Objective To investigate the expression of aquaporin 2 (AQP2) in an endolymphatic hydrops ani-mal model .Methods Forty adult guinea pigs were randomly divided into experiment group and control group (20 animals in each group ) . Guinea pigs in the experiment group were treated with deamino arginine vasopressin (DDAVP) intraperitoneally at the dosage of 4 μg · kg -1 · d-1 for 7 days ,while those in the control group were treated with physiological saline .The endolymphatic hydrops and expression of AQP2 in cochleas of all animals were evaluated by Hematoxylin and Eosin stain ,immunohistochemistry and Western blot .Results The endolymphatic hydrops in the experiment group were more severe than that in the control group(P<0 .05) .Expression of AQP2 were found in the stria vascularis and spiral ganglions in both groups with similar patterns .Both immunohistochem-istry and Western blot showed that the expressions of AQP2 in the experiment group were significantly stronger(P<0 .05 ) .Conclusion DDAVP can up-regulate the expression of AQP2 in the cochleae of guinea pigs ,thus may be closely related to the pathogenesis of endolymphatic hydrops .

Objective To investigate the changes in the expression of matrix metalloproteinase-1 (MMP-1),matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinase-3 (TIMP-3) in the articular cartilage of patients with Kashin-Beck disease (KBD) and the role of these proteins in pathogenesis of KBD.Methods The postoperative cartilage samples were collected from patients with KBD,osteoarthritis and patients with non-bone disease (control).The expression of MMP-1,MMP-3 and TIMP-3 in the cartilage was detected by immuohistochemistry,and the positive chondrocytes were counted in different layers of the articular cartilage under microscope.Results The positive rates of MMP-1 in the upper [(67.00 ± 1.69)％] and deeper [(22.07 ± 29.66)％] layers of articular cartilage from patients with KBD,and in the deeper layer of articular cartilage from patients with osteoarthritis [(70.52 ± 37.84)％] were significantly higher than those in the control group [(51.73 ± 36.74)％,(3.75 ± 6.85)％,all P ＜ 0.05].The positive rates of MMP-3 in the deeper layer of articular cartilage from patients with KBD [(28.84 ± 31.13)％] and in the middle and deeper layers of articular cartilage from patients with osteoarthritis [(55.69 ± 35.00)％,(45.96 ± 35.38％)] were significantly higher than those in normal cartilage [(34.09 ± 28.54)％,(14.46 ± 18.32)％,all P ＜ 0.05].The positive rates of TIMP-3 in the middle layer of articular cartilage from patients with KBD [(21.25 ± 25.23)％] and in the middle and deeper layers of articular cartilage from patients with osteoarthritis [(20.40 ± 22.19)％,(18.10 ± 22.58)％] were significantly lower than those in normal cartilage [(36.74 ± 26.61)％,(7.81 ± 20.58)％,all P ＜ 0.05].Conclusion MMP-1,MMP-3 and TIMP-3 play important roles in the articular cartilage damage of KBD.

Objective:Based on experience of robotic gastrointestinal surgery at the Department of General Surgery, Clinical Medicine Center of Gansu Provincial Hospital, this study explored the principles and methods of trocar layout for robotic "3+2" mode gastrointestinal surgery, suitable for beginners.Methods:From Apr 2017 to Oct 2022, the robotic gastrointestinal surgery team of Gansu Provincial Hospital completed 998 cases of robotic "3+2" mode gastrointestinal surgery, including 600 cases of gastric cancer, 100 cases of rectal cancer, 98 cases of descending colon and sigmoid colon cancer, 20 cases of transverse colon cancer, and 180 cases of right colon cancer. Through the continuous optimization and improvement of the problems encountered during the operation, combined with the operator's experience, and taking into account various aspects, we developed the robotic "3+2" mode trocar layout for gastrointestinal surgery.Results:Four principles of trocar layout were developed, namely, the principle of lens placement around the navel, the principle of symmetry in the main operation, the principle of 8-10cm distance between trocar holes, and the principle of symmetry in the auxiliary hole lens. Three trocar layout methods and principles applicable to robotic gastric surgery, and four applicable to robotic colorectal surgery were developed.Conclusion:The trocar layout method of robotic "3+2" mode gastrointestinal surgery is established based on a large number of robotic gastrointestinal surgery experiences. This method is simple and easy to learn, with strong repeatability and operability.

OBJECTIVETo explore the effect of colon cancer cell-derived interleukin-1α on the migration and proliferation of human umbilical vein endothelial cells as well as the role of IL-1α and IL-1ra in the angiogenesis process.

METHODSWestern blot was used to detect the expression of IL-1α and IL-1R1 protein in the colon cancer cell lines with different liver metastatic potential. We also examined how IL-1α and IL-1ra influence the proliferation and migration of umbilical vascular endothelial cells assessed by PreMix WST-1 assay and migration assay, respectively. Double layer culture technique was used to detect the effect of IL-1α on the proliferation and migration of vascular endothelial cells and the effect of IL-1ra on the vascular endothelial cells.

RESULTSWestern blot analysis showed that IL-1α protein was only detected in highly metastatic colon cancer HT-29 and WiDr cells, but not in the lowly metastatic CaCo-2 and CoLo320 cells.Migration assay showed that there were significant differences in the number of penetrated cells between the control (17.9±3.6) and 1 ng/ml rIL-1α group (23.2±4.2), 10 ng/ml rIL-1α group (31.7±4.5), and 100 ng/ml rIL-1α group (38.6±4.9), showing that it was positively correlated with the increasing concentration of rIL-1α (P<0.01 for all). The proliferation assay showed that the absorbance values were 1.37±0.18 in the control group, and 1.79±0.14 in the 1 ng/ml rIL-1α group, 2.14±0.17 in the 10 ng/ml rIL-1α group, and 2.21±0.23 in the 100 ng/ml rIL-1α group, showing a positive correlation with the increasing concentration of rIL-1α(P<0.01 for all). IL-1ra significantly inhibited the proliferation and migration of vascular endothelial cells (P<0.01). The levels of VEGF protein were (1.697±0.072) ng/ml, (3.507±0.064)ng/ml and (4.139±0.039)ng/ml in the control, HUVECs+ IL-1α and HUVECs+ HT-29 co-culture system groups, respectively, showing a significant difference between the control and HUVECs+ 10 pg/ml rIL-1α groups and between the control and HUVECs+ HT-29 groups (P<0.01 for both).

CONCLUSIONSOur findings indicate that colon cancer cell-derived IL-1α plays an important role in the liver metastasis of colon cancer through increased VEGF level of the colon cancer cells and enhanced vascular endothelial cells proliferation, migration and angiogenesis, while IL-1ra can suppress the effect of IL-1α and inhibit the angiogenesis in colon cancer.

Blotting, Western ; Caco-2 Cells ; Cell Line, Tumor ; Cell Movement ; physiology ; Cell Proliferation ; physiology ; Coculture Techniques ; Colonic Neoplasms ; blood supply ; metabolism ; pathology ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Interleukin 1 Receptor Antagonist Protein ; metabolism ; physiology ; Interleukin-1alpha ; metabolism ; physiology ; Liver Neoplasms ; secondary ; Neovascularization, Pathologic ; etiology

ObjectiveTo systematically review the efficacy and safety of laparoscopic choledochoscopy combined with holmium laser lithotripsy through a meta－analysis. MethodsThis study was conducted based on PRISMA guidelines， with a PROSPERO registration number of CRD42023406221. Chinese databases including CNKI， Wanfang Data， and VIP and foreign language databases such as PubMed， Embase， the Cochrane Library， and Web of Science were searched for original articles on traditional laparotomy versus laparoscopic choledochoscopy combined with holmium laser lithotripsy in the treatment of bile duct stones. Dichotomous variables were assessed by odds ratio （OR） and 95% confidence interval （CI）， while continuous variables were assessed by weighted mean difference （WMD） and 95%CI， and a sensitivity analysis was performed for outcome measures with relatively high heterogeneity. The Begg test and Egger test were used to evaluate publication bias. Stata 15.0 and Review Manager 5.3 were used to perform the statistical analysis. ResultsA total of 26 retrospective studies from China were included in this study， with 2 238 patients in total. The meta－analysis showed that compared with traditional laparotomy for the treatment of bile duct stones， laparoscopic choledochoscopy combined with holmium laser lithotripsy had significantly shorter time of operation （WMD＝－1.26， 95%CI： －1.36 to －1.16， P<0.001）， length of hospital stay （WMD＝－1.93， 95%CI： －2.64 to －1.12， P <0.001）， and time to bowel function recovery （WMD＝－1.52， 95%CI： －1.68 to －1.35， P<0.001）， significantly less intraoperative blood loss （WMD＝－1.79， 95%CI： －1.93 to －1.66， P<0.001）， a significantly lower rate of intraoperative residual stone （OR＝0.15， 95%CI： 0.11－0.20， P<0.001）， and significantly fewer complications （OR＝0.17， 95%CI： 0.13－0.23， P<0.001）. ConclusionCompared with traditional laparotomy， laparoscopic choledochoscopy combined with holmium laser lithotripsy shows better efficacy in the treatment of bile duct stones.