Pioglitazone Metformin Complex Improves Polycystic Ovary Syndrome Comorbid Psychological Distress via Inhibiting NLRP3 Inflammasome Activation: A Prospective Clinical Study.

OBJECTIVE: This study aimed at investigating the therapeutic effect and mechanism of pioglitazone metformin complex preparation (PM) in polycystic ovary syndrome (PCOS) comorbid psychological distress. METHODS: Seventy-five patients with PCOS comorbid psychological distress were randomly allocated into the PM, metformin, and placebo groups. The primary efficacy measure was the change from baseline to week 12 on the Symptom Checklist 90-R (SCL-90-R) scores. NLRP3 inflammasome, IL-1ß, IL-6, TNF-α, and biochemical parameters were determined at baseline and at week 12. The participants were required to meet the criteria for PCOS (Rotterdam, NIH) and psychological distress (any factor scores of SCL - 90 - R > 2). RESULTS: The participants had significantly high scores on the SCL-90-R scales of anxiety and depression. PM significantly decreased anxiety and depression symptom severity (from 2.31 ± 0.75 to 1.65 ± 0.38, p < 0.001, and from 2.08 ± 0.74 to 1.61 ± 0.46, p = 0.010, at week 12, respectively). PM significantly decreased the expression of NRPL3 and caspase-1. Patients in the PM group experienced a significant reduction in IL-1ß (from 98.42 ± 14.38 to 71.76 ± 13.66, p = 0.02), IL-6 (from 87.51 ± 8.74 to 71.98 ± 15.87, p = 0.02), and TNF-α (from 395.33 ± 88.55 to 281.98 ± 85.69, p = 0.04). PM was superior to metformin in reducing total testosterone (2.24 ± 0.74 versus 3.06 ± 0.83, p = 0.024, at week 12). CONCLUSIONS: This study is the first to reveal that PM alleviates psychological distress via inhibiting NLRP3 inflammasome and improves several markers, including total testosterone.

Isotope evidence for temporal and spatial variations of anthropogenic sulfate input in the Yihe River during the last decade.

Pyrite oxidation and sedimentary sulfate dissolution are the primary components of riverine sulfate (SO42-) and are predominant in global SO42- flux into the ocean. However, the proportions of anthropogenic SO42- inputs have been unclear, and their tempo-spatial variations due to human activities have been unknown. Thus, field work was conducted in a spatially heterogeneous human-affected area of the Yihe River Basin (YRB) during a wet year (2010) and drought years (2017/2018). Dual sulfate isotopes (δ34S-SO42- and δ18O-SO42-) and Bayesian isotope mixing models were used to calculate the variable anthropogenic SO42- inputs and elucidate their temporal impacts on riverine SO42- flux. The results of the mixing models indicated acid mine drainage (AMD) contributions increased from 56.1% to 83.1% of upstream sulfate and slightly decreased from 46.3% to 44.0% of midstream sulfate in 2010 and 2017/2018, respectively, in the Yihe River Basin. The higher upstream contribution was due to extensive metal-sulfide-bearing mine drainage. Sewage-derived SO42- and fertilizer-derived SO42- inputs in the lower reaches had dramatically altered SO42- concentrations and δ34S-SO42- and δ18O-SO42- values. Due to climate change, the water flow discharge decreased by about 70% between 2010 and 2017/2018, but the riverine sulfate flux was reduced by only about 58%. The non-proportional increases in anthropogenic sulfate inputs led to decreases in the flow-weighted average values of δ34S-SO42- and δ18O-SO42- from 10.3‰ to 9.9‰ and from 6.1‰ to 4.4‰, respectively. These outcomes confirm that anthropogenic SO42- inputs from acid mine drainage (AMD) have increased, but sewage effluents SO42- inputs have decreased.

Simultaneous partial splenectomy during liver transplantation for advanced cirrhosis patients combined with severe splenomegaly and hypersplenism.

BACKGROUND: The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation (LT). However, splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegaly. AIM: To examine the feasibility of performing partial splenectomy during LT in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism. METHODS: Between October 2015 and February 2019, 762 orthotopic LTs were performed for patients with end-stage liver diseases in Tianjin First Center Hospital. Eighty-four cases had advanced cirrhosis combined with severe splenomegaly and hypersplenism. Among these patients, 41 received partial splenectomy during LT (PSLT group), and 43 received only LT (LT group). Patient characteristics, intraoperative parameters, and postoperative outcomes were retrospectively analyzed and compared between the two groups. RESULTS: The incidence of postoperative hypersplenism (2/41, 4.8%) and recurrent ascites (1/41, 2.4%) in the PSLT group was significantly lower than that in the LT group (22/43, 51.2%; 8/43, 18.6%, respectively). Seventeen patients (17/43, 39.5%) in the LT group required two-stage splenic embolization, and further splenectomy was required in 6 of them. The operation time and intraoperative blood loss in the PSLT group (8.6 ± 1.3 h; 640.8 ± 347.3 mL) were relatively increased compared with the LT group (6.8 ± 0.9 h; 349.4 ± 116.1 mL). The incidence of postoperative bleeding, pulmonary infection, thrombosis and splenic arterial steal syndrome in the PSLT group was not different to that in the LT group, respectively. CONCLUSION: Simultaneous PSLT is an effective treatment and should be performed in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism to prevent postoperative persistent hypersplenism.

Comparison of Liver Transplantation and Liver Resection for Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus Type I and Type II.

PURPOSE: The aim of this study was to compare the efficacy of liver transplantation (LT) and liver resection (LR) for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) and to investigate risk factors affecting prognosis. MATERIALS AND METHODS: A total of 94 HCC patients with PVTT type I (segmental PVTT) and PVTT type II (lobar PVTT) were involved and divided into LR (n=47) and LT groups (n=47). Recurrence-free survival (RFS) and overall survival (OS) were compared before and after inverse probability of treatment weighting (IPTW). Prognostic factors for RFS and OS were explored. RESULTS: Two treatment groups were well-balanced using IPTW. In the entire cohort, LT provided a better prognosis than LR. Among patients with PVTT type I, RFS was better with LT (p=0.039); OS was not different significantly between LT and LR (p=0.093). In subgroup analysis of PVTT type I patients with α-fetoprotein (AFP) levels >200 ng/mL, LT elicited significantly longer median RFS (18.0 months vs. 2.1 months, p=0.022) and relatively longer median OS time (23.6 months vs. 9.8 months, p=0.065). Among patients with PVTT type II, no significant differences in RFS and OS were found between LT and LR (p=0.115 and 0.335, respectively). Multivariate analyses showed treatment allocation (LR), tumor size (>5 cm), AFP and aspartate aminotransferase (AST) levels to be risk factors of RFS and treatment allocation (LR), AFP and AST as risk factors for OS. CONCLUSION: LT appeared to afford a better prognosis for HCC with PVTT type I than LR, especially in patients with AFP levels >200 ng/mL.

Complex liver retransplantation to treat graft loss due to long-term biliary tract complication after liver transplantation: A case report.

BACKGROUND: Loss of graft function after liver transplantation (LT) inevitably requires liver retransplant. Retransplantation of the liver (ReLT) remains controversial because of inferior outcomes compared with the primary orthotopic LT (OLT). Meanwhile, if accompanied by vascular complications such as arterial and portal vein (PV) stenosis or thrombosis, it will increase difficulties of surgery. We hereby introduce our center's experience in ReLT through a complicated case of ReLT. CASE SUMMARY: We report a patient who suffered from hepatitis B-associated cirrhosis and underwent LT in December 2012. Early postoperative recovery was uneventful. Four months after LT, the patient's bilirubin increased significantly and he was diagnosed with an ischemic-type biliary lesion caused by hepatic artery occlusion. The patient underwent percutaneous transhepatic cholangial drainage and repeatedly replaced intrahepatic biliary drainage tube regularly for 5 years. The patient developed progressive deterioration of liver function and underwent liver re-transplant in January 2019. The operation was performed in a classic OLT manner without venous bypass. Both the hepatic artery and PV were occluded and could not be used for anastomosis. The donor PV was anastomosed with the recipient's left renal vein. The donor hepatic artery was connected to the recipient's abdominal aorta. The bile duct reconstruction was performed in an end-to-end manner. The postoperative process was very uneventful and the patient was discharged 1 mo after retransplantation. CONCLUSION: With the development of surgical techniques, portal thrombosis and arterial occlusion are no longer contraindications for ReLT.

Effects of positive acceleration (+Gz stress) on liver enzymes, energy metabolism, and liver histology in rats.

BACKGROUND: Exposure to high sustained +Gz (head-to-foot inertial load) is known to have harmful effects on pilots' body in flight. Although clinical data have shown that liver dysfunction occurs in pilots, the precise cause has not been well defined. AIM: To investigate rat liver function changes in response to repeated +Gz exposure. METHODS: Ninety male Wistar rats were randomly divided into a blank control group (BC group, n = 30), a +6 Gz/5 min stress group (6GS group, n = 30), and a +10 Gz/5min stress group (10GS group, n = 30). The 6GS and 10GS groups were exposed to +6 Gz and +10 Gz, respectively, in an animal centrifuge. The onset rate of +Gz was 0.5 G/s. The sustained time at peak +Gz was 5 min for each exposure (for 5 exposures, and 5-min intervals between exposures for a total exposure and non-exposure time of 50 min). We assessed liver injury by measuring the portal venous flow volume, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST), liver tissue malondialdehyde (MDA), Na+-K+-ATPase, and changes in liver histology. These parameters were recorded at 0 h, 6 h, and 24 h after repeated +Gz exposures. RESULTS: After repeated +Gz exposures in the 6GS and the 10GS groups, the velocity and flow signal in the portal vein (PV) were significantly decreased as compared to the BC group at 0 h after exposure. Meanwhile, we found that the PV diameter did not change significantly. However, rats in the 6GS group had a much higher portal venous flow volume than the 10GS group at 0 h after exposure. The 6GS group had significantly lower ALT, AST, and MDA values than the 10GS group 0 h and 6 h post exposure. The Na+-K+-ATPase activity in the 6GS group was significantly higher than that in the 10GS group 0 h and 6 h post exposure. Hepatocyte injury, determined pathologically, was significantly lower in the 6GS group than in the 10GS group. CONCLUSION: Repeated +Gz exposures transiently cause hepatocyte injury and affect liver metabolism and morphological structure.

Simultaneous liver, pancreas-duodenum and kidney transplantation in a patient with hepatitis B cirrhosis, uremia and insulin dependent diabetes mellitus.

Simultaneous liver, pancreas-duodenum, and kidney transplantation has been rarely reported in the literature. Here we present a new and more efficient en bloc technique that combines classic orthotopic liver and pancreas-duodenum transplantation and heterotopic kidney transplantation for a male patient aged 44 years who had hepatitis B related cirrhosis, renal failure, and insulin dependent diabetes mellitus (IDDM). A quadruple immunosuppressive regimen including induction with basiliximab and maintenance therapy with tacrolimus, mycophenolate mofetil, and steroids was used in the early stage post-transplant. Postoperative recovery was uneventful and the patient was discharged on the 15th postoperative day with normal liver and kidney function. The insulin treatment was completely withdrawn 3 wk after operation, and the blood glucose level remained normal. The case findings support that abdominal organ cluster and kidney transplantation is an effective method for the treatment of end-stage liver disease combined with uremia and IDDM.

[Subcellular Distribution and Chemical Forms of Heavy Metals in Three Types of Compositae Plants from Lead-Zinc Tailings Area].

Field investigation on the content of heavy metals in soils and three types of widely distributing compositae plants(Artemisia lavandulaefolia, Ageratum conyzoides L., Crassocephalum crepidioides) in lead-zinc tailings farmland of Yangshuo, Guangxi Zhuang Autonomous Region was carried out, and the differential centrifugation technique and sequential chemical extraction method were used to study the subcellular distribution and chemical forms of heavy metals in these plants. The results indicated that the soil in the tailings farmland was highly contaminated by Cd, Pb and Zn, and their concentrations were 37.7, 5.7 and 8.9 times higher than their respective values of national standard for soil environment quality(GradeⅡ). The contents of Cd, Pb and Zn in the analyzed plants exceeded the normal ranges. Ageratum conyzoides L. and Crassocephalum crepidioides showed strong capability in tolerance, accumulation and transport of Cd, and they could be used as pioneer plants for Cd-phytoremediation in study area and some related areas. In addition, Cd concentrations in the stem and leave of Crassocephalum crepidioides were 159.6 mg·kg-1 and 219.5 mg·kg-1, respectively, which exceeded the threshold of Cd hyperaccumulator. Thus, Crassocephalum crepidioides can be regarded as a Cd-hyperaccumulator. Majority of total Cd, Pb and Zn were found in soluble fraction and cell wall in the plants, while only a small quantity were distributed in organelles. As for chemical forms distribution, Cd, Zn and Pb predominated NaCl-, HAC-, and HCl-extractable forms both in roots and shoots of the plants. Therefore, cell wall binding, vacuolar compartmentalization and distribution mainly in lower active chemical forms were supposed to be the main mechanisms for tolerance to heavy metals in the study plants. A difference of Cd subcellular distribution and its chemical forms in the three Compositae plants was observed. Compared with the shoot of Artemisia lavandulaefolia, more Cd was located in the vacuolus and cellular soluble parts in Ageratum conyzoides L. and Crassocephalum crepidioides. Moreover, the proportion of active chemical Cd in the shoots was lower than that in the roots. These results showed that the subcellular distribution and chemical forms of Cd were related to the plant species,and also indicated Ageratum conyzoides L. and Crassocephalum crepidioides were likely to possess a higher tolerance and accumulation of Cd.

Molecular hydrogen increases resilience to stress in mice.

The inability to successfully adapt to stress produces pathological changes that can lead to depression. Molecular hydrogen has anti-oxidative and anti-inflammatory activities and neuroprotective effects. However, the potential role of molecular hydrogen in stress-related disorders is still poorly understood. The present study aims to investigate the effects of hydrogen gas on resilience to stress in mice. The results showed that repeated inhalation of hydrogen-oxygen mixed gas [67%:33% (V/V)] significantly decreased both the acute and chronic stress-induced depressive- and anxiety-like behaviors of mice, assessed by tail suspension test (TST), forced swimming test (FST), novelty suppressed feeding (NSF) test, and open field test (OFT). ELISA analyses showed that inhalation of hydrogen-oxygen mixed gas blocked CMS-induced increase in the serum levels of corticosterone, adrenocorticotropic hormone, interleukin-6, and tumor necrosis factor-α in mice exposed to chronic mild stress. Finally, inhalation of hydrogen gas in adolescence significantly increased the resilience to acute stress in early adulthood, which illustrates the long-lasting effects of hydrogen on stress resilience in mice. This was likely mediated by inhibiting the hypothalamic-pituitary-adrenal axis and inflammatory responses to stress. These results warrant further exploration for developing molecular hydrogen as a novel strategy to prevent the occurrence of stress-related disorders.

Liver transplantation for a giant mesenchymal hamartoma of the liver in an adult: Case report and review of the literature.

Mesenchymal hamartomas of the liver (MHLs) in adults are rare and potentially premalignant lesions, which present as solid/cystic neoplasms. We report a rare case of orthotopic liver transplantation in a patient with a giant MHL. In 2013, a 34-year-old female sought medical advice after a 2-year history of progressive abdominal distention and respiratory distress. Physical examination revealed an extensive mass in the abdomen. Computed tomography (CT) of her abdomen revealed multiple liver cysts, with the diameter of largest cyst being 16 cm × 14 cm. The liver hilar structures were not clearly displayed. The adjacent organs were compressed and displaced. Initial laboratory tests, including biochemical investigations and coagulation profile, were unremarkable. Tumor markers, including levels of AFP, CEA and CA19-9, were within the normal ranges. The patient underwent orthotopic liver transplantation in November 2013, the liver being procured from a 40-year-old man after cardiac death following traumatic brain injury. Warm ischemic time was 7.5 min and cold ischemic time was 3 h. The recipient underwent classical orthotopic liver transplantation. The recipient operative procedure took 8.5 h, the anhepatic phase lasting for 1 h without the use of venovenous bypass. The immunosuppressive regimen included intraoperative induction with basiliximab and high-dose methylprednisolone, and postoperative maintenance with tacrolimus, mycophenolate mofetil, and prednisone. The recipient's diseased liver weighed 21 kg (dry weight) and measured 41 cm × 32 cm × 31 cm. Histopathological examination confirmed the diagnosis of an MHL. The patient did not experience any acute rejection episode or other complication. All the laboratory tests returned to normal within one month after surgery. Three months after transplantation, the immunosuppressive therapy was reduced to tacrolimus monotherapy, and the T-tube was removed after cholangiography showed no abnormalities. Twelve months after transplantation, the patient remains well and is fulfilling all normal activities. Adult giant MHL is extremely rare. Symptoms, physical signs, laboratory results, and radiographic imaging are nonspecific and inconclusive. Surgical excision of the lesion is imperative to make a definite diagnosis and as a cure. Liver transplantation should be considered as an option in the treatment of a non-resectable MHL.

Application of quantum descriptors for predicting adsorption performance of starch and cyclodextrin adsorbents.

Adsorption trend of aromatic compounds on epichlorohydrin (EPI), 1,6-hexamethylene diisocyanate (HDI), and 4,4-methylene diphenyl diisocyanate (MDI) cross-linked starch and cyclodextrin adsorbents were comparatively studied by density functional theorem (DFT) based interaction descriptors and batch adsorption studies. The DFT quantum chemical descriptors predicted adsorption trend of MDI adsorbents>HDI adsorbents>EPI adsorbents. The values of the fractional number of electrons transferred (ΔN) for all the studied adsorbent-adsorbate pair were negative, indicating that the adsorbents were electron donors in the studied adsorption interaction. The batch adsorption performance for the studied cross-linked adsorbents was in agreement with the DFT predictions. Energy gap, chemical hardness, and softness showed good linear correlation (R(2)=0.8,073 ± 0.2259) to the batch adsorption performance for most of the studied adsorbent-adsorbate pairs. The present study demonstrated that DFT quantum chemical parameters are suitable adsorption descriptors for predicting adsorption performance of cross-linked adsorbents.

[Research on the effect and technique of remediation for multi-metal contaminated tailing soils].

Soil samples were collected from compound polluted tailings to analyze the contents of total heavy metals and their speciation in the soil. Laboratory batch tests were conducted to examine the effects of distilled water and different concentrations of oxalic acid, citric acid, acetic acid, HNO3 and EDTA on the removal of heavy metals from the polluted soils. The suitable eluent and its optimal conditions including liquid to soil ratio, reaction time and washing number were also optimized, and the total toxicity reduction index was proposed to evaluate the effect of the eluent on the remediation of polluted soil. The results showed that Cd and Pb were the most abundant heavy metals in the soil, reaching 52.2 mg x kg(-1) and 4836.5 m x kg(-1), respectively. There was significant difference in the removal efficiency for different heavy metals. Cr had a maximum removal efficiency of 2.7%, while the maximum Cd and Pb removal efficiency was both about 60%. Distilled water had little removal efficiency for heavy metals, with less than 0.1% removal rate; the heavy metal removal efficiency of oxalic acid and acetic acid was also quite low; EDTA in 0.1 mol x L(-1) was selected as the suitable eluent for the polluted soil. Evaluation of the total toxicity reduction index and the cost suggested that EDTA should be used with a liquid to soil ratio of 6:1, a reaction time of 3 h and 2 washings.

The cell surface GRP78 facilitates the invasion of hepatocellular carcinoma cells.

Invasion is a major characteristic of hepatocellular carcinoma and one of the main causes of refractory to treatment. We have previously reported that GRP78 promotes the invasion of hepatocellular carcinoma although the mechanism underlying this change remains uncertain. In this paper, we explored the role of the cell surface GRP78 in the regulation of cancer cell invasion in hepatocellular carcinoma cells. We found that neutralization of the endogenous cell surface GRP78 with the anti-GRP78 antibody inhibited the adhesion and invasion in hepatocellular carcinoma cell lines Mahlavu and SMMC7721. However, forced expression of the cell surface GRP78 facilitated the adhesion and invasion in SMMC7721. We further demonstrated that inhibition of the endogenous cell surface GRP78 specifically inhibited the secretion and activity of MMP-2 but did not affect the secretion and activity of MMP-9. We also found that inhibition of the cell surface GRP78 increased E-Cadherin expression and decreased N-Cadherin level. On the contrary, forced expression of the cell surface GRP78 increased N-Cadherin expression and decreased E-Cadherin level, suggesting that the cell surface GRP78 plays critical role in the regulation of EMT process. These findings suggest that the cell surface GRP78 plays a stimulatory role in the invasion process and may be a potential anti-invasion target for the treatment of hepatocellular carcinoma.

Neuropeptide Trefoil factor 3 improves learning and retention of novel object recognition memory in mice.

Accumulating evidence has implicated neuropeptides in modulating recognition, learning and memory. However, to date, no study has investigated the effects of neuropeptide Trefoil factor 3 (TFF3) on the process of learning and memory. In the present study, we evaluated the acute effects of TFF3 administration (0.1 and 0.5mg/kg, i.p.) on the acquisition and retention of object recognition memory in mice. We found that TFF3 administration significantly enhanced both short-term and long-term memory during the retention test, conducted 90 min and 24h after training respectively. Remarkably, acute TFF3 administration transformed a learning event that would not normally result in long-term memory into an event retained for a long-term period and produced no effect on locomotor activity in mice. In conclusion, the present results provide an important role of TFF3 in improving object recognition memory and reserving it for a longer time, which suggests a potential therapeutic application for diseases with recognition and memory impairment.

Spatial distribution of soil heavy metal pollution estimated by different interpolation methods: accuracy and uncertainty analysis.

Mapping the spatial distribution of contaminants in soils is the basis of pollution evaluation and risk control. Interpolation methods are extensively applied in the mapping processes to estimate the heavy metal concentrations at unsampled sites. The performances of interpolation methods (inverse distance weighting, local polynomial, ordinary kriging and radial basis functions) were assessed and compared using the root mean square error for cross validation. The results indicated that all interpolation methods provided a high prediction accuracy of the mean concentration of soil heavy metals. However, the classic method based on percentages of polluted samples, gave a pollution area 23.54-41.92% larger than that estimated by interpolation methods. The difference in contaminated area estimation among the four methods reached 6.14%. According to the interpolation results, the spatial uncertainty of polluted areas was mainly located in three types of region: (a) the local maxima concentration region surrounded by low concentration (clean) sites, (b) the local minima concentration region surrounded with highly polluted samples; and (c) the boundaries of the contaminated areas.

[Identification of using organic carbon isotopic composition of soil pollution process].

This study has taken advantage of the characteristics of concentration of soil organic matter (SOC) and delta13 C(SOC) values to provide proofs for environment quality assessment and to know more about polluted sources, sizes and processes in Beijing steel company area. delta13C values of SOC is good for tracing sources and documenting shifts in community composition and distribution. Two sections (Beijing steel company area and Yongledian, Tongzhou) which belong to two different soil types collected in Beijing, and organic carbon isotopic composition and total soil organic carbon were analyzed. These results shows that SOC of soil samples from Beijing steel company area are quite high, and even 9.7% at the surface sample, however SOC from unpolluted area (Yongledian area) is lower than those of industrial area. delta13 C(SOC) from soils of Beijing steel company area and Yongledian area respectively vary from -24.8 per thousand to -23.1 per thousand and -26.4 per thousand to -20.5 per thousand, the results are quite different. The results reflect that there are different organic carbon sources in different types' soil: Organic carbon from Beijing steel company area has been mainly affected by coal burning, soil organic carbon concentrations are quite high, and pollution can affect on soils 70 cm deep underground; and soils from Yongledian area, have been not polluted, and organic matter is from natural litter (C3 plants). Although there are different soil organic carbon concentrations and isotope compositions, two soil sections have similar variation trends. This study provides proofs for environment quality assessment and know more about polluted and natural sources, sizes in Beijing.