Passivation protein-adhesion platform promoting stent reendothelialization using two-electron-assisted oxidation of polyphenols.

Superhydrophilic surfaces play an important role in nature. Inspired by this, scientists have designed various superhydrophilic materials that are widely used in the field of biomaterials, such as PEG molecular brushes and zwitterionic materials. However, superhydrophilic coatings with only anti-fouling properties do not satisfy the requirements for rapid reendothelialization of cardiovascular stent surfaces. Herein, a novel polyphenol superhydrophilic surface with passivated protein-adsorption properties was developed using two-electron oxidation of dopamine and polyphenols. This coating has a multiscale effects: 1) macroscopically: anti-fouling properties of superhydrophilic; 2) microscopically: protein adhesion properties of active groups (quinone-, amino-, hydroxyphenyl groups and aromatic ring). Polyphenols not only enhance the ability of coating to passivate protein-adsorption, but also make the coating have polyphenol-related biological functions. Therefore, the polyphenol and passivated protein-adsorption platform together maintain the stability of the scaffold microenvironment. This, in turn, provides favorable conditions for the growth of endothelial cells on the scaffold surface. In vivo implantation of the coated stents into the abdominal aorta resulted in uniform and dense endothelial cells covering the surface of the neointima. Moreover, new endothelial cells secreted large amounts of functional endothelial nitric oxide synthase like healthy endothelial cells. These results indicate that the polyphenol superhydrophilic coating potentially resists intra-stent restenosis and promotes surface reendothelialization. Hence, polyphenol superhydrophilic coatings with passivated protein-adsorption properties constructed by two-electron-assisted oxidation are a highly effective and versatile surface-modification strategy for implantable cardiovascular devices.

Design, fabrication, and applications of bioinspired slippery surfaces.

Bioinspired slippery surfaces (BSSs) have attracted considerable attention owing to their antifouling, drag reduction, and self-cleaning properties. Accordingly, various technical terms have been proposed for describing BSSs based on specific surface characteristics. However, the terminology can often be confusing, with similar-sounding terms having different meanings. Additionally, some terms fail to fully or accurately describe BSS characteristics, such as the surface wettability of lubricants (hydrophilic or hydrophobic), surface wettability anisotropy (anisotropic or isotropic), and substrate morphology (porous or smooth). Therefore, a timely and thorough review is required to clarify and distinguish the various terms used in BSS literature. This review initially categorizes BSSs into four types: slippery solid surfaces (SSSs), slippery liquid-infused surfaces (SLISs), slippery liquid-like surfaces (SLLSs), and slippery liquid-solid surfaces (SLSSs). Because SLISs have been the primary research focus in this field, we thoroughly review their design and fabrication principles, which can also be applied to the other three types of BSS. Furthermore, we discuss the existing BSS fabrication methods, smart BSS systems, antifouling applications, limitations of BSS, and future research directions. By providing comprehensive and accurate definitions of various BSS types, this review aims to assist researchers in conveying their results more clearly and gaining a better understanding of the literature.

miR-138-5p targets MCU to inhibit mitochondrial biogenesis and colorectal cancer growth.

miR-138-5p has been identified as a novel cancer-related miRNA molecule in a variety of malignancies. However, the functions and mechanisms underlying miR-138-5p in colorectal carcinoma (CRC) remains largely unknown. In the present study, we analysed the biological effects and clinical significance of miR-138-5p in CRC. miR-138-5p expression was analysed by quantitative real-time PCR in CRC tissues and cell lines. The effects of miR-138-5p on CRC cell growth was detected by cell proliferation, colony formation, cell cycle and cell apoptosis assays in vitro and in vivo. Our data showed that miR-138-5p was significantly downregulated in CRC. Downregulated miR-138-5p was related with poor prognosis in patients with CRC. miR-138-5p suppressed CRC growth but promoted cell death both in vitro and in vivo. Online predictions and integrated experiments identified that miR-138-5p targeted MCU, and downregulated miR-138-5p promoted mitochondrial biogenesis in CRC. In the light of the underlying mechanisms, our results indicated that downregulated miR-138-5p led to increased expression of MCU, which subsequently increased the production of ROS to promote CRC growth. Our results indicated that downregulated miR-138-5p strengthened mitochondrial biogenesis through targeting MCU, thus contributing to CRC cell growth, which may provide a potential therapeutic target for CRC.

Inhibitory effect and related mechanism of decitabine combined with gemcitabine on proliferation of NK/T cell lymphoma cells.

Background: EBV-associated lymphoma is a neoplasm with a poor prognosis, highly aggressive, and progressive rapidly. There is no standard clinical treatment protocol. Decitabine and gemcitabine are known to have anticancer properties against cells of various cancer, respectively. However, the effect of the combination medication on NK/T cell lymphoma cells and potential mechanisms have not been thoroughly investigated. Methods: Human NK/T cell lymphoma cells NK92MI were treated with decitabine and gemcitabine alone or in combination. Experiments, including the Cell Counting Kit-8 and flow cytometry, were performed to investigate how the combination of decitabine and gemcitabine affects the biological behavior of NK92MI cells in vitro. mRNA sequencing, RT-PCR, and western blotting were used to detect changes in the related signal pathway, mRNA, and protein expressions. Results: Decitabine and gemcitabine significantly inhibited the viability and proliferation of NK92MI cells in a dose-dependent manner. The combination index was less than 1 after treating with two drugs, which was a significant synergistic effect. The decitabine concentration with the best synergistic effect was 4.046 µM, and the gemcitabine concentration was 0.005 µM. Flow cytometry showed that combining two drugs could significantly promote apoptosis and arrest the cell cycle at the S phase. In the combined DAC and GEM group, caspase3 protein levels were higher than in either group alone or the control group. The transcriptome sequence, KEGG, and PPI analysis showed that the differential genes after combined treatment were mainly enriched in signal pathways related to cell proliferation, adhesion, and migration compared with using alone and control groups. Based on the sequencing results, we further investigated the role of DAC and GEM in ferroptosis-related signaling molecules using RT-PCR and Western blot techniques. RT-PCR and western blotting showed that the expression levels of HMOX1 and EBV cleavage gene BRLF1 were higher in the group with combined DAC and GEM than in the group alone and the control group, while the protein and mRNA expression levels of SLC7A11 were lower than the others. In addition, the GPX4 protein expression level in the combination group was lower than in the drug-alone and control groups. In addition, the combination treatment increased the ROS level of NK92MI cells. Conclusion: Our current findings suggested that decitabine had an inhibitory effect on the proliferation of NK92MI cells when co-treated with gemcitabine. This combination may increase the expression of ferroptosis-related signaling molecules, thus inhibiting the proliferation of NK92MI cells. It also promoted apoptosis in NK/T cell lymphoma. For patients with NK/T cell lymphoma, this novel combination may provide clinical benefits.

A novel mitochondria-related gene signature in esophageal carcinoma: prognostic, immune, and therapeutic features.

Esophageal carcinoma (ESCA) is a common and lethal malignant tumor worldwide. The mitochondrial biomarkers were useful in finding significant prognostic gene modules associated with ESCA owing to the role of mitochondria in tumorigenesis and progression. In the present work, we obtained the transcriptome expression profiles and corresponding clinical information of ESCA from The Cancer Genome Atlas (TCGA) database. Differential expressed genes (DEGs) were overlapped with 2030 mitochondria-related genes to get mitochondria-related DEGs. The univariate cox regression, Least Absolute Shrinkage and Selection Operator (LASSO) regression, and multivariate cox regression were sequentially used to define the risk scoring model for mitochondria-related DEGs, and its prognostic value was verified in the external datasets GSE53624. Based on the risk score, ESCA patients were divided into high- and low-risk groups. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA) were performed to further investigate the difference between low- and high-risk groups at the gene pathway level. CIBERSORT was used to evaluate immune cell infiltration. The mutation difference between high- and low-risk groups was compared by using the R package "Maftools". Cellminer was used to assess the association between the risk scoring model and drug sensitivity. As the most important outcome of the study, a 6-gene risk scoring model (APOOL, HIGD1A, MAOB, BCAP31, SLC44A2, and CHPT1) was constructed from 306 mitochondria-related DEGs. Pathways including the "hippo signaling pathway" and "cell-cell junction" were enriched in the DEGs between high and low groups. According to CIBERSORT, samples with high-risk scores demonstrated a higher abundance of CD4+ T cells, NK cells, M0 and M2 macrophages, and a lower abundance of M1 macrophages. The immune cell marker genes were correlated with the risk score. In mutation analysis, the mutation rate of TP53 was significantly different between the high- and low-risk groups. Drugs with a strong correlation with the risk model were selected. In conclusion, we focused on the role of mitochondria-related genes in cancer development and proposed a prognostic signature for individualized integrative assessment.

Lattice Compressive Strain of Co3O4 Induced by Synthetic Solvents Promotes Efficient Oxidation of Benzene at Low Temperature.

A series of Co3O4 with different surface defective structures were prepared by the solvothermal method and tested for the activity of benzene oxidation. The characterizations revealed that the synthetic solvent had a dramatic effect on the composition of Co3O4 precursors as well as the physicochemical properties of Co3O4. Although all Co3O4 exhibited a cubic spinel structure, Co3O4 prepared with triethylene glycol (Co-TEG) had the highest compressive strain due to the nature of high viscosity of triethylene glycol. These in turn affected the surface chemical structure and the low-temperature redox properties. Co-TEG exhibited the best benzene oxidation activity and showed excellent stability and good water resistance. In situ diffuse reflectance infrared Fourier transform spectroscopy was used to study the oxidation process of benzene. It was found that Co-TEG with more defective structures had abundant surface adsorbed oxygen and active lattice oxygen, which promoted the conversion of benzene and the corresponding intermediates at low temperature.

A honokiol-mediated robust coating for blood-contacting devices with anti-inflammatory, antibacterial and antithrombotic properties.

Thrombus, bacterial infections, and severe inflammation are still serious problems that have to be faced with blood-contacting materials. However, it is a great challenge to simultaneously meet the above functional requirements in a simple, economical and efficient method. As such, we put forward a robust and versatile coating strategy by covalently modifying the multi-pharmacological drug honokiol (HK) with an amine-rich polydopamine/polyethyleneimine coating, through which anticoagulant, antibacterial and anti-inflammatory properties were obtained (DPHc) simultaneously. The amine content in the DPHc coating was lower than the detection limit, while it contained abundant phenolic hydroxyl groups (49 µmol cm-2). Meanwhile, the 30 day drug release test confirmed that the drug was firmly modified on the surface of the coating without release. A systematic in vitro and ex vivo evaluation confirmed that the coating had significant anti-thrombotic properties. The antibacterial rates of the DPHc coating against Staphylococcus aureus and Escherichia coli reached 99.98% and 99.99%, respectively. In addition, subcutaneous implantation indicated that the DPHc coating also has excellent histocompatibility. To the best of our knowledge, this is the first study using HK as a coating material that can not only combat thrombosis and infection but also significantly inhibit inflammation associated with the use of blood-contacting materials, thus expanding the application of HK in the field of biomaterials.

Fisetin Improves Hyperuricemia-Induced Chronic Kidney Disease via Regulating Gut Microbiota-Mediated Tryptophan Metabolism and Aryl Hydrocarbon Receptor Activation.

The intestinal flora serves a critical role in the development of hyperuricemia-induced chronic kidney disease (CKD). We previously found that natural flavonol fisetin exhibited nephroprotective effects in hyperuricemic mice. However, the mechanism remains largely unknown. To investigate the underlying mechanism of fisetin, mice were fed with potassium oxonate and adenine to introduce hyperuricemia-induced CKD. Fisetin improved kidney function, ameliorated renal fibrosis, and restored enteric dysbacteriosis in hyperuricemia-induced CKD mice. Meanwhile, gut microbiota-derived tryptophan metabolites, especially l-kynurenine, showed correlations with nephroprotective profiles of fisetin. Additionally, the kidney expression of the aryl hydrocarbon receptor (AHR), an endogenous receptor of l-kynurenine, was enhanced in hyperuricemic mice and further reduced in fisetin-treated mice. Finally, in vitro results showed that inhibition of AHR activation attenuated l-kynurenine-induced fibrosis. These results highlighted that fisetin protected against hyperuricemia-induced CKD via modulating gut microbiota-mediated tryptophan metabolism and AHR activation.

Ethanol extract of Liriodendron chinense (Hemsl.) Sarg barks attenuates hyperuricemic nephropathy by inhibiting renal fibrosis and inflammation in mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Liriodendron chinense (Hemsl.) Sarg, known as the Chinese tulip tree, has a long history of cultivation and utilization in many Asia countries, especially in China to use in traditional Chinese medicine for expelling "wind and dampness", a term corresponding to rheumatic fever and rheumatoid arthritis. Interestingly, the barks of Liriodendron chinense (Hemsl.) Sarg was also found in folk to treat gout. However, further experimental studies remained to confirm its uric acid-lowering effects. AIM OF THE STUDY: The aim of the study was to evaluate the protective effect of ethanol extract of the barks of Liriodendron chinense (Hemsl.) Sarg (EELC) in a mouse model of hyperuricemic nephropathy (HN) and the involved mechanisms. MATERIALS AND METHODS: EELC at a respective dose of 250 mg/kg/d or 500 mg/kg/d were orally administered to HN mice induced by a mixture of adenine (160 mg/kg/d)/potassium oxonate (2.4 g/kg/d) for 21 days. At the end of the treatment, serum uric acid, kidney functions (serum creatinine, blood urea nitrogen and urine microalbumin), 24-h urine uric acid excretion, as well as kidney pathological changes were investigated by biochemical assay, histopathological score, immunofluorescence and histochemistry, RT-qPCR, and western blotting analysis. RESULTS AND DISCUSSION: Oral administration of EELC significantly lowered serum uric acid level at 500 mg/kg (185.75 ± 15.49 µmol/L of EELC vs. 238.28 ± 20.97 µmol/L of HN model, p < 0.01) in HN mice. EELC at 500 mg/kg also remarkably reduced the levels of serum creatinine (82.92 ± 7.86 µmol/L of EELC vs. 92.08 ± 6.13 µmol/L of HN model, p < 0.0001), blood urea nitrogen (21.50 ± 1.87 mmol/L of EELC vs. 29.40 ± 3.95 mmol/L of HN model, p < 0.001) and urine microalbumin (4.25 ± 0.40 mg/L of EELC vs. 5.95 ± 0.33 mg/L of HN model, p < 0.001) to improve renal function. It also attenuated renal fibrosis, especially the high-dose of EELC. Furthermore, EELC could inhibit the activation of NF-κB, ASK1/JNK/c-Jun, JAK2/STAT3 signaling pathways and reduce the release of pro-inflammatory cytokine TNF-α in the kidneys of HN mice. Additionally, EELC remarkably increased urine uric acid excretion of HN mice, which may be achieved by the upregulation of organic anion transporter 1 (OAT1), OAT3 and ATP-binding cassette subfamily G member 2 (ABCG2) proteins. CONCLUSIONS: EELC alleviated the progression of HN by suppressing the activation of NF-κB, ASK1/JNK/c-Jun and JAK2/STAT3 signaling pathway, reducing the infiltration of inflammatory factors and uric acid accumulation in the kidney.

Histamine H3 Receptor Promotes Cell Survival via Regulating PKA/CREB/CDKN1A Signal Pathway in Hepatocellular Carcinoma.

BACKGROUND: The histamine H3 receptor (HRH3) is mainly expressed in areas of the brain involved in the regulation of the release of various neurotransmitters. Recent studies have shown that HRH3 expression is increased in several types of carcinomas. However, the functional roles and underlying molecular mechanism by which HRH3 regulates cell survival in hepatocellular carcinoma (HCC) remain unknown. METHODS: The mRNA and protein expression level of target genes were evaluated by qRT-PCR, Western blot and immunohistochemistry, respectively. Cell viability and cell proliferation activity were assessed by MTS assay and EdU incorporation assay. Cell apoptosis and cell cycle were assessed by flow cytometry analysis. A xenograft mouse model was constructed to investigate the effect of HRH3 on tumor growth in vivo. RESULTS: Our results indicated that HRH3 was significantly upregulated in HCC, which promoted cell survival by accelerating cell proliferation and inhibiting cell apoptosis. Our results also showed that HRH3 in HCC downregulated the expression of cyclin-dependent kinase inhibitor p21 (CDKN1A) to promote G1-S phase transition by inactivating the cAMP/PKA/CREB pathway, which finally contributed to the malignant growth of HCC. CONCLUSION: Our findings indicated that HRH3 functioned in promoting HCC survival by inactivating the cAMP/PKA/CREB pathway to downregulate CDKN1A expression. Thus, HRH3 might serve as a potential therapeutic target in HCC treatment.

The role of echocardiography in prognosis for dysfunction and abandonment of radiocephalic arteriovenous fistula in elderly Chinese patients on hemodialysis.

The objective of this study was to examine the impact of cardiac structure and function at baseline on the outcomes associated with arteriovenous fistula (AVF) in patients on hemodialysis (HD). Patients who initiated HD aged ≥70 years and received a mature AVF creation were included retrospectively. Echocardiographic parameters measured within 1 week before AVF creation were acquired. The observational period for each patient was from the point of AVF creation to the last time of follow-up unless AVF abandonment or death occurred. Kaplan-Meier and Cox proportional hazard regression analyses were conducted. A total of 82 elderly Chinese HD patients with mature radiocephalic AVF (RCAVF) and EF ≥50% were analyzed. During the median study period of 26.8 (12-40) months, 42 (51.2%) experienced RCAVF dysfunction and 34 (41.5%) progressed to abandonment. Primary and cumulative patencies at 6, 12, 24, and 36 months were 81%, 73%, 48%, 38%, and 84%, 81%, 68%, 55%, respectively. Left ventricle end-diastolic volume (LVEDV) ≤103.5 mL (HR = 2.5, P = .019) and the right side of RCAVF (HR = 3.59, P = .003) significantly predicted RCAVF dysfunction. The main pulmonary artery internal diameter (MPAID) ≤21.5 mm (HR = 4.3, P = .001) as well as the right side (HR = 2.95, P = .047) were the independent predictors for RCAVF abandonment. In conclusion, LVEDV, MPAID assessed by echocardiography and the right side of RCAVF, showed significant predictive implications for the outcomes of RCAVF. Disparities among nationalities in the areas of utilization and patency of AVFs necessitate additional studies.

Vascular Access Type Was Not Associated with Mortality and the Predictors for Cardiovascular Death in Elderly Chinese Patients on Hemodialysis.

OBJECTIVES: Current studies suggest arteriovenous fistula (AVF) and arteriovenous graft as superior vascular access (VA) types for elderly hemodialysis (HD) patients due to better outcomes. This study aimed to examine the impact of VA type on cardiovascular and all-cause mortality as well as the predictors for outcome in elderly Chinese patients. METHODS: Patients who initiated HD aged ≥70 years and received a primary VA creation at the West China Hospital were enrolled in this retrospective study. Clinical characteristics, maturation, utilization, conversion of VA, and outcomes were collected. The observational period for each patient was from the point of the first permanent VA creation to the last time of follow-up. Kaplan-Meier and multivariate regression analysis were employed. RESULTS: A total of 358 elderly Chinese HD patients with a median age of 74 (72-78) years were analyzed. During the study period of 25.8 (12-43) months, 54 (15.1%) and 113 patients (15.1%) died of cardiovascular events and all-cause, respectively. With regard to VA type, the modality of AVF, tunneled cuffed central venous catheter (tcCVC), or AVF and tcCVC was not associated with mortality. Furthermore, diastolic blood pressure (DBP) and congestive heart failure (CHF) were the independent predictors for cardiovascular mortality. CONCLUSIONS: The modality of VA types showed an insignificant effect on mortality in elderly Chinese population, while preoperative DBP and the presence of CHF might be used for the risk assessment of cardiovascular death. Disparities among nations in the areas of VA and HD necessitate additional studies.

pH-sensitive microemulsion-based gels for removal of colonic ammonia: a novel preventative oral preparation for hepatic encephalopathy in rats.

Microemulsions with limited stability in mimetic gastrointestinal environments have previously demonstrated potential for the effective removal of ammonia from artificial colonic fluid. Specialized pH­sensitive microemulsion­based gels for the removal of colonic ammonia (MBG­RCA), however, possess relative stability in the gastrointestinal (GI) tract of normal rats, indicating potential use in in vivo applications. An investigation of the effects of oral MBG­RCA was conducted in order to evaluate the reduction of intestinal ammonia and the prevention of hepatic encephalopathy (HE) in rat models. Eighty rats were allocated into eight 4­day treatment groups: The HE model (intraperitoneal injection of thioacetamide) group; the high­, medium­ and low­dose MBG­RCA therapeutic groups (15, 10 and 5 ml/kg MBG­RCA, respectively); and the normal, blank, lactulose and acetic acid control groups, each of which received daily treatment administration. Oral MBG­RCA effects were identified using behavioral monitoring observed by an infrared night vision supervisory control system, electroencephalograms, blood ammonia levels, intestinal ammonia levels, liver functionality and pathological observation. High­ and medium­dose oral administrations of MBG­RCA significantly decreased the blood and intestinal ammonia levels (P<0.05), improved liver functionality and reduced the clinical manifestations of HE in rats. MBG­RCA demonstrated high clearance of rat colonic ammonia while maintaining sufficient stability in the GI tract, indicating the potential for the development of new clinically relevant oral preparations for the prevention of HE. Additionally, such preparations are advantageous in that ammonia is eliminated without the production of potentially harmful metabolic byproducts.

Octreotide and celecoxib synergistically encapsulate VX2 hepatic allografts following transcatheter arterial embolisation.

To evaluate the encapsulation of VX2 hepatic allografts in rabbits induced by octreotide and celecoxib administration following transcatheter arterial embolisation (TAE), rabbits with hepatic VX2 allografts were divided into four groups: control, TAE, octreotide + celecoxib (O+C) and the multimodality therapy (TAE+O+C). Allograft metastasis, capsule thickness and percentage of clear cells were measured and vascular endothelial growth factor (VEGF) and CD31 were detected by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) analysis. The extrahepatic metastases of each intervention group were significantly fewer than those of the control group, with the TAE+O+C group exhibiting the fewest extrahepatic metastases. The TAE+O+C group had the greatest proportion of clear cells and thickest capsule on day 30. Increased capsule thickness was negatively correlated with tumour metastasis. In addition, VEGF expression levels assessed by immunohistochemistry and RT-PCR in the three intervention groups were significantly lower than those in the control group. Furthermore, the TAE+O+C group had a significantly reduced CD31 count induced by TAE. These results demonstrate that TAE, followed by long-term administration of octreotide and celecoxib, synergistically inhibits VX2 hepatic allograft metastasis by increasing the proportion of clear cells, promoting encapsulation and inhibiting angiogenesis.

Hepatic arterial administration of ginsenoside Rg3 and transcatheter arterial embolization for the treatment of VX2 liver carcinomas.

Ginsenoside Rg3 has been demonstrated to inhibit tumor cell proliferation and angiogenesis. However, its effect on liver tumors when administered via the hepatic artery has not been investigated. The purpose of this study was to evaluate the therapeutic effect of hepatic artery administration of Rg3 combined with transcatheter arterial embolization (TAE) in the treatment of liver tumors. A total of 48 rabbits with VX2 liver tumors were randomly divided into four groups: Group 1, Rg3; Group 2, TAE; Group 3, Rg3 and TAE; and Group 4, control. Abdominal contrast computed tomography (CT) scans were performed 2 weeks before and after intervention to assess tumor growth. Immunohistochemical staining was used to detect the expression of the angiogenesis biomarkers CD31 and VEGF, and the cell apoptosis marker caspase-3. Semi-quantitative RT-PCR and western blotting were employed to detect the expression of the caspase-3, Bax and Bcl-2 apoptosis-related genes and proteins. In addition, HepG2 cells were treated with Rg3 at different concentrations (0, 25, 50, 75 and 100 mg/l) in vitro. An MTT assay and western blot analysis were used to analyze the cell proliferation and VEGF expression. Compared with the other experimental groups, the Rg3 and TAE group expressed significantly lower levels of CD31 and VEGF (P<0.05), significantly increased levels of the pro-apoptotic genes caspase-3 and Bax (P<0.05), and significantly reduced levels of anti-apoptotic Bcl-2 at the mRNA and protein levels (P<0.05). In vitro, Rg3 inhibited HepG2 cell proliferation and downregulated VEGF expression significantly. These results indicated that ginsenoside Rg3 combined with TAE may effectively inhibit tumor growth by inhibiting tumor angiogenesis and inducing cancer cell apoptosis.

Transjugular insertion of bare-metal biliary stent for the treatment of distal malignant obstructive jaundice complicated by coagulopathy.

PURPOSE: This study was designed to investigate retrospectively the feasibility of transjugular insertion of biliary stent (TIBS) for the treatment of distal malignant obstructive jaundice complicated by coagulopathy. METHODS: Between April 2005 and May 2010, six patients with distal malignant obstructive jaundice associated with coagulopathy that was unable to be corrected underwent TIBS at our institution for the palliation of jaundice. Patients' medical record and imaging results were reviewed to obtain information about demographics, procedure details, complications, and clinical outcomes. RESULTS: The intrahepatic biliary tract was successfully accessed in all six patients via transjugular approach. The procedure was technically successfully in five of six patients, with a bare-metal stent implanted after traversing the biliary strictures. One procedure failed, because the guidewire could not traverse the biliary occlusion. One week after TIBS, the mean serum bilirubin in the five successful cases had decreased from 313 µmol/L (range 203.4-369.3) to 146.2 µmol/L (range 95.8-223.3) and had further decreased to 103.6 µmol/L (range 29.5-240.9) at 1 month after the procedure. No bleeding, sepsis, or other major complications were observed after the procedure. The mean survival of these five patients was 4.5 months (range 1.9-5.8). On imaging follow-up, there was no evidence of stent stenosis or migration, with 100 % primary patency. CONCLUSIONS: When the risks of hemorrhage from percutaneous transhepatic cholangiodrainage are high, TIBS may be an effective alternative for the treatment of distal malignant obstructive jaundice.

[Study of anatomy of the lateral attachment of the renal fascia in adult with multidetector computed tomography].

The present paper is aimed to observe the lateral attachment of the renal fascia (RF) in vivo with multidetector computed tomography (MDCT) scanning, and to discuss its diagnostic value. 121 healthy adults were adopted into this experiment. All images were obtained with MDCT and double phase enhancement scanning. Then we observed the lateral attachment of RF. In addition, we mad a fresh body specimen as anatomical basis. The study found that above the renal hilar plane (RHP), the anterior renal fascia laterally fused with the peritoneum of the liver on the right and the peritoneum of the spleen on the left,and the posterior renal fascia fused with the subdiaphragmatic fascia. The lateral attachment of the RF at the RHP and the lower renal pole(LRP)is divided into three types. The RF in Type I is about 47.9% (58/121) at the left RHP, while about 33.9% (41/121) at the right RHP. At the LRP of the kidney is about 55.3% (67/121) on the left, and about 42.1% (51/121) on the right. The RF in Type I is about 38.8% (47/121) on the left side at the RHP, about 26.4% (32/121) on the right side. At the LRP, left side about 27.3% (33/121), right side about 13.3%(16/121). The RF in Type III at the RHP is 13.3% (16/121) on the left side, and on the right side is about 39.7% (48/121). At the LRP, it is about 17.4% (21/121) on the left side, and about 44.6% (54/121) on the right side. MDCT can display the lateral attachment of the RF better as well as the outside connection of the retroperitoneal space.

Melena-associated regional portal hypertension caused by splenic arteriovenous fistula.

Regional portal hypertension is a rare cause of upper gastrointestinal bleeding. We reported an extremely rare case in which regional portal hypertension was associated with both the splenic arteriovenous fistula and chronic pancreatitis. In June 2010, our patient, a 41-year-old man, was admitted to a local hospital due to a sudden melena and dizziness without haematemesis and jaundice. The splenic arteriovenous fistula in this patient was successfully occluded through transcatheter arterial embolization. At the 12-mo follow-up, our patient was in good condition.

Antitumor effects of ginsenoside Rg3 on human hepatocellular carcinoma cells.

The antitumor effects of ginsenoside Rg3 have been reported in several kinds of human malignant tumors. The purpose of this study was to investigate whether ginsenoside Rg3 can inhibit the growth of human hepatocellular carcinoma cell lines and to discuss the possible molecular mechanism(s). We cultured the human hepatocellular carcinoma cell lines, SMMC-7721 and HepG2. The cells were treated with different concentrations of ginsenoside Rg3 (0, 25, 50, 75 and 100 µg/ml), and the cell proliferation was detected by MTT assay at the 12, 24, 36 and 48 h time-points. Flow cytometry experiments were carried out to investigate the effect of Rg3 on cell apoptosis after the cells had been treated with Rg3 (50 and 100 µg/ml) for 24 and 48 h. The expression levels of caspase-3, bax and bcl-2 in Rg3-treated cells (100 µg/ml, 48 h), as well as normal cells were detected through real-time PCR experiments. MTT assay showed that the inhibition rate of cell proliferation in the Rg3 groups was significantly higher compared to the control groups in both the SMMC-7721 and HepG2 cell lines, and the inhibition rate increased with increasing Rg3 concentrations and duration of treatment. Flow cytometry analysis demonstrated that the Rg3 groups had a significantly higher cell apoptotic rate compared to the control groups in both the SMMC-7721 and HepG2 cell lines, and that the effect of Rg3 on cell apoptosis occurred in a concentration- and time-dependent manner, as was also shown by the MTT assay. Real-time PCR analysis showed that the gene expression levels of caspase-3 and bax were significantly enhanced in the Rg3 groups compared to the control groups in both the SMMC-7721 and HepG2 cell lines, but the gene expression level of bcl-2 was significantly inhibited. These results indicate that ginsenoside Rg3 can effectively inhibit the growth of human hepatocellular carcinoma cell lines by inhibiting cancer cell proliferation and promoting cancer cell apoptosis, and it may promote cancer cell apoptosis via the endogenous mitochondrial-mediated caspase-dependent apoptotic pathway.