Tmem39b promotes tumor progression and sorafenib resistance by inhibiting ferroptosis in hepatocellular carcinoma

Hepatocellular carcinoma(HCC)poses a significant threat to human health.Resistance to sorafenib in the chemotherapy of HCC is a common and significant issue that profoundly impacts clinical treatment.While several members of the transmembrane(TMEM)protein family have been implicated in the occurrence and progression of HCC,the association between TMEM39b and HCC remains unexplored.This study revealed a significant overexpression of TMEM39b in HCC,which correlated with a poor prognosis.Subsequent investigation revealed that RAS-selective lethal 3(RSL3)induced pronounced ferroptosis in HCC,and knocking down the expression of TMEM39b significantly decreased its severity.Similarly,following the induction of ferroptosis in HCC by sorafenib,knocking down the expression of TMEM39b also decreased the severity of ferroptosis,enhancing HCC tolerance to sorafenib.In conclusion,we propose that TMEM39b promotes tumor progression and resistance to sorafenib by inhibiting ferroptosis in HCC.

ERCP for patients who have undergone Billroth Ⅱ gastroenterostomy and Braun anastomosis

Endoscopic retrograde cholangiopancreatography (ERCP) is efficacious in patients who have undergone Billroth II gastroenterostomies, but the success rate decreases in patients who also have experienced Braun anastomoses. There are currently no reports describing the preferred enterography route for cannulation in these patients. We first review the patient’s previous surgery records, which most often indicate that the efferent loop is at the greater curvature of the stomach. We recommend extending the duodenoscope along the greater curvature of the stomach and then advancing it through the “lower entrance” at the site of the gastrojejunal anastomosis, along the efferent loop, and through the “middle entrance” at the site of the Braun anastomosis to reach the papilla of Vater. Ten patients who had each undergone Billroth II gastroenterostomy and Braun anastomosis between January 2009 and December 2011 were included in our study. The overall success rate of enterography was 90% for the patients who had undergone Billroth II gastroenterostomy and Braun anastomosis, and the therapeutic success rate was 80%. We believe that this enterography route for ERCP is optimal for a patient who has had Billroth II gastroenterostomy and Braun anastomosis and helps to increase the success rate of the procedure.

Retrieval-balloon-assisted enterography for ERCP after Billroth Ⅱ gastroenterostomy and Braun anastomosis

AIM: To describe an optimal route to the Braun anastomosis including the use of retrieval-balloon-assisted enterography.METHODS: Patients who received a Billroth Ⅱ gastroenterostomy(n = 109) and a Billroth Ⅱ gastroenterostomy with Braun anastomosis(n = 20) between January 2009 and May 2013 were analyzed in this study. Endoscopic ret-rograde cholangiopancreatography(ERCP) was performed under fluoroscopic control using a total length of 120 cm oblique-viewing duodenoscope with a 3.7-mm diameter working channel. For this procedure, we used a triplelumen retrieval balloon catheter in which a 0.035-inch guidewire could be inserted into the "open-channel" guidewire lumen while the balloon could be simultaneously injected and inflated through the other 2 lumens.RESULTS: For the patients with Billroth Ⅱ gastroenterostomy and Braun anastomosis, successful access to the papilla was gained in 17 patients(85%) and there was therapeutic success in 16 patients(80%). One patient had afferent loop perforation, but postoperative bleeding did not occur. For Billroth Ⅱ gastroenterostomy, there was failure in accessing the papilla in 15 patients(13.8%). ERCP was unsuccessful because of tumor infiltration(6 patients), a long afferent loop(9 patients), and cannulation failure(4 patients). The papilla was successfully accessed in 94 patients(86.2%), and there was therapeutic success in 90 patients(82.6%). Afferent loop perforation did not occur in any of these patients. One patient had hemorrhage 2 h after ERCP, which was successfully managed with conservative treatment.CONCLUSION: Retrieval-balloon-assisted enterography along an optimal route may improve the ERCP success rate after Billroth Ⅱ gastroenterostomy and Braun anastomosis.

Retrieval-balloon-assisted enterography in post-pancreaticoduodenectomy endoscopic retrograde cholangiopancreatography

This case reports an application of conventional duodenoscope in a post pancreaticoduodenectomy patient with the help of retrieval balloon assisted enterography.The 56-year-old woman had pancreaticoduodenectomy with Child reconstruction 9 mo ago because of pancreatic adenocarcinoma and now there are recurrent enlarged lymph nodes in the anastomotic stoma of hepaticojejunostomy.Considering the patient's late-stage cancer,a plastic stent was then successfully placed there to drainage.The main challenge in this case was the extremely long afferent loop and blind cannulation through the anastomotic stoma of hepaticojejunostomy.Retrieval balloon assisted enterography is very helpful for duodenoscope going through the reconstructed intestinal tract and for the cannulation.After two weeks,the patient remained free of painful symptoms and free of fever.Liver function improved well.Four months after the placement of stent,the patient died of cachexia without jaundice,fever and abdominal pain according to her daughter's statement.

Process Modeling and Control Simulation for a 500W@4.5K Helium Refrigerator

In order to investigate dynamic behaviors of a 500W@ 4.5K helium refrigerator,the process simulator has been completed. The cryogenic process model is described and main components are customized. The realtime communication between the process model and the control system has been achieved. Compared with the preliminary experimental data,the errors of temperatures during the process of 300 K-80 K are less than 10%.The process model is validated to predict the cool-down process very well. The controller parameters are tuned in simulation and applied to the actual refrigerator suitably. Based on the dynamic simulation,the operation of Joule-Thomson( JT) by pass valve has been optimized. And the cool- down process from 300 K to 4. 5 K has been simulated under the control programs. Simulation results indicate that this dynamic simulator based on actual control architecture is available to process control and operation optimization for the helium refrigerators.

疫情期间海外工程项目防控管理分析

从强化责任落实、建立防控措施、编制应急预案及保障防疫物资等四个方面探讨在建海外工程项目的疫情防控管理方针。以肯尼亚某项目为例,详细介绍海外疫情防控管理方针在该项目上的应用成效。结果表明,该管理方针是海外在建工程项目行之有效的疫情防控方案,平衡了疫情防控和海外项目施工进度之间的关系。