co_(3)O_(4)Composites for Sensitive Electrochemical Detection of Hydrogen Peroxide

Accurate and effective detection of hydrogen peroxide(H_(2)O_(2))is of great significance in physiological functions as well as industrial applications.In this paper,the rod-like NiO-Co_(3)O_(4)nanomaterials were synthesized by a simple hydrothermal method for electrochemical detection of H_(2)O_(2).The characterization results indicated that the nanomaterials possess high porosity and excellent conductivity,and displayed good electrocatalysis activity at the same time.Under alkaline conditions,the as-prepared nanomaterials can catalyze the reduction of H_(2)O_(2)and realize the electron transfer between H_(2)O_(2)and the electrode.The H_(2)O_(2)electrochemical sensor based on NiO-Co_(3)O_(4)nanomaterials exhibited a wide linear response(1-250 and 250-1200μmol/L),a low detection limit(0.1μmol/L)and a high sensitivity(5305.59μA/(mmol/L·cm^(2))(S/N=3)).In addition,the fabricated sensor showed high selectivity,good repeatability and high stability.The applications of the proposed sensor for H_(2)O_(2)detection in food samples were demonstrated and satisfactory results were obtained.