Objective:To evaluate the short-term efficacy of parallel overlapping anastomosis in 3D laparoscopic radical resection for transverse colon cancer.Methods:A retrospective analysis of clinical data was conducted on 73 patients who underwent 3D laparoscopic radical resection and parallel overlapping anastomosis for reconstruction of digestive tract transverse colon cancer at He'nan Provincial People's Clinical Medical School of Zhengzhou University between Apr 2019 and Jul 2023.Results:The average operation time was (165.3±28.9) min, the parallel overlapping anastomosis time was (15.6±2.6) min, the intraoperative blood loss was (47.7±19.4) ml, the first postoperative exhaust time was(2.2±0.9) d, the first time getting out of bed was (1.1±0.4) d, the number of lymph node dissection was (18.2±5.1), the first postoperative oral fluid diet time was (4.4±0.8) d, the postoperative hospital stay was (6.4±1.8) d. Anastomotic leakage occurred in one patient , who was discharged after enterostomy; Two patients with poor wound healing were cured after wound debridement and dressing change; Pulmonary infection in one patient was healed by anti-infection treatment. The postoperative complication rate was 6%, and no complications such as anastomotic bleeding, anastomotic stenosis, intestinal obstruction, abdominal infection occurred.Conclusion:Parallel overlapping anastomosis is a safe and reliable anastomotic procedure for the reconstruction of digestive tract in patients undergoing 3D laparoscopic radical resection of transverse colon cancer.

Objective:To evaluate the short-term efficacy of parallel overlapping anastomosis in 3D laparoscopic radical resection for transverse colon cancer.Methods:A retrospective analysis of clinical data was conducted on 73 patients who underwent 3D laparoscopic radical resection and parallel overlapping anastomosis for reconstruction of digestive tract transverse colon cancer at He'nan Provincial People's Clinical Medical School of Zhengzhou University between Apr 2019 and Jul 2023.Results:The average operation time was (165.3±28.9) min, the parallel overlapping anastomosis time was (15.6±2.6) min, the intraoperative blood loss was (47.7±19.4) ml, the first postoperative exhaust time was(2.2±0.9) d, the first time getting out of bed was (1.1±0.4) d, the number of lymph node dissection was (18.2±5.1), the first postoperative oral fluid diet time was (4.4±0.8) d, the postoperative hospital stay was (6.4±1.8) d. Anastomotic leakage occurred in one patient , who was discharged after enterostomy; Two patients with poor wound healing were cured after wound debridement and dressing change; Pulmonary infection in one patient was healed by anti-infection treatment. The postoperative complication rate was 6%, and no complications such as anastomotic bleeding, anastomotic stenosis, intestinal obstruction, abdominal infection occurred.Conclusion:Parallel overlapping anastomosis is a safe and reliable anastomotic procedure for the reconstruction of digestive tract in patients undergoing 3D laparoscopic radical resection of transverse colon cancer.

Objective To explore the effect and possible mechanism of berberine on the macro-phage polarization of human myeloid leukemia monocytic cell line THP-1 induced by oxidized low-density lipoprotein(ox-LDL).Methods THP-1 cells were induced into macrophages by PMA,and then according to different concentrations of berberine,the cells were divided into con-trol group,and 5,10,20,40 and 50 μmol/L berberine groups.After intervention for 24 or 48 h,CCK8 assay was used to detect cell viability for optimal concentration and time of berberine treat-ment.PMA-induced THP-1 macrophages were assigned into blank group,model group(ox-LDL),berberine group,inhibitor group(phosphatidyl inositol 3-kinase(PI3K)inhibitor LY294002)and berberine+inhibitor group(berberine+LY294002).The contents of inducible nitric oxide syn-thase(iNOS)and TGF-β1 were detected by ELISA.qPCR was employed to measure the mRNA expression of TNF-α,arginase 1(Arg1),PI3K and protein kinase B Akt1,and Western blotting was applied to detect the protein levels of Akt1 and phosphorylated protein kinase B antibody(p-Akt1).Results In 24 h after intervention,the macrophage activity was significantly lower in the 40 and 50 μmol/L berberine groups than the control group(P＜0.05),and after 48 h,the ac-tivity in all the 5 doses of berberine groups was obviously lower than that in the control group[(0.89±0.02)％,(0.82±0.03)％,(0.71±0.02)％,(0.62±0.03)％and(0.53±0.02)％vs(1.01±0.01)％,P＜0.05].Berberine treatment of 20 μmol/L for 24 h had little effect on cell viability,and the dose and the time were regarded as the best concentration and time.Compared with the blank group,iNOS content and TNF-α mRNA level were increased in the model group,while TGF-β1 content,mRNA levels of Arg1,PI3K and Akt1,and p-Akt1/Akt1 protein levels were de-creased(P＜0.05).iNOS content and TNF-α mRNA level were decreased,while TGF-β1 content,mRNA levels of Arg1,PI3K and Akt1 and protein levels of p-Akt1/Akt1s were increased in the berberine group than the model group(P＜0.05).Compared with the berberine group,iNOS con-tent and TNF-α mRNA level were increased,while mRNA levels of Arg1,PI3K and Akt1 and protein levels of p-Akt1/Akt1 were decreased in the berberine+inhibitor group(P＜0.05).Con-clusion Berberine can inhibit the inflammatory response of THP-1 macrophages induced by ox-LDL by activating PI3K/Akt1 pathway,and inhibit the M1 polarization and promote the M2 polarization of macrophages.

Objectives:To investigate the application value of laparoscopic double stapler firings and double stapling technique combined with rectal eversion and total extra-abdominal resection (LDER) in the anal preservation treatment of low rectal cancer.Methods:Inclusion criteria: (1) age was 18-70; (2) the distance of the lower tumor edge from the anal verge was 4-5 cm; (3) primary tumor with a diameter ≤3 cm; (4) preoperative staging of T1~2N1~2M0; (5) "difficult pelvis", defined as ischial tuberosity diameter<10 cm or body mass index>25 kg/m 2; (6) patients with strong intention for sphincter preservation; (7) no preoperative treatment (e.g., chemotherapy, radiotherapy, molecular targeted therapy, or immunotherapy); (8) no lateral lymph node enlargement; (9) no previous anorectal surgery; (10) patients with good basic condition who could tolerate surgery. Exclusion criteria: (1) previously suffered from malignant tumors of the digestive tract or currently suffering from malignant tumors out of the digestive tract; (2) patients with preoperative anal dysfunction (Wexner score ≥ 10), or fecal incontinence. The specific surgical steps are as follows: the distal end of the rectum was dissected to the level of the interspace between internal and external sphincters of anal canal. Five centimeters proximal to the tumor, the mesorectum was ligated, and a liner stapler was used to transect the rectum. The distal rectum with the tumor were then everted and extracted through the anus. The rectum was transected 0.5-1.0 cm distal to the tumor with a linear stapler. Full thickness suture was used to reinforce the stump of the rectum, which was then brought back into the pelvic cavity. Finally, an end-to-end anastomosis between the colon and the rectum was performed. A retrospective descriptive study was performed of the clinical and pathological data of 12 patients with T1-T2 stage low rectal cancer treated with LDER at Henan Provincial People's Hospital from January 2020 to December 2022. Results:All 12 patients successfully completed LDER with sphincter preservation, without conversion to open surgery or changes in surgical approach. The median surgical time was 272 (155-320) minutes, with a median bleeding volume of 100 (50-200) mL. No protective stoma was performed, and all patients received R0 resection. The average hospital stay was 9 (7-15) days. There were no postoperative anastomotic leakage or perioperative deaths. All 12 patients received postoperative follow-up, with a median follow-up of 12 months (6-36 months) and a Wexner score of 8 (5-14) at 6 months postoperatively. There was no tumor recurrence or metastasis during the follow-up period.Conclusions:LDER is safe and effective for the treatment of low rectal cancer.

Atherosclerosis(AS)is a common cardiovascular disease,and its treatment and prevention have been the focus of medical research.AS an emerging technology,nanotechnology has unique advantages and plays an important role in the prevention,diagnosis and treatment of AS.This paper reviews the latest research on the application of nanotechnology in AS diseases,systematically discusses the role of nanotechnology in the diag-nosis and treatment of AS,and comprehensively analyzes the effects of nano-drug carriers based on different sur-face trimmers,loading diagnostic and therapeutic drugs so as to monitordisease progression of AS and its targeted treatment.The aim is to provide new thought for the clinical treatment of AS.

Objectives:To investigate the application value of laparoscopic double stapler firings and double stapling technique combined with rectal eversion and total extra-abdominal resection (LDER) in the anal preservation treatment of low rectal cancer.Methods:Inclusion criteria: (1) age was 18-70; (2) the distance of the lower tumor edge from the anal verge was 4-5 cm; (3) primary tumor with a diameter ≤3 cm; (4) preoperative staging of T1~2N1~2M0; (5) "difficult pelvis", defined as ischial tuberosity diameter<10 cm or body mass index>25 kg/m 2; (6) patients with strong intention for sphincter preservation; (7) no preoperative treatment (e.g., chemotherapy, radiotherapy, molecular targeted therapy, or immunotherapy); (8) no lateral lymph node enlargement; (9) no previous anorectal surgery; (10) patients with good basic condition who could tolerate surgery. Exclusion criteria: (1) previously suffered from malignant tumors of the digestive tract or currently suffering from malignant tumors out of the digestive tract; (2) patients with preoperative anal dysfunction (Wexner score ≥ 10), or fecal incontinence. The specific surgical steps are as follows: the distal end of the rectum was dissected to the level of the interspace between internal and external sphincters of anal canal. Five centimeters proximal to the tumor, the mesorectum was ligated, and a liner stapler was used to transect the rectum. The distal rectum with the tumor were then everted and extracted through the anus. The rectum was transected 0.5-1.0 cm distal to the tumor with a linear stapler. Full thickness suture was used to reinforce the stump of the rectum, which was then brought back into the pelvic cavity. Finally, an end-to-end anastomosis between the colon and the rectum was performed. A retrospective descriptive study was performed of the clinical and pathological data of 12 patients with T1-T2 stage low rectal cancer treated with LDER at Henan Provincial People's Hospital from January 2020 to December 2022. Results:All 12 patients successfully completed LDER with sphincter preservation, without conversion to open surgery or changes in surgical approach. The median surgical time was 272 (155-320) minutes, with a median bleeding volume of 100 (50-200) mL. No protective stoma was performed, and all patients received R0 resection. The average hospital stay was 9 (7-15) days. There were no postoperative anastomotic leakage or perioperative deaths. All 12 patients received postoperative follow-up, with a median follow-up of 12 months (6-36 months) and a Wexner score of 8 (5-14) at 6 months postoperatively. There was no tumor recurrence or metastasis during the follow-up period.Conclusions:LDER is safe and effective for the treatment of low rectal cancer.

Objective To evaluate the potential of serum exosomal miR-148a-5p as a biomarker and to investigate its role in the pathogenesis of rheumatoid arthritis(RA).Methods A total of 80 participants(30 healthy controls,HCs;50 RA patients)were recruited.Serum exosomes were extracted and identified.The expressions of exsomal miR-148a-5p will be screened by next-generation sequencing,validated by qRT-PCR and assessed its clinical significance.Target genes and their functions were determined by the luciferase reporter assays,cell transfection,and ELISA.Results Fifty-five differentially expressed serum exomiRNAs were identified(44 upregulated,11 downregulated).The high expression of the exo-miR-148a-5p in the serum of patients with RA was validated by qRT-PCR,comparing to HCs(P<0.000 1),which showed a strong correlation with the disease activity score(DAS)28,rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)and exhibited higher sensitivity and specificity of diagnostic(AUC 0.8633,95%CI 0.77～0.95).CREB5 was the potential target gene of miR-148a-5p.CCK-8 assays showed that miR-148a-5p mimic significantly promoted proliferation of MH7A and M0 macrophages at 48 h and 72 h(P<0.005).The miR-148a-5p inhibitor inhibited proliferation of MH7A and M0 macrophage at 48 h slightly(P<0.05),and better effects shown at 72 h(P<0.001).Additionally,miR-148a-5p mimic significantly reduced CREB5 protein expression in MH7A cells and increased the levels of MMP3 and CXCL10 in culture supernatant(P<0.001),which could be reversed by miR-148a-5p inhibitor.However,miR-148a-5p had no impact on protein expression of RBMXL1 or CREB5 in M0 macrophages.Conclusion Serum exosomal miR-148a-5p is a diagnostic marker and involves in the pathogenesis of RA,which promotes MH7A cell proliferation by affecting protein levels of CREB5 and excessive secretion of MMP-3,CXCL10.

Objective To evaluate the potential of serum exosomal miR-148a-5p as a biomarker and to investigate its role in the pathogenesis of rheumatoid arthritis(RA).Methods A total of 80 participants(30 healthy controls,HCs;50 RA patients)were recruited.Serum exosomes were extracted and identified.The expressions of exsomal miR-148a-5p will be screened by next-generation sequencing,validated by qRT-PCR and assessed its clinical significance.Target genes and their functions were determined by the luciferase reporter assays,cell transfection,and ELISA.Results Fifty-five differentially expressed serum exomiRNAs were identified(44 upregulated,11 downregulated).The high expression of the exo-miR-148a-5p in the serum of patients with RA was validated by qRT-PCR,comparing to HCs(P<0.000 1),which showed a strong correlation with the disease activity score(DAS)28,rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)and exhibited higher sensitivity and specificity of diagnostic(AUC 0.8633,95%CI 0.77～0.95).CREB5 was the potential target gene of miR-148a-5p.CCK-8 assays showed that miR-148a-5p mimic significantly promoted proliferation of MH7A and M0 macrophages at 48 h and 72 h(P<0.005).The miR-148a-5p inhibitor inhibited proliferation of MH7A and M0 macrophage at 48 h slightly(P<0.05),and better effects shown at 72 h(P<0.001).Additionally,miR-148a-5p mimic significantly reduced CREB5 protein expression in MH7A cells and increased the levels of MMP3 and CXCL10 in culture supernatant(P<0.001),which could be reversed by miR-148a-5p inhibitor.However,miR-148a-5p had no impact on protein expression of RBMXL1 or CREB5 in M0 macrophages.Conclusion Serum exosomal miR-148a-5p is a diagnostic marker and involves in the pathogenesis of RA,which promotes MH7A cell proliferation by affecting protein levels of CREB5 and excessive secretion of MMP-3,CXCL10.

[This corrects the article DOI: 10.1016/j.apsb.2021.07.006.].

Given the opposing effects of Akt and AMP-activated protein kinase (AMPK) on metabolic homeostasis, this study examined the effects of deletion of Akt2 and AMPKα2 on fat diet-induced hepatic steatosis. Akt2–Ampkα2 double knockout (DKO) mice were placed on high fat diet for 5 months. Glucose metabolism, energy homeostasis, cardiac function, lipid accumulation, and hepatic steatosis were examined. DKO mice were lean without anthropometric defects. High fat intake led to adiposity and decreased respiratory exchange ratio (RER) in wild-type (WT) mice, which were ablated in DKO but not Akt2−/− and Ampkα2−/− mice. High fat intake increased blood and hepatic triglycerides and cholesterol, promoted hepatic steatosis and injury in WT mice. These effects were eliminated in DKO but not Akt2−/− and Ampkα2−/− mice. Fat diet promoted fat accumulation, and enlarged adipocyte size, the effect was negated in DKO mice. Fat intake elevated fatty acid synthase (FAS), carbohydrate-responsive element-binding protein (CHREBP), sterol regulatory element-binding protein 1 (SREBP1), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), peroxisome proliferator-activated receptor-α (PPARα), PPARγ, stearoyl-CoA desaturase 1 (SCD-1), phosphoenolpyruvate carboxykinase (PEPCK), glucose 6-phosphatase (G6Pase), and diglyceride O-acyltransferase 1 (DGAT1), the effect was absent in DKO but not Akt2−/− and Ampkα2−/− mice. Fat diet dampened mitophagy, promoted inflammation and phosphorylation of forkhead box protein O1 (FoxO1) and AMPKα1 (Ser485), the effects were eradicated by DKO. Deletion of Parkin effectively nullified DKO-induced metabolic benefits against high fat intake. Liver samples from obese humans displayed lowered microtubule-associated proteins 1A/1B light chain 3B (LC3B), Pink1, Parkin, as well as enhanced phosphorylation of Akt, AMPK (Ser485), and FoxO1, which were consolidated by RNA sequencing (RNAseq) and mass spectrometry analyses from rodent and human livers. These data suggest that concurrent deletion of Akt2 and AMPKα2 offers resilience to fat diet-induced obesity and hepatic steatosis, possibly through preservation of Parkin-mediated mitophagy and lipid metabolism.