Background: s/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results.There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape. Methods: We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated. Results: The median operative time was 289.6 min (178−540 min), the median intraoperative blood loss was 209 mL (30−1,600 mL).Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%. Conclusions The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.

Salvia miltiorrhiza is a traditional medicinal plant used in Asian medicine for various therapeutic purposes. This plant contains numerous bioactive secondary metabolites, particularly abietane-type diterpenoids. In this study, 16 abietane-type diterpenoids were isolated from S. miltiorrhiza root extracts and structurally identified through advanced spectroscopic techniques. Among them, tanshinone IIA (6) and 15,16-dihydrotanshinone I (11) exhibited potent α-glucosidase inhibition, with IC 50 values of 48.38 ± 0.57 and 48.02 ± 0.47 µM, respectively. Enzyme kinetic studies revealed that these compounds served as non-competitive inhibitors of α-glucosidase. Our findings indicate that natural compounds from S. miltiorrhiza show promise as safe and effective α-glucosidase inhibitors, providing an alternative approach to diabetes treatment. This study contributes to the growing interest in utilizing natural sources for α-glucosidase inhibition and their potential application in healthcare and disease management.

Diabetes, characterized by elevated blood glucose levels, has a significant impact on cardiovascular, neural, and vascular systems. α-Glucosidase inhibitors have emerged as potential therapeutic agents for type 2 diabetes, as they slow carbohydrate digestion and reduce postprandial blood sugar levels. In this study, we investigated the phytochemical and pharmacological properties of Celastrus orbiculatusThunb., renowned for its diverse phytochemical constituents and potential medicinal applications. Through the application of chromatographic and spectroscopic techniques, we successfully isolated and structurally elucidated 16 compounds from the stems of C. orbiculatus. The in vitro α-glucosidase inhibitory activity of these compounds was evaluated. Notably, celaphanol A (1) and (+) lariciresinol (7) exhibited strong α-glucosidase inhibition, with IC 50 values of 8.06 ± 0.30 and 48.02 ± 0.47 µM, respectively. Enzyme kinetics analysis revealed that the most active compound 1 acted as a non-competitive inhibitor against α-glucosidase, with a K i> value of 7.77 ± 0.16 µM. These findings underscore C. orbiculatus as a valuable source for discovering and developing new α-glucosidase inhibitors. Furthermore, compound 1 shows promise as a candidate for natural herbal therapy targeting α-glucosidase inhibition. This suggests the potential for further investigation into its effectiveness through in silico or in vivo studies using a diabetes model.

Even though the combined use of ultrasound (US) and alpha-fetoprotein (AFP) is recommended for the surveillance of hepatocellular carcinoma (HCC), the utilization of AFP has its challenges, including accuracy dependent on its cut-off levels, degree of liver necroinflammation, and etiology of liver disease. Though various studies have demonstrated the utility of protein induced by vitamin K absence II (PIVKA-II) in surveillance, treatment monitoring, and predicting recurrence, it is still not recommended as a routine biomarker test. A panel of 17 experts from Asia-Pacific, gathered to discuss and reach a consensus on the clinical usefulness and value of PIVKA-II for the surveillance and treatment monitoring of HCC, based on six predetermined statements. The experts agreed that PIVKA-II was valuable in the detection of HCC in AFP-negative patients, and could potentially benefit detection of early HCC in combination with AFP. PIVKA-II is clinically useful for monitoring curative and intra-arterial locoregional treatments, outcomes, and recurrence, and could potentially predict microvascular invasion risk and facilitate patient selection for liver transplant. However, combining PIVKA-II with US and AFP for HCC surveillance, including small HCC, still requires more evidence, whilst its role in detecting AFP-negative HCC will potentially increase as more patients are treated for hepatitis-related HCC. PIVKA-II in combination with AFP and US has a clinical role in the Asia-Pacific region for surveillance. However, implementation of PIVKA-II in the region will have some challenges, such as requiring standardization of cut-off values, its cost-effectiveness and improving awareness among healthcare providers.

The COVID-19 pandemic outbreak and subsequent lockdowns impacted the mental health of numerous sociodemographic groups globally. This crisis can produce stress, overwhelm, and powerful emotions in susceptible people, especially older persons. Our study examined the relationship between well-being and fear of COVID-19 among older persons residing in Ho Chi Minh City, Vietnam, during the pandemic. A sociodemographic survey was undertaken. Two scales are used for a month of the COVID-19 outbreak: the Mental Health Continuum Short Form (MHC-SF) and the Fear of COVID-19 Scale (FCV-19S). We surveyed 158 senior citizens in Ho Chi Minh City between February and April 2021. There was no lockdown in Ho Chi Minh before the fourth wave of infection. Despite this, citizens have maintained high compliance with coronavirus prophylaxis. Sociodemographic data were described using descriptive statistics. A one-way MANOVA assessed the financial impact on older individuals' well-being. The Pearson correlation was employed to find the link between happiness and COVID-19 dread. During the COVID-19 pandemic, older persons who received various monthly allowances had statistically significant emotional and psychological well-being differences. There was no association between well-being and COVID-19 dread. The COVID-19 epidemic has disproportionately affected vulnerable groups. Older individuals are a risk population that requires material and mental care.

The Omicron variant caused a surge of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Viet Nam in early 2022, signalling community transmission. We report on active whole-genome sequencing surveillance of positive SARS-CoV-2 samples collected at that time in northern Viet Nam from international arrivals and community clusters. We used an amplicon protocol developed with 14 polymerase chain reaction products and the Illumina iSeq 100 platform. Overall, 213 nasopharyngeal or throat swabs were analysed, of which 172 samples were identified with the Omicron variant. Of these, 80 samples were collected from community cases in February 2022, among which 59 samples were sublineage BA.2 and one sample was the recombinant XE variant. Our results indicated that Omicron had replaced Delta as the dominant variant in a very short period of time and that continuously conducting active whole-genome sequencing surveillance is necessary in monitoring the evolution and genomic diversity of SARS-CoV-2 in Viet Nam.

As authorities braced for the arrival of the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infrastructure investments and government directives prompted action in central Viet Nam to establish capacity for genomic surveillance sequencing. From 17 November 2021 to 7 January 2022, the Pasteur Institute in Nha Trang sequenced 162 specimens from 98 150 confirmed SARS-CoV-2 cases in the region collected from 8 November to 31 December 2021. Of these, all 127 domestic cases were identified as the B.1.617.2 (Delta) variant, whereas 92% (32/35) of imported cases were identified as the B.1.1.529 (Omicron) variant, all among international flight passengers. Patients were successfully isolated, enabling health-care workers to prepare for additional cases. Most (78%) of the 32 Omicron cases were fully vaccinated, suggesting continued importance of public health and social measures to control the spread of new variants.

Purpose: Cranial magnetic resonance imaging (MRI) is recommended to identify intracranial lesions in girls with central precocious puberty (CPP). Yet, the use of routine MRI scans in girls with CPP is still debatable, as pathological findings in girls 6 years of age or older with CPP are limited. Therefore, we aimed to identify the prevalence of brain lessons in CPP patients stratified by age group (0–2, 2–6, and 6–8 years). Methods: This retrospective cross-sectional study recruited 257 girls diagnosed with CPP for 6 years (2010–2016). MRI was used to detect brain abnormalities. Levels of luteinizing hormone, follicle-stimulating hormone, and sex hormones in blood samples were measured. Results: Most girls had no brain lesions (82.9%, n=213), and of the minor proportion of girls with CPP that exhibited brain lesions (17.1%, n=44), 32 girls had organic CPP. Pathological findings were detected in 33.3% (2 of 6) of girls aged 0–2 years, 15.6% (5 of 32) of girls aged 2–6 years, and 3.6% (8 of 219) of girls aged 6–8 years. Hypothalamic hamartoma and tumors in the pituitary stalk were the most common pathological findings. The likelihood of brain lesions decreased with age. Girls with organic CPP were more likely to be younger (6.1±2.4 vs. 7.3±1.3 years, p<0.01) than girls with idiopathic CPP. Conclusion Older girls appeared to have a lower prevalence of organic CPP. Clinicians should cautiously use cranial MRI for girls aged 6–8 years with CPP.

The aim of this study is to delineate ‘admixed hybrid’ and ‘introgressive’ Fasciola genotypes present in the Fasciola population in Vietnam. Adult liver flukes collected from ruminants in 18 Provinces were morphologically sorted out by naked eyes for small (S), medium (M) and large (L) body shapes; and human samples (n=14) from patients. Nuclear ribosomal (rDNA) ITS1 and ITS2, and mitochondrial (mtDNA) nad1 markers were used for determination of their genetic status. Total 4,725 worm samples of ruminants were tentatively classified by their size: 6% (n=284) small (S)-, 13% (n=614) medium (M)-, and 81% (n=3,827) large (L)-forms. All the representative (n=120, as 40 each group) and 14 human specimens, possessed maternal mtDNA of only F. gigantica and none of F. hepatica. Paternally, all (100%) of the L-(n=40) and 77.5% (n=31) of the M-flukes had single F. gigantica rDNA indicating ‘pure’ F. gigantica. A majority (90%, n=36) of the S- and 15% (n=6) of the M-worms had single F. hepatica rDNA, indicating their introgressive; the rest (10%, n=4) of the S- and 7.5% (n=3) of the M-flukes had mixture of both F. gigantica and F. hepatica rDNAs, confirming their admixed hybrid genetic status. Fourteen human samples revealed 9 (64%) of pure F. gigantica, 3 (22%) of introgressive and 2 (14%) of admixed hybrid Fasciola spp. By the present study, it was confirmed that the small worms, which are morphologically identical with F. hepatica, are admixed and/or introgressive hybrids of Fasciola spp., and able to be the pathogens of human fascioliasis.
Adult ; DNA, Mitochondrial ; DNA, Ribosomal ; Fasciola hepatica ; Fasciola ; Fascioliasis ; Genotype ; Humans ; Liver ; Ranunculaceae ; Ruminants ; Vietnam

Objective: To evaluate the antitumor activity both in vitro and in vivo of saponin–phospholipid complex of Panax notoginseng. Methods: The in vitro cytotoxic effect of saponins extract and saponin–phospholipid complex against human lung cancer NCI-H460 and breast cancer cell lines BT474 was examined using MTS assay. For in vivo evaluation of antitumor potential, saponin and saponin–phospholipid complex were administered orally in rats induced mammary carcinogenesis by 7,12-dimethylbenz(a)anthracene, for 30 days. Results: Our data showed that saponin–phospholipid complex had stronger anticancer effect compared to saponin extract. The IC50 values of saponin–phospholipid complex and saponin extract for NCI-H460 cell lines were 28.47μg/mL and 47.97μg/mL, respectively and these values for BT474 cells were 53.18μg/mL and 86.24μg/mL, respectively. In vivo experiments, administration of saponin, saponin–phospholipid complex and paclitaxel (positive control) effectively suppressed 7,12-dimethylbenz(a) anthracene-induced breast cancer evidenced by a decrease in tumor volume, the reduction of lipid peroxidation level and increase in the body weight, and elevated the enzymatic antioxidant activities of su-peroxide dismutase, catalase, glutathione peroxidase in rat breast tissue. Conclusions: Our study suggests that saponin extract from Panax notoginseng and saponin–phospholipid complex have potential to prevent cancer, especially breast cancer.