Efficacy and safety of percutaneous transhepatic biliary radiofrequency ablation in patients with malignant obstructive jaundice

BACKGROUND Percutaneous transhepatic cholangiodrainage(PTCD)and endoscopic retrograde cholangiopancreatography/endoscopic nasobiliary drainage are the most common clinical procedures for jaundice control in patients with unresectable malignant obstructive jaundice,yet the safety and effect of endobiliary radiofrequency ablation(EB-RFA)combined PTCD is rarely reported,in this article,we report our experience of EB-RFA combined PTCD in such patients.AIM To retrospectively study the efficacy and safety of EB-RFA combined PTCD in patients with unresectable malignant obstructive jaundice.METHODS Patients with unresectable malignant obstructive jaundice treated with EB-RFA under PTCD were selected,the bile ducts of the right posterior lobe was selected as the target bile ducts in all cases.The general conditions of all patients,preoperative tumour markers,total bilirubin(TBIL),direct bilirubin(DBIL),albumin(ALB),alkaline phosphatase(ALP),and glutamyl transferase(GGT)before and on the 7th day after the procedure,as well as perioperative complications,stent patency time and patient survival were recorded.RESULTS All patients successfully completed the operation,TBIL and DBIL decreased significantly in all patients at the 7th postoperative day(P=0.009 and 0.006,respectively);the values of ALB,ALP and GGT also decreased compared with the preoperative period,but the difference was not statistically significant.Perioperative biliary bleeding occurred in 2 patients,which was improved after transfusion of blood and other conservative treatments,pancreatitis appeared in 1 patient after the operation,no serious complication and death happened after operation.Except for 3 patients with loss of visits,the stent patency rate of the remaining 14 patients was 100%71%and 29%at the 1^(st),3^(rd),and 6^(th)postoperative months respectively,with a median survival of 4 months.CONCLUSION EB-RFA under PTCD in patients with unresectable malignant obstructive jaundice has a satisfactory therapeutic effect and high safety,which is worthy of further clinical practice.

Analysis of long-term outcome of modified gastric bypass for type 2 diabetes mellitus in Chinese patients

BACKGROUND Bariatric and metabolic surgery have been routinely performed following the rapid increase in obesity and metabolic diseases worldwide.Of all evolving procedures,Roux-en-Y gastric bypass(RYGB)is considered the gold standard for surgical treatment of patients with type 2 diabetes mellitus(T2DM)and obesity.RYGB was introduced in China nearly 20 years ago,but the number of RYGB surgeries only accounts for 3.1%of the total number of weight loss and metabolic surgeries in China,it’s effect on Chinese people still needs further study.AIM To investigate the effect and safety of a modified gastric bypass performed in Chinese patients with T2DM.METHODS Patients with obesity and T2DM who underwent modified gastric bypass,with>5-year follow-up data,were analyzed.RESULTS All 37 patients underwent uneventful laparoscopic surgery,no patient was switched to laparotomy during the surgery,and no severe complications were reported.Average weight and body mass index of the patients reduced from 84.6±17.3(60.0–140.0)kg and 30.9±5.0(24.7–46.2)kg/m2 to 67.1±12.2(24.7–46.2)kg and 24.6±3.9(17.7–36.5)kg/m2,respectively,and fasting plasma glucose and glycated hemoglobin decreased from 7.4±3.4 mmol/L and 8.2%±1.7%preoperatively to 6.5±1.3 mmol/L and 6.5%±0.9%5-years postoperatively,respectively.Only 29.7%(11/37)of the patients used hypoglycemic drugs 5-years postoperatively,and the complete remission rate of T2DM was 29.7%(11/37).Triglyceride level reduced significantly but high-density lipoprotein increased significantly(both P<0.05)compared with those during the preoperative period.Liver and renal function improved significantly postoperatively,and binary logistic regression analysis revealed that the patients’preoperative history of T2DM and fasting C-peptide were significant prognostic factors influencing complete T2DM remission after RYGB(P=0.006 and 0.012,respectively).CONCLUSION The modified gastric bypass is a safe and feasible procedure for Chinese patients with obesity and T2DM,exhibiting satisfactory amelioration of weight problems,hyperglycemia,and combination disease.

Demands and influencing factors of digital transition care service in discharged older patients:a cross-sectional study

Objective:To identify the group classification of discharged older adults’digital transition care demands and analyze its influencing factors.Methods:From July to August 2022,we used stratified random sampling to recruit older patients who were discharged between July 2021 and July 2022 from tertiary hospitals in Shanghai.We used latent profile analysis to classify the older patients into distinct groups based on their service demands:low,medium,and high.We use multiple logistic regression to explore the factors influencing the different demand levels.Results:The degree of discharged older patients’demand was classified as low(Category 1(C1),34.2%),medium(Category 2(C2),49.5%),high-demand levels(Category 3(C3),16.3%).Compared to those have C2,older adults in C1 are more likely to be male(Odds Ratio(OR)=2.81,P=0.02),have 2 chronic diseases(OR=3.91,P=0.03),and are less likely to be junior high and below(OR=0.09,P=0.00),hospitalized for 1–2 times in the past year(1 times:OR=0.19,P=0.07;2 times:OR=0.14,P=0.02),living with children(OR=0.32,P=0.05),have less insurance(OR=0.48,P=0.03),less understanding of digital transitional care(OR=0.47,P=0.01),have less eHealth literacy(OR=0.80,P=0.00),have less degree of importance attributed by family(OR=0.52,P=0.03);Compared to those have medium demand level,older adults in high demand level are more likely to have self and spouse as primary income(self:OR=26.35,P=0.00;spouse:OR=24.06,P=0.02),walking to the nearest health facility(self:6.74,P=0.03),have higher eHealth literacy(OR=1.88,P=0.00),degree of importance within the family(OR=5.19,P=0.01),higher self’s influence on medical decisions-making(OR=5.69.P=0.01).They are less likely to be in 60–79 years group(OR=0.00–0.37,P=0.00–0.03),Household Annual Income<5,000 CNY(OR=0.05,P=0.02).Conclusion:Digital transitional care demands of discharged older patients can be divided into three categories.Constructing a digital transitional care service system that aligns with the demands of discharged older patients is essential.Communication,care plan development,and follow-up are the most fundamental services.Additionally,it is essential to understand the characteristics of high-demand populations to provide tailored services and identify vulnerable populations from health and social perspectives to offer cost-effective transitional care services.

LncRNA XIST在子宫内膜癌组织中的表达及其靶向microRNA-101-3p对癌细胞生物行为学的影响

目的探究lncRNA XIST在子宫内膜癌组织中的表达及其靶向microRNA-101-3p(miR-101-3p)对癌细胞生物行为学的影响。方法选取2019年7月—2021年7月南通市妇幼保健院82例手术切除且经术后病理确诊的子宫内膜癌患者的癌组织及癌旁正常子宫内膜组织标本。采用实时荧光定量聚合酶链反应(qRT-PCR)检测子宫内膜组织lncRNA XIST、miR-101-3p mRNA的相对表达量;比较不同因素间lncRNA XIST、miR-101-3p mRNA的差异;取Ishikawa细胞随机分为对照组(C组)、空质粒组(NC组)、lncRNA XIST表达抑制组(sh-XIST组),其中NC组和sh-XIST组分别转染空载质粒与plko-lncRNA XIST-shRNA,C组不进行任何处理;CCK-8法检测细胞增殖活性;划痕实验检测细胞迁移能力;Transwell小室实验检测细胞侵袭能力;双荧光素酶报告基因观察lncRNA XIST与miR-101-3p的靶向性。结果子宫内膜癌组织中lncRNA XIST mRNA相对表达量高于癌旁组织(P<0.05),miR-101-3p mRNA相对表达量低于癌旁组织(P<0.05)。不同TNM分期和淋巴结是否转移患者的lncRNA XIST、miR-101-3p mRNA相对表达量比较,差异有统计学意义(P<0.05)。C组、NC组、sh-XIST组在不同时间点Ishikawa细胞增殖活性的比较采用重复测量设计的方差分析,结果:①不同时间点的Ishikawa细胞增殖活性有差异(P<0.05);②3组的Ishikawa细胞增殖活性有差异(P<0.05);③3组的Ishikawa细胞增殖活性变化趋势有差异(P<0.05)。sh-XIST组细胞迁移率低于C组和NC组(P<0.05)。sh-XIST组侵袭个数少于C组和NC组(P<0.05)。双荧光素酶报告基因显示,lncRNA XIST可以靶向作用于miR-101-3p。结论lncRNA XIST和miR-101-3p mRNA在子宫内膜癌组织中异常高表达,并且在不同TNM分期及是否淋巴结转移患者子宫内膜癌组织中的表达有差异。抑制Ishikawa细胞中lncRNA XIST的表达可以抑制癌细胞的恶性细胞生物学行为,其机制可能与靶向调控miR-101-3p有关。

中共革命及其组织的地理学视角(1921-1945)

要从多维度、多学科拓展对中共革命及其组织的理解,地理学是一个重要的视角。本文在美国学者施坚雅和霍夫亨兹的相关研究启发下,对1921年至1945年发生中共革命的地域进行了“地文大区”的划分,对影响中共革命及其组织的地理诸因素(包括地缘、南北、东西、山河、路江、红白、政区、文武、客家等)进行了述要分析,辨识了中共革命及其组织的核心区、次核心区和边缘区,并在地理示意图的绘制上尝试应用了中国历史地理信息系统。

主力红军在“五湖四海”的崛起(1927—1930)——再论中共革命的地理学视角

红军的崛起既是中共军队的根系所在,也是研究中共军队及其政党组织形态的基本线索。本文以红军于1927年至1930年间在“五湖四海”崛起的地理学视角为线索,先对影响红军崛起的诸地理因素(包括南北之分、军阀割据的势力划分和统治类型、山带分布和山匪分布等)作出分析,然后对中央关于主力红军的规划以及各主力红军建军的实际情况尤其是背后的地理学因素逐一作出剖析,这有助于深化中共革命及其组织研究的地理学视角。本文在地理示意图的绘制上应用了中国历史地理信息系统。

交界·交叉·交融——浅论史学与社会科学在“新革命史”中的结合

近些年来,“新革命史”逐渐成为历史学界关注的热点话题之一,这是一个值得探讨的学术问题。为继续推动相关学术理念的科学讨论,进一步提升革命史研究的学术化水准,我刊开设“‘新革命史’理念的再审视与再建构”笔谈栏目。本期先行推出几位学者的笔谈文章,以飨读者。

政党治理传统的实践逻辑

本文从历史社会学和政治社会学的角度,概要地展示了中国共产党在新民主主义革命时期政党治理传统的实践逻辑。源自联共(布)的民主集中制在中共的革命实践中经历了政党吸纳、组织架构、政党干部、政党纪律及党内斗争等多方面的复杂变革。本文强调对这种实践逻辑的揭示不仅仅是要把握这些实践要素本身,而且需要把空间、事件、人物和话语分析结合到时间分析中去。这种把政党治理和历史分析带入社会学的做法有助于拓宽社会学的视野。

Tetramethylpyrazine stimulates cystic fibrosis transmembrane conductance regulator-mediated anion secretion in distal colon of rodents

AIM： To investigate the effect of tetramethylpyrazine （TMP）, an active compound from Ligustium Wollichii Franchat, on electrolyte transport across the distal colon of rodents and the mechanism involved.METHODS： The short-circuit current （Isc） technique in conjunction with pharmacological agents and specific inhibitors were used in analyzing the electrolyte transport across the distal colon of rodents. The underlying cellular signaling mechanism was investigated by radioimmunoassay analysis （RIA） and a special mouse model of cystic fibrosis.RESULTS： IMP stimulated a conoentration-dependent rise in ISCl, which was dependent on both Cl^- and HCO3^-, and inhibited by apical application of diphenylamine-2,2＇-dicarboxylic acid （DPC） and glibenclamide, but resistant to 4,4＇-diisothiocyanatostilbene-2,2＇-disulfonic acid disodium salt hydrate （DIDS）. Removal of Na^＋ from basolateral solution almost completely abolished the Isc response to TMP, but it was insensitive to apical Na^＋ replacement or apical Na^＋ channel blocker, amiloride. Pretreatment of colonic mucosa with BAPTA-AM, a membrane-permeable selective Ca2＋ chelator, did not significantly alter the TMP-induced Iso No additive effect of forskolin and 3-isobutyl-l-methylxanthine （[BMX） was observed on the TMP-induced Isc, but it was significantly reduced by a protein kinase A inhibitor, H89.RIA results showed that TMP （1 mmol/L） elicited a significant increase in cellular cAMP production, which was similar to that elicited by the adenylate cyclase activator, forskolin （10μmol/L）. The TMP-elicited Isc as well as forskolin- or IBMX-induced Isc were abolished in mice with homozygous mutation of the cystic fibrosis transmembrane conductance regulator （CFTR） presenting defective CFTR functions and secretions.CONCLUSION： TMP may stimulate cAMP-dependent and CFTR-mediated Cl^- and HCO3^- secretion. This may have implications in the future development of alternative treatment for constipation.

Two outward potassium current types are expressed during the neural differentiation of neural stem cells

The electrophysiological properties of potassium ion channels are regarded as a basic index for determining the functional differentiation of neural stem cells. In this study, neural stem cells from the hippocampus of newborn rats were induced to differentiate with neurotrophic growth factor, and the electrophysiological properties of the voltage-gated potassium ion channels were observed. Immunofluorescence staining showed that the rapidly proliferating neural stem cells formed spheres in vitro that expressed high levels of nestin. The differentiated neurons were shown to express neuron-specific enolase. Flow cytometric analysis revealed that the neural stem cells were actively dividing and the percentage of cells in the S ＋ G2/M phase was high. However, the ratio of cells in the S ＋ G2/M phase decreased obviously as differentiation proceeded. Whole-cell patch-clamp re- cordings revealed apparent changes in potassium ion currents as the neurons differentiated. The potassium ion currents consisted of one transient outward potassium ion current and one delayed rectifier potassium ion current, which were blocked by 4-aminopyridine and tetraethylammonium, respectively. The experimental findings indicate that neural stem cells from newborn rat hippo- campus could be cultured and induced to differentiate into functional neurons under defined condi- tions in vitro. The differentiated neurons expressed two types of outward potassium ion cur＇ents similar to those of mature neurons in vivo.

“精神气质”与中共早期党员的“训练”技术——以罗亦农及中共旅莫支部为中心

“训练”技术是早期中共干部队伍形成的一个关键要素,它将意识形态与组织框架融合在一起,深入到个人的内心世界,塑造出“新德治”体制的理想载体。本文运用历史社会学的视角,以罗亦农及其领导的中共旅莫支部为个案,以罗亦农所具有的“践履者”的“精神气质”为切入点,考察“训练”技术与地域化的道德践履传统以及“主义化”时代思潮之间的关联。这种“训练”技术以“系统化”“纪律化”“集体化”为主要特征,实现了在认同、行动和人格上的统一,对早期中共的组织形态产生了重要影响。

代际交融与双城摆荡:大革命前后四川共产主义运动的组织网络研究

从建党之初到大革命前后,四川地区中共党团组织的萌芽、发展与共产主义运动的落地生根,既有与其他地方相似的共通样态,也有自身的特殊脉络,较鲜明地体现了中共革命进程的一般性与特殊性,其中最值得探讨的便是新老两代本地革命者之间的代际交融与互动路径,以及巴蜀革命重心在成都、重庆双城之间的来回摆荡与位移,这当中包含了观察中共早期革命进程的时间与空间两个维度。多个维度的交织与共振,呈现了中国共产主义运动在区域社会落地的多样性与丰富性。

在顺应群众与引领群众之间:党群关系的早期调适——以闽西永定暴动为例

群众路线是中国共产党根本的政治路线和组织路线,它要求党在处理党群关系时既要顺应群众,又要引领群众,需要在二者之间把握良性的平衡。运用历史社会学的微观比较历史分析方法,以1928年的闽西永定暴动为例,分析了在党群关系上一种较为复杂的实践形态:平衡与失衡的交替,"尾巴主义"与"命令主义"的交织。对党群关系的调适,不仅取决于对党的政策的准确把握,而且取决于对地方特定的场域和民情的深刻体察。闽西的革命实践成为中国共产党日后真正成熟的党群关系的一个重要源头。

Injury of cortical neurons is caused by the advanced glycation end products-mediated pathway

Advanced glycation end products lead to cell apoptosis, and cause cell death by increasing endoplasmic reticulum stress. Advanced glycation end products alone may also directly cause damage to tissues and cells, but the precise mechanism remains unknown. This study used primary cultures of rat cerebral cortex neurons, and treated cells with different concentrations of glycation end products （50, 100, 200, 400 mg/L）, and with an antibody for the receptor of advanced glycation end products before and after treatment with advanced glycation end products. The results showed that with increasing concentrations of glycation end products, free radical content increased in neurons, and the number of apoptotic cells increased in a dose-dependent manner. Before and after treatment of advanced glycation end products, the addition of the antibody against advanced glycation end-products markedly reduced hydroxyl free radicals, malondialdehyde levels, and inhibited cell apoptosis. This result indicated that the antibody for receptor of advanced glycation end-products in neurons from the rat cerebral cortex can reduce glycation end product-induced oxidative stress damage by suppressing glycation end product receptors. Overall, our study confirms that the advanced glycation end products-advanced glycation end products receptor pathway may be the main signaling pathway leading to neuronal damage.

Superconductivity and Fermi Surface Anisotropy in Transition Metal Dichalcogenide NbTe_2

Transition metal dichalcogenides, featuring layered structures, have aroused enormous interest as a platform for novel physical phenomena and a wide range of potential applications. Among them, special interest has been placed upon WTe_2 and MoTe_2, which exhibit non-trivial topology both in single layer and bulk as well as pressure induced or enhanced superconductivity. We study another distorted IT material NbTe_2 through systematic electrical transport measurements. Intrinsic superconductivity with onset transition temperature(T_c^(onset)) up to 0.72 K is detected where the upper critical field(H_c) shows unconventional quasi-linear behavior,indicating spin-orbit coupling induced p-wave paring. Furthermore, a general model is proposed to fit the angledependent magnetoresistance, which reveals the Fermi surface anisotropy of NbTe_2. Finally, non-saturating linear magnetoresistance up to 50 T is observed and attributed to the quantum limit transport.

Risk factors for post-hepatectomy liver failure in 80 patients

BACKGROUND Post-hepatectomy liver failure(PHLF)is a serious complication and a leading cause of death after hepatectomy,an accurate prediction of PHLF is important for improvement of prognosis after hepatectomy.AIM To retrospectively analyze the risk factors for postoperative liver failure in patients undergoing hepatectomy for liver tumors.METHODS The clinical data of 80 patients undergoing hepatectomy in our hospital from June 2018 to January 2020 were collected.With laboratory examination as well as preand post-operative abdominal three-dimensional reconstructive computed tomography,the demographic data,surgical data,biochemical indicators,coagulation index,routine blood tests,spleen and liver volumes,relative remnant liver volume,and other related indicators were obtained and compared between patients with PHLF and those without PHLF.RESULTS PHLF occurred in 19(23.75%)patients.Univariate logistic regression analysis showed that gender,history of hepatitis/cirrhosis,and preoperative bilirubin,albumin,coagulation function,albumin-bilirubin ratio,aspartate aminotransferase-to-platelet ratio index(APRI),Model for End-Stage Liver Disease score,spleen volume(SV),spleen volume/liver volume ratio(SV/LV),and relative remnant liver volume were statistically associated with the occurrence of PHLF(all P<0.05).Multivariate regression analysis showed that preoperative total bilirubin,platelets(PLT),APRI,and SV/LV were independent risk factors for PHLF(all P<0.05).The area under the curve and cut-off values were 0.787 and 18.6 mmol/L for total bilirubin,0.893 and 146×1012/L for PLT,0.907 and 0.416 for APRI,and 0.752 and 20.84%for SV/LV,respectively.CONCLUSION For patients undergoing liver resection,preoperative total bilirubin,PLT,APRI,and SV/LV are independent risk factors for PHLF.These findings may provide guidance to safely perform liver surgery in such patients.

Effect of microenvironment modulation on stem cell therapy for spinal cord injury pain

Spinal cord injury （SCI） currently ranks second after mental retarda- tion among neurological disorders in terms of cost to society. Pain is a debilitating consequence of SCI related to the nature of the lesion, neurological structures damaged, and secondary pathophysiological changes of surviving tissues （Yezierski, 2005; D＇Angelo et al., 2013）.

Non-viral liposome-mediated transfer of brain-derived neurotrophic factor across the blood-brain barrier

Brain-derived neurotrophic factor（BDNF） plays an important role in the repair of central nervous system injury,but cannot directly traverse the blood-brain barrier.Liposomes are a new type of non-viral vector,able to carry macromolecules across the blood-brain barrier and into the brain.Here,we investigate whether BDNF could be transported across the blood-brain barrier by tail-vein injection of liposomes conjugated to transferrin（Tf） and polyethylene glycol（PEG）,and carrying BDNF modified with cytomegalovirus promoter（pC MV） or glial fibrillary acidic protein promoter（p GFAP）（Tf-p CMV-BDNF-PEG and Tf-p GFAP-BDNF-PEG,respectively）.Both liposomes were able to traverse the blood-brain barrier,and BDNF was mainly expressed in the cerebral cortex.BDNF expression in the cerebral cortex was higher in the Tf-p GFAP-BDNF-PEG group than in the Tf-p CMV-BDNF-PEG group.This study demonstrates the successful construction of a non-virus targeted liposome,Tf-p GFAP-BDNF-PEG,which crosses the blood-brain barrier and is distributed in the cerebral cortex.Our work provides an experimental basis for BDNF-related targeted drug delivery in the brain.

Effects of Slow-release Fertilizers and Sugarcane-specific Fertilizers on Yield and Quality of Sugarcane

The effects of slow-release fertilizers and sugarcane-specific fertilizers on the growth and quality of sugarcane were studied to provide a theoretical basis for cultivation of sugarcane with lower costs but higher efficiency. Field experiments were carried out in two major sugarcane areas in Guangxi and three fertilization treatments were studied: single application of compound fertilizers( treatment I),compound fertilizers + slow-release fertilizers( treatment II) and sugarcane-specific base fertilizers + sugarcane-specific topdressing( treatment III). Effects of equal fertilization conditions of treatment I,II and III on growth,yield and sugar of sugarcane were studied. The three fertilization treatments had little effects on emergence,tillering,and effective stems of sugarcane,but compared with the treatment of compound fertilizer( treatment I) with a ratio of N,P,and K of 1∶1∶1,treatment II using slow-release fertilizers as topdressing had better growth,higher plant height and stem diameter,so the yield was higher. Treatment III designed sugarcane-specific fertilizers with proper ratio according to fertilizer demands of sugarcane. Besides,the treatment III sugarcane-specific base fertilizers,containing certain amount of organic matters,could promote the sugar accumulation of sugarcane. Therefore,the sugarcane yield of treatment III was higher than that of treatment II. In conclusion,slow-release fertilizers and sugarcane-specific fertilizers can significantly increase sugarcane yield,especially sugarcane-specific fertilizers. Sugarcane-specific fertilizers have reasonable ratio and contain certain amount of organic matters,and can increase sugar content,obtain significant economic benefits,so it is worth popularization in large areas.

Use of RNAi silencing to target preconditioned glial cell line-derived neurotrophic factor in neuronal apoptosis

Several studies have suggested that exogenous glial cell line-derived neurotrophic factor may pro-tect neurons from cerebral ischemic injury. However, the mechanisms underlying the neuroprotec-tive effects of endogenous glial cell line-derived neurotrophic factor remain unclear. The present experiments sought to elucidate the influence of various conditioned media on neuronal apoptosis, using a normal culture medium for astrocytes, an astrocyte medium highly expressing glial cell line-derived neurotrophic factor, and an astrocyte medium in which glial cell line-derived neurotro-phic factor expression was silenced using RNAi technology. The results confirmed that the use of RNAi silencing to target pretreated glial cell line-derived neurotrophic factor expression promoted neuronal apoptosis. In addition, oxygen and glucose deprivation preconditioning was found to upregulate glial cell line-derived neurotrophic factor expression, and significantly reduce neuronal apoptosis.