Nonalcoholic fatty liver disease(NAFLD)is the chronic liver disease with the highest global preva-lence.It has multiple causes and complex mechanisms,and its prevalence is increasing year by year.Currently,there are still no drugs that are widely promoted and used.Quercetin possesses multiple pharmacological activities such as antioxida-tion,anti-inflammation,lipid-lowering and regulation of intestinal flora.Recent studies have shown that it can intervene in the progression of NAFLD through multiple pathways,including anti-inflammation,promotion of autophagy,inhibition of oxidative stress,attenuation of insulin resistance,regulation of endoplasmic reticulum stress and improvement of cogni-tion.In addition,quercetin can also inhibit diabetes mellitus complicated with NAFLD lesions.This article reviews the mechanism by which quercetin alleviates NAFLD,with the aim of providing a reference for the clinical prevention and treatment of NAFLD.

Nonalcoholic fatty liver disease(NAFLD)is the chronic liver disease with the highest global preva-lence.It has multiple causes and complex mechanisms,and its prevalence is increasing year by year.Currently,there are still no drugs that are widely promoted and used.Quercetin possesses multiple pharmacological activities such as antioxida-tion,anti-inflammation,lipid-lowering and regulation of intestinal flora.Recent studies have shown that it can intervene in the progression of NAFLD through multiple pathways,including anti-inflammation,promotion of autophagy,inhibition of oxidative stress,attenuation of insulin resistance,regulation of endoplasmic reticulum stress and improvement of cogni-tion.In addition,quercetin can also inhibit diabetes mellitus complicated with NAFLD lesions.This article reviews the mechanism by which quercetin alleviates NAFLD,with the aim of providing a reference for the clinical prevention and treatment of NAFLD.

Objective:To determine neutralizing antibodies against Japanese encephalitis virus (JEV) among healthy people of Southeast Gansu province, and to evaluate immunologic barrier, and provide the data for Japanese encephalitis (JE) control.Methods:Healthy people were divided into the following 3 groups: less than 14 years, 15-39 years, and above 40 years in 2018 in four cities (Pingliang city, Qingyang city, Longnan city, Tianshui city) of Southeast Gansu province. Serum samples of the participants were obtained, and JEV antibody was detected by plaque reduction neutralization assays. The JEV neutralizing antibody positive rates among different groups were compared by chi square test.Results:A total of 1 590 people were investigated. The total positive rate of JEV neutralizing antibody was 28.81%, and the geometric mean titer (GMT) of JEV neutralizing antibody was 1∶27.09. The antibody positive rates of 0-14, 15-39 and ≥ 40 years groups were 32.96%, 20.32%, 30.63%, the difference of antibody positive rates among different age groups was statistically significant ( χ2=22.29, P<0.001). The antibody positive rates in Pingliang city, Qingyang city, Longnan city, Tianshui city were 29.62%, 22.22%, 33.00%, 30.30%, the difference of antibody positive rates among cities was statistically significant( χ2=12.39, P=0.006). Conclusions:The positive rates of neutralizing antibodies against JEV was low among healthy people in Southeast Gansu province, and there is an epidemic risk of JE.

Purpose: Recently, totally laparoscopic gastrectomy has been gradually accepted by surgeons worldwide for gastric cancer treatment. Complete dissection of the lymph nodes and the establishment of the surgical margin are the most important considerations for curative gastric cancer surgery. Previous studies have demonstrated that indocyanine green (ICG)-traced laparoscopic gastrectomy significantly improves the completeness of lymph node dissection. However, it remains difficult to identify the tumor location intraoperatively for gastric cancers that are staged ≤T3. Here, we investigated the feasibility of ICG fluorescence for lymph node mapping and tumor localization during totally laparoscopic distal gastrectomy. Materials and Methods: Preoperative and perioperative data from consecutive patients with gastric cancer who underwent a totally laparoscopic distal gastrectomy were collected and analyzed. The patients were categorized into the ICG (n=61) or the non-ICG (n=75) group based on whether preoperative endoscopic mucosal ICG injection was performed. Results: The ICG group had a shorter operation time and less intraoperative blood loss.Moreover, significantly more lymph nodes were harvested in the ICG group than the non-ICG group. No pathologically positive margin was found and there was no significant difference in either the proximal or distal surgical margins between the 2 groups. Conclusions Near-infrared fluorescence imaging with ICG can be successfully used in totally laparoscopic distal gastrectomy, and it contributes to both the completeness of D2 lymph node dissection and confirmation of the gastric transection line. Well-designed prospective randomized studies are needed in the future to fully validate our findings.

Objective: To explore the value of indocyanine green fluorescence imaging in tumor localization and lymph node dissection in totally laparoscopic distal gastrectomy. Methods: A retrospective cohort study was used. The clinical and pathological data of 126 patients with distal gastric cancer diagnosed through gastroscopy and pathology dated from August 2017 to August 2019 in Peking University Cancer Hospital & Institute was collected. Among these 126 patients, 62 patients underwent laparoscopy with indocyanine green-labeled near-infrared fluorescence (observation group), and 64 patients underwent conventional laparoscopy (control group). The effects of preoperative indocyanine green-labeled, intraoperative endoscopic positioning and lymph node dissection were compared and evaluated between the two groups. Result: The distance of proximal incision margin was measured in patients with stage T1-2 gastric cancer. The observation group vs. the control group: (4.92±1.65 cm vs. 4.76±1.66 cm, P=0.671). Number of second station lymph node dissection of patients with stage T3-4 gastric cancer in the observation group vs. the control group: (11.09±6.19 vs. 8.89± 4.35, P=0.049); the number of damaged lymph nodes in the observation group vs. the control group: (0.74±0.46 vs. 1.27±1.22, P= 0.009). Conclusions: The preoperative indocyanine green-fluorescence imaging in patients with stage T1-2 gastric cancer can accurately mark the tumor boundary, and its tumor localization effect is comparable with intraoperative gastroscopy in the surgery, which can guide the decision of the appropriate resection line during total laparoscopic surgery. Indocyanine green in the lymphatic navigation of T3-4 gastric cancer can guide the operation precisely and completely in the lymph node dissection, increase the number of lymph nodes dissection, and reduce the damage of lymph nodes during the operation.

Objective To investigate the effects and mechanism of verbascoside on hypoxia-induced memory impairment.Methods The eight-arm maze was used to train mice′s spatial memory ability.After successful training, mice were randomly divided into five groups:a normoxic control group (distilled water, 0.1ml/10g), hypoxic model group (distilled water, 0.1ml/10g), the verbascoside low dose group (50 mg/kg), medium dose group (150 mg/kg), and high dose group (300mg/kg) were administered orally once a day for a total of 7days.After administration on the fourth day, except for the normoxic control group was placed in the animal room (1 500m), the remaining four groups were placed in a large-scale hypobaric chamber to simulate the hypoxic environment of the plateau (7 500m, 3days).Eight-armed maze test (4 000m) was used and the plasma and brain tissues were dissected out and measured for reactive oxygen species (ROS) in the brain, malondialdehyde (MDA), reduced glutathione (GSH) and total superoxide dismutase (T-SOD) activity in plasma and brain.Results Compared with the normoxic control group, the indexes of the eight-armed maze, ROS and MDA in the brain, MDA in the plasma of the hypoxia model group were significantly increased, and the GSH and T-SOD enzyme activities in the brain and plasma were notably decreased.Compared with the hypoxic model group, the indexes of the eight-armed maze, ROS and MDA in the brain, MDA in the plasma in the various groups of verbascoside were reduced more or less, the GSH and T-SOD enzyme activities in the brain and plasma slightly were increased.Conclusion Verbascoside could ameliorate the hypoxic memory impairment at high altitude, which might be related to the stabilization of the body′s antioxidant enzyme system balance and

OBJECTIVE: To investigate the risk factors of postoperative pulmonary infection (PPI) in patients over 60 years of age with gastric cancer after radical gastrectomy. METHODS: Clinicopathological data of 373 patients over 60 years of age who underwent radical gastrectomy at Department IV of Gastrointestinal Cancer Center, Peking University Cancer Hospital, from April 2009 to December 2016 were retrospectively collected in this case-control study. The clinicopathological characteristics of patients with postoperative pulmonary infection (including postoperative atelectasis) and those without pulmonary infection were compared. A Student t-test (reported as Mean±SD if data matching normal distribution) or Mann-Whitney U test [reported as median (quartile) if data did not conform to normal distribution] was used to analyze continuous variables. A χ² test or Fisher exact tests (reported as number and percentage) was used for categorical variables. Multivariable logistic regression was used to analyze the risk factors for pulmonary infection after operation of gastric cancer.PPI was defined as postoperative patients with elevated body temperature (>38.0 degrees centigrade) for more than 24 hours; cough and expectoration; positive sputum bacteria culture;recent infiltration, consolidation or atelectasis confirmed by chest imaging examination. RESULTS: Among 373 patients, 50 cases had PPI(13.4%, PPI group), 323 cases had no PPI(86.6%, non-PPI group). There were 39 (78.0%) and 178(55.1%) patients with comorbidities (including hypertension, diabetes and cardiopulmonary disease) preoperatively in PPI and non-PPI group, respectively. The difference between two groups was statistically significant (χ²=9.325,P=0.002). The incidence of preoperative hypoalbuminemia in PPI group was also significantly higher than that in non-PPI group [10.0%(5/50) vs. 3.1% (10/323),χ²=4.098, P=0.048]. Compared to non-PPI group, the rate of total gastrectomy [54.0%(27/50) vs. 34.4% (111/323), χ²=12.501, P=0.002], postoperative wound pain [34.0%(17/50) vs. 11.8% (38/323),χ²=16.928, P<0.001], secondary operation [6.0%(3/50) vs. 0.6% (2/323), χ²=6.032, P=0.014] and the rate of gastric tube removal later than 7 days postoperatively [96.0%(48/50) vs. 84.5%(273/323),χ²=4.811, P=0.028] were significantly higher in PPI group, respectively. The postoperative hospital stay was also prolonged in PPI group [16.0(9.5) days vs. 12.0(5.0) days, U=4 275.0, P<0.001]. Multivariate logistic regression analysis showed that preoperative comorbidities (OR=4.008, 95%CI:1.768-9.086, P=0.001), abdominal infection (OR=3.164, 95%CI:1.075-9.313, P=0.037), and wound pain (OR=3.428, 95%CI:1.557-7.548, P=0.002) were independent risk factors for PPI in patients over 60 years of age with gastric cancer. Furthermore, 50 patients with pulmonary infection were classified according to the length of latency and the type of infection. The patients with PPI latency ≤ 3 days were classified as early onset (34 cases, 68.0%), and those with latency ≥ 4 days as delayed onset (16 cases, 32.0%); PPI combined with surgical infection (including anastomotic leakage, abdominal infection, duodenal stump leakage, wound infection, etc.) was classified into mixed infection group (13 cases, 26.0%), with non-surgical infection as simple infection group (37 cases, 74.0%). The results showed that the pulmonary infection occurred 0 to 12 days (median 3 days) before surgical infection in mix infection group. The incidence of previous chronic obstructive pulmonary disease (COPD) in patients with early onset was significantly higher than that in patients with delayed onset [17.6%(6/34) vs. 0, χ²=5.005, P=0.025], and the incidence of mixed infection in patients with delayed onset was significantly higher than that in patients with early onset [50%(8/16) vs. 14.7%(5/34), χ²=6.730, P=0.009],but there was no significant difference in postoperative hospital stay between the two groups[17.0(9.8) days vs. 14.0(9.5) days, U=224.0, P=0.317]. CONCLUSIONS Postoperative pulmonary infection is common in gastric cancer patients over 60 years of age. Preoperative comorbidities, abdominal infection and wound pain are independent risk factors for postoperative pulmonary infection. Pulmonary infection within 3 days after operation is associated with preoperative COPD. For patients suffering from PPI after the 4th day,attentions should be paid to abdominal infection and anastomotic leakage.
Age Factors ; Anastomotic Leak ; etiology ; Case-Control Studies ; Gastrectomy ; adverse effects ; methods ; Humans ; Intraabdominal Infections ; etiology ; Middle Aged ; Pneumonia ; etiology ; Pulmonary Atelectasis ; etiology ; Pulmonary Disease, Chronic Obstructive ; complications ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; complications ; surgery

Objective With the development of laparoscopic surgery technique, the concept of minimally invasive surgery has gradually gained popularity. Laparoscopic minimally invasive technique applied in the treatment of gastric cancer has been recognized by surgeons. In recent years, the indocyanine green labeled near-infrared fluorescence laparoscopic technique has been gradually applied to the surgical treatment of gastric cancer. This technique overcomes the drawbacks of tactile lack of laparoscopic surgery and makes the laparoscopic surgery of gastric cancer more precise and minimally invasive. This article introduces the injection method of indocyanine green and discusses the application of fluorescent laparoscopy in gastric cancer surgery, including intraoperative tumor localization of early gastric cancer, sentinel lymph node biopsy, lymph node navigation of advanced gastric cancer, digestive tract reconstruction and gastrointestinal blood perfusion assessment during the procedure.

Objective With the development of laparoscopic surgery technique, the concept of minimally invasive surgery has gradually gained popularity. Laparoscopic minimally invasive technique applied in the treatment of gastric cancer has been recognized by surgeons. In recent years, the indocyanine green labeled near?infrared fluorescence laparoscopic technique has been gradually applied to the surgical treatment of gastric cancer. This technique overcomes the drawbacks of tactile lack of laparoscopic surgery and makes the laparoscopic surgery of gastric cancer more precise and minimally invasive. This article introduces the injection method of indocyanine green and discusses the application of fluorescent laparoscopy in gastric cancer surgery, including intraoperative tumor localization of early gastric cancer, sentinel lymph node biopsy, lymph node navigation of advanced gastric cancer, digestive tract reconstruction and gastrointestinal blood perfusion assessment during the procedure.

Objective With the development of laparoscopic surgery technique, the concept of minimally invasive surgery has gradually gained popularity. Laparoscopic minimally invasive technique applied in the treatment of gastric cancer has been recognized by surgeons. In recent years, the indocyanine green labeled near?infrared fluorescence laparoscopic technique has been gradually applied to the surgical treatment of gastric cancer. This technique overcomes the drawbacks of tactile lack of laparoscopic surgery and makes the laparoscopic surgery of gastric cancer more precise and minimally invasive. This article introduces the injection method of indocyanine green and discusses the application of fluorescent laparoscopy in gastric cancer surgery, including intraoperative tumor localization of early gastric cancer, sentinel lymph node biopsy, lymph node navigation of advanced gastric cancer, digestive tract reconstruction and gastrointestinal blood perfusion assessment during the procedure.