Asia-Pacific Association for the Study of the Liver published the guidelines on management of ascites in liver disease in May 2023， which introduces the diagnosis， differential diagnosis， and treatment of ascites， hyponatremia， hepatic hydrothorax， and hepatorenal syndrome in patients with liver cirrhosis and acute-on-chronic liver failure. This article summarizes the main recommendations in the guidelines， so as to provide a reference for the treatment of ascites in patients with liver diseases in China.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

METTL3 and METTL14 are two components that form the core heterodimer of the main RNA m6A methyltransferase complex (MTC) that installs m6A. Surprisingly, depletion of METTL3 or METTL14 displayed distinct effects on stemness maintenance of mouse embryonic stem cell (mESC). While comparable global hypo-methylation in RNA m6A was observed in Mettl3 or Mettl14 knockout mESCs, respectively. Mettl14 knockout led to a globally decreased nascent RNA synthesis, whereas Mettl3 depletion resulted in transcription upregulation, suggesting that METTL14 might possess an m6A-independent role in gene regulation. We found that METTL14 colocalizes with the repressive H3K27me3 modification. Mechanistically, METTL14, but not METTL3, binds H3K27me3 and recruits KDM6B to induce H3K27me3 demethylation independent of METTL3. Depletion of METTL14 thus led to a global increase in H3K27me3 level along with a global gene suppression. The effects of METTL14 on regulation of H3K27me3 is essential for the transition from self-renewal to differentiation of mESCs. This work reveals a regulatory mechanism on heterochromatin by METTL14 in a manner distinct from METTL3 and independently of m6A, and critically impacts transcriptional regulation, stemness maintenance, and differentiation of mESCs.
Animals ; Mice ; Methylation ; Chromatin ; Histones/metabolism* ; RNA, Messenger/genetics* ; Methyltransferases/metabolism* ; RNA/metabolism*

Objective:To evaluate the feasibility and safety of a novel transjugular intrahepatic portosystemic shunt (TIPS) puncture set for transjugular intrahepatic portal puncture in swine.Methods:Thirteen domestic swine were randomly divided into experimental group ( n=7) and control group ( n=6) and received transjugular intrahepatic portal puncture with the novel puncture set and the R?sch-Uchida Transjugular Liver Access Set (RUPS-100), respectively. Three swines in each group were randomly selected and sacrificed immediately after the procedure and the rest were sacrificed 1 week later. The intraoperative technical success rate, puncture attempts, procedure time, fluoroscopy time, vital signs and occurrence of complications related to the procedure as well as the changes of liver and kidney function before, immediately after and 1 week after the procedure were compared between two groups. Independent sample t test, paired t test, Mann-Whitney U test, chi-square test or Fisher′s exact test were performed to compare the differences between groups. Results:The technical success rate was 100% for both groups. No significant difference in portal puncture attempts [2.0 (1.0, 5.0) vs. 2.0(1.0, 5.5), P>0.999], procedure time [(47.7±20.6) vs. (52.5±28.0)min, P=0.729] and fluoroscopy time [(725.1±489.2) vs. (763.7±562.4)s, P=0.897] was observed between two groups. In addition, no significant difference of the major liver and kidney function between two groups before, immediately after and 1 week after procedure ( P>0.05 at all time points). No significant difference of the major liver and kidney function change in two groups during perioperative period was identified (all P>0.05). Furthermore, no significant difference of non-target puncture occurrence was observed between two groups ( P>0.999). In the meantime, no significant difference of occurrence of small hematomas around hepatic hilar was discovered among swine sacrificed immediately after procedure between two groups ( P>0.999). No other major complications were identified in either group. Conclusion:The novel TIPS puncture set is feasible and safe to perform transjugular intrahepatic portal puncture in swine.

Objective:To investigate the preventive efficacy of pirfenidone in esophageal stent-related restenosis and the related underlying mechanisms.Methods:Twenty-four rats underwent esophageal stent placement were included in this study. The rats were randomly assigned to three groups, with 8 rats in each group. The three groups were set to receive placebo, 150 mg/kg pirfenidone and 300 mg/kg pirfenidone daily by oral administration for 28 days, respectively. Twenty-eight days after stent placement, the stented esophagi were harvested for histological examinations. The number of epithelial layers, the thickness of submucosal fibrosis, the percentage of granulation tissue area, the degree of inflammatory cell infiltration, the degree of collagen deposition, and the α-SMA staining scores were evaluated. One-way ANOVA was performed for the statistical comparison of the number of epithelial layers, the degree of inflammatory cell infiltration, the degree of collagen deposition and the α-SMA staining scores among these three groups. The Kruskal-Wallis H test was used for comparison of the thickness of submucosal fibrosis and the percentage of granulation tissue area among the three groups. Results:Gross pathological findings showed that both pirfenidone groups had significantly less luminal fibrotic tissue formation and restenosis than placebo group. The percentage of granulation tissue areas in placebo group, 150 mg/kg and 300 mg/kg pirfenidone groups were 57.23%±25.68%, 21.80%±6.65% and 12.18%±6.37%, respectively. Both pirfenidone groups showed significantly less granulation tissue areas than placebo group ( P<0.01). The degree of inflammatory cell infiltration, the degree of collagen deposition and the α-SMA staining scores were 3.28±0.55, 3.38±0.63 and 2.75±0.38 in placebo group, 2.30±0.46, 2.36±0.58 and 2.00±0.42 in 150 mg/kg pirfenidone group, and 1.86±0.38, 1.91±0.41 and 1.57±0.28 in 300 mg/kg pirfenidone group, respectively. Both pirfenidone groups showed significantly less inflammatory cell infiltration, collagen deposition and α-SMA staining scores than placebo group ( P<0.01). Conclusion:Pirfenidone can suppress esophageal stent-related restenosis in rats by significantly inhibiting inflammation, myofibroblast activation and proliferation, and fibrotic tissue formation.

Objective:To discuss the safety and feasibility of transradial access (TRA) in performing peripheral arterial intervention.Methods:The clinical data of the patients underwent peripheral vascular intervention via TRA in our hospital from September 2017 to March 2019 were reviewed. The success rate of radial artery puncture and subsequent operation after puncture, and related postoperative complications within 30 days were analyzed.Results:The clinical data of 112 peripheral arterial intervention procedures via TRA performed on 106 patients were reviewed, including transcatheter arterial chemoembolization in 83 cases, bronchial arterial infusion in 4 cases, pelvic tumor embolization in 11 cases and 14 other cases. The success rate of all interventional punctures was 97.3% (109/112), the operative success rate of interventional procedures was 98.2% (107/109). The TRA operation was failed in 5 patients, who were then converted to receive the femoral artery puncture and complete successfully. The severe complication of the operation was aortic dissection (2 cases). Minor complications included 2 cases of radial artery occlusion, radial artery spasm, arm pain and puncture point hematoma for each case. The severe complication and the minor complication rates were 1.8% (2/112) and 4.5% (5/112), respectively. Sixteen emergency operations were performed successfully, and no complication occurred.Conclusion:The TRA is a clinically safe and feasible approach for peripheral arterial interventional procedure.

Objective:To discuss the safety and feasibility of transradial access (TRA) in performing peripheral arterial intervention.Methods:The clinical data of the patients underwent peripheral vascular intervention via TRA in our hospital from September 2017 to March 2019 were reviewed. The success rate of radial artery puncture and subsequent operation after puncture, and related postoperative complications within 30 days were analyzed.Results:The clinical data of 112 peripheral arterial intervention procedures via TRA performed on 106 patients were reviewed, including transcatheter arterial chemoembolization in 83 cases, bronchial arterial infusion in 4 cases, pelvic tumor embolization in 11 cases and 14 other cases. The success rate of all interventional punctures was 97.3% (109/112), the operative success rate of interventional procedures was 98.2% (107/109). The TRA operation was failed in 5 patients, who were then converted to receive the femoral artery puncture and complete successfully. The severe complication of the operation was aortic dissection (2 cases). Minor complications included 2 cases of radial artery occlusion, radial artery spasm, arm pain and puncture point hematoma for each case. The severe complication and the minor complication rates were 1.8% (2/112) and 4.5% (5/112), respectively. Sixteen emergency operations were performed successfully, and no complication occurred.Conclusion:The TRA is a clinically safe and feasible approach for peripheral arterial interventional procedure.

Objective:To investigate the effect of long-chain non coding RNA (lncrna) loc730101 in the proliferation, invasion and migration of U2OS cells, and its mechanism.Methods:From February, 2019 to October, 2019, U2OS cells cultured in vitro were divided into control group (normal culture), negative group (transfection nega- tive control), and interference group (transfection of interference sequences targeting LOC730101). The expression of LOC730101 in cells was detected by reverse transcription-polymerase chain reaction (RT-PCR). Cell proliferation ac tivity was tested by methylthiazolyldiphenyl-tetrazolium bromide (MTT) method. Cell clone formation rate was mearused by plate clone formation test. Cell cycle distribution was tested by flow cytometry. Cell invasion and migra- tion were examed by Transwell chamber. The expression levels of epithelial-mesenchymal transition-related proteins Vimentin, N-cadherin, E-cadherin, and Wnt/β-catenin signaling pathway related proteins in cells β-catenin, c-Myc, cyclin D1(CyclinD1) and matrix metalloproteinase-7(MMP-7) proteins were detected by Western blotting method. The date was statistical analysed and considered as statistically significant when P<0.05. Results:Compared with the control group, the expression level of LOC730101 (0.25±0.03 and 1.00±0.06) in interference group and control group, respectively. The same below), cell survival rate [(57.65±3.26)% and (100.00±7.39)%], clone formation rate [(13.03± 2.12)% and (25.35±3.58)%], number of invasive cells(51.36±3.48 and 92.85±6.62), number of migrating cells (77.15± 5.05 and 136.92±15.35), the percentage of cells in S phase [(20.54±2.15)% and (28.15±2.38)%] and G 2/M phase [(16.87±2.12)% and (23.36±3.12)%], as well as the expression level of Vimentin (0.52±0.04 and 1.17±0.13), N-cadherin (0.31±0.03 and 0.65±0.04), β-catenin (0.42±0.03 and 0.73±0.04), c-Myc (0.29±0.03 and 0.65±0.03), CyclinD1 (0.26± 0.02 and 0.58±0.04), MMP-7 protein (0.55±0.03 and 0.86±0.06) was decreased significantly ( P<0.05), while the per- centage of cells in G 0/G 1 phase [(62.62±5.15)% and (48.46±3.65)%] and the expression level of E-cadherin protein(0.82± 0.06 and 0.38±0.03) were increased significantly in the interference group ( P<0.05). But there was no significant differ- ence in each index in the negative group ( P>0.05). Conclusion:Reduce the regulation of LOC730101 can inhibit the proliferation, invasion and migration of U2OS cells, and its mechanism may be related to the inhibition of Wnt/β-catenin signaling pathway.

Objective: To present the evolutionary path of Chinese Medical Ethics, analyze the development vein of periodical, explore the journal' s research focuses, and provide reference for related personnel to understand the development of the current research status in the field through visualization technology. Methods:Using biblio-metric method,taking "China National Knowledge Infrastructure" as source of data collection, we used the visual-ization software CiteSpace to draw scientific knowledge maps and analyzed literatures published from 1990 to 2014 in Chinese Medical Ethics. Results:The annualvolume of journal articles fluctuated upwards,with peaks in 1992, 2000 and 2009, and of which the most was in 2009, with 393 articles. "Medical Ethics" and "Doctor-patient Relationship" were hotwords in this field. The publications of domestic and foreign scholars promoted the interna-tional exchange and the development of Chinese medical ethics, and the most productive institutions were often col-leges or universities. Conclusion:Chinese Medical Ethics has effectively promoted the development of bioethics in China, more and more scholars are involved in the relative research of medical ethics, and the old, middle and young scientists and research teams inherit, cooperate and develop with each other. The cross-regional, inter-a-gency and interdisciplinary collaboration remains very limited, whichwill become the important factorinfluencingthe development of the field of Chinese medical ethics in the future.

Objective To observe the efficacy ofvitrectomy combined with internal limiting membrane (ILM) peeling and scleral shortening for myopic foveoschisis (MF).Methods Prospective and non-randomized concurrent control study.A total of 35 MF patients (35 eyes) were enrolled in this study.The patients were divided into 2 groups according to surgery,including group A (18 eyes) and group B (17 eyes),all received vitrectomy combined with ILM peeling,but group A also received scleral shortening.The best corrective visual acuity (BCVA) examination using the Snellen vision chart was converted to the minimum resolution logarithm (logMAR).Ocular axis length (AL) was measured by Zeiss IOL-Master or A-scan ultrasound (Quantel Medical,France).The maximal value of retinal foveoschisis (MxFT) was measured by frequency-domain optical coherence tomography (Heidelberg,Germany).Multifocal electroretinogram (mfERG) responses were obtained with the RETIscan system (Roland Consult,Gemany).There was no statistically significant difference between the two groups (P＞0.05) in age (t=0.460),AL (t=1.520),diopter (t=0.020),logMAR BCVA (t=-2.280),MxFT (Z=-4.179) and b-wave ERG amplitude (Z=-0.198).The changes of BCVA,AL,MxFT and b wave amplitude were followed-up for 3-12 months.Results At the last follow-up,the height of MF was decreased in 18 eyes of group A,and MF was completely disappeared in 4 eyes.The logMAR BCVA (t=7.272,5.951),MxFT (Z=-3.724,-3.622) and b-wave ERG amplitude (Z=-3.223,-3.243) in both groups A and B were statistically improved (P=0.000,0.000,0.000,0.000,0.001,0.001) compared to pre-operational results.There was significant difference of logMAR BCVA (t=-2.280) and MxFT (Z=-4.179) between the two groups (P=0.029,0.000).But there was no significant difference in the amplitude of b-wave (Z=-0.198,P=0.843).The AL in group A was shortened after surgery,the difference was statistically significant (t=10.017,P=0.000).During the follow-up,there was no ocular hemorrhage,endophthalmitis and other complications.Conclusion PPV combined with ILM peeling and scleral shortening can shorten AL significantly for MF patients,and gain relative normal anatomical structure of the fovea,thus improve the vision.