Nitric oxide (NO) is an intra- and intercellular messenger with a broad spectrum of activities in the central nervous system, cardiovascular and immune systems. Mitochondrial nitric oxide synthase(mtNOS), which might be a new form of NOS in mitochondria, has been discovered to be active in the regulation of mitochondrial respiration, energy metabolism and many pathophysiological processes. In this review, the location, properties, physiological and pathophysiological significance of mtNOS were summarized.

Objective To introduce a surgical technique for the cases with the papilla of Vater located in the diverticula. Methods When diverticula was opened, there was a cuff shape edge left in the bottom, which reduced tensility of oversew, and the probability of postoperative leakage was reduced. Fistula Oddi sphincteroplasty was adopted oversewwing when it was splitted,and the length of each time was not more than 3mm,and the total length was not more than 2cm. ResultsNone of 11 cases died in postoperation, 3 of them occured biliary fistula,duodenal fistula,and pancreatic fistula, the rate of fistula was 27.27%. They were all followed-up, and the result was satisfactory.ConclusionAlthough the operation technique is ifficult,and there are many complications,it is a good technique.

Objective:To investigate the impact of small extracellular vesicles(sEVs) derived from perirenal adipose cells on the biological behavior of renal tubular epithelial cells under diabetic conditions and the underlying molecular mechanisms.Methods:Primary perirenal adipose cells were extracted from db/m and db/db mice for in vitro culture. The culture supernatant was collected and sEVs(NDM-sEVs PRAT-Adipo, DM-sEVs PRAT-Adipo) were extracted by ultracentrifugation. The sEVs were incubated with human renal tubular epithelial cell line(HK-2) to observe changes in their proliferation, apoptosis, autophagy, and epithelial-mesenchymal transition(EMT) levels. The protein composition of sEVs was analyzed using mass spectrometry to explore the molecular mechanisms. Results:CCK8 results showed that the proliferation level of HK-2 cells after DM-sEVs PRAT-Adipo intervention did not change significantly compared with the two control groups(Ctrl group and NDM-sEVs PRAT-Adipo intervention group). Western Blot(WB) results indicated that there were no significant changes in apoptosis levels(Bcl-2, Cleaved-caspase 3, Caspase 3) and autophagy levels(p62, LC3BⅠ, LC3BⅡ) in the DM-sEVs PRAT-Adipo intervention group compared with the two control groups. WB and immunofluorescence results demonstrated that DM-sEVs PRAT-Adipo intervention upregulated the expression levels of mesenchymal cell marker proteins(Vimentin, α-SMA, Snail2) and downregulated the expression level of epithelial cell marker protein ZO-1 in HK-2 cells compared with the two control groups. Mass spectrometry analysis of sEVs revealed that the differential proteins between DM-sEVs PRAT-Adipo and NDM-sEVs PRAT-Adipo were enriched in EMT-related pathways. Among them, the enrichment of thrombospondin(THBS1) in DM-sEVs PRAT-Adipo might be involved in the regulation of EMT in HK-2 cells. Conclusion:Under diabetic conditions, sEVs secreted by PRAT-derived adipocytes promote the upregulation of EMT in renal tubular epithelial cells, a process that may be mediated by the enrichment of THBS1 in sEVs.