Hepatic artery reconstruction in pediatric liver transplantation:Experience from a single group

Background:The reconstruction of hepatic artery is a challenging part of the pediatric liver transplantation procedure.Hepatic artery thrombosis(HAT)and stenosis are complications which may result in ischemic biliary injury,causing early graft lost and even death.Methods:Two hundred and fifty-nine patients underwent liver transplantation in 2017 in a single liver transplantation group.Among them,225 patients were living donor liver transplantation(LDLT)and 34 deceased donor liver transplantation(DDLT).Results:In LDLT all reconstructions of hepatic artery were microsurgical,while in DDLT either microsurgical reconstruction or traditional continuous suture technique was done depending on different conditions.There were five(1.9%)HATs:four(4/34,11.8%)in DDLT(all whole liver grafts)and one(1/225,0.4%)in LDLT(P=0.001).Four HATs were managed conservatively using anticoagulation,and 1 accepted salvage surgery with re-anastomosis.Until now,3 HAT patients remain in good condition,whereas two developed biliary complications.One of them needed to be re-transplanted,and the other patient died due to biliary complications.Conclusions:Microsurgical technique significantly improves the reconstruction of hepatic artery in pediatric liver transplantation.The risk for arterial complications is higher in DDLT.Conservative therapy can achieve good outcome in selected HAT cases.

A Review of the Pharmacology, Application, Ethnopharmacology, Phytochemistry, Quality Control, Processing, Toxicology, and Pharmacokinetics of Paridis Rhizoma

Paridis Rhizoma(PR) is also known as the flower with seven leaves and one branch, PR with golden thread, etc. It tastes bitter, numb, and slightly cold and has little poison. It is often used for the treatment of external skin infection, sore throat, snake bite, fall pain, frightening convulsion, and other diseases. PR has analgesic, sedative, anti-inflammatory, hemostatic, antitumor, antibacterial, antiviral, and renal and liver protective effects;inhibition of angiogenesis;immune regulation;and antioxidant and cardiovascular effects, and antifertility and anti-early pregnancy sperm killing effects. Steroidal saponins, β-ecdysone, polysaccharides, microelements, flavonoid glycosides, and amino acids were isolated from PR. In this paper, its pharmacology, application, ethnopharmacology, phytochemistry, quality control, toxicology, and pharmacokinetics were reviewed. This information suggests that we should focus on the development of new drugs related to PR, including specific ingredients, so as to make PR play a greater therapeutic potential. At the same time, attention should be paid to the rational use of PR resources to avoid excessive using, resulting in resource shortage. Therefore, we can carry out the research on the substitutes of PR, a large-scale planting of(Paridis Rhizoma) PR, and develop the same genus of PR and other resources. So far, great progress has been made in pharmacology and phytochemistry, especially in antitumor research, and many traditional uses have been confirmed and clarified by modern pharmacological research. However, there are few studies on the mechanism of its pharmacological action and few studies on processing. To develop new drugs in the future, more studies and experiments are still needed to prove the effect of PR and explore more new effects.

The Fruits of Xanthium sibiricum Patr: A Review on Phytochemistry, Pharmacological Activities, and Toxicity

In recent years,drug development and research have gradually shifted from chemical synthesis to biopharmaceutical and natural drugs.Natural medicines,such as traditional Chinese medicine,have been among the first studied because of their long medicinal history,simplicity,and the relatively low cost of research.Among them,Xanthii Fructus(XF)is famous for the treatment of sinusitis.In this article,the achievements of research on XF from 1953 to 2020 are systematically reviewed,focusing on the aspects of chemical constituents,pharmacological effects,clinical applications,toxicity and side effects,and processing methods.To date,there have been significant advances in both the phytochemistry and pharmacology of XF.Some traditional uses have been validated and clarified in modern pharmacological studies.However,its mechanism of action in the treatment of allergic diseases has not been satisfactorily explained.Further in vitro and in vivo studies are required to rationally develop new drugs and to elucidate the therapeutic potential of XF.A comprehensive evaluation of XF and an understanding of network pharmacology are also needed.

Simultaneous Determination of Six Compounds in Rat Plasma by Ultra-Performance Liquid Chromatography with Tandem Mass Spectrometry: Application in the Pharmacokinetic Study of Qing Gan-Shu Yu-Fang

A rapid and high selective ultra-performance liquid chromatography(UPLC)with tandem mass spectrometry method for simultaneous determination of six compounds including albiflorin,paeoniflorin,picroside I,picroside II,saikosaponin A,and saikosaponin D in rat plasma was developed and validated using butyl p-hydroxybenzoate as an internal standard.One-step direct protein precipitation with acetonitrile was used to extract the compounds from the rat plasma samples.Chromatographic separation was achieved using an ACQUITY UPLC BEH C18 column(100 mm×2.1 mm,1.7μm)at a flow rate of 0.4 m L/min,using gradient mode containing 0.1%formic acid in water and acetonitrile were used as the Mobile phase A and B.Electrospray ionization in negative ion mode and multiple reaction monitoring were used to identify and quantify active components.Calibration curves showed good linearity(R^2>0.9908)over a wide concentration range for all compounds.The intra-and interday precision(relative standard deviation)ranged 2.4%–7.0%and 2.6%–8.0%,respectively.The accuracy(relative error)was from-13.0%to 13.2%at all quality control levels.The recovery ranged from 81.1%to 92.5%.The validated method was successfully applied to pharmacokinetic study in rats after oral administration of Qing Gan-Shu Yu-Fang.The results show that one can draw a conclusion that these six active ingredients can be quickly absorbed and play a pharmacodynamic role rapidly in vivo.

A Review: The Phytochemistry, Pharmacology, and Pharmacokinetics of Curcumae Longae Rhizoma(Turmeric)

Curcumae Longae Rhizoma(CLR)is the rhizome of Curcuma longa L.Pharmacological studies show that CLR can be used to treat cervical cancer,lung cancer,lupus nephritis,and other conditions.In this paper,we review botany,traditional application,phytochemistry,pharmacological activity,and pharmacokinetics of CLR.The literature from 1981 to date was entirely collected from online databases,such as Web of Science,Google Scholar,China Academic Journals full-text database(CNKI),Wiley,Springer,PubMed,and ScienceDirect.The data were also obtained from ancient books,theses and dissertations,and Flora Reipublicae Popularis Sinicae.There are a total of 275 compounds that have been isolated from CLR,including phenolic compounds,volatile oils,and others.The therapeutic effect of turmeric has been expanded from breaking blood and activating qi in the traditional sense to antitumor,anti-inflammatory,antioxidation,neuroprotection,antibacterial,hypolipidemic effects,and other benefits.However,the active ingredients and mechanisms of action related to relieving disease remain ill defined,which requires more in-depth research and verification at a clinical level.