Does the provision of live black soldier fly and yellow mealworm larvae improve Muscovy duck welfare?

Background The provision of environmental enrichments to Muscovy ducks could reduce the expression of the aggressive behaviors.The aim of the present study was to evaluate the effects of black soldier fly(BSF)and yellow mealworm(YM)live larva provision on Muscovy duck performance,excreta corticosterone metabolites(ECM),behavior,and blood parameters.Methods A total of 1263-day-old female Muscovy ducklings were allotted to 18 pens(6 replicates/treatment,7 birds/pen)and assigned to 3 experimental treatments:a control group fed commercial feed,and two experimental treatments fed commercial feed plus the 5%(based on the expected daily feed intake,as fed basis)of BSF and YM live larvae(BSF and YM groups,respectively).A two-phase feeding program was applied:starter(from 3 to 31 days of age)and grower-finisher(from 32 to 55 days of age).The live weight,average daily gain,average daily feed intake,and feed conversion ratio were calculated.Larva consumption times were collected,and video recordings were performed during 3 periods(P)each day:the hour before(P1),during(P2),and after(P3)the larva administration.ECM were evaluated at 3,31,and 55-day-old.Finally,the total red and white blood cell counts,serum proteins,lipids,and liver and renal function serum enzymes were evaluated on 12 birds/treatment.Results The experimental treatment did not affect the growth performance of the birds(P>0.05).Larva consumption times were always similar between the two insect species,except at 14–18 days of age,were BSF larvae were consumed faster than YM larvae(P<0.001).The birds showed less walking activity during P2,and preening behavior increased in YM birds during P3.The C birds increased the attack behavior over the weeks(P<0.05).During weeks 1–3 the YM group reduced the attack frequency(P1>P3;P<0.05).Finally,the provision of live BSF and YM larvae significantly reduced the ECM at 55 days of age and the heterophil to lymphocyte ratio(P<0.05).Conclusions Live BSF and YM larva supplementation in Muscovy duck improves duck welfare,without impairing birds'growth performance.

Surgical management of tegmen defects of the temporal bone and meningoencephalic herniation: our experience

1. Introduction The tegmental wall of the tympanic cavity is a thin plate of the temporal bone that separates the middle cranial fossa(MCF) from the ear. This anatomical region consists of two areas: an anterior one, comprised of the tegmen tympani(To′th et al., 2007), and a posterior one, formed by the tegmen antri and the tegmen mastoideum(Makki et al., 2011). In some patients, the tegmental region of the temporal bone can be interrupted, causing a tegmen defect(TD). A TD is sometimes associated with a meningoencephalic herniation(MEH), in which brain tissue herniates through a TD.

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.

From mice to humans:a need for comparable results in mammalian neuroplasticity

Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Overall,different types of plasticity,including stem cell-driven genesis of new neurons(adult neurogenesis),cells in arrested maturation(dormant neurons),neuro-glial and synaptic plasticity,can coexist and contribute to grant plastic changes in the brain,from a cellular to system level(Benedetti and Couillard-Despres,2022;Bonfanti et al.,2023).

Does mesenchymal stem cell’s secretome affect spinal sensory circuits?Implication for pain therapies

Mesenchymal stem cells(MSCs)are multipotent adult stem cells of mesodermal origin that can be isolated from various tissues,including bone marrow,tooth pulp,adipose tissue,and umbilical cord.MSCs have gained significant attention in regenerative medicine due to their ability to modulate the immune system and favor tissue repair.MSCs enrich the medium in which they are cultivated with a broad range of bioactive molecules,including growth factors,cytokines,chemokines,enzymes,nucleic acids,and extracellular vesicles that collectively compose the MSC secretome.An increasing number of pre-clinical studies suggest that delivering in vivo an MSC-conditioned medium(i.e.,the medium collected from MSC cultures after at least 3 days of exposure)exerts neuroprotective and anti-inflammatory effects in a variety of neurological conditions.

Ischemia/reperfusion injury and cardioprotective mechanisms:Role of mitochondria and reactive oxygen species

Reperfusion therapy must be applied as soon as possible to attenuate the ischemic insult of acute myocardial infarction(AMI).However reperfusion is responsible for additional myocardial damage,which likely involves opening of the mitochondrial permeability transition pore(mPTP).In reperfusion injury,mitochondrial damage is a determining factor in causing loss of cardiomyocyte function and viability.Major mechanisms of mitochondrial dysfunction include the long lasting opening of mPTPs and the oxidative stress resulting from formation of reactive oxygen species(ROS).Several signaling cardioprotective pathways are activated by stimuli such as preconditioning and postconditioning,obtained with brief intermittent ischemia or with pharmacological agents.These pathways converge on a common target,the mitochondria,to preserve their function after ischemia/reperfusion.The present review discusses the role of mitochondria in cardioprotection,especially the involvement of adenosine triphosphate-dependent potassium channels,ROS signaling,and the mPTP.Ischemic postconditioning has emerged as a new way to target the mitochondria,and to drastically reduce lethal reperfusion injury.Several clinical studies using ischemic postconditioning during angioplasty now support its protective effects,and an interesting alternative is pharmacological postconditioning.In fact ischemic postconditioning and the mPTP desensitizer,cyclosporine A,have been shown to induce comparable protection in AMI patients.

Nutritional value of a partially defatted and a highly defatted black soldier fly larvae (Hermetia illucens L.) meal for broiler chickens: apparent nutrient digestibility,apparent metabolizable energy and apparent ileal amino acid digestibility

Background: The study aimed to determine the apparent total tract digestibility coefficients(ATTDC) of nutrients, the apparent metabolizable energy(AME and AMEn) and the amino acid(AA) apparent ileal digestibility coefficients(AIDC)of a partially defatted(BSFp) and a highly defatted(BSFh) black soldier fly larvae meal. The experimental diets were: a basal diet and two diets prepared by substituting 250 g/kg(w/w) of the basal diet with BSFp or BSFh, respectively.Results: Significant differences were found between BSFp and BSFh meals for ATTDC of the nutrients: BSFp resulted more digestible than BSFh, except for ATTDC of CP which did not differed between meals, while a statistical trend was observed for ATTDC of DM and EE. The AME and AMEn values were significantly(P < 0.05) different between the two BSF meals, with higher levels for BSFp(16.25 and 14.87 MJ/kg DM, respectively). The AIDC of the AA in BSFp ranged from 0.44 to 0.92, while in BSFh they ranged from 0.45 to 0.99. No significant differences were observed for the AA digestibility(0.77 and 0.80 for BSFp and BSFh, respectively), except for glutamic acid, proline and serine that were more digestible in the BSFh meal(P < 0.05).Conclusions: Defatted BSF meals can be considered as an excellent source of AME and digestible AA for broilers with a better efficient nutrient digestion. These considerations suggested the effective utilization of defatted BSF larvae meal in poultry feed formulation.

Partially defatted black soldier fly larva meal inclusion in piglet diets: effects on the growth performance, nutrient digestibility,blood profile, gut morphology and histological features

Background:The aim of this trial was to investigate the effects of different inclusion levels of a partially defatted black soldier fly (BSF,Hermetia illucens L.) larva meal on the growth performance,nutrient digestibility,blood profile,gut morphology and histological features of piglets.A total of 48 newly weaned piglets were individually weighed (initial body weight (IBW):6.1 ± 0.16 kg) and randomly allocated to 3 dietary treatments (4 boxes as replicates/treatment and 4 animals/box).BSF larva meal was included at increasing levels (0% [BSF0],5% [BSFS] and 10% [BSF10]) in isonitrogenous and isoenergetic diets formulated for two feeding phases:Ⅰ (from d 1 to d 23) and Ⅱ (from d 24 to d 61).The weight gain (WG),average daily gain (ADG),average daily feed intake (ADFI) and feed conversion ratio (FCR) were calculated for each feeding phase and for the whole trial.The haematochemical parameters and nutrient digestibility of the piglets were also evaluated.A total of 3 piglets per box were slaughtered on d 61 and the slaughtered piglets were submitted to morphometric investigations and histopathological examinations.Results:No overall significant differences were observed for growth performance (P > 0.05),except for the ADFI of phase Ⅱ,which showed a linear response to increasing BSF meal levels (P < 0.05,maximum for the BSF10 group).Dietary BSF meal inclusion did not significantly influence the blood profile,except as far as monocytes and neutrophils are concerned,and these showed a linear and quadratic response,respectively,to increasing BSF meal levels (P < 0.05,maximum for the BSF10 and BSF5 groups,respectively).On the other hand,the nutrient digestibility,gut morphology and histological features were not affected by dietary BSF meal inclusion (P > 0.05).Conclusions:The obtained results show that a partially defatted BSF larva meal can be used as a feed ingredient in diets for weaned piglets without negatively affecting their growth performance,nutrient digestibility,blood profile,gut morphology or histological features.

MR with Gd-EOB-DTPA in assessment of liver nodules in cirrhotic patients

To date the imaging diagnosis of liver lesions is based mainly on the identification of vascular features, which are typical of overt hepatocellular carcinoma(HCC), but the hepatocarcinogenesis is a complex and multistep event during which, a spectrum of nodules develop within the liver parenchyma, including benign small and large regenerative nodule(RN), low-grade dysplastic nodule(LGDN), high-grade dysplastic nodule(HGDN), early HCC, and well differentiated HCC. These nodules may be characterised not only on the basis of their respective different blood supplies, but also on their different hepatocyte function. Recently, in liver imaging the introduction of hepatobiliary magnetic resonance imaging contrast agent offered the clinicians the possibility to obtain, at once, information not only related to the vascular changes of liver nodules but also information on hepatocyte function. For this reasons this new approach becomes the most relevant diagnostic clue for differentiating low-risk nodules(LGDN-RN) from highrisk nodules(HGDN/early HCC or overt HCC) and consequently new diagnostic algorithms for HCC have been proposed. The use of hepatobiliary contrast agents is constantly increasing and gradually changing the standard of diagnosis of HCC. The main purpose of this review is to underline the added value of Gd-EOB-DTPA in early-stage diagnoses of HCC. We also analyse the guidelines for the diagnosis and management of HCC, the key concepts of HCC development, growth and spread and the imaging appearance of precursor nodules that eventually may transform into overt HCC.

Gastric cancer: Current status of lymph node dissection

D2 procedure has been accepted in Far East as the standard treatment for both early(EGC) and advanced gastric cancer(AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials(RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique. In case of AGC the debate on the extent of nodal dissection has been open for many decades. While D2 gastrectomy was performed as the standard procedure in eastern countries, mostly based on observational and retrospective studies, in the west the Medical Research Council(MRC), Dutch and Italian RCTs have been conducted to show a survival benefit of D2 over D1 with evidence based medicine. Unfortunately both the MRC and the Dutch trials failed to show a survival benefit after the D2 procedure, mostly due to the significant increase of postoperative morbidity and mortality, which was referred to splenopancreatectomy. Only 15 years after the conclusion of its accrual, the Dutch trial could report a significant decrease of recur-rence after D2 procedure. Recently the long term survival analysis of the Italian RCT could demonstrate a benefit for patients with positive nodes treated with D2 gastrectomy without splenopancreatectomy. As nowadays also in western countries D2 procedure can be done safely with pancreas preserving technique and without preventive splenectomy, it has been suggested in several national guidelines as the recommended procedure for patients with AGC.

Nutritional effects of the dietary inclusion of partially defatted Hermetia illucens larva meal in Muscovy duck

Background: The present work is aimed at evaluating the effect of different inclusion levels of a partially defatted black soldier fly(Hermetia illucens,L.;HI) larva meal for ducks.A total of 192 female 3-day-old Muscovy ducklings(Cairina moschata domestica,Canedins R71 L White,Grimaud Freres Selection,France) were divided into 4 groups,assigned 4 different dietary treatments(6 replicates/treatment and 8 birds/replicate) and reared from 3 to 50 days of age.HI larva meal was included at increasing levels(0,3%,6% and 9%,HI0,HI3,HI6 and HI9,respectively) in isonitrogenous and isoenergetic diets formulated for 3 feeding phases: starter(3–17 days of age),grower(18–38 days of age) and finisher(39–50 days of age).The growth performance and apparent total tract digestibility were evaluated during the trial using titanium dioxide as an inert marker(0.3% of inclusion).At 51 days of age,two birds per pen were slaughtered and histomorphological investigations were performed.Results: The live weight and average daily gain showed a quadratic response to increasing HI meal in the grower period(minimum corresponding to the HI6 group).No effects of dietary inclusion levels were observed for the daily feed intake or feed conversion ratio.The apparent dry matter and organic matter digestibility were not affected by the dietary treatment.A linear decrease was observed for the crude protein apparent digestibility in the starter period(minimum for the HI9 groups).The ether extract apparent digestibility increased linearly during the grower and finisher periods(minimum for the HI0 group).The morphometric indices were not influenced by the dietary treatments.Conclusions: The inclusion of up to 9% of HI partially defatted larva meal in the diet of ducks did not cause any effect on growth performance,as well as the apparent digestibility.Moreover,dietary HI inclusion preserved the physiological intestinal development.

Recent advances in non-invasive magnetic resonance imaging assessment of hepatocellular carcinoma

Magnetic resonance(MR) imaging of the liver is an important tool for the detection and characterization of focal liver lesions and for assessment of diffuse liver disease,having several intrinsic characteristics,represented by high soft tissue contrast,avoidance of ionizing radiation or iodinated contrast media,and more recently,by application of several functional imaging techniques(i.e.,diffusion-weighted sequences,hepatobiliary contrast agents,perfusion imaging,magnetic resonance(MR)-elastography,and radiomics analysis). MR functional imaging techniques are extensively used both in routine practice and in the field of clinical and pre-clinical research because,through a qualitative rather than quantitative approach,they can offer valuable information about tumor tissue and tissue architecture,cellular biomarkers related to the hepatocellular functions,or tissue vascularization profiles related to tumor and tissue biology. This kind of approach offers in vivo physiological parameters,capable of evaluating physiological and pathological modifications of tissues,by the analysis of quantitative data that could be used in tumor detection,characterization,treatmentselection,and follow-up,in addition to those obtained from standard morphological imaging. In this review we provide an overview of recent advanced techniques in MR for the diagnosis and staging of hepatocellular carcinoma,and their role in the assessment of response treatment evaluation.

Effectiveness of chest radiography,lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure

Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis.

Effects of full replacement of dietary fishmeal with insect meal from Tenebrio molitor on rainbow trout gut and skin microbiota

Background:Aquaculture must continue to reduce dependence on fishmeal(FM)and fishoil in feeds to ensure sustainable sector growth.Therefore,the use of novel aquaculture feed ingredients is growing.In this regard,insects can represent a new world of sustainable and protein-rich ingredients for farmed fish feeds.Accordingly,we investigated the effects of full replacement of FM with Tenebrio molitor(TM)larvae meal in the diet of rainbow trout(Oncorhynchus mykiss)on fish gut and skin microbiota.Methods:A feeding trial was conducted with 126 trout of about 80 g mean initial weight that were fed for 22 weeks with two isonitrogenous,isolipidic,and isoenergetic extruded experimental diets.Partially defatted TM meal was included in one of the diets to replace 100%(TM 100)of FM,whereas the other diet(TM 0)was without TM.To analyse the microbial communities,the Illumina MiSeq platform for sequencing of 16S rRNA gene and Qiime pipeline were used to identify bacteria in the gut and skin mucosa,and in the diets.Results:The data showed no major effects of full FM substitution with TM meal on bacterial species richness and diversity in both,gut mucosa-and skin mucus-associated microbiome.Skin microbiome was dominated by phylum Proteobacteria and especially by Gammaproteobacteria class that constituted approximately half of the bacterial taxa found.The two dietary fish groups did not display distinctive features,except for a decrease in the relative abundance of Deefgea genus(family Neisseriaceae)in trout fed with insect meal.The metagenomic analysis of the gut mucosa indicated that Tenericutes was the most abundant phylum,regardless of the diet.Specifically,within this phylum,the Mollicutes,mainly represented by Mycoplasmataceae family,were the dominant class.However,we observed only a weak dietary modulation of intestinal bacterial communities.The only changes due to full FM replacement with TM meal were a decreased number of Proteobacteria and a reduced number of taxa assigned to Ruminococcaceae and Neisseriaceae families.Conclusions:The data demonstrated that TM larvae meal is a valid alternative animal protein to replace FM in the aquafeeds.Only slight gut and skin microbiota changes occurred in rainbow trout after total FM replacement with insect meal.The mapping of the trout skin microbiota represents a novel contribution of the present study.Indeed,in contrast to the increasing knowledge on gut microbiota,the skin microbiota of major farmed fish species remains largely unmapped but it deserves thorough consideration.

Alterations of seminal and hormonal parameters:An extrahepatic manifestation of HCV infection?

AIM： To evaluate the possible influences of HCV infection and relative antiviral treatment on seminal parameters and reproductive hormonal serum levels. METHODS： Ten male patients with HCV-related chronic hepatitis and 16 healthy male volunteers were studied. In all subjects seminal parameters （nemaspermic concentration, progressive motility, morphology） and hormonal levels were determined. Seminal parameters and inhibin B, follicle-stimulating hormone, luteinizing hormone, total and free testosterone, estradiol, prolactine in patients were measured after six and twelve months of antiviral combined （interferon ± ribavirin） treatment. RESULTS： Patients before treatment showed a significantly lower nemaspermic motility and morphology as well as lower inhibin B and free testosterone levels than controls. Inhibin B levels in cases were improved six and 12 mo after treatment in five responders （161.9 ± 52.8 pg/mL versus 101.7 ± 47.0 pg/mL and 143.4 ± 46.1 pg/ mL versus 95.4 ± 55.6 pg/mL, respectively）. Hormonal pattern of patients did not significantly change after treatment, with the exception of estradiol levels with an initial reduction and an overall subsequent increment （19.7 ± 6.4 pg/mL versus 13.6 ± 5.0 pg/mL versus 17.3 ± 5.7 pg/mL）. However in 1-year responders a significant increment of free testosterone （14.2 ± 2.54 pg/mL versus 17.1 ± 2.58 pg/mL） occurred. An impairment of nemaspermic morphology occurred, while other seminal parameters did not change significantly during antiviral treatment. CONCLUSION： Patients with HCV infection show worse spermatic parameters than controls, suggesting a possible negative influence of virus on spermatogenesis, with further mild impairment during antiviral treatment. However therapy could improve the spermatic function, as suggested by the increased inhibin B levels and improved hormonal pattern in responders. Further studies are needed to confirm these preliminary intriguing results.

Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment

Locoregional treatments,as alternatives to surgery,play a key role in the management of hepatocellular carcinoma(HCC).Liver magnetic resonance imaging(MRI)enables a multiparametric assessment,going beyond the traditional dynamic computed tomography approach.Moreover,the use of hepatobiliary agents can improve diagnostic accuracy and are becoming important in the diagnosis and follow-up of HCC.However,the main challenge is to quickly identify classical responses to loco-regional treatments in order to determine the most suitable management strategy for each patient.The aim of this review is to provide a summary of the most common and uncommon liver MRI findings in patients who underwent loco-regional treatments for HCC,with a special focus on ablative therapies(radiofrequency,microwaves and cryoablation),transarterial chemoembolization,trans-arterial radio-embolization and stereotactic ablative radiotherapy techniques,considering the usefulness of gadoxetate disodium(Gd-EOB-DTPA)contrast agent.

Role of inflammatory cytokines in peripheral nerve injury

Inflammatory events occurring in the distal part of an injured peripheral nerve have, nowadays, a great resonance. Investigating the timing of action of the several cytokines in the important stages of Wallerian degeneration helps to understand the regenerative process and design pharmacologic intervention that promotes and expedites recovery. The complex and synergistic action of inflammatory cytokines finally promotes axonal regeneration. Cytokines can be divided into pro- and anti-inflammatory cytokines that upregulate and downregulate, respectively, the production of inflammatory mediators. While pro-inflammatory cytokines are expressed in the first phase of Wallerian degeneration and promote the recruitment of macrophages, anti-inflammatory cytokines are expressed after this recruitment and downregulate the production of all cytokines, thus determining the end of the process. In this review, we describe the major inflammatory cytokines involved in Wallerian degeneration and the early phases of nerve regeneration. In particular, we focus on interleukin-1, interleukin-2, interleukin-6, tumor necrosis factor-β, interleukin-10 and transforming growth factor-β.

Thiazolidinedione treatment inhibits bile duct proliferation and fibrosis in a rat model of chronic cholestasis

AIM： To investigate the effects of troglitazone （TGZ）, an anti-diabetic drug which activates peroxisome proliferatoractivated receptor-y （PPAR-y）, for liver tissue repair, and the development of ductular reaction, following common bile duct ligation （BDL） in rats. METHODS： Rats were supplemented with TGZ （0.2% w/w in the pelleted food） for i wk before BDL or sham operation. Animals were killed at 1, 2, or 4 wk after surgery. RESULTS： The development of liver fibrosis was reduced in rats receiving TGZ, as indicated by significant decreases of procollagen type I gene expression and liver hydroxyproline levels. Accumulation of a-smooth-muscle actin （SMA）-expressing cells surrounding newly formed bile ducts following BDL, as well as total hepatic levels of SMA were partially inhibited by TGZ treatment, indicating the presence of a reduced number and/or activation of hepatic stellate cells （HSC） and myofibroblasts. Development of the ductular reaction was inhibited by TGZ, as indicated by histochemical evaluation and hepatic activity of γ-glutamyltransferase （GGT）. CONCLUSION： Treatment with thiazolidinedione reduces ductular proliferation and fibrosis in a model of chronic cholestasis, and suggests that limiting cholangiocyte proliferation may contribute to the lower development of scarring in this system.

Pathophysiology, clinical features and radiological findings of differentiation syndrome/all-trans-retinoic acid syndrome

In acute promyelocytic leukemia, differentiation thera-py based on all-trans-retinoic acid can be complicated by the development of a differentiation syndrome(DS). DS is a life-threatening complication, characterized by respiratory distress, unexplained fever, weight gain, interstitial lung infiltrates, pleural or pericardial effusions, hypotension and acute renal failure. The diagnosis of DS is made on clinical grounds and has proven to be difficult, because none of the symptoms is pathognomonic for the syndrome without any definitive diagnostic criteria. As DS can have subtle signs and symptoms at presentation but progress rapidly, end-stage DS clinical picture resembles the acute respiratory distress syndrome with extremely poor prognosis; so it is of absolute importance to be conscious of these complications and initiate therapy as soon as it was suspected. The radiologic appearance resembles the typical features of cardiogenic pulmonary edema. Diagnosis of DS remains a great skill for radiologists and haematologist but it is of an utmost importance the cooperation in suspect DS, detect the early signs of DS, examine the patients' behaviour and rapidly detect the complications.

Lack of association between seroprevalence of Helicobacterpylori infection and primary biliary cirrhosis

AIM:To determine the association between seroprevalence of Helicobacter pylori(H pylori)infection and primary biliary cirrhosis(PBC). METHODS:In this case-control study,149 consecutive patients(10 males,139 females,mean age 58.2±11 years, range 26-82 years)suffering from PBC and 619 consecutive healthy volunteer blood donors(523 males,96 females, mean age 47±5.3 years,range 18-65 years)attending the Hospital Blood Bank and residing in the same area were recruited.A commercial enzyme linked immunosorbent assay was used to detect anti-H pylori(IgG)antibodies in serum. RESULTS:AnUbodies to Hpyloriwere present in 78(52.3%) out of 149 PBC-patients and in 291(47%)out of 619 volunteers(P=0.24,OR 1.24,95% CI 0.85-1.80).In the subjects less than 60 years old,the prevalence of H pylori infection among PBC-patients(40/79)was slightly higher than in controls(50.6% vs 46.2%)P=0.46,OR=1.19,95% CI:0.72-1.95).In those over 60 years,the prevalence of Hpylori infection was similar between PBC-patients and controls(54.2% vs57.8%,P=0.7,OR 0.86,95% CI 0.36- 2.07). CONCLUSION:There is no association between seroprevalence of H pylori in fection and primary biliary cirrhosis.