C23 ameliorates carbon tetrachloride-induced liver fibrosis in mice

BACKGROUND C23,an oligo-peptide derived from cold-inducible RNA-binding protein(CIRP),has been reported to inhibit tissue inflammation,apoptosis and fibrosis by binding to the CIRP receptor;however,there are few reports on its role in liver fibrosis and the underlying mechanism is unknown.AIM To explore whether C23 plays a significant role in carbon tetrachloride(CCl4)-induced liver fibrosis.METHODS CCl4 was injected for 6 weeks to induce liver fibrosis and C23 was used beginning in the second week.Masson and Sirius red staining were used to examine changes in fiber levels.Inflammatory factors in the liver were detected and changes inα-smooth muscle actin(α-SMA)and collagen I expression were detected via immu-nohistochemical staining to evaluate the activation of hematopoietic stellate cells(HSCs).Western blotting was used to detect the activation status of the trans-forming growth factor-beta(TGF-β)/Smad3 axis after C23 treatment.RESULTS CCl4 successfully induced liver fibrosis in mice,while tumor necrosis factor-alpha(TNF-α),IL(interleukin)-1β,and IL-6 levels increased significantly and the IL-10 level decreased significantly.Interestingly,C23 inhibited this process.On the other hand,C23 significantly inhibited the activation of HSCs induced by CCl4,which inhibited the expression ofα-SMA and the synthesis of collagen I.In terms of mechanism,C23 can block Smad3 phosphorylation significantly and inhibits INTRODUCTION At present there is no specific and effective drug for treating liver fibrosis caused by acute or chronic injury.Although preclinical research has made breakthroughs,their suitability as clinical treatments is still unknown.The activation of hepatic stellate cells(HSCs)caused by chronic inflammation is a key process in the development of liver fibrosis and activated HSCs expressα-smooth muscle actin(α-SMA)and transdifferentiate into myofibroblasts with proliferation,migration and secretion abilities,synthesizing the extracellular matrix to deposit in the hepatocyte space and subse-quently forming liver fibrosis[1].Although therapeutic strategies have improved due to past few efforts there is no ideal treatment for hepatic fibrosis[2].Extracellular cold inducible RNA binding protein(CIRP)has been shown to play a role in various acute and chronic inflammatory diseases by promoting tissue inflammation and apoptosis and inducing fibrosis through its receptor Toll-like receptor 4(TLR4)[3].C23 is a recognized competitive inhibitor of CIRP that can competitively bind to CIRP receptors and reduce tissue damage in inflammatory diseases[4].C23 has been shown to significantly reduce serum tumor necrosis factor-alpha(TNF-α),IL(interleukin)-6 and IL-1βlevels.In addition,it can reduce tissue TLR4,TNF-α,IL-6 and IL-1βlevels and inhibit the colocalization of CIRP and TLR4,which plays a significant role in systemic inflammation[5].Re-search has shown that CIRP induces the inflammatory phenotype of lung fibroblasts in a TLR4-dependent manner[6].On the other hand,CIRP is associated with markers of fibrosis andα-SMA is significantly positively correlated with CIRP.Cirp-/-mice exhibit attenuated expression ofα-SMA and collagen(COL1A1 and COL3A1),decreased hydroxyproline content,decreased histological fibrosis scores,and improved pulmonary hypertension[7].C23 inhibited the release of TNF-α,the degradation of IκB and the nuclear translocation of NF-κB in CIRP-stimulated macrophages in a dose-dependent manner and C23 treatment significantly increased the serum levels of lactic dehydrogenase,alanine ami-notransferase,IL-6,TNF-αand IL-1βin septic CLP mice[8].Based on previous research we hypothesized that C23 might alleviate liver fibrosis by inhibiting acute and chronic inflammation.As a selective hepatotoxic chemical carbon tetrachloride(CCl4).can induce inflammation and activate HSCs,promoting liver fibrosis.This study reveals the role and mechanism of C23 in CCl4-induced liver fibrosis in mice.at room temperature for 30 minutes.The gray value of each group was calculated after chemiluminescence.

Is longer sevoflurane preconditioning neuroprotective in permanent focal cerebral ischemia?

Sevoflurane preconditioning has neuroprotective effects in the cerebral ischemia/reperfusion model. However, its influence on permanent cerebral ischemia remains unclear. In the present study, the rats were exposed to sevoflurane for 15, 30, 60, and 120 minutes, followed by induction of perma- nent cerebral ischemia. Results demonstrated that 30- and 60-minute sevoflurane preconditioning significantly reduced the infarct volume at 24 hours after cerebral ischemia, and 60-minute se- voflurane preconditioning additionally reduced the number of TUNEL- and caspase-3-positive cells in the ischemic penumbra. However, 120-minute sevoflurane preconditioning did not show evident neuroprotective effects. Moreover, 60-minute sevoflurane preconditioning significantly attenuated neurological deficits and infarct volume in rats at 4 days after cerebral ischemia. These findings in- dicated that 60-minute sevoflurane preconditioning can induce the best neuroprotective effects in rats with permanent cerebral ischemia through the inhibition of apoptosis.

Role of radiomics in the diagnosis and treatment of gastrointestinal cancer

Gastrointestinal cancer(GIC)has high morbidity and mortality as one of the main causes of cancer death.Preoperative risk stratification is critical to guide patient management,but traditional imaging studies have difficulty predicting its biological behavior.The emerging field of radiomics allows the conversion of potential pathophysiological information in existing medical images that cannot be visually recognized into high-dimensional quantitative image features.Tumor lesion characterization,therapeutic response evaluation,and survival prediction can be achieved by analyzing the relationships between these features and clinical and genetic data.In recent years,the clinical application of radiomics to GIC has increased dramatically.In this editorial,we describe the latest progress in the application of radiomics to GIC and discuss the value of its potential clinical applications,as well as its limitations and future directions.

Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma

The morbidity and mortality of hepatocellular carcinoma(HCC)rank 6th and 4th,respectively,among malignant tumors worldwide.Traditional diffusion-weighted imaging(DWI)uses the apparent diffusion coefficient(ADC)obtained by applying the monoexponential model to reflect water molecule diffusion in active tissue;however,the value of ADC is affected by microcirculation perfusion.Using a biexponential model,intravoxel incoherent motion(IVIM)-DWI quantitatively measures information related to pure water molecule diffusion and microcirculation perfusion,thus compensating for the shortcomings of DWI.The number of studies examining the application of IVIM-DWI in patients with HCC has gradually increased over the last few years,and many results show that IVIMDWI has vital value for HCC differentiation,pathological grading,and predicting and evaluating the treatment response.The present study principally reviews the principle of IVIM-DWI and its research progress in HCC differentiation,pathological grading,predicting and evaluating the treatment response,predicting postoperative recurrence and predicting gene expression prediction.

Successful endoscopic extraction of a proximal esophageal foreign body following accurate localization using endoscopic ultrasound: A case report

BACKGROUND It is rare to find fish bones completely embedded in the wall of the esophagus with endoscopic findings similar to those of submucosal tumors.Most of the patients had the foreign body removed by thoracotomy or thoracoscopy in the past,which resulted in great trauma.CASE SUMMARY We report a 58-year-old woman who experienced dysphagia for 6 d after eating fish.Cervical computed tomography(CT)and endoscopic ultrasonography(EUS)indicated a fish bone completely embedded in the wall of the esophagus with endoscopic findings similar to those of submucosal tumors.The results of CT reconstruction and EUS suggested that the fish bone was parallel to the longitudinal axis of the esophagus.We performed a longitudinal mucosal incision from the highest point of the uplift by using an Olympus dual knife to find the fish bone.Unfortunately,no fish bone was found,so we extended the incision and endoscopic submucosal dissection(ESD)technique was used to detect and remove the fish bone entirety.CONCLUSION The extraction of fish bone via ESD immediately after the injection of methylene blue into the submucous membrane under EUS guidance to obtain accurate localization of the foreign body may be the best treatment for such patients.

Efficacy and safety of S-1 maintenance therapy in advanced nonsmall- cell lung cancer patients

BACKGROUND Previous reports have demonstrated that S-1 has remarkable effects in the maintenance treatment of advanced non-small-cell lung cancer(NSCLC),and has less toxic and side effects than conventional drugs.AIM To investigate the efficacy and safety of S-1 maintenance therapy in patients with advanced NSCLC.METHODS Ninety-four patients with NSCLC admitted to our hospital from September 2015 to April 2018 were included in the study and divided into the S-1 group(47 cases)and the gemcitabine group(47 cases)by random digital table method.The S-1 group was treated with S-1,while the gemcitabine group received gemcitabine treatment.The clinical efficacy and quality of life of the patients after treatment in the two groups were evaluated.RESULTS There was no significant difference in the total effectiveness rate between the two groups(P=0.519).The quality-of-life scores indicated that there was no significant difference between the two groups in terms of four dimensions of the GQOLI-74 questionnaire(P=0.518,0.094,0.338,0.418).The incidence of nausea and vomiting,granulocytopenia and diarrhea in the S-1 group was significantly lower than that in the gemcitabine group(P=0.001,0.001 and 0.001,respectively).There was no significant difference in the incidence of thrombocytopenia(P=0.366),the progression-free survival(P=0.064),and the survival between the two groups(P=0.050).CONCLUSION S-1 maintenance therapy shows a significant therapeutic effect in patients with advanced NSCLC.It has the same clinical efficacy as gemcitabine,but with less toxic and side effects than conventional drugs.

Endoscopic full-thickness resection to treat active Dieulafoy's disease: A case report

BACKGROUND At present,minimally invasive endoscopic treatment is mostly used for patients with actively bleeding Dieulafoy’s lesions,,as it has the advantages of minimal trauma,short operation time and good hemostatic effect,although bleeding can easily recur postoperatively.Recently,extensive gastric cuneiform resection has been advocated for use in these patients because the constant-diameter artery follows a long path to the gastric mucosa.CASE SUMMARY A 47-year-old man was admitted to the hospital for repeated hematemesis and black stool,and he was diagnosed with Dieulafoy’s disease.We chose a method that not only simulates surgical gastric cuneiform resection but also reduces trauma.We performed enlarged local endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery and sutured the gastric wall.Postoperative follow-up showed that the constant-diameter artery had been resected from the gastric wall,which was confirmed to have no blood flow signals by endoscopic ultrasonography.CONCLUSION Endoscopic full-thickness resection of the gastric wall and abdominal constantdiameter artery with suturing of the gastric wall has demonstrated potential as a new treatment for Dieulafoy's disease.

Common bile duct diameter in an asymptomatic population:A magnetic resonance imaging study

AIM: To measure the common bile duct(CBD) diameter by magnetic resonance cholangiopancreatography(MRCP) in a large asymptomatic population and analyze its some affecting factors.METHODS: This study included 862 asymptomatic subjects who underwent MRCP. The CBD diameter was measured at its widest visible portion on regular endexpiration MRCP for all subjects. Among these 862 subjects, 221 volunteers also underwent end-inspiration MRCP to study the effect of respiration on the CBD diameter. The age, sex, respiration, body length, body weight, body mass index(BMI), portal vein diameter(PVD), length of the extrahepatic duct and CBD, cystic junction radial orientation and location were recorded. The subjects were divided into 7 groups according to age. All of the above factors were compared with the CBD diameter on end-expiration MRCP.RESULTS: Among the 862 subjects, the CBD diameter was 4.13 ± 1.11 mm(range, 1.76-9.45 mm) and was correlated with age(r = 0.484; P < 0.05), with a dilation of 0.033 mm per year. The upper limit of the 95% reference range was 5.95 mm, resulting in a reasonable upper limit of 6 mm for the asymptomatic population. Respiration and other factors, including sex, body length, body weight, BMI, PVD, length of the extrahepatic duct and CBD, cystic junction radia orientation and location, were not related to the CBD diameter.CONCLUSION: We established a reference range for the CBD diameter on MRCP for an asymptomatic population. The CBD diameter is correlated with age. Respiration did not affect the non-dilated CBD diameter.

Application of 3D-printed prosthesis in revision surgery with large inflammatory pseudotumour and extensive bone defect: A case report

BACKGROUND Hip revision surgery is the final treatment option for the failure of artificial hip joints, but it is more difficult than the initial operation. For patients with hip joint loosening around the prosthesis combined with large inflammatory pseudotumours and large segment bone defects, hip revision is even more difficult, and clinical reports are rare.CASE SUMMARY Male, 59 years old. The patient underwent left hip replacement 35 years ago and was now admitted to hospital due to massive masses in the left thigh, shortening of the left lower extremity, and pain and lameness of the left hip joint. X-ray, computed tomography and magnetic resonance imaging revealed prosthesis loosening, left acetabular bone defect(Parprosky IIIB type), and a bone defect of the left proximal femur(Parprosky IIIA type). Inflammatory pseudotumours were seen in the left hip and left thigh. Hip revision surgery was performed using a 3Dprinted custom acetabular prosthesis was used for hip revision surgery, which was produced by Arcam Electron Beam Melting system with Electron Beam Melting technology. The operation was successful, and the patient was followed up regularly after the operation. The custom-made acetabular prosthesis was well matched, the inflammatory pseudotumour was completely removed, the postoperative hip prosthesis was stable, and the old greater trochanter fracture was well reduced and fixed. The patient was partially weight-bearing with crutches 3 mo after the operation and walked with full weight-bearing after 6 mo. The hip prosthesis was stable, and there was no recurrence of inflammatory pseudotumours at the last follow-up. The Visual Analogue Scale was 3, and the Harris hip score was 90.CONCLUSION The use of 3D-printed personalized custom prostheses for complex hip revision surgery has satisfactory surgical results and has great clinical application value.

Clinical control effect analysis of intravenous infusion of lidocaine and dexmedetomidine for prevention and treatment of CRBD

Objective To investigate the clinical value of intravenous lidocaine in reducing CRBD in male patients who need catheterization after general anesthesia.Methods A total of 210 male patients who underwent elective general anesthesia in our hospital from May 2017 to April 2018 were selected.Random number table method was used to divide into the lidocaine group(1.5 mg?kg-1 of intravenous lidocaine infusion during anesthesia induction,and continuous intravenous infusion of lidocaine 2 mg?kg-1?h-1 after intubation),Dexmedetomidine group(0.5μg?kg-1 of dexmedetomidine intravenously during anesthesia induction,continuous intravenous infusion of dexmedetomidine 0.4μg?kg-1?h-1 after intubation).Control group(intravenous saline infusion during anesthesia induction,continuous intravenous infusion of the same amount of saline after intubation),70 cases in each group.All three groups were placed in the bladder with a 16F comfortable urethral catheter lubricated with paraffin oil.The amount of sufentanil used during the operation,the amount of sufentanil used after surgery,and the CRBD score and VAS at different time points after extubation were compared.Scoring,HR,SBP.Results T1 to T4,the CRBD scores of the lidocaine group were lower than those of the dexmedetomidine group and the control group(P<0.05).The VAS scores of the lidocaine group were lower than those of the control group(P<0.05),the CRBD score and VAS score of the dexmedetomidine group were lower than those of the control group(P<0.05);From T0 to T4,the differences in HR and SBP between the three groups were not statistically significant(P>0.05).Conclusion Lidocaine administration in male patients requiring catheterization after general anesthesia can significantly reduce the incidence of CRBD.

Study on linage Acquisition of Transthoracic Echocardiography in Mechanically Ventilated ICU Patients

Objective This study aimed to determine which parameters in transthoracic echocardiography(TTE)are more likely to be affected when applied in a critical care setting with mechanical ventilation.Methods Ninety mechanically ventilated ICU patients were enrolled into the study group.The control group consisted of 90 patients who underwent interventional therapy.All patients had bedside TTE for parametric measurements including the right ventricular size,septal kinetics and left ventricular ejection fraction(LVEF)by eyeballing(visual assessment),the tricuspid annular plane systolic excursion(TAPSE),mitral annular plane systolic excursion(MAPSE)by M-mode sonography,the right ventricular outflow tract velocity-time integral(RVOT VTI)and left ventricular outflow tract velocity-time integral(LVOT VTI)by pulse-Doppler,the right ventricular fraction of area change(FAC)and left ventricular ejection fraction(LVEF Simpson)by endocardium tracing.We compared the differences in the frequency of optimal image acquisition in assessments of these parameters between the two groups,as well as the differences in acquisition rates of parameter measurements in ventilated ICU patients.Results There were significantly fewer patients in the study group than in the control group who had optimal images acquisitions for parameter assessments with M-mode method,pulse Doppler method and endocardiumtracing method(P<0.05);no significant difference was obsered in the number of patients with optimal images for RV eyeballing and LVEF eyeballing between the two groups.In the study group,significantly fewer optimal images were acquired for FAC than forTAPSE(22.2%vs、72.2%,χ2=45.139,P<0.001)and RVOT VTI(22.2%vs.71.1%,χ2=43.214,P<0.001);there were also fewer optimal images acquired for LVEF Simpson than for MAPSE(37.8%ys.84.4%,χ2=41.236,P<0.001)and LVOT VTI(37.8%vs.85.6%,/=43.455,P<0.001).Conclusions Images acquisition of optimal TTE images tend to be difRcult in mechanically ventilated ICU patients,but eyeballing method for functional evaluation could be an alternative method.For quantitative parameters measurements,M-mode based longitudinal function evaluation and pulse Doppler-based VTI were superior to the endocardium-tracing based parameter assessments.

Analysis of correlation between carotid atherosclerotic plaques and serum hs-CRP, Apo-B, ox-LDL and MMP-9 levels in patients with atherosclerotic cerebral infarction

ObjectiveTo analyze the correlation between the levels of serum hypersensitive c-reactive protein(hs-CRP),apolipoprotein-B(Apo-B),oxidized low-density lipoprotein(ox-LDL)and matrix metalloproteinase-9(MMP-9)and carotid arteryplaque(CAP)in patients with atherosclerotic cerebral infarction(ASCI).Methods 125 patients with ASCI diagnosed in the Department of Neurology of Panzhihua Central Hospital from January 2018 to December 2018 were selected as the case group,and 125 healthy volunteers in the same period were selected as the control group.Serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 were compared between the two groups.Carotid ultrasound was performed in patients with ASCI.The correlation between serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 and the formation of CAP in patients with ASCI was analyzed by SPSS 23.0 statistics.Results Compared with the control group,the levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 increased significantly in the case group(P<0.01).The serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with CAP were significantly higher than those without CAP in the case group(P<0.01).Multivariate logistic regression analysis showed that serum levels of hs-CRP(OR=4.76,95%CI:2.35-9.18),Apo-B(OR=3.16,95%CI:1.59-7.32),ox-LDL(OR=1.48,95%CI:1.15-2.01)and MMP-9(OR=3.86,95%CI:1.63-9.14)were independent risk factors for CAP formation in patients with ASCI(P<0.05).ConclusionsThe contents of serumhs-CRP,Apo-B,ox-LDL and MMP-9 may reflect the serverity of inflammation and instability of carotid atherosclerotic plaque in ASCI patient.The levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with ASCI are significantly increased,which are closely related to the formation of CAP in patients with ASCI,so it can be used as important serum biomarkers for clinical diagnosis of ASCI and CAP formation.

Association between vitamin D receptor gene polymorphism and prognosis in patients with end stage renal disease undergoing dialysis

Objective:To investigate the relationship between vitamin D receptor gene polymorphism and prognosis in patients with end stage renal disease(ESRD)undergoing dialysis.Methods:80 patients with ESRD who underwent regular hemodialysis in our hospital were admitted from January 2016 to June 2016,and 80 healthy volunteers from our hospital were collected as control group during the same period.The polymorphisms of rs1544410(BsmI)of vitamin D receptor gene were identified by peripheral blood DNA amplification and specific enzyme digestion,including wild type GG(bb)and mutant GA(Bb)and AA(BB).Then analyze and compare the distribution of BsmI in patients with ESRD and normal volunteers,further analyze the correlation between BsmI locus and clinical characteristics of patients with ESRD,and analyze the relationship between BsmI locus and prognosis of patients with ESRD according to the follow-up results of patients.Results:The incidence of wild type(bb)of vitamin D receptor BsmI locus in patients with ESRD was significantly lower than that in the control group,while the incidence of mutant type(Bb and BB)was higher than that in the control group,with an advantage ratio of 1.378(P=0.004).The allele frequency of BsmI locus showed that the incidence of A-base in patients with ESRD was higher than that in control group,with an advantage ratio of 1.368(P=0.010).Comparing the genotype and clinical characteristics of BsmI locus in patients with ESRD,it was found that there were no differences in age,sex ratio between men and women,BMI,hypertension,diabetes,LDL,HDL,TG,urea nitrogen,creatinine,calcium,phosphorus,albumin and vitamin D levels among different genotypes.One year after treatment,the survival rate of bb group was significantly higher than that of Bb group and BB group(P=0.006).K-M analysis showed that the median survival time of BB group was 20 months,that of BB group was 8 months,and that of BB group was 4 months(P=0.000).Conclusion:There is a high mutation rate of BsmI locus(GA,AA type)in patients with ESRD,that is,the mutation rate of G-base to A is higher,and the survival time of patients with mutation is significantly shortened.

Effect of PCDH10 on infiltrative growth and epithelial-mesenchymal transition of cancer cells in gastric cancer

Objective:To study the effect of protocadherin 10 (PCDH10) on infiltrative growth and epithelial-mesenchymal transition of cancer cells in gastric cancer.Methods: The patients with gastric cancer who underwent surgical resection in Panzhihua Central Hospital were selected as the research subjects, and the gastric cancer lesions and adjacent lesions were collected after surgical resection to determine the mRNA expression of PCDH10 gene and epithelial-mesenchymal transition genes as well as the protein levels of proteases and their inhibitory molecules.Results: PCDH10, TIMP1, TIMP2, RASAL2 and E-cadherin mRNA expression levels in gastric cancer lesions were significantly lower than those in adjacent lesions whereas Vav2, Vav3, CatB, MMP9, ZEB1, Twist1 and Vimentin contents were significantly higher than those in adjacent lesions;Vav2, Vav3, CatB, MMP9, ZEB1, Twist1 and Vimentin contents in gastric caner lesions with lower PCDH10 expression were significantly higher than those in gastric caner lesions with higher PCDH10 expression whereas TIMP1, TIMP2, RASAL2 and E-cadherin contents were significantly lower than those in gastric caner lesions with higher PCDH10 expression.Conclusion: The low expression of PCDH10 in gastric cancer can promote the infiltrative growth and epithelial-mesenchymal transition of cancer cells.