OBJECTIVE To explore the mechanism of Chaiqi yigan granules （CQYG） against liver cancer through the ferroptosis pathway. METHODS Network pharmacology combined with ferroptosis-related database was used to screen key targets and main effective components of CQYG against liver cancer via regulating ferroptosis； molecular docking technology was employed to analyze the binding ability of main active components to key targets. Human liver Huh-7 cells were divided into blank serum control （CON） group， CQYG drug-containing serum （CQYGKL） group， ferroptosis inducer （RSL3） group， mammalian target of rapamycin complex 1 （mTORC1） inhibitor （RMC-5552） group， mTORC1 agonist （CCT007093） group， and CCT007093+CQYGKL group. The levels of Fe 2+ ， malondialdehyde （MDA）， and glutathione （GSH） in the cells were detected in the former three groups； mRNA expressions of mammalian target of rapamycin （mTOR）， sterol regulatory element-binding protein 1 （SREBP1）， and stearoyl-CoA desaturase 1 （SCD1）， protein expressions of SREBP1 and SCD1 as well as phosphorylation levels of mTOR and ribosomal S6 kinase （S6K） proteins were detected in all groups. RESULTS Key targets of CQYG for anti-liver cancer through the ferroptosis pathway were mTOR， SREBP1， SCD1，etc. The main active components included quercetin， tanshinone Ⅱ A ， baicalein， etc. The binding energies of main active components to key targets were all less than －5 kJ/mol. Compared with CON group， the levels of Fe 2+ and MDA in the cells in CQYGKL group and RSL3 group were significantly increased， while the levels of GSH were significantly decreased （ P ＜0.05）. mRNA expressions of mTOR， SREBP1 and SCD1， protein expressions of SREBP1 and SCD1， as well as the phosphorylation levels of mTOR and S6K proteins were significantly decreased in the CQYGKL group， RSL3 group， and RMC-5552 group， whereas all the above indicators were significantly increased in the CCT007093 group （ P ＜0.05）. Compared with CCT007093 group， the changes in all the above indicators were significantly suppressed in the CCT007093+CQYGKL group （ P ＜0.05）. CONCLUSIONS CQYG may induce ferroptosis by inhibiting mTORC1/SREBP1/SCD1 axis， thereby exerting anti-liver cancer effects.

Objective To explore the MRI and clinical features of squamous carcinoma transformation-mature teratoma(SCT-MT)of the ovary.Methods The pre-operative data from 7 patients with SCT-MT confirmed by surgery and pathology were collected.The MRI features(such as location,morphology,size,signal,boundaries,and the presence of a mural nodule,with or without fat or calcifi-cation,limited diffusion,transmural growth,and angle to the cyst wall)and clinical features(including age,clinical manifestations,serologi-cal markers,pelvic effusion,peripheral tissue infiltration,and lymph node metastasis)were retrospectively analyzed.Results Among the seven SCT-MT,all originated unilaterally,and were cystic-solid masses with a predominantly cystic component of round or round-like appearance.Six cases had well-defined boundaries,and six exhibited fat-fluid levels.The tumor sizes ranged from 9 cm to 17 cm.Seven cases showed mural nodules,without calcification and fat,with limited diffusion,and the mean apparent diffusion coefficient(ADC)value was(0.96±0.11)× 10-3 mm2/s.Six cases showed transmural growth,and the angle between the nodule and the cyst wall was obtuse in 5 cases,and the mural nodules were significantly enhanced.The seven SCT-MT patients ranged in age from 53 to 75 years old.Four patients had clinical manifestations of pain related to pelvic distension.Conclusion SCT-MT MRI typically presents as a unilateral large solid mass in the pelvic cavity,with a predominantly cystic component.The mural nodules within it lack calcification or fat,show limited diffusion,and may breech the wall and infiltrate adjacent structures,with significant enhancement.Furthermore,SCT-MT may be associated with older age and elevated serological markers.

Objective To explore the MRI findings and clinical features of ovarian endometrioid carcinoma(OEC).Methods The preoperative data from 23 patients with surgical pathologic evidence of OEC were collected.The MRI signs[including shape,size,signal,enhancement mode,height of mural nodule,width,height-to-width ratio(HWR)],and apparent diffusion coefficient(ADC)value,as well as clinical features(including age,clinical manifestations,serological markers,pelvic effusion,lymph node metastasis,endometrial cancer,and endometriosis)were retrospectively analyzed.Results Among the 23 cases of OEC,21 exhibited cystic-solid masses with single cyst,and 20 cases displayed well-defined boundaries.The tumor sizes ranged from 4.3 to 17.5 cm.Lymph node metastasis was observed in 4 cases.Thirteen cases were accompanied by pelvic effusion.Additionally,6 cases(26%)with endometrial cancer,and 10 cases(43%)with endometriosis.Elevated CA125 levels were detected in 21 cases(91%),and elevated HE4 levels were found in 18 cases(78%).Regarding the cystic components of the tumors,both T2WI and fat suppression(FS)T2WI showed high signal intensity.In 9 cases,slightly high T1WI signal was detected with no enhancement,and mild enhancement was detected of the cyst wall.The mural nodule of the tumor were predominantly multifocal and wide-based,appearing isointense on T1WI and isoin-tense to slightly hyperintense on T2WI.They was measured with height of 1.8-10.3 cm,widths ranged from 2.7 to 10.6 cm,HWR of 0.68±0.15,high signal on diffusion weighted imaging(DWI),ADC values of(0.937±0.14)×10-3 mm2/s,and mainly showed progressive moderate to significant enhancement.Conclusion OEC typically exhibit a single cyst with multiple mural nodules.The mural nodules are predominantly multifocal and wide-based,with HWR of less than 0.69,limited diffusion,and moderate to signifi-cant enhancement.The enhancement of the parenchymal components is more pronounced than that of the cyst wall.Furthermore,OEC may be accompanied by pelvic effusion,endometrial cancer,endometriosis,and elevated serological markers.

Objective To explore the MRI findings and clinical features of ovarian endometrioid carcinoma(OEC).Methods The preoperative data from 23 patients with surgical pathologic evidence of OEC were collected.The MRI signs[including shape,size,signal,enhancement mode,height of mural nodule,width,height-to-width ratio(HWR)],and apparent diffusion coefficient(ADC)value,as well as clinical features(including age,clinical manifestations,serological markers,pelvic effusion,lymph node metastasis,endometrial cancer,and endometriosis)were retrospectively analyzed.Results Among the 23 cases of OEC,21 exhibited cystic-solid masses with single cyst,and 20 cases displayed well-defined boundaries.The tumor sizes ranged from 4.3 to 17.5 cm.Lymph node metastasis was observed in 4 cases.Thirteen cases were accompanied by pelvic effusion.Additionally,6 cases(26%)with endometrial cancer,and 10 cases(43%)with endometriosis.Elevated CA125 levels were detected in 21 cases(91%),and elevated HE4 levels were found in 18 cases(78%).Regarding the cystic components of the tumors,both T2WI and fat suppression(FS)T2WI showed high signal intensity.In 9 cases,slightly high T1WI signal was detected with no enhancement,and mild enhancement was detected of the cyst wall.The mural nodule of the tumor were predominantly multifocal and wide-based,appearing isointense on T1WI and isoin-tense to slightly hyperintense on T2WI.They was measured with height of 1.8-10.3 cm,widths ranged from 2.7 to 10.6 cm,HWR of 0.68±0.15,high signal on diffusion weighted imaging(DWI),ADC values of(0.937±0.14)×10-3 mm2/s,and mainly showed progressive moderate to significant enhancement.Conclusion OEC typically exhibit a single cyst with multiple mural nodules.The mural nodules are predominantly multifocal and wide-based,with HWR of less than 0.69,limited diffusion,and moderate to signifi-cant enhancement.The enhancement of the parenchymal components is more pronounced than that of the cyst wall.Furthermore,OEC may be accompanied by pelvic effusion,endometrial cancer,endometriosis,and elevated serological markers.

Objective To explore the MRI and clinical features of squamous carcinoma transformation-mature teratoma(SCT-MT)of the ovary.Methods The pre-operative data from 7 patients with SCT-MT confirmed by surgery and pathology were collected.The MRI features(such as location,morphology,size,signal,boundaries,and the presence of a mural nodule,with or without fat or calcifi-cation,limited diffusion,transmural growth,and angle to the cyst wall)and clinical features(including age,clinical manifestations,serologi-cal markers,pelvic effusion,peripheral tissue infiltration,and lymph node metastasis)were retrospectively analyzed.Results Among the seven SCT-MT,all originated unilaterally,and were cystic-solid masses with a predominantly cystic component of round or round-like appearance.Six cases had well-defined boundaries,and six exhibited fat-fluid levels.The tumor sizes ranged from 9 cm to 17 cm.Seven cases showed mural nodules,without calcification and fat,with limited diffusion,and the mean apparent diffusion coefficient(ADC)value was(0.96±0.11)× 10-3 mm2/s.Six cases showed transmural growth,and the angle between the nodule and the cyst wall was obtuse in 5 cases,and the mural nodules were significantly enhanced.The seven SCT-MT patients ranged in age from 53 to 75 years old.Four patients had clinical manifestations of pain related to pelvic distension.Conclusion SCT-MT MRI typically presents as a unilateral large solid mass in the pelvic cavity,with a predominantly cystic component.The mural nodules within it lack calcification or fat,show limited diffusion,and may breech the wall and infiltrate adjacent structures,with significant enhancement.Furthermore,SCT-MT may be associated with older age and elevated serological markers.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective To explore the feasibility of minimally invasive autopsy by natural orifice transluminal endoscopic surgery.Methods Autopsy was performed on a deceased patient with COVID-19 via transesophageal,transtrachea,and transgastric natural orifice transluminal endoscopic surgery.The white light endoscopic manifestations of the corresponding organs were observed,and organ tissue specimens were obtained for routine pathological examination.Results All four pathways reached the corresponding organs successfully.Diffuse congestion and submucous bleeding were seen in the trachea,bronchus and bronchus of the pulmonary lobes.The bronchus of the left lower lobe was filled with dark red sputum;the surface of the left lung was congested obviously.Four thrombi and plaque rupture were seen on the aortic wall.The gastric mucosa was congested,eroded,and had active ulcers.The surface of heart and liver was smooth.Small lamellar panniculitis was seen in the omentum.Routine pathology showed chronic inflammation with acute inflammation of the bronchial mucosa and inflammatory exudation,and partial squamous metaplasia of the epithelium.In lung tissue,some alveolar epithelial hyperplasia,a little fibrin-like exudation,widened alveolar septa,and infiltration of acute and chronic inflammatory cells were seen.The columnar epithelial mucosa of the gastric mucosa showed chronic inflammation with acute inflammation and exudates and fungal masses.Conclusion Natural orifice transluminal endoscopic surgery is feasible for autopsy,and covid-19 virus can cause multi-system and multi-organ damage.

Objective:To investigate the preventive and therapeutic effects of epigallocatechin gallate (EGCG) on tetracycline-induced acute drug-induced liver injury (DILI) in mice.Methods:Thirty-two BALB/C mice were divided into four groups, with eight mice in each group. The normal group was raised under conventional condition. Tetracycline-induced acute DILI models were established by intraperitoneal injection of tetracycline in the model group, the blank control group was intraperitoneally injected with equivalent 0.9% NaCl soluation, and EGCG prevention/treatment group was treated with EGCG on the basis of modeling. Blood samples, feces, liver and intestinal tissues of mice were obtained and analyzed by flow cytometry, biochemical test, pathological examination, and 16S rRNA sequencing. The effects of EGCG on gut microbiota, serum lipopolysaccharides (LPS) and transaminase, CD64 expression in intestinal mucosa, hepatic macrophage typing, and hepatic steatosis were evaluated. One-way analysis of variance was performed for analysis of significant difference among groups, and independent sample t test was used for further pairwise comparison. Results:Intraperitoneal injection of tetracycline-caused disorder of gut microbiota in the model group with hepatocytes showing steatosis grade 3 in 7 mice and grade 4 in 1 mouse. The serum level of LPS in model group was significantly higher than that of normal group ( (5.50±0.20) EU/L vs. (3.96±0.19) EU/L) and by the gut-liver axis which caused M1-type macrophages in liver tissues more than that of normal group ((40.00±2.91)% vs. (36.12±2.53)%), and the differences were statistically significant( t=15.83, 2.46; P<0.001, =0.034), and CD64 expression in intestinal mucosa also increased. EGCG intervention altered the gut microbiota in mice with tetracycline-induced acute DILI. The Shannon index and Simpson index of the model group were lower than those of the normal group (4.98±0.56 vs. 5.62±0.47, 0.91±0.03 vs. 0.95±0.02), while the Shannon index (4.08±0.62) and Simpson index (0.83±0.07) of the EGCG prevention/treatment group were lower than those of the model group. The differences were statistically significant ( t=-2.30, -2.85, -2.85, 2.82; P=0.038, 0.013, 0.013, 0.014). Compared with those of the model group, liver pathological changes of EGCG prevention/treatment group improved significantly (grade 2 in 8 mice), the serum level of LPS((4.22±0.17) EU/L) decreased, and the difference was statistically significant( t=-13.63, P<0.001), but had no significant effects on the CD64 expression in intestinal mucosa. Hepatic macrophage typing was compared between EGCG prevention/treatment group and model group, M2-type macrophages promoting repair were predominant in EGCG prevention/treatment group (M2-type macrophoges ratio: (6.20±0.17)% vs. (4.74±0.48)%, t=2.84, P=0.017; M1/M2-type macrophages ratio: 6.20±1.25 vs. 8.48±0.66, t=-4.95, P=0.001). Conclusion:EGCG alleviates tetracycline-induced acute DILI by altering gut microbiota to modulate liver innate immune system.

Objective:To investigate the preventive and therapeutic effects of epigallocatechin gallate (EGCG) on tetracycline-induced acute drug-induced liver injury (DILI) in mice.Methods:Thirty-two BALB/C mice were divided into four groups, with eight mice in each group. The normal group was raised under conventional condition. Tetracycline-induced acute DILI models were established by intraperitoneal injection of tetracycline in the model group, the blank control group was intraperitoneally injected with equivalent 0.9% NaCl soluation, and EGCG prevention/treatment group was treated with EGCG on the basis of modeling. Blood samples, feces, liver and intestinal tissues of mice were obtained and analyzed by flow cytometry, biochemical test, pathological examination, and 16S rRNA sequencing. The effects of EGCG on gut microbiota, serum lipopolysaccharides (LPS) and transaminase, CD64 expression in intestinal mucosa, hepatic macrophage typing, and hepatic steatosis were evaluated. One-way analysis of variance was performed for analysis of significant difference among groups, and independent sample t test was used for further pairwise comparison. Results:Intraperitoneal injection of tetracycline-caused disorder of gut microbiota in the model group with hepatocytes showing steatosis grade 3 in 7 mice and grade 4 in 1 mouse. The serum level of LPS in model group was significantly higher than that of normal group ( (5.50±0.20) EU/L vs. (3.96±0.19) EU/L) and by the gut-liver axis which caused M1-type macrophages in liver tissues more than that of normal group ((40.00±2.91)% vs. (36.12±2.53)%), and the differences were statistically significant( t=15.83, 2.46; P<0.001, =0.034), and CD64 expression in intestinal mucosa also increased. EGCG intervention altered the gut microbiota in mice with tetracycline-induced acute DILI. The Shannon index and Simpson index of the model group were lower than those of the normal group (4.98±0.56 vs. 5.62±0.47, 0.91±0.03 vs. 0.95±0.02), while the Shannon index (4.08±0.62) and Simpson index (0.83±0.07) of the EGCG prevention/treatment group were lower than those of the model group. The differences were statistically significant ( t=-2.30, -2.85, -2.85, 2.82; P=0.038, 0.013, 0.013, 0.014). Compared with those of the model group, liver pathological changes of EGCG prevention/treatment group improved significantly (grade 2 in 8 mice), the serum level of LPS((4.22±0.17) EU/L) decreased, and the difference was statistically significant( t=-13.63, P<0.001), but had no significant effects on the CD64 expression in intestinal mucosa. Hepatic macrophage typing was compared between EGCG prevention/treatment group and model group, M2-type macrophages promoting repair were predominant in EGCG prevention/treatment group (M2-type macrophoges ratio: (6.20±0.17)% vs. (4.74±0.48)%, t=2.84, P=0.017; M1/M2-type macrophages ratio: 6.20±1.25 vs. 8.48±0.66, t=-4.95, P=0.001). Conclusion:EGCG alleviates tetracycline-induced acute DILI by altering gut microbiota to modulate liver innate immune system.

ObjectiveA high-risk group of diabetes in a community in Shanghai was followed up for 2 years. The level of blood glucose control was monitored， the incidence and risk factors of the high-risk group were analyzed， and the incidence and risk factors distribution in the community were studied. The results will provide a basis for the community to formulate strategies for early prevention and treatment of diabetes in Shanghai. MethodsA total of 580 subjects were collected， according to the criteria of high-risk groups of diabetes. Among them， 77 people whose blood glucose had reached the diagnostic criteria for diabetes entered the patient group， and the rest 503 people entered the high-risk group. Corresponding intervention methods such as outpatient follow-up and health education were given， and blood glucose monitoring was repeated at the 12th month and 24th month after enrollment. Blood glucose control， new-onset diabetes and the effect of intervention were analyzed. ResultsThe patients’ venous fasting blood glucose level at the 12th and 24th month was significantly lower than that at the baseline survey， and there was no significant change in body mass index （BMI） and waist circumference. Subjects in patient group were older and had a higher proportion of a history of impaired glycemic regulation， family history of diabetes， hypertension， and hyperlipidemia than those in high-risk group. In the high-risk group of 503 cases， 74 （14.7%） were new-onset diabetics during the follow-up period， A higher proportion of new-onset diabetics were male， BMI， a combined history of impaired glucose regulation and gestational diabetes history of gestational diabetes mellitus （women only） was a contributing factor to the onset of diabetes. ConclusionHigh-risk groups are more susceptible to diabetes； patients in the diabetes group have better control of fasting blood glucose levels during the 2-year follow-up period， and outpatient follow-up combined with comprehensive interventions helps diabetic patients to control blood glucose.