Objective To explore the efficiency of indocyanine green (ICG) fluorescence imaging-guided hepatectomy and its short-term prognosis in patients with primary liver carcinoma. Methods Retrospective analysis was conducted on 166 patients diagnosed with primary liver carcinoma and admitted to the Department of Hepatobiliary Surgery of Shanghai General Hospital affiliated to Shanghai Jiao Tong University School of Medicine from June 2018 to June 2021. Patients were categorized into ICG group (n=72) and non-ICG group (n=94) based on the utilization of ICG during surgery. Moreover, the clinical information of preoperation, intraoperation, and postoperation were collected and compared between the two groups. ICG fluorescence images of the lesions in the ICG group were recorded for analysis. Results ICG fluorescence intensity is associated with the histopathology, differentiation grade of primary liver cancer, and the presence of liver cirrhosis. Hepatocellular carcinoma lesions predominantly displayed partial fluorescence, while intrahepatic cholangiocarcinoma lesions showed circular fluorescence. Well differentiated tumors exhibited complete fluorescence (7/11), moderately differentiated tumors demonstrated partial fluorescence (28/51), and poorly differentiated tumors displayed circular fluorescence (7/10). Most patients with liver cirrhosis exhibited partial fluorescence (18/35) or complete fluorescence (13/35).Compared to the non-ICG group, the ICG group demonstrated higher serum albumin levels on the first (34.6 g/L vs. 31.4 g/L) and the third postoperative days (32.4 g/L vs. 31.2 g/L)(P<0.001). Conversely, the ICG group showed shorter operation time (170 min vs. 210 min), lower rate of intraoperative hepatic portal blockade (9.7% vs. 33.0%), less intraoperative blood loss (400 mL vs. 430 mL), shorter postoperative hospital stay (10 d vs. 14 d), and lower incidence of short-term postoperative complications (4.2% vs. 20.2%) (P<0.05) compared to the non-ICG group. Conclusions ICG fluorescence intensity is associated with the histopathology, differentiation grade of primary liver cancer, and the presence of liver cirrhosis.The judicious application of ICG fluorescence imaging technology alongside surgical techniques holds promise for improving short-term prognosis and expediting the postoperative recovery.

BACKGROUND: The mechanisms distinguishing metabolically healthy from unhealthy phenotypes within the same BMI categories remain unclear. This study aimed to investigate the associations between regional fat distribution and metabolically unhealthy phenotypes in Chinese adults across different BMI categories. METHODS: This cross-sectional study involving 11833 Chinese adults aged 20 years and older. Covariance analysis, adjusted for age, compared the percentage of regional fat (trunk, leg, or arm fat divided by whole-body fat) between metabolically healthy and unhealthy participants. Trends in regional fat percentage with the number of metabolic abnormalities were assessed by the Jonckheere-Terpstra test. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. All analyses were performed separately by sex. RESULTS: In non-obese individuals, metabolically unhealthy participants exhibited higher percent trunk fat and lower percent leg fat compared to healthy participants. Additionally, percent trunk fat increased and percent leg fat decreased with the number of metabolic abnormalities. After adjustment for demographic and lifestyle factors, as well as BMI, higher percent trunk fat was associated with increased odds of being metabolically unhealthy [highest vs. lowest quartile: ORs (95%CI) of 1.64 (1.35, 2.00) for men and 2.00 (1.63, 2.46) for women]. Conversely, compared with the lowest quartile, the ORs (95%CI) of metabolically unhealthy phenotype in the highest quartile for percent arm and leg fat were 0.64 (0.53, 0.78) and 0.60 (0.49, 0.74) for men, and 0.72 (0.56, 0.93) and 0.46 (0.36, 0.59) for women, respectively. Significant interactions between BMI and percentage of trunk and leg fat were observed in both sexes, with stronger associations found in individuals with normal weight and overweight. CONCLUSIONS Trunk fat is associated with a higher risk of metabolically unhealthy phenotype, while leg and arm fat are protective factors. Regional fat distribution assessments are crucial for identifying metabolically unhealthy phenotypes, particularly in non-obese individuals.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Adipose Tissue ; Body Fat Distribution ; Body Mass Index ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Phenotype

Objective:To explore the role of cathepsin S(CTSS) in diabetic vascular injury-induced restenosis.Methods:(1) Dendritic cells(DCs) were stimulated with different concentrations of glucose, and CTSS was either knocked down or upregulated in dendritic cells using adenovirus transfection. The mRNA and protein expression levels of CTSS were detected by RT-qPCR and Western blot, and the changes of interleukin(IL)-6 levels were assessed using RT-qPCR and ELISA in response to CTSS. (2) The extent of Th17 cell differentiation was evaluated with Flow cytometry when CTSS was downregulated or overexpressed. Levels of ROR-γt, IL-17A, IL-17F, IL-22, and IL-23 were measured. (3) Streptozomycin(STZ, 60 mg/kg) was injected into the intraperitoneal cavity of rats fasted for 12 h to obtain a diabetic rat model, and the restenosis model was obtained by balloon catheter and carotid guidewire injury, and the differentiation degree of Th17 cells in different groups of rats was compared when CTSS was up-regulated and down-regulated.Results:(1) DC viability decreased when stimulated with 35 mmol/L glucose for 48 hours. Compared to the control group, glucose treatment led to a concentration-dependent increase in CTSS and IL-6 levels in DCs( P<0.05). Inhibition of CTSS reduced IL-6 protein levels, while its overexpression increased IL-6 protein levels( P<0.05). (2) Compared with the control group, CTSS inhibition in DC decreased the percentage of Th17 cells in T cells, with decreased protein levels of ROR-γt, IL-17A, IL-17F, IL-22, and IL-23, and vice versa ( P<0.050). (3) After carotid artery injury, CTSS expression was increased in perivascular adipose tissue(PVAT) of rats, and levels of ROR-γt, IL-17A, IL-17F, IL-22, and IL-23 in PVAT were significantly elevated. Down-regulation of CTSS eliminated the glucose-induced enhancement. Conclusion:Inhibition of CTSS in DC reduces Th17 cell differentiation and thereby suppresses restenosis following diabetic vascular injury.

In the context of the digital economy， the operational relationship between traditional Chinese medicine （TCM） and Internet healthcare organizations as well as related governance institutions has attracted much attention. As the market scale of the Internet healthcare has continued to grow in recent years， the quality of Internet TCM healthcare has also been improved. By analyzing the development status of Internet TCM healthcare， it is proposed that Internet TCM health service should seize the opportunities and challenges in future， promote the growth of market scale from varied aspects， enhance patient-centered care awareness， and strengthen the promotion and popularization of digital services， thereby promoting the high-quality development of Internet TCM health service in the context of the digital economy.

Objective To detect the effect of Guided Relaxation Method with Music on pain sensitivity and hemodynamics in acupuncture.Methods 70 volunteers aged 18 to 22, all in good condition, were randomized to study group or control group (each 35).In the control group, volunteers were only treated with acupuncture in a routine way while volunteers in the study group were treated with acupuncture using Guided Relaxation Method with Music .Comparing the change of heart rate and blood pressure before and after the experiment, and the pain sensitivity between these two groups.Results By comparing the two groups, it showed that there were no significant differences in heart rate, diastolic blood pressure and systolic blood pressure level(p>0.05).Numerical rat-ing scale scores in study group was much lower (p<0.001), and systolic blood pressure level after the experiment decreased more significantly than that in the control group (p<0.05).However, no significant differences can be seen in heart rate and diastolic blood pressure level after the experiment (p>0.05).Conclusion Guided Relaxation Method with Music could help to alleviate the feeling of pain, and make acupuncture therapy more acceptable.

Chemotherapeutic regimens based on fluoropyrimidines such as 5-fluorouracil, capecitabine,and tegafur,gimeracil and oteracil potassium(S1)are widely used in a variety of solid tumor therapy. Cancer patients are high-risk persons of thrombosis and anticoagulant therapy is recommended for patients with thrombosis or with risk factors of thrombosis. At present,warfarin is the widely used oral anticoagulant. There are drug interactions when 5-fluorouracil, capecitabine, and S1 are given in combination with warfarin and it may lead to elevated international normalized ratio and symptoms of bleeding. Most patients could recover after warfarin withdrawal,dosage reducing,and replacement with low-molecular heparin. However, a few patients may require blood transfusion. The mechanism of drug interactions due to concomitant use of fluoropyrimidines and warfarin remains unclear and may be related to inhibiting activity of metabolic enzyme of warfarin-hepatic cytochrome P450 1C9 by 5-fluorouracil or its metabolites.

Chemotherapeutic regimens based on fluoropyrimidines such as 5-fluorouracil, capecitabine,and tegafur,gimeracil and oteracil potassium(S1)are widely used in a variety of solid tumor therapy. Cancer patients are high-risk persons of thrombosis and anticoagulant therapy is recommended for patients with thrombosis or with risk factors of thrombosis. At present,warfarin is the widely used oral anticoagulant. There are drug interactions when 5-fluorouracil, capecitabine, and S1 are given in combination with warfarin and it may lead to elevated international normalized ratio and symptoms of bleeding. Most patients could recover after warfarin withdrawal,dosage reducing,and replacement with low-molecular heparin. However, a few patients may require blood transfusion. The mechanism of drug interactions due to concomitant use of fluoropyrimidines and warfarin remains unclear and may be related to inhibiting activity of metabolic enzyme of warfarin-hepatic cytochrome P450 1C9 by 5-fluorouracil or its metabolites.