Objective: To examine the clinical value of fluorescence-guided indocyanine green (ICG) laparoscopic anatomical hepatectomy in the treatment of primary hepatocellular carcinoma. Methods: Data from patients diagnosed with hepatocellular carcinoma and who underwent laparoscopic hepatectomy with ICG fluorescence navigation in the Department of Liver Surgery and Liver Transplantation Center of West China Hospital between September 2020 and May 2022 were retrospectively collected. There were 53 males and 19 females, with an age of (55.5±12.9)years(range:42.6 to 68.4 years). Among them, 13 of the cases underwent laparoscopic anatomical liver resection(LALR) guided by tans-arterial ICG,43 of the cases received LAIR guided by portal vein negative ICG, and 16 of the cases received LALR positive by portal vein. Comparison among the three groups was performed by one-way ANOVA; and the rank sum test was used for comparison between groups. The counting data was expressed as percentage,and the χ² test or Fisher's exact probability method was used for comparison between groups. Results: (1) Postoperative pathology: Resection R0 was achieved in all operations. The maximum tumor diameter of the patients in the arterial staining group, the reverse staining group, and the positive staining group(M (IQR)) was 2.5 (2.4) cm, 3.0 (2.5) cm and 3.0(2.4) cm,respectively. There were no statistically significant differences in the maximum tumor diameter between the three groups (P=0.364). The minimum tumor margin was 1.1 (1.1) cm, 1.0 (1.0) cm, 1.1 (1.6) cm in the the arterial staining group, reverse staining group and the positive staining group, respectively. There was no significant difference in the margin among the three groups (P=0.878). (2) Operation conditions: the operation time of the arterial staining group, the negative staining group, and the positive portal staining group was (348±93)minutes,(277±112)minutes,and (295±116)minutes,respectively. There were no significant differences in operation time among the three groups (P=0.134). The intraoperative blood loss of the three groups was 80(150)ml,200(350)ml,and 100(150)ml,respectively. There was no statistically significant difference in intraoperative bleeding volume between the three groups(P=0.743). All cases were not transfused during the operation and were not converted to laparotomy. ALT in the arterial staining group was higher than in the negative staining group in the first two days after the operation ((559±398)IU/L307(257) IU/L, q=235.5,P=0.004;(611±389)IU/L(331±242) IU/L, q=265.2, P=0.002). There was only one case of a grade III complication (Clavien-Dindo grading system) postoperative complication in the negative and positive staining group of the portal vein, respectively. Tumor markers in all patients decreased to the normal range after 2 months of operation. Conclusion: Laparoscopic anatomical hepatectomy guided by ICG fluorescence through arterial staining and portal vein staining is safe and feasible for primary hepatocellular carcinoma treatment.

Child ; Humans ; Circulating Tumor DNA ; Lymphangioma ; Family ; Hemangioendothelioma ; Sarcoma, Kaposi

An immunologically stressed rat model was used in a metabolomics study on the ability of Paeoniae Rubra Radix to reduce the liver toxicity of Psoraleae Fructus. Different groups of rats were given the extracts of Psoraleae Fructus and Psoraleae Fructus together with Paeoniae Rubra Radix or combined with a non-toxic dose of lipopolysaccharide (LPS). The biochemical indices of liver function and pathological changes in liver tissue were used to evaluate histopathological changes. UHPLC-QTOF/MS was used to analyze the metabolic profile of serum samples, combined with principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) methods. The HMDB database and Metabo Analyst online tool were used for biomarker identification and metabolic pathway-enrichment analysis. The results show that the co-treatment Psoraleae Fructus and LPS resulted in significant liver injury, indicated by the elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities, as well as obvious pathological changes. Liver injury was significantly decreased by treatment with Paeoniae Rubra Radix. Metabolomic analysis showed that the addition of Paeoniae Rubra Radix ameliorated the abnormal serum metabolism in rats mainly through regulation of arachidonic acid metabolism and glycerophospholipid metabolism pathways.

Aortic Valve/surgery* ; Aortic Valve Stenosis/surgery* ; China/epidemiology* ; Heart Valve Prosthesis Implantation ; Humans ; Severity of Illness Index ; Treatment Outcome

Objective:Based on the previous epidemiological investigation of hyperparathyroxinemia in Urumqi community, a follow-up study was conducted to understand the changes of serum parathyroid hormone (PTH) level and clinical characteristics of residents with PTH.Methods:In the previous study (2013), an epidemiological cross-sectional study of hyperparathyroxinemia was conducted on 1 473 residents of the resident community, and 180 people with hyperparathyroxinemia were found. The serum PTH, parathyroid related laboratory indexes and vitamin D were observed in high PTH population of different genders.Results:According to the inclusion criteria, 159 patients with high PTH were included in the study. The total follow-up rate was 88.3% (159/180), including 24 males (15.09%) and 135 females (84.91%). The serum PTH level in the follow-up population was 68.60 (47.85-98.80)pg/ml, which was significantly different from that in the first visit ( P<0.01). There was no significant difference in serum PTH levels between men and women ( P>0.05). The levels of serum 25(OH)D, calcium, phosphorus, magnesium, creatinine, albumin and alkaline phosphatase in the follow-up population had no significant changes compared with the first visit population (all P>0.05); After stratified by sex, the serum creatinine level of men with high PTH was significantly higher than that of women ( P<0.01), and there was no significant difference in other PTH related laboratory indexes ( P>0.05); Although the vitamin D level was still deficient (<20 ng/ml), the proportion of people with sufficient vitamin D was significantly higher than that at the first visit. Conclusions:25(OH) D deficiency was still common in the follow-up population, but the vitamin D level of the residents with PTH was significantly improved and the serum PTH level was significantly lower than that in the first visit.

【Objective】 To study the therapeutic effects of tetrahydrocurcumin(THC) via intraperitoneal(i.p.) injection on the respiratory symptoms and inflammatory responses in asthmatic mice. 【Methods】 BALB/c mice were randomly divided into 4 groups, including normal control group, ovalbumin(OVA) -induced model group, positive group and THC administration group. The latter two groups were treated with 2.5 mg/kg of dexamethasone(DEX) or 20 mg/kg of THC via i.p. injection from Day 21 to Day25. The weight changes and nasal symptoms were recorded before and after OVA challenge. The mice were sacrificed at the end of the experiment and the lung tissue and broncho-alveolar lavage fluid(BALF) were collected for assessment of histopathological alterations, Th cell subsets and related cytokine level. 【Results】 After THC treatment via i.p. injection, the asthmatic mice’s rubbing frequencies were reduced(P < 0.05) with a difference of 5.2 between the two means(95% CI = 0.66 to 9.74), lungs’pathological scores were reduced(P < 0.05) with a difference between the two means being 1.6(95% CI = 0.32 to 2.88), mucus production induced by hyperplasia of goblet cells was alleviated(P < 0.0001) with a difference between the two means being 9.56(95% CI = 5.05 to 14.07). Besides, compared with OVA group, the percentages of Th2 and Th17 cells were reduced(P < 0.01) with a difference between the two means being 1.49 and 2.15(95% CI = 0.50 to 2.49 and 0.72 to 3.58), respectively. The levels of interleukin(IL) -4, IL-5, IL-13 and IL-17A in BALF were decreased(P < 0.05) with a difference between the two means being 5.45, 4.13, 5.17 and 2.44 (95% CI = 1.95 to 8.94, 1.08 to 7.19, 0.80 to 9.54 and -0.30 to 5.17), respectively. The further comparison between THC and DEX groups showed no significant difference(P > 0.05) in the lung pathological change, Th17 cells, IL-13, and IL-17A levels. 【Conclusions】 It is concluded that i.p. injection of THC could effectively alleviate the respiratory symptoms and inhibit inflammatory reaction in asthmatic mice in short time with high safety. Therefore, i.p. injection of THC has the potential value to be the alternative therapeutic strategy for asthma.

Objective To analyze how enterovirus D68 (EV-D68) protease 2A affects the anti-vi-ral interferon typeⅠ(IFN-Ⅰ) pathway in 293T cells following infection. Methods Western blot was used to detect the expression of recombinant protease 2A, IFN-α and signal transducers and activators of tran-scription 1 (STAT1) at protein level. Expression of EV-D68 viral protein (VP1) and protease 2A was ana-lyzed by immunofluorescence at different time points. Cytopathic effects were recorded to calculate 50％ cell culture infective dose ( CCID50 ) . Expression of the genes involved in the anti-viral IFN-Ⅰ pathway was measured by real-time PCR (RT-PCR). Results The recombinant plasmid pCLIPf-2A was successfully constructed and the expression of recombinant protease 2A could be detected by Western blot 24 h after transfection. The recombinant protease 2A promoted the proliferation of EV-D68 at the late stage of infection and induced the production of IFN-α. Expression of the genes involved in the anti-viral IFN-Ⅰ pathway at mRNA level was up- or down-regulated to different degrees with various trends in different groups following infection. Expression of STAT1 was enhanced in all groups. Conclusions EV-D68 protease 2A promoted the activation of anti-viral IFN-Ⅰpathway in response to viral infection and enhanced the proliferation of virus at the late stage of infection.

In this work,a high performance liquid chromatography-ultraviolet( HPLC-UV) detection technology was used to establish fingerprint analysis method for Sanye Tangzhiqing Decoction following an analytical quality by design( AQb D) approach. Firstly,column temperature,flow rate,and gradient elution conditions were determined as the method parameters needing to be optimized. Then according to the results of definitive screening design,three critical method attributes( CMAs) were identified,including peak number,the percentage of common peak area to total peak area,and retention time of the last peak. A stepwise regression method was used then to build quantitative models between CMAs and method parameters. Probability-based design space was calculated and successfully verified using the experimental error simulation method. After the analysis conditions were optimized,the contents of six components,namely chlorogenic acid,paeoniflorin,rutin,hyperoside,quercetin-3-O-β-D-glucuronide,and salvianolic acid B were simultaneously determined. There were 19 common peaks in the fingerprint and their common peak area accounted for 96% of the total peak area. Both fingerprint and quantitative analysis methods were validated applicable in methodology study,and they can be applied to determine new samples.
Chlorogenic Acid ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal

OBJECTIVEThe purpose of this study was to screen for frequencies of different CYP450 genotypes in the Chinese population and explore the relationship between sorafenib toxicity and CYP450 polymorphism.

METHODSA total of 600 peripheral blood samples were obtained from two groups for this study. The first group of 300 samples were from Chinese patients with HBV/HCV-associated HCC, while the remaining 300 samples were from a healthy population of recruited subjects. Allele-specific PCR and long-fragment gene sequencing was used to identify the frequencies of CYP450 polymorphism. Aflatoxin-induced HCC rat models expressing CYP3A4*1, CYP3A5*3, CYP2C19*2, and CYP2D6*10 were established and treated with sorafenib at certain time points. Hepatic and renal function, along with plasma concentration of sorafenib, were monitored regularly.

RESULTSThe most common forms of CYP mutations in the Chinese population were identified. The levels of sorafenib plasma concentration, as well as damage to hepatic and renal function in aflatoxin-induced HCC rat models varied significantly across the different CYP genotypes.

CONCLUSIONThe mutational frequencies of CYP3A5, CYP3A4, CYP2C19, and CYP2D6 genotypes varied among different ethnic groups and populations. Individuals with CYP3A5*3 demonstrated minimal sorafenib metabolism, which led to severe hepatic and renal damage. Inter-individual variability in sorafenib-toxicity may be interpreted by CYP450 genetic polymorphisms, suggesting that identification of CYP polymorphism within a certain population should be considered in sorafenib therapy.

With the growth of number of Chinese patent medicines and clinical use, the rational use of Chinese medicine is becoming more and more serious. Due to the complexity of Chinese medicine theory and the uncertainty of clinical application, the prescription review of Chinese patent medicine always relied on experience in their respective, leading to the uncontrolled of clinical rational use. According to the traditional Chinese medicine (TCM) theory and characteristics of the unique clinical therapeutics, based on the practice experience and expertise comments, our paper formed the expert consensus on the prescription review of Chinese traditional patent medicine for promoting the rational use of drugs in Beijing. The objective, methods and key points of prescription review of Chinese patent medicine, were included in this expert consensus, in order to regulate the behavior of prescription and promote rational drug use.