Sleeve gastrectomy ameliorates endothelial function and prevents lung cancer by normalizing endothelin-1 axis in obese and diabetic rats

BACKGROUND Previous evidence has implied that obesity is an independent risk factor for developing cancer.Being closely related to obesity,type 2 diabetes mellitus provides a suitable environment for the formation and metastasis of tumors through multiple pathways.Although bariatric surgeries are effective in preventing and lowering the risk of various types of cancer,the underlying mechanisms of this effect are not clearly elucidated.AIM To uncover the role and effect of sleeve gastrectomy(SG)in preventing lung cancer in obese and diabetic rats.METHODS SG was performed on obese and diabetic Wistar rats,and the postoperative transcriptional and translational alterations of the endothelin-1(ET-1)axis in the lungs were compared to sham-operated obese and diabetic rats and age-matched healthy controls to assess the improvements in endothelial function and risk of developing lung cancer at the postoperative 4 th,8 th,and 12 th weeks.The risk wasalso evaluated using nuclear phosphorylation of H2 A histone family member X as a marker of DNA damage(double-strand break).RESULTS Compared to obese and diabetic sham-operated rats,SG brought a significant reduction to body weight,food intake,and fasting blood glucose while improving oral glucose tolerance and insulin sensitivity.In addition,ameliorated levels of gene and protein expression in the ET-1 axis as well as reduced DNA damage indicated improved endothelial function and a lower risk of developing lung cancer after the surgery.CONCLUSION Apart from eliminating metabolic disorders,SG improves endothelial function and plays a protective role in preventing lung cancer via normalized ET-1 axis and reduced DNA damage.

Charge regulation by ferromagnetic metal/LiF spin-polarized interface for high-performance Li metal anodes

The interfacial characteristics of the Li metal anode(LMA)play a crucial role in its overall performance.Despite various materials being applied to modify the interface,a comprehensive understanding of their specific mechanisms remains to be investigated.Herein,we have prepared carbon cloth(CC)frameworks with their surfaces modified using ferromagnetic metal/LiF heterogeneous films(T^M-LiF-CC)as the substrate for LMA,which exhibit superior electrochemical performance.Utilizing ferromagnetic Co as a representative example,our study demonstrates that the enhanced performance of Co-LiF-CC,compared to bare CC,is attributed to the spinpolarized interface contributed by the Co/LiF heterostructure.Co and LiF play individual roles in redistributing electrons and Li^(+)to promote homogeneous Li deposition.Co nanoparticles play a crucial role in generating strong surface capacitance by storing electrons in spin-split bands,while LiF,with low surface diffusion barriers,ensures fast transportation of Li^(+).The Co-LiF-CC@Li electrodes deliver long lives of 7400 and 3600 h at 1 and 2 mA·cm^(-2)in symmetric cells,respectively;moreover,they enable full batteries with high and durable capacities,particularly when the N/P ratios are low(3.3 or even 1.7).

Higher CO_2-insufflation pressure inhibits the expression of adhesion molecules and the invasion potential of colon cancer cells

AIM:To investigate the influence of CO2-insufflation pressure on adhesion,invasion and metastatic potential of colon cancer cells based on adhesion molecules expression.METHODS:With an in vitro artificial pneumoperitoneum model,SW1116 human colon carcinoma cells were exposed to CO2-insufflation in 5 different pressure groups:6 mmHg,9 mmHg,12 mmHg,15 mmHg and control group,respectively for 1 h.Expression of E-cadherin,ICAM-1,CD44 and E-selectin was measured at 0,12,24,48 and 72 h after CO2-insufflation using flow cytometry.The adhesion and invasion capacity of SW1116 cells before and after exposure to CO2-insufflation was detected by cell adhesion/invasion assay in vitro.Each group of cells was injected intraperitoneally into 16 BALB/C mice.The number of visible abdominal cavity tumor nodules,visceral metastases and survival of the mice were recorded in each group.RESULTS:The expression of E-cadherin,ICAM-1,CD44 and E-selectin in SW1116 cells were changed significantly following exposure to CO2 insufflation at different pressures(P<0.05).The expression of E-cadherin,CD44 and ICAM-1 decreased with increasing CO2-insufflation pressure.The adhesive/invasive cells also decreased gradually with increasing pressure as determined by the adhesion/invasion assay.In animal experiments,the number of abdominal cavity tumor nodules in the 15 mmHg group was also signif icantly lower than that in the 6 mmHg group(29.7±9.91 vs 41.7±14.90,P=0.046).However,the survival in each group was not statistically different.CONCLUSION:CO2-insufflation induced a temporary change in the adhesion and invasion capacity of cancer cells in vitro.Higher CO2-insufflation pressure inhibited adhesion,invasion and metastatic potential in vitro and in vivo,which was associated with reduced expression of adhesion molecules.

Color Doppler ultrasonographic assessment of the risk of injury to major branch of the midddle hepatic vein during laparoscopic cholecystectomy

OBJEGTIVE: To investigate the causes of hemorrhage from the gallbladder bed during laparoscopic cholecystectomy. METHODS: 617 patients who had received laparoscopic cholecystectomy from September, 2000 to March, 2001 at this hospital were reviewed retrospectively. Ninety-one of these patients were selected randomly for prospective observation. Color Doppler ultrasound was used to examine the cause of venous hemorrhage from the gallbladder bed during laparoscopic cholecystectomy and to examine the anatomic relationship between the gallbladder bed and the branches of the middle hepatic vein in 91 patients preoperatively. RESULTS: A large branch of the middle hepatic vein extended closely behind the gallbladder bed in all 91 patients. The mean distance between the closest point (C point) of this branch to the gallbladder bed was 5.0±4.6 mm. The branch of the middle hepatic vein was completely adherent to the gallbladder bed in 14 (15.38%) of the 91 patients. The distance between this branch and the gallbladder bed was within I mm in 10 (10.99%) of the 91 patients. The inside diameter at C point of this branch was 3.2±1.1 mm. The C point was found on the left side of the longitudinal axis of the gallbladder in 31 (34.66%) of the 91 patients, on the right side in 39 patients (42.86%), just on the axis in 21 patients (23.08%). The venous blood flow rate at the C point was 9.9±3.3 cm/s. CONCLUSIONS: A large branch of the middle hepatic vein passes behind the gallbladder. The inside diameter of this branch is relatively larger. The bleeding of this branch during operation can only be stopped by transfixion. The closest point of this vein to the gallbladder is mostly situated on the right side of the longitudinal axis of the gallbladder. Patients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy and should be identified preoperatively with ultrasound.

Reconstruction of complex chest wall defects:A case report

BACKGROUND Chronic radiative chest wall ulcers are common in patients undergoing radiation therapy.If not treated early,then symptoms such as erosion,bleeding and infection will appear on the skin.In severe cases,ulcers invade the ribs and pleura,presenting a mortality risk.Small ulcers can be repaired with pedicle flaps.Because radioactive ulcers often invade the thorax,surgeons need to remove large areas of skin and muscle,and sometimes ribs.Repairing large chest wall defects are a challenge for surgeons.CASE SUMMARY A 74-year-old female patient was admitted to our department with chest wall skin ulceration after radiation therapy for left breast cancer.The patient was diagnosed with chronic radioactive ulceration.After multidisciplinary discussion,the authors performed expansive resection of the chest wall ulcers and repaired large chest wall defects using a deep inferior epigastric perforator(DIEP)flap combined with a high-density polyethylene(HDPE)patch.The patient was followed-up 6 mo after the operation.No pigmentation or edema was found in the flap.CONCLUSION DIEP flap plus HDPE patch is one of the better treatments for radiation-induced chest wall ulcers.

Impact of edaravone on serum CXC chemokine ligand-13 levels and perioperative neurocognitive disorders in elderly patients with hip replacement

Background:Perioperative neurocognitive disorders(PND)are a series of severe complications in the perioperative and anesthetic periods with a decline in memory,execution ability,and information processing speed as the primary clinical manifestation.This study aimed to evaluate the impact of edaravone(EDA)on PND and peripheral blood C-X-C motif chemokine ligand 13(CXCL13)levels in elderly patients with hip replacement.Methods:A total of 160 elderly patients undergoing hip arthroplasty in Affiliated Dongguan People’s Hospital of Southern Medical University(from March 2016 to March 2018)were randomly and double-blindly categorized into an EDA group and a control group(CON).Group EDA was administered intravenously EDA 30 min before surgery,and group CON was administered intravenously saline.The cognitive function of the two groups was evaluated 1-day before the operation and at 1 and 12 months after surgery,and the incidence of post-operative delirium was tested on days 1,3,and 7 after surgery using the Chinese version of the confusion assessment method.Serum CXCL13 and interleukin(IL)-6 concentrations were measured before anesthesia,during surgery(30 min after skin incision),and on days 1,3,and 7 after surgery.The continuous variables in accordance with normal distribution were tested using the Student’s t test,the continuous variables without normal distribution using the Mann-Whitney U test,and categorical variables by the x 2 test or Fisher exact test.Results:The incidence of post-operative delirium within 7 days after surgery was significantly higher in group CON than that in group EDA(31.3%vs.15.0%,t=-5.6,P<0.001).The modifiedtelephone interview for cognitive status andactivities of daily life scores were significantly higher in the group EDA than those in the group CON at 1 month(39.63±4.35 vs.33.63±5.81,t=-2.13,P<0.05and 74.3±12.6 vs.61.2±13.1,t=-1.69,P<0.05)and 12 months(40.13±5.93 vs.34.13±5.36,t=-3.37,P<0.05 and 79.6±11.7 vs.65.6±16.6,t=-2.08,P<0.05)after surgery;and the incidence of neurocognitive dysfunction was significantly lower in the group EDA than that in the group CON(P<0.05).Serum CXCL13 and IL-6 concentrations were significantly lower in the group EDA than those in the group CON during and after surgery(P<0.05).Conclusion:EDA can significantly reduce the serum concentrations of CXCL13 and IL-6 and improve the PND of patients.