Background: Epimedii Folium, first recorded in the Shennong’s Classic of Materia Medica (Shen Nong Ben Cao Jing), is a traditional Chinese medicine (TCM) known for its effects of “benefiting Qi and strengthening the heart.” Icariside II (ICS II) is one of the main active components of Epimedii Folium, possessing cardiovascular protective and anti-inflammatory properties. However, the potential mechanisms of ICS II on myocardial ischemia (MI) remain unclear. Objective: The aim of the study was to investigate the effects and preliminary molecular mechanisms of ICS II in treating isoproterenolinduced MI in rats. Methods: A rat model of MI was established by subcutaneous injection of isoproterenol. Electrocardiography, echocardiography, myocardial enzymes analysis, heart weight index, triphenyltetrazolium chloride staining, histopathology, TUNEL staining, RT-qPCR, and Western blot were employed to evaluate the effects and preliminary molecular mechanisms of ICS II on MI rats. Results: Pharmacodynamic studies suggested that ICS II inhibited ST-segment elevation in electrocardiograms, improved cardiac function, reduced heart weight index and myocardial enzyme levels, decreased myocardial infarct size, alleviated cardiac histological damage, and inhibited apoptosis, thereby exerting cardioprotective effects in MI rats. Further studies revealed that ICS II may partially inhibit the expression of NLRP3/Caspase-1 axis-related targets at both protein and mRNA levels. Conclusions: Our findings indicate that ICS II exerts anti-MI effects, and its preliminary molecular mechanisms may be related to inhibiting the activation of the NLRP3/Caspase-1 axis to alleviate inflammatory responses.

Background: Epimedii Folium, first recorded in the Shennong’s Classic of Materia Medica (Shen Nong Ben Cao Jing), is a traditional Chinese medicine (TCM) known for its effects of “benefiting Qi and strengthening the heart.” Icariside II (ICS II) is one of the main active components of Epimedii Folium, possessing cardiovascular protective and anti-inflammatory properties. However, the potential mechanisms of ICS II on myocardial ischemia (MI) remain unclear. Objective: The aim of the study was to investigate the effects and preliminary molecular mechanisms of ICS II in treating isoproterenolinduced MI in rats. Methods: A rat model of MI was established by subcutaneous injection of isoproterenol. Electrocardiography, echocardiography, myocardial enzymes analysis, heart weight index, triphenyltetrazolium chloride staining, histopathology, TUNEL staining, RT-qPCR, and Western blot were employed to evaluate the effects and preliminary molecular mechanisms of ICS II on MI rats. Results: Pharmacodynamic studies suggested that ICS II inhibited ST-segment elevation in electrocardiograms, improved cardiac function, reduced heart weight index and myocardial enzyme levels, decreased myocardial infarct size, alleviated cardiac histological damage, and inhibited apoptosis, thereby exerting cardioprotective effects in MI rats. Further studies revealed that ICS II may partially inhibit the expression of NLRP3/Caspase-1 axis-related targets at both protein and mRNA levels. Conclusions: Our findings indicate that ICS II exerts anti-MI effects, and its preliminary molecular mechanisms may be related to inhibiting the activation of the NLRP3/Caspase-1 axis to alleviate inflammatory responses.

Background: Epimedii Folium, first recorded in the Shennong’s Classic of Materia Medica (Shen Nong Ben Cao Jing), is a traditional Chinese medicine (TCM) known for its effects of “benefiting Qi and strengthening the heart.” Icariside II (ICS II) is one of the main active components of Epimedii Folium, possessing cardiovascular protective and anti-inflammatory properties. However, the potential mechanisms of ICS II on myocardial ischemia (MI) remain unclear. Objective: The aim of the study was to investigate the effects and preliminary molecular mechanisms of ICS II in treating isoproterenolinduced MI in rats. Methods: A rat model of MI was established by subcutaneous injection of isoproterenol. Electrocardiography, echocardiography, myocardial enzymes analysis, heart weight index, triphenyltetrazolium chloride staining, histopathology, TUNEL staining, RT-qPCR, and Western blot were employed to evaluate the effects and preliminary molecular mechanisms of ICS II on MI rats. Results: Pharmacodynamic studies suggested that ICS II inhibited ST-segment elevation in electrocardiograms, improved cardiac function, reduced heart weight index and myocardial enzyme levels, decreased myocardial infarct size, alleviated cardiac histological damage, and inhibited apoptosis, thereby exerting cardioprotective effects in MI rats. Further studies revealed that ICS II may partially inhibit the expression of NLRP3/Caspase-1 axis-related targets at both protein and mRNA levels. Conclusions: Our findings indicate that ICS II exerts anti-MI effects, and its preliminary molecular mechanisms may be related to inhibiting the activation of the NLRP3/Caspase-1 axis to alleviate inflammatory responses.

Objective:To analyze the influencing factors of pancreatic fistula after pancreaticoduodenectomy (PD), and to construct and evaluate the prediction model of postoperative pancreatic fistula (POPF).Methods:Clinical data of 255 PD patients undergoing PD at the General Surgery Department of the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to January 2023 were retrospectively analyzed as the training set, including 148 males and 107 females, aged 58.0 (52.0, 64.5) years. According to the occurrence of POPF, patiennts were divided into the pancreatic fistula group ( n=65, including grade B and C POPF) and the non-pancreatic fistula group ( n=190). The age, gender, body mass index (BMI), white blood cell (WBC) count and neutrophil/lymphocyte ratio (NLR) before surgery and on the postoperative day (POD) 3, albumin, diameter of pancreatic duct, texture of the pancreas, operation time, and amylase concentration in the drainage fluid on POD3 were compared between the groups. Multivariate logistic regression analyses were conducted to identify the influencing factors of POPF. The nomogram of the pancreatic fistula prediction model was constructed using the rms package. One thousand cases were selected as the test set through the Bootstrap resampling method. And in the test set the receiver operating characteristic (ROC) curve and calibration curve were drawn to evaluate the model. Results:Logistic univariate analysis showed that there were significant differences between the two groups in terms of age, BMI, WBC count and NLR (preoperative and on POD3), the concentration of amylase in drainage fluid on POD3, pancreatic duct diameter, and operation time (all P<0.05). The results of logistic multivariate regression analysis showed age ( OR=1.050, 95% CI: 1.011-1.091), BMI ( OR=1.127, 95% CI: 1.005-1.264) and the amylase concentration of the drainage fluid >367.5 U/L on POD3 ( OR=3.688, 95% CI: 1.849-7.354) were the influencing factors of POPF ( P<0.05). Based on the three influencing factors screened out by multivariate analysis, a histogram for the prediction of pancreatic fistula was constructed using the rms package. The area under the ROC curve of the nomogram for predicting the occurrence of pancreatic fistula after PD was 0.744 (95%CI: 0.679-0.809), with a sensitivity of 69.2% and a specificity of 70.5%. The calibration curve shows that the model's prediction is consistent with the actual situation in the overall trend, indicating a relatively high degree of calibration. Conclusion:Age, BMI and amylase concentration of drainage fluid >367.5 U/L on POD3 are the influencing factors for pancreatic fistula after PD. The nomogram model for predicting pancreatic fistula constructed based on this has good predictive and application value.

Objective:To analyze the influencing factors of pancreatic fistula after pancreaticoduodenectomy (PD), and to construct and evaluate the prediction model of postoperative pancreatic fistula (POPF).Methods:Clinical data of 255 PD patients undergoing PD at the General Surgery Department of the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to January 2023 were retrospectively analyzed as the training set, including 148 males and 107 females, aged 58.0 (52.0, 64.5) years. According to the occurrence of POPF, patiennts were divided into the pancreatic fistula group ( n=65, including grade B and C POPF) and the non-pancreatic fistula group ( n=190). The age, gender, body mass index (BMI), white blood cell (WBC) count and neutrophil/lymphocyte ratio (NLR) before surgery and on the postoperative day (POD) 3, albumin, diameter of pancreatic duct, texture of the pancreas, operation time, and amylase concentration in the drainage fluid on POD3 were compared between the groups. Multivariate logistic regression analyses were conducted to identify the influencing factors of POPF. The nomogram of the pancreatic fistula prediction model was constructed using the rms package. One thousand cases were selected as the test set through the Bootstrap resampling method. And in the test set the receiver operating characteristic (ROC) curve and calibration curve were drawn to evaluate the model. Results:Logistic univariate analysis showed that there were significant differences between the two groups in terms of age, BMI, WBC count and NLR (preoperative and on POD3), the concentration of amylase in drainage fluid on POD3, pancreatic duct diameter, and operation time (all P<0.05). The results of logistic multivariate regression analysis showed age ( OR=1.050, 95% CI: 1.011-1.091), BMI ( OR=1.127, 95% CI: 1.005-1.264) and the amylase concentration of the drainage fluid >367.5 U/L on POD3 ( OR=3.688, 95% CI: 1.849-7.354) were the influencing factors of POPF ( P<0.05). Based on the three influencing factors screened out by multivariate analysis, a histogram for the prediction of pancreatic fistula was constructed using the rms package. The area under the ROC curve of the nomogram for predicting the occurrence of pancreatic fistula after PD was 0.744 (95%CI: 0.679-0.809), with a sensitivity of 69.2% and a specificity of 70.5%. The calibration curve shows that the model's prediction is consistent with the actual situation in the overall trend, indicating a relatively high degree of calibration. Conclusion:Age, BMI and amylase concentration of drainage fluid >367.5 U/L on POD3 are the influencing factors for pancreatic fistula after PD. The nomogram model for predicting pancreatic fistula constructed based on this has good predictive and application value.

Objective:To explore the application value of a novel separated magnetic-controlled forceps in transumbilical single-incision laparoscopic cholecystectomy (SILC).Methods:This is a prospective case series study. Data from patients who underwent SILC at the Department of General Surgery, the Second Affiliated Hospital of Air Force Medical University from March to August 2023 were prospectively collected, based on inclusion and exclusion criteria. All patients underwent cholecystectomy assisted by a novel separated magnetic-controlled forceps. Surgical time, intraoperative blood loss, the need for additional incisions during surgery, and the length of hospital stay were recorded to assess surgical difficulty and effectiveness. Postoperative pain scores and complications were documented to evaluate the safety of the procedure. The collaboration experience of the surgeon and assistant was evaluated using a 5-point Likert scale to assess the feasibility of this surgical approach. Informed consent was obtained from all patients in accordance with medical ethical regulations. Patients were followed up through outpatient visits or telephone calls, with follow-up at 7 days and 1 month after surgery, and evaluation of incisional scar healing and completion of satisfaction questionnaires. Follow-up was conducted until September 30, 2023.Results:A total of 45 patients were included in the study,including 19 males and 26 females,aged (42.7±4.2)years(range:32 to 61 years). The difficulty of the operation was evaluated as grade 1 or 2 in 38 cases(84.4%) and grade 3 in 7 cases(15.6%). Operation time was (37.3±5.3) minutes(range: 25 to 80 minutes),and intraoperative blood loss( M(IQR)) was 17.8(35.0) ml (range:10 to 60 ml). All surgical procedures proceeded smoothly without intraoperative incidents, and the overall satisfaction of the surgeon and assistants was high. All patients underwent successful day surgery management and were discharged within 48 hours of hospitalization. The postoperative pain scores at 1, 7, and 30 days were 3 (4), 1 (3), and 0 (2), respectively. The follow-up time was 5.0(2.2) weeks (range: 3 to 7 weeks), with no occurrence of grade 3 to 4 adverse reactions, and the patients were satisfied with the cosmetic effect of the umbilical incision. Conclusions:The novel separated magnetic-controlled forceps can be applied in transumbilical SILC. It has the advantages of convenient operation, and patients are satisfied with the surgical results.

Objective:To explore the application value of a novel separated magnetic-controlled forceps in transumbilical single-incision laparoscopic cholecystectomy (SILC).Methods:This is a prospective case series study. Data from patients who underwent SILC at the Department of General Surgery, the Second Affiliated Hospital of Air Force Medical University from March to August 2023 were prospectively collected, based on inclusion and exclusion criteria. All patients underwent cholecystectomy assisted by a novel separated magnetic-controlled forceps. Surgical time, intraoperative blood loss, the need for additional incisions during surgery, and the length of hospital stay were recorded to assess surgical difficulty and effectiveness. Postoperative pain scores and complications were documented to evaluate the safety of the procedure. The collaboration experience of the surgeon and assistant was evaluated using a 5-point Likert scale to assess the feasibility of this surgical approach. Informed consent was obtained from all patients in accordance with medical ethical regulations. Patients were followed up through outpatient visits or telephone calls, with follow-up at 7 days and 1 month after surgery, and evaluation of incisional scar healing and completion of satisfaction questionnaires. Follow-up was conducted until September 30, 2023.Results:A total of 45 patients were included in the study,including 19 males and 26 females,aged (42.7±4.2)years(range:32 to 61 years). The difficulty of the operation was evaluated as grade 1 or 2 in 38 cases(84.4%) and grade 3 in 7 cases(15.6%). Operation time was (37.3±5.3) minutes(range: 25 to 80 minutes),and intraoperative blood loss( M(IQR)) was 17.8(35.0) ml (range:10 to 60 ml). All surgical procedures proceeded smoothly without intraoperative incidents, and the overall satisfaction of the surgeon and assistants was high. All patients underwent successful day surgery management and were discharged within 48 hours of hospitalization. The postoperative pain scores at 1, 7, and 30 days were 3 (4), 1 (3), and 0 (2), respectively. The follow-up time was 5.0(2.2) weeks (range: 3 to 7 weeks), with no occurrence of grade 3 to 4 adverse reactions, and the patients were satisfied with the cosmetic effect of the umbilical incision. Conclusions:The novel separated magnetic-controlled forceps can be applied in transumbilical SILC. It has the advantages of convenient operation, and patients are satisfied with the surgical results.

ObjectiveTo investigate the role of radionuclide hepatobiliary scintigraphy in the evaluation of gallbladder contraction function, and to provide a theoretical basis for preoperative evaluation of gallbladder contraction function in patients undergoing laparoscopic-hard endoscopic gallbladder-preserving cholecystolithotomy. MethodsA total of 47 patients with gallstones who were admitted to The Second Affiliated Hospital of Air Force Medical University from June to December, 2016, and underwent 99mTc-EHIDA hepatobiliary imaging to evaluate gallbladder contraction function were enrolled. The radioactive count of the gallbladder was measured after fat meal and gallbladder contraction function was evaluated. A comparative analysis was performed based on intraoperative exploration and gallbladder-preserving outcome. ResultsA total of 26 patients with negative results of the EHIDA gallbladder contraction test underwent a successful gallbladder-preserving surgery, and some of them had no recurrence of stones after 24 months of follow-up. Among the 12 patients with impaired gallbladder contraction function shown by EHIDA, 1 underwent cholecystectomy due to roughness of the gallbladder wall and deposition of a large amount of cholesterol crystal, and 11 underwent gallbladder-preserving cholecystolithotomy. Among the 9 patients without the image of the gallbladder, 1 was found to have stones with a diameter of 2 cm embedded in the neck of the gallbladder by intraoperative exploration and underwent gallbladder-preservation surgery, and no recurrence of gallbladder stones was observed after 24 months of follow-up; the remaining 8 patients underwent cholecystectomy. Conclusion99mTc-EHIDA hepatobiliary scintigraphy has a certain value in evaluating gallbladder contraction function, but it cannot be used as the only evidence for the selection of surgical approach. Laparoscopic-hard endoscopic intraoperative exploration is a strong evidence for the selection of gallbladder-preserving surgery, and formal industry standards can be developed.

Objective: To investigate the protective effect of intraperitoneal transplantation of human liver-derived stem cells at different times against concanavalin A (ConA)-induced acute liver injury in mice. Methods: A total of 88 male C57BL/6 mice were randomly divided into normal control group (group C), ConA model group (group M), and human liver-derived stem cells (HYX1)+ConA group (group E); according to the interval between phosphate buffer/HYX1 injection and ConA injection, Groups M and E were further divided into 3-hour groups (M1 and E1 groups), 6-hour groups (M2 and E2 groups), 12-hour groups (M3 and E3 groups), 24-hour groups (M4 and E4 groups), and 48-hour groups (M5 and E5 groups). The levels of alanine aminotransferase (ALT), aspartate transaminase (AST), and total bilirubin (TBil) in peripheral blood were measured, liver tissue sections were used to observe pathological changes, and the Ishak score for liver inflammation was determined. The independent samples t-test was used for comparison between groups, and P < 0.05 was considered statistically significant. Results: The levels of ALT, AST, and TBil in group C were (36.25±1.16) U/L, (120.20±5.77) U/L, and (2.20±0.23) μmol/L, respectively; the levels of ALT, AST, and TBil and Ishak score were (8 721.23±837.39) U/L, (8 110.31±290.10) U/L, (8.41±0.10) μmol/L, and (13.32±1.30), respectively, in group M1, (8 334.31±666.50) U/L, (7 560.20±760.34) U/L, (10.40±0.80) μmol/L, and (12.67±0.81), respectively, in group M2, (8 960.75±551.93) U/L, (8 535.62±675.14) U/L, (10.95±1.43) μmol/L, and (14.57±0.65), respectively, in group M3, (8 618.57±886.40) U/L, (11 440.54 ± 1 327.86) U/L, (13.30±1.86) μmol/L, and (13.21±1.06), respectively, in group M4, and (10 170.13±1 112.37) U/L, (11 470.56±1 108.40) U/L, (12.75±1.55) μmol/L, and (15.07±1.58), respectively, in group M5. The levels of ALT, AST, and TBil and Ishak score were (1 016.35±163.47) U/L, (952.30±103.91) U/L, (7.77±0.62) μmol/L, and (3.50±0.21), respectively, in group E1, (42.10±6.20) U/L, (126.72±13.33) U/L, (3.41±0.53) μmol/L, and (2.01±0.40), respectively, in group E2, (44.21±4.30) U/L, (216.71±35.88) U/L, (3.47±0.44) μmol/L, and (2.13±0.25), respectively, in group E3, (2 909.69±212.14) U/L, (2 988.43±333.70) U/L, (7.03±0.93) μmol/L, and (4.70±0.50), respectively, in group E4, and (7 874.26±799.60) U/L, (10 940.54±947.35) U/L, (10.53±1.09) μmol/L, and (8.60±0.83), respectively, in group E5. Groups M1-M5 had significantly higher levels of ALT, AST, and TBil than group C (all P < 0.01), and groups M1-M4 had significantly higher levels of AST and ALT than groups E1-E4 (all P < 0.01), while there were no significant differences in the levels of AST and ALT between groups M5 and E5 (both P > 0.05). The pathological sections of liver tissue showed that compared with group M, group E had significant reductions in the degree of necrosis and Ishak score (both P < 0.05). Conclusion Intraperitoneal transplantation of human liver-derived stem cells has a protective effect against ConA-induced acute liver injury in mice, and the injection at 6 and 12 hours in advance has the best protective effect.

AIM:To explore the effects of miR-21 on biological behavior of colon cancer cells and their sensi-tivity to epidermal growth factor receptor monoclonal antibody cetuximab .METHODS:Lentiviral vectors were constructed to generate up-and down-regulations of miR-21 lentiviruses (LV-miR-21 and LV-anti-miR-21, respectively), and the cor-responding negative control viruses (LV-miR-21 NC and LV-anti-miR-21 NC, respectively) were also constructed.The vi-ruses were used to infect human colon cancer RKO cells .The changes of the miR-21 expression level , the cell prolifera-tion, the colony-forming ability, the cell apoptosis and the sensitivity of the cells to cetuximab were detected by real -time PCR, MTT assay, soft agar colony assay , flow cytometry and CCK-8 assay.RESULTS: The lentivirus titers of LV-miR-21, LV-miR-2 NC, LV-anti-miR-21 and LV-anti-miR-21 NC were 3.0 ×1012 TU/L, 6.0 ×1011 TU/L, 2.0 ×1012 TU/L and 8.0 ×1011 TU/L, respectively.The infection efficiency was over 80% by the observation of green fluorescence .The miR-21 expression level , the cell proliferation , and the colony-forming ability in LV-miR-21 group were significantly higher than those in LV-anti-miR-21 group.The early apoptotic rate and the inhibitory rate of cetuximab for the cells in LV-anti-miR-21 group were higher than those in LV-miR-21 group.CONCLUSION: miR-21 promotes the proliferation of colon cancer cells.Down-regulation of miR-21 enhances the sensitivity of the colon cancer cells to the targeted therapy drug cetuximab.