Benign anastomotic stenosis remains a common complication after bilojejunal anastomosis. Its pathogenesis includes the histology of bile duct, bile erosion, and inappropriate choice of surgical anastomosis or suture materials. Biliojejunal anastomotic stenosis can be determined preoperatively by MRCP, CT, and three-dimensional image reconstruction. Surgery remains treatment of choice for most cases, including surgical reconstruction and minimally invasive treatment, while the incidence of restenosis, residual stone, and reoperation is still high. Surgeons are still in search of optimal treatment modality to avoid anastomotic stenosis. In this article, we review the literature and summarize the latest clinical progress in the diagnosis and treatment of biliojejunal anastomotic stenosis combined with hepatic ductal stones.

Kidney is a highly energy-demanding organ rich in mitochondria. Numerous studies have indicated that mitochondria play a crucial role in maintaining normal kidney function and in the pathogenesis of various kidney diseases. Mitochondrial DNA is the exclusive genome of mitochondria. Damage to mtDNA not only leads to mitochondrial dysfunction and degradation of mitochondrial quality, but also acts as an endogenous inflammatory molecule, activating various inflammatory pathways, which contribute to cellular damage and the progression of kidney diseases. This article reviews the mechanisms of mitochondrial DNA damage and its significant role in triggering inflammatory injury in kidney diseases. Additionally, it summarizes the current research progress on various intervention strategies targeting this type of damage.

Objective:To evaluate the technical approach and application value of DynaCT biliary reconstruction with CT images fusion (DynaCT-CT fusion) for the treatment of complex hepatolithiasis.Methods:The data of 18 patients with complex hepatolithiasis admitted to the First Affiliated Hospital of Guangzhou Medical University from May 2022 to October 2022 were retrospectively analyzed, including 7 males and 11 females, aged (50.6±15.0) years. Preoperative DynaCT biliary reconstruction with CT images fusion was performed to guide the percutaneous transhepatic one-step biliary fistulation (PTOBF). The technical data, including the bile duct with stones identified by preoperative imaging, the actual bile duct with stones confirmed intraoperatively, the satisfied stone removal time for each targeted bile duct, the actual stone removal time for each targeted bile duct, the intraoperative identification of CT-negative stones, the postoperative complications and reoperation were analyzed.Results:In 18 patients, a total of 95 target bile ducts with stones were identified by preoperative DynaCT-CT fusion technology, involving the first, secondary and tertiary bile ducts. Preoperative CT identified 29 lesions of stones involving the first and secondary bile ducts. CT negative stones were confirmed in 5 patients by DynaCT-CT fusion. Bile duct stricture occurred in 12 patients. All procedures were completed without postoperative bile leakage or hemorrhage. A total of 82 lesions of stones were successfully removed with a removal time of (25.9±12.8) min. The satisfied stone removal time for each targeted bile duct was (10.1±7.6) min, and the actual stone removal time was (10.5±7.4) min. Immediate stone clearance was achieved in 13 patients. Biliary tract infection occurred in 2 patients, and 5 patients underwent reoperation for residual or recurrent stones.Conclusion:The DynaCT-CT fusion technology guided PTOBF is feasible and safe in patients with complex hepatolithiasis. It could effectively detect more stones, shorten the stone clearance time. DynaCT-CT fusion technology provides a new strategy for the treatment of hepatolithiasis.

Liver cancer is one of the most common and fatal malignancies worldwide, with high mortality and morbidity. As an important tumor suppressor gene, p53 gene plays a key role in cell cycle regulation, cell growth and apoptosis of tumor cells. P53 gene mutations are closely related to the occurrence of liver cancer. At present, the treatment of liver cancer includes surgery, local treatment and systemic treatment. However, since most liver cancer patients are in advanced stages at the time of diagnosis, non-surgical treatment has become the best choice for the treatment of patients with intermediate and advanced liver cancer. But patients still have problems such as short survival and easy drug resistance. Therefore, the development of new treatment options is essential to improve the treatment outcomes of liver cancer patients. P53-related gene therapy products have great potential as drugs for the treatment of liver cancer. This article will briefly review the relationship between p53 gene and primary liver cancer, and explore its role in diagnosis and treatment, in order to provide a new direction for future clinical treatment.

Immunoscenescence plays a key role in the initiation and development of tumors. Furthermore, immunoscenescence also impacts drug delivery and cancer therapeutic efficacy. To reduce the impact of immunosenescence on anti-tumor therapy, this experimental plan aimed to use neutrophils with tumor tropism properties to deliver sialic acid (SA)-modified liposomes into the tumor, kill tumor cells via SA-mediated photochemotherapy, enhance infiltration of neutrophils into the tumor, induce immunogenic death of tumor cells with chemotherapy, enhance infiltration of CD8⁺ T cells into the tumor-draining lymph nodes and tumors of immunosenescent mice, and achieve SA-mediated photochemotherapy. We found that CD8⁺ T cell and neutrophil levels in 16-month-old mice were significantly lower than those in 2- and 8-month-old mice; 16-month-old mice exhibited immunosenescence. The anti-tumor efficacy of SA-mediated non-photochemotherapy declined in 16-month-old mice, and tumors recurred after scabbing. SA-mediated photochemotherapy enhanced tumor infiltration by CD8⁺ T cells and neutrophils, induced crusting and regression of tumors in 8-month-old mice, inhibited metastasis and recurrence of tumors and eliminated the immunosenescence-induced decline in antitumor therapeutic efficacy in 16-month-old mice via the light-heat-chemical-immunity conversion.

Objective To analyze the pollution characteristics of 12 kinds of metals and metalloid elements in PM_2.5 in Xi'an city, and to assess the health risks. Methods In 2018, PM2.5 samples were collected regularly every month at two monitoring points in Lianhu District and Yanta District of Xi'an City. The content of twelve metal and metalloid elements (Sb, Al, As, Be, Cd, Cr, Hg, Pb, Mn, Ni, Se, and Ti) in the samples were determined. The test results were statistically analyzed and evaluated according to different regions and seasons. The health risk assessment model recommended by the US Environmental Protection Agency (EPA) was used to assess the health risks of the metal and metalloid elements. Results A total of 165 PM_2.5 samples were collected and analyzed. The qualified rates of As and Cd were 51.52% and 83.03%, respectively, and there was no significant difference between regions (P＞0.05). The qualified rate of As in each season from high to low was summer> autumn> winter> spring. The average concentration of As was 8.21 ng/m³, being 1.37 times higher than the standard. The average concentration of As in each season exceeded the standard, and the order from high to low was winter> spring> autumn> summer. The average concentrations of other elements did not exceed the standard. HQ value and HI value of As, Cd, Cr, Pb, Mn, Ni, Hg, Ti and Se were all less than 1. The ILCR value of carcinogenic elements As, Cd, Cr and Ni was between 3.63×10^-07 ~2.58×10^-05. The ILCR value was highest for As, followed by Cr. The ILCR value was highest in winter, followed by spring and autumn, and lowest in summer. The order of ILCR value was adult males> adult females> children and adolescents. Conclusion The pollution of metal and metalloid elements in the atmospheric PM_2.5 in Xi'an in the winter is most serious. Arsenic and chromium in PM_2.5 pose a higher potential health risk to the population through the respiratory route.

Objective:To investigate the role of mitofusion 2 (Mfn2) in high glucose (HG)-induced endoplasmic reticulum stress (ERS) and apoptosis of podocytes.Methods:(1) Streptozocin was used to induce a diabetes mellitus (DM) rat model. Renal histopathological changes in rats were observed by HE staining. Expression of Mfn2 and CCAAT/enhancer-binding protein homologous protein (CHOP) in glomeruli was observed by immunohistochemistry. Protein levels of Mfn2, protein kinase RNA-like ER kinase (PERK), phospho(p)-PERK, and CHOP in glomeruli were analyzed by Western blotting. (2) Conditionally immortalized human podocytes (HPC) cultured in vitro were divided into control, mannitol (MA) and HG groups. Expression of Mfn2 was observed by immunofluorescence. Protein levels of Mfn2, p-PERK, PERK and CHOP in HPC were analyzed by Western blotting. Podocyte apoptosis in each group was evaluated by flow cytometry with AnnexinⅤ-PE/7AAD double staining method. (3) HPC were divided into control, HG, HG+Mfn2-Myc plasmid-transfected and HG+control plasmid-transfected groups. Protein levels of Mfn2, p-PERK, PERK and CHOP in HPC were analyzed by Western blotting. Expression of CHOP was observed by immunofluorescence. Mitochondrial membrane potential in each group was observed by mitochondrial membrane potential assay kit with JC-1. Podocyte apoptosis in each group was evaluated by flow cytometry with AnnexinⅤ-PE/7AAD double staining method. Results:(1) Compared with the control group, the glomerular mesangial matrix of the DM group rats was significantly proliferated, and the expression of Mfn2 was down-regulated with the expression of ERS-related proteins p-PERK/PERK and CHOP up-regulated (all P<0.05). (2) Compared with the control group, Mfn2 was down-regulated and p-PERK/PERK and CHOP were up-regulated in HPC of HG group (all P<0.05). Apoptosis of HPC was also increased in HG group. There was no significant difference in the above indicators between the control group and the mannitol group (all P>0.05). (3) Compared with the HG group, mitochondrial membrane potential of HPC was alleviated and apoptosis of HPC was decreased in HG+Mfn2-Myc plasmid-transfected group ( P<0.05). P-PERK/PERK and CHOP were down-regulated in HG+Mfn2-Myc plasmid-transfected group (both P<0.05). There was no significant difference in the above indicators between the HG group and the HG+control plasmid-transfected group (all P>0.05). Conclusions:Mfn2 down-regulation in HG-stimulated podocytes may induce ERS to increase apoptosis of podocytes. Up-regulation of Mfn2 can alleviate the HG-induced ERS and apoptosis in podocytes.

Objective: To investigate and analyze the drinking water quality among rural primary and secondary schools in Guanzhong area in 2018, and to provide a basis for the targeted improvement of water supply facilities. Methods: Develop a questionnaire on the basic situation of centralized water supply in rural schools, according to the Standard Test Method for Drinking Water (GB/T 5750—2006) and the Sanitary Standard for Drinking Water (GB 5749—2006) for the rural school network in Guanzhong area. The peripheral water collection and testing carried out single factor and multifactor statistical analysis on the relationship between water quality influencing factors and water quality pass rate. Results: The total qualified rate of drinking water quality in rural schools in Guanzhong area was 59.1%. Univariate analysis showed that water quality rate was affected by four factors including water source type, engineering type, sanitation permit and disinfection equipment use, and the difference was statistically significant(P<0.05). Unconditional two-class logistic regression analysis showed that disinfection (OR=3.14), engineering type (OR=2.05), and sanitation permit (OR=1.99)(P<0.05) affected the water quality pass rate. Conclusion It is recommended to further strengthen the investment in the renovation of water supply for rural schools in Guanzhong area, and specifically strengthen water supply treatment and standard disinfection.

Objective: To understand the status and trend of heavy metal indicators of drinking water in rural schools in different regions of Shaanxi Province, so as to provide scientific basis for safety of drinking water in rural schools. Methods: In 2017-2019, 697 rural school water supply projects in Shaanxi Province were tested for heavy metal indicators in the peripheral water. According to the sanitary standard for drinking water (GB 5749—2006), five heavy metal indicators, including arsenic, cadmium, hexavalent chromium, lead and mercury, were analyzed and evaluated in different years and regions. Results: A total of 2 298 valid water samples were collected and analyzed in 3 years. Except that lead and mercury are all up to standard, the standard rates of other heavy metals such as arsenic, cadmium and hexavalent chromium were 98.83%, 99.91% and 96.95% respectively. Compared with the Northern Shaanxi plateau and Qinba mountain area, the standard rate of water arsenic in Guanzhong Plain was lower (χ2=5.67, 13.59,P<0.01). The standard rate of hexavalent chromium was the highest in Qinba mountain area, followed by Guanzhong Plain, and the lowest in Northern Shaanxi plateau (χ2=20.48, 17.05, 48.32, P<0.01). Two samples of cadmium exceeding standard were from the Northern Shaanxi plateau. Conclusion The heavy metal index of drinking water in rural schools in Shaanxi Province exceeds the standard, which has obvious regional characteristics. We should focus on the harm of arsenic, hexavalent chromium and other heavy metals to the health of students in the Northern Shaanxi plateau and Guanzhong Plain. Cadmium and mercury in drinking water in local areas should be paid continued attention. Safety of drinking water in schools should be ensured from the aspects of water source selection and water treatment technology.

Objective: To investigate the effect of enolase 1 (ENO1) expression on proliferation, apoptosis and migration of lung cancer PC14 cells. Methods: ENO1 over-expression vector-pcDNA3.1/ENO1 was constructed and transfected into PC14 cells at logarithmic growth phase with liposome LipofectamineTM 2000. G418 was used to screen PC14 cells that stably expressing ENO1. The effects of ENO1 over-expression on proliferation, migration and apoptosis of PC14 cells were detected by CCK-8 method, scratch-healing assay and flow cytometry, respectively. Results: The ENO1 over-expression cell model was successfully constructed. Compared with PC14-vehicle and wild-type PC14 cells, the mRNA and protein expression levels of ENO1 in PC14-ENO1 cells were significantly elevated (all P<0.05), and the proliferation of PC14-ENO1 cells was significantly increased (all P<0.05). The relative mobility of PC14ENO1 cells was significantly higher than that of pcDNA3.1-vehicle cells and wild-type PC14 cells ([13.26±1.13]% vs [8.46±1.11]%, [7.86±1.00]%, both P<0.05). There was no significant difference in apoptotic rate among PC14-ENO1, PC14-vehicle and PC14 cells (all P> 0.05) Conclusion: Over-expression of ENO1 promotes proliferation and migration of lung cancer PC14 cells.