Hepatic ischemia/reperfusion injury (IRI) remains a critical complication contributing to graft dysfunction following liver surgery. As part of an ongoing search for hepatoprotective natural products, five previously unreported homoadamantane-type polycyclic polyprenylated acylphloroglucinols (PPAPs), named hyperhomanoons A-E (1-5), and one known analog, hypersampsone O (6), were isolated from Hypericum patulum. Among these, compound 6 demonstrated potent protective effects against CoCl₂-induced hypoxic injury in hepatocytes. Furthermore, in a murine model of hepatic IRI induced by vascular occlusion, pretreatment with 6 markedly alleviated liver damage and reduced hepatocyte apoptosis. This study is the first to identify PPAPs as promising scaffolds for the development of therapeutic agents targeting hepatic IRI, underscoring their potential as lead compounds in drug discovery efforts for ischemic liver diseases.
Reperfusion Injury/prevention & control* ; Animals ; Hypericum/chemistry* ; Phloroglucinol/administration & dosage* ; Mice ; Humans ; Male ; Liver/blood supply* ; Apoptosis/drug effects* ; Molecular Structure ; Protective Agents/pharmacology* ; Hepatocytes/drug effects* ; Mice, Inbred C57BL ; Liver Diseases/drug therapy*

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Laparoscopic pancreaticoduodenectomy(LPD) poses a high risk of intraoperative bleeding due to the complex anatomy and rich blood supply in the pancreatic head region. This paper innovatively proposes a blood flow control technique system for LPD, adopting a strategy of “priority devascularization and pre-blocking”.By first addressing the peripheral collateral blood supply and the gastroduodenal artery, and then performing dual-system pre-blocking, the dorsal pancreatic artery and the inferior pancreaticoduodenal artery are treated in situ through a combined middle and left posterior approach. This progressive blood flow control method enhances surgical safety and oncological radicality, offering a new paradigm for the development of minimally invasive pancreatic surgery.

Objective To investigate the effect of polymorphism at the-94ins/del ATTG(rs28362491)site in the promoter region of nuclear transcription factor-κB(NF-κB)1 on the lipid-lowering and anti-inflammatory efficacy of atorvastatin in patients with coronary heart disease(CHD).Methods A total of 180 patients with CHD in Jinhua People's Hospital from June 2022 to June 2024 were selected as the research objects.The genotypes of rs28362491 locus of NF-κB1 gene were detected.The levels of blood lipids and inflammatory factors before treatment,1 month and 6 months after treatment were analyzed,and the incidence of adverse reactions during treatment were observed.Results A total of 180 CHD patients underwent genetic testing and were divided into DD genotypes 46 cases,ID genotypes 76 cases,and II genotypes 58 cases.The levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),interleukin(IL)-6,IL-8,and tumor necrosis factor-α(TNF-α)in DD genotypes were higher than those in ID genotypes and Ⅱ genotypes(P<0.05).After 1month and 6 months treatment,the levels of TC,LDL-C,IL-6,IL-8,and TNF-α in three groups of patients decreased significantly compared to before treatment(P<0.05).At the same time point,the change rates of TC,LDL-C,IL-6,IL-8,and TNF-α levels in ID genotypes and Ⅱgenotypes were higher than those in DD genotypes(P<0.05).Conclusion The efficacy of atorvastatin in CHD patients is associated with the rs28362491 polymorphism of the NF-κB1 gene,with II genotypes and ID genotypes showing better efficacy than DD genotypes.

Objective To investigate the effect of polymorphism at the-94ins/del ATTG(rs28362491)site in the promoter region of nuclear transcription factor-κB(NF-κB)1 on the lipid-lowering and anti-inflammatory efficacy of atorvastatin in patients with coronary heart disease(CHD).Methods A total of 180 patients with CHD in Jinhua People's Hospital from June 2022 to June 2024 were selected as the research objects.The genotypes of rs28362491 locus of NF-κB1 gene were detected.The levels of blood lipids and inflammatory factors before treatment,1 month and 6 months after treatment were analyzed,and the incidence of adverse reactions during treatment were observed.Results A total of 180 CHD patients underwent genetic testing and were divided into DD genotypes 46 cases,ID genotypes 76 cases,and II genotypes 58 cases.The levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),interleukin(IL)-6,IL-8,and tumor necrosis factor-α(TNF-α)in DD genotypes were higher than those in ID genotypes and Ⅱ genotypes(P<0.05).After 1month and 6 months treatment,the levels of TC,LDL-C,IL-6,IL-8,and TNF-α in three groups of patients decreased significantly compared to before treatment(P<0.05).At the same time point,the change rates of TC,LDL-C,IL-6,IL-8,and TNF-α levels in ID genotypes and Ⅱgenotypes were higher than those in DD genotypes(P<0.05).Conclusion The efficacy of atorvastatin in CHD patients is associated with the rs28362491 polymorphism of the NF-κB1 gene,with II genotypes and ID genotypes showing better efficacy than DD genotypes.

Laparoscopic pancreaticoduodenectomy(LPD) poses a high risk of intraoperative bleeding due to the complex anatomy and rich blood supply in the pancreatic head region. This paper innovatively proposes a blood flow control technique system for LPD, adopting a strategy of “priority devascularization and pre-blocking”.By first addressing the peripheral collateral blood supply and the gastroduodenal artery, and then performing dual-system pre-blocking, the dorsal pancreatic artery and the inferior pancreaticoduodenal artery are treated in situ through a combined middle and left posterior approach. This progressive blood flow control method enhances surgical safety and oncological radicality, offering a new paradigm for the development of minimally invasive pancreatic surgery.

Objective:To investigate the clinical effect of proper management of inferior pancreaticoduodenal artery (IPDA) in laparoscopic pancreaticoduodenectomy (LPD).Methods:This is a retrospective case series study. The clinical and pathological data of 70 patients who received LPD due to pancreatic head tumors, periampullary tumors, or distal common bile duct tumors in the Pancreatic Center of the Second Clinical College of Guangzhou University of Chinese Medicine from January to December 2022 were retrospectively collected. There were 47 males(67.1%) and 23 females(32.9%),aged (59.9±12.8)years(range:13 to 87 years).The procedure of IPDA exposure was as follows:a middle approach was utilized to expose the right half of superior mesenteric artery(SMA) and its right branches between the SMA and superior mesenteric vein(SMV) in superior colonic region. In the subcolonic region,SMA trunk exposure via dissection along the jejunal artery from feet to head and identification the association between IPDA and jejunal artery were prior to IPDA root ligation and dissection. The safety and efficacy of intraoperative IPDA handling were assessed based on surgical videos. Follow-up was carried out in outpatient clinic or by telephone, and outpatient follow-up was conducted once every 1 to 3 months after surgery.Results:The percentage of total LPD was 98.6%(69/70),with all patients achieving R0 resection. Nine cases(12.9%) were involved in combined vascular resection and reconstruction,with 1 case (1.4%) requiring additional upper abdominal incision for vascular and gastrointestinal reconstruction,while the remaining eight cases (11.4%) were completed laparoscopically. The operative time was (432.7±115.4)minutes(range:282 to 727 minutes), and the blood loss was (140.0±125.7)ml(range:20 to 800 ml). Only two patients(2.9%) received fresh frozen plasma transfusion,with an average volume of 650 ml. Reliable ligation and safe handling of the IPDA were achieved in 91.4%(64/70) of cases, with 8.6%(6/70) suffering from IPDA injury-related bleeding. No one was converted to opened surgery. Pathologically,the mean tumor size was (3.3±1.6)cm (range:1 to 7 cm),and the mean number of harvested lymph nodes was 17.0±7.3(range:0 to 46). Lymph node metastasis was observed in 13 cases (18.6%). Five cases (13.2%) developed grade B pancreatic fistula,while no grade C pancreatic fistula occurred. Other complications included bile leakage in one case(1.4%),delayed gastric emptying in two cases(2.9%), lymphatic leakage in 2 cases(2.9%),intra-abdominal infection in 9 cases(12.9%),and fat liquefaction of surgical incision in 1 case(1.4%). Two cases(2.9%) experienced postoperative intra-abdominal bleeding,one due to mesangial bleeding of lesser curvature of the stomach and the other due to oozing from the hepatic arterial sheath. These bleeding events were not concerned with IPDA. The average length of postoperative hospital stay was (15.2±4.6)days(range:9 to 28 days).Conclusion:Proper intraoperative management of IPDA in LPD might reduce IPDA-related bleeding during and after surgery and improve the safety of LPD.

Objective:To explore the clinical and genetic etiology of a Chinese pedigree affected with type 2 Long QT syndrome (LQTS).Methods:A pedigree with type 2 LQTS presented at Fuwai Central China Cardiovascular Hospital on August 23, 2019 was selected as the study subject. Peripheral blood samples were collected from the proband and her parents. Following extraction of genomic DNA, whole exome sequencing (WES) was carried out for the proband, and candidate variant was screened through functional annotation and protein-protein interaction (PPI) analysis. Sanger sequencing was conducted to verify the pathogenicity of candidate variant. This study was approved by Medical Ethics Committee of the Fuwai Central China Cardiovascular Hospital (Ethics No. 2019-15).Results:WES revealed that the proband has harbored a missense variant of the KCNH2 gene, namely c. 1478A>G (p.Tyr493Cys), which was confirmed by Sanger sequencing to have inherited from her father. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as likely pathogenic (PM2_supporting+ PM5+ PP3+ PP4). Conclusion:The KCNH2 gene c. 1478A>G (p.Tyr493Cys) variant probably underlay the type 2 LQTS in this pedigree.

Objectives:The purpose of this study is to evaluate the impact of the cumulative workload of HUTT testing physicians on diagnostic outcomes. Methods:This study retrospectively and consecutively included the data of testing physicians and patients who underwent HUTT at Fuwai Hospital,Chinese Academy of Medical Sciences,from January 2016 to December 2022.Based on the cumulative workload of physicians during the period from the initiation of tilt tests at the hospital to the end of the study,the physicians were categorized into low (50-100 sases),moderate (100-350 sases),and high (1000-4000 sases) cumulative workload groups,the cumulatie workload of no physician is 351-999 sases.Additionally,physicians were grouped by sex,educational background,and professional title to analyze differences in diagnostic rates of tilt table test reports within and between these groups. Results:The study included 22 testing physicians and 6122 patients.There were statistically significant differences in the rates of positive,suspicious positive,and negative reports among the 22 physicians (P<0.001).The average suspicious positive report rate in the moderate cumulative workload group was significantly higher than in the low and high cumulative workload groups (3.21％ vs.1.09％ vs.1.62％,P=0.001).The suspicious positive report rate was higher in the female physician group compared to the male physician group (2.25％ vs.1.07％,P=0.017),in the undergraduate physician group compared to the postgraduate physician group (2.46％ vs.1.52％,P=0.013),and in the junior title group compared to the intermediate and senior title groups (3.40％ vs.1.75％ vs.2.53％,P=0.024).Multivariate logistic regression analysis showed that a moderate cumulative workload was an influencing factor for suspicious positive reports,regardless of whether negative or positive was used as the reference (all P<0.05). Conclusions:There are certain differences in the diagnostic report rates of HUTT among different individual physicians.Physicians with a moderate cumulative workload are more likely to issue suspicious positive HUTT diagnostic reports.

Objective:To investigate the clinical effect of proper management of inferior pancreaticoduodenal artery (IPDA) in laparoscopic pancreaticoduodenectomy (LPD).Methods:This is a retrospective case series study. The clinical and pathological data of 70 patients who received LPD due to pancreatic head tumors, periampullary tumors, or distal common bile duct tumors in the Pancreatic Center of the Second Clinical College of Guangzhou University of Chinese Medicine from January to December 2022 were retrospectively collected. There were 47 males(67.1%) and 23 females(32.9%),aged (59.9±12.8)years(range:13 to 87 years).The procedure of IPDA exposure was as follows:a middle approach was utilized to expose the right half of superior mesenteric artery(SMA) and its right branches between the SMA and superior mesenteric vein(SMV) in superior colonic region. In the subcolonic region,SMA trunk exposure via dissection along the jejunal artery from feet to head and identification the association between IPDA and jejunal artery were prior to IPDA root ligation and dissection. The safety and efficacy of intraoperative IPDA handling were assessed based on surgical videos. Follow-up was carried out in outpatient clinic or by telephone, and outpatient follow-up was conducted once every 1 to 3 months after surgery.Results:The percentage of total LPD was 98.6%(69/70),with all patients achieving R0 resection. Nine cases(12.9%) were involved in combined vascular resection and reconstruction,with 1 case (1.4%) requiring additional upper abdominal incision for vascular and gastrointestinal reconstruction,while the remaining eight cases (11.4%) were completed laparoscopically. The operative time was (432.7±115.4)minutes(range:282 to 727 minutes), and the blood loss was (140.0±125.7)ml(range:20 to 800 ml). Only two patients(2.9%) received fresh frozen plasma transfusion,with an average volume of 650 ml. Reliable ligation and safe handling of the IPDA were achieved in 91.4%(64/70) of cases, with 8.6%(6/70) suffering from IPDA injury-related bleeding. No one was converted to opened surgery. Pathologically,the mean tumor size was (3.3±1.6)cm (range:1 to 7 cm),and the mean number of harvested lymph nodes was 17.0±7.3(range:0 to 46). Lymph node metastasis was observed in 13 cases (18.6%). Five cases (13.2%) developed grade B pancreatic fistula,while no grade C pancreatic fistula occurred. Other complications included bile leakage in one case(1.4%),delayed gastric emptying in two cases(2.9%), lymphatic leakage in 2 cases(2.9%),intra-abdominal infection in 9 cases(12.9%),and fat liquefaction of surgical incision in 1 case(1.4%). Two cases(2.9%) experienced postoperative intra-abdominal bleeding,one due to mesangial bleeding of lesser curvature of the stomach and the other due to oozing from the hepatic arterial sheath. These bleeding events were not concerned with IPDA. The average length of postoperative hospital stay was (15.2±4.6)days(range:9 to 28 days).Conclusion:Proper intraoperative management of IPDA in LPD might reduce IPDA-related bleeding during and after surgery and improve the safety of LPD.