Objective To evaluate the long-term efficacy of transjugular intrahepatic portosystemic shunt(TIPS)with bare stents and Fluency covered stents in the treatment of portal hypertension,and to discuss its clinical value.Methods The clinical data of 29 patients with intractable ascites or esophagogastric fundus varices rupture and hemorrhage caused by cirrhotic portal hypertension,who received TIPS with bare stents and covered stents at the First Affiliated Hospital of Xinjiang Medical University of China(25 patients)and the Lishui Municipal Central Hospital of China(4 patients)between August 2012 and December 2017,were retrospectively analyzed.The patients were regularly followed up to check the survival status.The postoperative cumulative shunt patency rate and cumulative survival rate of the patients were analyzed by Kaplan-Meier method.Results The technical success rate of TIPS was 100％.The mean portal vein pressure was decreased from preoperative(40.21±3.24)cmH2O to postoperative(24.55±3.55)cmH2O(P＜0.05).The patients were followed up for 5.1-10.5 years.The postoperative 1-,3-,5-,7-year primary cumulative patency rates of the shunt were 89.7％,75.9％,75.9％ and 52.5％,respectively.The postoperative 5-,7-,9-and 10-year cumulative survival rates were 100％,66.9％,66.9％ and 33.4％,respectively.The incidence of hepatic encephalopathy was 13.8％(4/29).Conclusion Using bare stents combined with Fluency covered stents for TIPS is clinically safe and effective in the treatment of portal hypertension.This technique carries higher long-term shunt patency rate and low incidence of hepatic encephalopathy.Therefore,it can be used as a substitute for Viatorr stent when necessary.(J Intervent Radiol,2024,33:295-299)

Hepatocellular carcinoma(HCC)is one of the most common tumor types and remains a major clinical challenge.Increasing evidence has revealed that mitophagy inhibitors can enhance the effect of chemotherapy on HCC.However,few mitophagy inhibitors have been approved for clinical use in humans.Pyrimethamine(Pyr)is used to treat infections caused by protozoan parasites.Recent studies have reported that Pyr may be beneficial in the treatment of various tumors.However,its mechanism of action is still not clearly defined.Here,we found that blocking mitophagy sensitized cells to Pyr-induced apoptosis.Mechanistically,Pyr potently induced the accumulation of autophagosomes by inhibiting autophagosome-lysosome fusion in human HCC cells.In vitro and in vivo studies revealed that Pyr blocked autophagosome-lysosome fusion by upregulating BNIP3 to inhibit synaptosomal-associated protein 29(SNAP29)-vesicle-associated membrane protein 8(VAMP8)interaction.Moreover,Pyr acted synergistically with sorafenib(Sora)to induce apoptosis and inhibit HCC proliferation in vitro and in vivo.Pyr enhances the sensitivity of HCC cells to Sora,a common chemotherapeutic,by inhibiting mitophagy.Thus,these results provide new insights into the mechanism of action of Pyr and imply that Pyr could potentially be further developed as a novel mitophagy inhibitor.Notably,Pyr and Sora combination therapy could be a promising treatment for malignant HCC.

Objective To study the antioxidant activity and free radical scavenging kinetics of Chrysanthemi flos stems and leaves,and online screen the active components related to free radical scavenging.Methods Using DPPH method and ABTS method the antioxidant activity of extracts from Chrysanthemi flos stems and leaves was observed,and the effects of different influencing factors,such as drug concentration,reaction temperature and reaction time on free radical scavenging rate were compared,the half scavenging rate(IC50)was determined.The flavonoids,such as luteolin glucuronic acid,luteolin,and caffeic acid,phenolic acids such as chlorogenic acid,neochlorogenic acid,cryptochlorogenic acid,isochlorogenic acid A,B,and C in the samples before and after the reaction were chosen as indexes,and their contents were determined by HPLC.Results The drug concentration,reaction temperature and reaction time could affect the scavenging rate of DPPH free radical and ABTS.The IC50 of DPPH and ABTS were 0.395 mg·mL-1 and 2.039 mg·mL-1 respectively.After reaction with DPPH and ABTS,the contents of the analytes above all decreased significantly,which suggested that,the components above might be the antioxidant components in Chrysanthemi flos stems and leaves.Conclusions Chrysanthemi flos Stems and leaves have good free radical scavenging activity.In this study,the kinetic characteristics of scavenging DPPH and ABTS free radicals in Chrysanthemi flos stems and leaves were preliminarily clarified,and the active components were found out.It provides an experimental basis for the future comprehensive development of Chrysanthemi flos stems and leaves.

Objective To evaluate the clinical application value of medical tissue glue in the treatment of acute hemoptysis by bronchial arterial embolization(BAE).Methods The clinical data of 78 patients who underwent emergency BAE for hemoptysis were retrospectively collected.Among them,18 patients who underwent embolization with medical tissue glue were selected as a study group,and other 18 patients who underwent embolization with absorbent gelatin sponge particles and spring coil were selected as a control group.The technical success rates,average surgical operation time,average surgical cost,postoperative hemoptysis recur-rence rate,and incidence of adverse reactions of the two groups were compared and analyzed.Results The technical success rates of the two groups were both 100％.There were no statistically significant differences in recurrence rate of postoperative hemoptysis and incidence of adverse reactions between the two groups(P＞0.05).The average surgical operation time of study group and control group were 53.4 min[(53.4±2.2)min]and 65.4 min[(65.4±2.8)min],and the average surgical cost were 3 651 yuan[(3 651±102.7)yuan]and 5 094 yuan[(5 094±136.3)yuan],respectively.Compared with the control group,the average surgical operation time and aver-age surgical cost of the study group were shorter,and the differences were statistically significant(P＜0.05).Conclusion Compared with absorbent gelatin sponge particles combined with spring coil embolization,the use of medical tissue glue for embolization is also safe and effective in the treatment of acute hemoptysis patients by BAE.The average surgical operation time is shorter,and the surgical cost for patients is lower.It is worth promoting in clinical practice.

Objective To investigate the clinical value of intermittent oral-to-esophageal tube feeding combined with perioral massage in treating dysphagia of children with Pierre Robin Syndrome (PRS). Methods A total of 92 PRS children with mandibular distraction osteogenesis were selected and divided into observation group and control group by stratified randomization, with 46 cases in each group. The control group received continuous nasal tube feeding intervention, while the observation group received intermittent oral-to-esophageal tube feeding combined with perioral massage intervention. The changes in nutritional status[body mass index (BMI), serum hemoglobin (Hb), total protein (TP), albumin (ALB)] before and after 1 month of intervention were compared between the two groups. The clinical indicators (hospital stay, time to start oral feeding, and time to full gastrointestinal feeding) were also compared 1 month after the intervention. The swallowing conditions and incidence of complications were recorded in both groups. Results After 1 month of intervention, BMI, Hb, TP and ALB in both groups significantly increased, and the observation group had significant higher values in BMI of (21.58±1.26) kg/m², Hb of (118.76±10.36) g/L, TP of (55.28±6.74) g/L, ALB of (33.46±4.37) g/L compared to BMI of (20.30±1.22) kg/m², Hb of (112.74±9.46) g/L, TP of (51.68±6.33) g/L and ALB of (30.59±4.68) g/L in the control group (P < 0.05). In the observation group, the feeding time was (32.26±4.43) minutes, hospital stay was (21.48±3.11) days, time to start oral feeding was (14.26±3.16) days, and time to full gastrointestinal feeding was (16.79±2.32) days, which were significantly shorter than (36.79±4.65) min, (24.39±3.31) days, (17.25±3.24) days, and (20.48±3.29) days respectively in the control group (P < 0.05); the average residual feeding volume was (10.26±2.18) mL and the number of cases with milk flow was 8 (17.39%) in the observation group, which were significantly less than (12.79±2.31) mL and 17 (36.95%) in the control group (P < 0.05). Conclusion Intermittent oral-to-esophageal tube feeding combined with perioral massage can effectively improve swallowing difficulty in children with PRS and shorten the hospital stay.

Epilepsy is a disorder of the brain charac-terized by abnormal neuron excitability.However,the underlying molecular mechanism of neuron excitability modulation remains elusive.With the help of bioinformatic methods,we have identified receptor-type tyrosine-pro-tein phosphatase-like N(PTPRN)as a critical gene dur-ing epileptogenesis.PTPRN recruits NEDD4L ubiquitin E3 ligase to NaV1.2 sodium channels,facilitating NEDD4L-mediated ubiquitination and endocytosis.Knockout of PTPRN endows hippocampal granule cells with augmented depolarization currents and higher intrinsic excitability,which is reflected by increased seizure susceptibility of transgenic mice.On the contrary,reduced neuron excit-ability and decreased seizure susceptibility are observed after PTPRN overexpression.Meanwhile,we find that a 133 aa fragment recaptures modulation effect of PTPRN full-length,and this fragment shows therapeutic potential towards epilepsy caused by NaV1.2 gain of function vari-ants.In brief,our results demonstrate PTPRN playsa criti-calroleinregulatingneuronexcitability,providing a poten-tial therapeutic approach for epilepsy.

Objective:To investigate the application effects of MOTOmed in stepped individualized rehabilitation intervention of older adult patients with post-stroke hemiplegia.Methods:A total of 130 older adult patients with post-stroke hemiplegia who received treatment in the Affiliated People's Hospital of Ningbo University from June 2019 to June 2021 were included in this study. They were randomly assigned to undergo either stepped individualized rehabilitation intervention with MOTOmed training system (observation group, n = 65) or routine rehabilitation intervention (control group, n = 65) for 1 month. Before and after intervention, the Fugl- Meyer Assessment score, Berg Balance Scale score, Functional Ambulation Category scale score, modified Ashworth scale score, and modified Barthel Index, Self-Perceived Burden Scale score, nerve growth factor, brain-derived neurotrophic factor and neurotrophin 3 levels were compared between the two groups. Results:After intervention, Fugl-Meyer Assessment and Berg Balance Scale scores in the observation groups were (75.48 ± 6.54) points and (48.55 ± 5.18) points, which were significantly greater than (72.55 ± 6.33) points and (46.50 ± 4.79) points in the control group ( t = 2.59, 2.34, both P < 0.05). Functional Ambulation Category scale score in the observation group was significantly higher than that in the control group [(3.22 ± 0.43) points vs. (3.05 ± 0.39) points, t = 2.36, P < 0.05). Modified Ashworth scale score in the observation group was significantly lower than that in the control group [(1.23 ± 0.24) points vs. (1.33 ± 0.26) points, t = 2.27, P < 0.05). Modified Barthel Index score in the observation group was significantly higher than that in the control group [(59.32 ± 5.18) points vs. (57.33 ± 4.92) points, t = 2.24, P < 0.05]. There was no significant difference in Self-Perceived Burden Scale score between the two groups ( t = 1.64, P > 0.05). Nerve growth factor level in the observation group was significantly higher than that in the control group [(12.93 ± 2.31) ng/L vs. (12.06 ± 2.29) ng/L, t = 2.15, P < 0.05]. There were no significant differences in brain-derived neurotrophic factor and neurotrophin 3 levels between the two groups ( t = 0.91, 1.25, both P > 0.05). Conclusion:The stepped individualized rehabilitation intervention with MOTOmed training system can greatly improve the limb function, balance ability, walking ability and self-care ability, reduce muscle tension, and increase nerve growth factor level in older adult patients with post-stroke hemiplegia, which are conducive to the rehabilitation and prognosis of post-stroke hemiplegia.

Hypoxia conditioning could increase the survival of transplanted neuronal progenitor cells (NPCs) in rats with cerebral ischemia but could also hinder neuronal differentiation partly by suppressing mitochondrial metabolism. In this work, the mitochondrial metabolism of hypoxia-conditioned NPCs (hcNPCs) was upregulated via the additional administration of resveratrol, an herbal compound, to resolve the limitation of hypoxia conditioning on neuronal differentiation. Resveratrol was first applied during the in vitro neuronal differentiation of hcNPCs and concurrently promoted the differentiation, synaptogenesis, and functional development of neurons derived from hcNPCs and restored the mitochondrial metabolism. Furthermore, this herbal compound was used as an adjuvant during hcNPC transplantation in a photothrombotic stroke rat model. Resveratrol promoted neuronal differentiation and increased the long-term survival of transplanted hcNPCs. 18-fluorine fluorodeoxyglucose positron emission tomography and rotarod test showed that resveratrol and hcNPC transplantation synergistically improved the neurological and metabolic recovery of stroke rats. In conclusion, resveratrol promoted the neuronal differentiation and therapeutic efficiency of hcNPCs in stroke rats via restoring mitochondrial metabolism. This work suggested a novel approach to promote the clinical translation of NPC transplantation therapy.
Animals ; Brain Ischemia/drug therapy* ; Cell Differentiation ; Hypoxia ; Neurons ; Rats ; Resveratrol/pharmacology*

ObjectiveTo investigate the clinical features and causes of death after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatic sinus obstruction syndrome (HSOS), as well as the prevention and treatment measures to further improve the survival rate of such patients. MethodsA retrospective analysis was performed for 293 patients with HSOS who were admitted to Nanjing Drum Tower Hospital from January 2013 to December 2019, among whom 20 patients died after TIPS. General information, laboratory examination, and clinical treatment regimen were analyzed, and clinical indices and complications were compared at different stages of the disease. The paired t-test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups. ResultsThe mean survival time was 15.15±4.21 weeks for the 20 patients who died, among whom there were 15 male patients and 5 female patients, with a mean age of 67.60±7.01 years; there were 17 patients (85%) aged ≥60 years, and more than 90% of the patients had abdominal distention and oliguria. Among the 20 patients who died, 9 (45%) had chronic underlying diseases, and 5 (25%) had more than two underlying diseases. Portal venous pressure decreased from 21.67±5.15 mm Hg before surgery to 8.17±4.98 mm Hg after surgery (t=10.318,P＜0.05). The levels of total bilirubin, direct bilirubin, and D-dimer were significantly higher than the normal values before surgery, and there were significant increases in these levels on day 5 after surgery (Z=3.823,3.823,2.756, all P＜0.05); the hemoglobin level, platelet count, and creatinine level tended to decrease on day 5 after surgery (t=4.979,t=2.147,Z=-3.125, all P＜005). Three patients had hepatic encephalopathy before surgery, while 10 patients (50%) had hepatic encephalopathy after surgery. Causes of death included acute liver failure, infectious shock, and multiple organ failure syndrome (MODS). ConclusionThe possible risk factors for death after TIPS in HSOS patients include underlying diseases, high bilirubin, and complications such as hepatic encephalopathy and renal dysfunction. Causes of death mainly include acute liver failure and MODS. Ultrasound and laboratory markers should be reexamined during anticoagulation therapy to identify the patients with progression to severe diseases as early as possible, and in case of progressive deterioration of indices, TIPS should be selected as early as possible to improve the survival rate and prognosis of such patients. In addition, hemobilia should be observed during and after surgery, and intervention measures should be adopted in time to further reduce mortality rate.

Objective: To explore the impact role of Mandibular Distraction Osteogenesis technique (MDO) on the health quality of life in children with Pierre-Robin Sequence (PRS). Methods: From January 2017 to August 2017, 44 cases of children with PRS admitted in children′s hospital of Nanjing Medical University were recruited. Glasgow Children′s benefit inventory(GCBI), Chinese version was used to study postoperative qualify of life in four aspects: physiology, emotions, learning, and vitality. Clinical data and the quality of life score were collected from the patients, and comparison analysis was performed. Results: GCBI total score of the 44 cases of PRS treated with MDO surgery was 46, indicating that the overall quality of life was improved; Physical dimension score was 72, which was the highest, showing the most positive changes. GCBI total scores for the children with different types of PRS were type Ⅰ62, type Ⅱ43, type Ⅲ18, respectively. Nonparametric test showed that quality of life in typeⅠpatients was improved compared to typeⅢ. The difference was statistically significant (Z = -3.34, P=0.01). For the comparisons between type Ⅰ and Ⅱ and type Ⅱ and type Ⅲ, there was no statistically significant difference (P>0.05). Conclusions MDO plays a positive role in improving life of quality . Physiological conditions were the aspects that were improved most. The milder the case is, the more the postoperative quality of life is improved.