Utility of gadoxetate disodium-enhanced magnetic resonance imaging in evaluating liver failure risk after major hepatic resection.

Background: Post-hepatectomy liver failure (PHLF) is still a predominant cause of hepatectomy-related mortality. However, it is difficult to evaluate the remnant liver functional reserve accurately before surgery to prevent PHLF. In this study, we aimed to explore the role of gadoxetate disodium-enhanced magnetic resonance imaging (MRI) in evaluating remnant liver functional reserve. Methods: For this cross-sectional study, the sample retrospectively included 56 patients undergoing liver resections of at least three segments between June 2019 and September 2022 at The General Hospital of the Western Theater Command. Pre-surgery assessments involved liver computer tomography (CT), an indocyanine green (ICG) clearance test, the Child-Pugh scoring system, and liver function serum biochemical indicators. Each patient underwent a gadoxetate disodium-enhanced MRI before the hepatectomy, and we measured the remnant hepatocellular uptake index (rHUI) as well as the standard remnant hepatocellular uptake index (SrHUI). We examined the diagnostic utility of rHUI, SrHUI, indocyanine green retention rate of 15 minutes (ICG R15), and Albumin for PHLF. Receiver operating characteristics (ROC) analyses were used to measure the preoperative liver function parameters (namely, rHUI, SrHUI, ICG R15, and Albumin) for predicting PHLF. The areas under the curve (AUCs) were calculated and compared between different preoperative liver function parameters using the Wilson/Brown method. The Pearson or Spearman correlation coefficient was used for correlation analysis between ICG R15, Albumin, and rHUI and between ICG R15, Albumin, and SrHUI, respectively. Results: Twelve patients (21.43%) had complications of PHLF. We found significant differences in rHUI, SrHUI, ICG R15, and Albumin between the non-PHLF and PHLF groups. The pooled r between ICG R15 and rHUI was -0.591 [95% confidence interval (CI): -0.740 to -0.389, P<0.001], and between ICG R15 and SrHUI was -0.534 (95% CI: -0.703 to -0.308, P<0.001). The area under the curve (AUC) values of rHUI, SrHUI, ICG R15, and Ablumin were 0.871 (sensitivity 81.82%; specificity 91.67%), 0.878 (sensitivity 79.55%; specificity 83.33%), 0.835 (sensitivity 99.73%; specificity 66.67%), and 0.782 (sensitivity 88.64%; specificity 58.33%), respectively. Conclusions: We found that the rHUI and SrHUI calculated using the gadoxetate disodium-enhanced MRI reflected a combination of remnant hepatocyte function and liver volume, and these were useful as a quantitative assessment indicator of remnant liver functional reserve and can be a better predictor of PHLF after major hepatic resection.

WAY-262611 ameliorates the inflammatory bowel disease by activating Wnt/ß-catenin pathway.

Inflammatory bowel disease (IBD) is a non-specific and relapsing intestinal inflammation. The injury and repair of intestinal epithelial together determine the occurrence and development of IBD. Wnt/ß-catenin pathway is considered as the key role in the proliferation and differentiation of intestinal stem cells which is negative regulated by Dickkiop (DKKs). WAY-262611 is a novel inhibitor of DKK-1, and has demonstrated therapeutic effect on some disease including osteoporosis. Thus, we investigated the effect of WAY-262611 on IBD. Firstly, a mice model of IBD was established by DSS induction, by which the expression of Wnt3a and DKK-1 were detected by immumohistochemical staining to display their correlation. Next, using WAY-262611 the ameliorative effect on IBD was validated by histopathological staining. Using Mode-k cells the experiments in vitro were also conducted, in which the viability and apoptosis were determined. By detecting expression of Wnt3a and DKK-1 and observing nuclear translocation of ß-catenin, the activation of Wnt/ß-catenin pathway was validated. Finally, the incidence of the orthotopic colorectal cancer was calculated under continuous administration by DSS. Results demonstrated that the expression of Wnt3a is negative correlated with DKK-1. WAY-262611 ameliorated the IBD and reduced apoptosis of Mode-k cells induced by DSS. The protective effect of WAY-262611 on Mode-k cells is mediated by Wnt/ß-catenin pathway activation. In addition, WAY-262611 lowered the incidence rate of orthotopic colorectal cancer. All these results concluded that WAY-262611 could mitigate the IBD by activating Wnt/ß-catenin pathway in mice.

Soil habitat condition shapes Tamarix chinensis community diversity in the coastal saline-alkali soils.

Introduction: Unfavorable coastal saline-alkali soil habitats degrade plant community diversity and reduce terrestrial ecological functions. Previous studies have been conducted on the mechanisms by which certain saline-alkali soil properties determine plant community diversity, however, how those properties synergistically affect plant community diversity remains unclear. Methods: Here, 36 plots of typical Tamarix chinensis communities were investigated for a range of parameters at three different distances (10, 20, and 40 km) from the coastline in the Yellow River Delta between 2020 and 2022, and corresponding soil samples were taken and analyzed. Results and discussion: Our results suggest that although T. chinensis density, ground diameter, and canopy coverage significantly increased (P<0.05) with increasing distance from the coast, the communities with the most plant species were found at 10 to 20 km distance from the coastline, indicating the effects of soil habitat on T. chinensis community diversity. Simpson dominance (species dominance), Margalef (species richness), and Pielou indices (species evenness) differed significantly among the three distances (P<0.05) and were significantly correlated with soil sand content, mean soil moisture, and electrical conductivity (P<0.05), indicating that soil texture, water, and salinity were the main factors governing T. chinensis community diversity. Principal component analysis (PCA) was performed to construct an integrated soil habitat index (SHI) representing the synthesis of the soil texture-water-salinity condition. The estimated SHI quantified a 64.2% variation in the synthetic soil texture-water-salinity condition and was significantly higher at the 10 km distance than at the 40 and 20 km distances. The SHI linearly predicted T. chinensis community diversity (R2 = 0.12-0.17, P<0.05), suggesting that greater SHI (coarser soil texture, wetter soil moisture regime, and higher soil salinity) was found closer to the coast and coincided with higher species dominance and evenness and lower species richness in the T. chinensis community. These findings on the relationship between T. chinensis communities and soil habitat conditions will be valuable in planning the restoration and protection of the ecological functions of T. chinensis shrubs in the Yellow River Delta.

Laparoscopic Treatment Strategies for Liver Echinococcosis.

Liver echinococcosis is clinically mainly composed of hepatic cystic echinococcosis (CE) and hepatic alveolar echinococcosis (AE). At present, laparoscopy has been comprehensively applied in the treatment of two types of liver echinococcosis. For hepatic CE treatment, both laparoscopic total pericystectomy and laparoscopic hepatectomy can achieve radical results, but the former is considered the first choice owing to its being more minimally invasive; laparoscopic subtotal pericystectomy and laparoscopic partial pericystectomy can be accepted as complementary options, considering the presence of complicated cysts and the level of laparoscopic technique in remote hospitals; laparoscopic cystectomy is simple, but it is not currently recommended for treatment of hepatic CE owing to poor efficacy and high risk of postoperative complications. For hepatic AE treatment, laparoscopy not only achieves the same radical effect as open surgery in selected patients, but also is more minimally invasive, so it has a better prospect.

Reverse rolling-mat type lymph node dissection is the key step to solve the operative difficulties in hand-assisted laparoscopic D2 radical gastrectomy.

BACKGROUND: We have improved and named a new reverse rolling-mat type lymph node dissection, which effectively solves the dilemma faced by the traditional lymph node dissection in hand-assisted laparoscopic D2 radical gastrectomy through the optimization of the surgical procedure. However, the relevant clinical data are still scarce. The study aims to compare the clinical effects of two surgical procedure and explore the safety and feasibility of "reverse procedure". STUDY DESIGN: The clinicopathological data of 195 patients who underwent hand-assisted D2 radical total gastrectomy (HALTG) in our hospital from January 2011 to September 2017 were collected. A retrospective case-control study was used to compare the clinical outcomes of the two patterns of lymph node dissection. Among them, 89 patients underwent "cabbage type" lymph node dissection and 106 patients underwent the "reverse procedure" lymph node dissection. RESULTS: There were no significant differences between the two groups of patients in terms of gender, age, tumor location, incision length, postoperative hospitalization duration, pathological classification, recent complications, long-term recurrence and metastasis. The operation time of "cabbage type" group was shorter than that of "reverse procedure" group (178.35 ± 31.52 min vs 191.25 ± 32.77 min; P = 0.006). While, in the "reverse procedure" group, intraoperative blood loss was less (249.4 ± 143.12 vs 213.58 ± 101.43; P = 0.049), and there were more numbers of lymph nodes dissected (18.04 ± 7.00 vs 32.25 ± 14.23; P < 0.001). CONCLUSION: The pattern of reverse rolling-mat type lymph node dissection in HALTG perform well in terms of safety and feasibility.