[Effects of Xiangdan Injection on pharmacokinetics and pharmacodynamics of warfarin in rats in vivo].

This study is to explore the effect of Xiangdan Injection on anticoagulation of warfarin in rats. Rats were randomly divided into different groups and then administered, subsequently the blood samples were collected at a set series of time points to measure PT(prothrombin time) and APTT(activated partial thromboplastin time) values, and INR(international normalized ratio) value was calculated. The plasma concentrations of warfarin enantiomers were determined by UPLC-MS/MS technology, and pharmacokinetic parameters were calculated by DAS 2.0 software. Statistical analysis was performed to compare differences between the groups. Single-dose study of warfarin showed that Xiangdan Injection alone had no effects on PT, APTT and INR, but when co-administrated with warfarin, PT and INR values were increased(P<0.01), while APTT was unaffected; after co-administration of the two drugs, C_(max), AUC_(0-t), and AUC_(0-∞) of S-warfarin increased(P<0.01), and t_(1/2) prolonged(P<0.01), while the pharmacokinetic parameters of R-warfarin were not changed significantly. Steady-state study of warfarin showed that after co-administration of the two drugs, the PT and INR values increased(P<0.05), and the plasma concentration of S-warfarin increased(P<0.01), while the plasma concentration of R-warfarin was not changed significantly. The results suggest that Xiangdan Injection itself has no effect on coagulation index, but can enhance the anticoagulant effect of warfarin by slowing metabolism of S-warfarin.

The crosstalk between ferroptosis and mitochondrial dynamic regulatory networks.

Ferroptosis is an iron-driven cell death modality characterized by iron accumulation and excessive lipid peroxidation. Ferroptosis is closely related to mitochondrial function, as indicated by studies showing that mitochondrial dysfunction and damage promote oxidative stress, which in turn induces ferroptosis. Mitochondria play crucial roles in cellular homeostasis, and abnormalities in their morphology and function are closely associated with the development of many diseases. Mitochondria are highly dynamic organelles, and their stability is maintained through a series of regulatory pathways. Mitochondrial homeostasis is dynamically regulated, mainly via key processes such as mitochondrial fission, mitochondrial fusion and mitophagy; however, mitochondrial processes are prone to dysregulation. Mitochondrial fission and fusion and mitophagy are intimately related to ferroptosis. Therefore, investigations into the dynamic regulation of mitochondrial processes during ferroptosis are important to provide a better understanding of the development of disease. In this paper, we systematically summarized changes in ferroptosis, mitochondrial fission and fusion and mitophagy to promote an in-depth understanding of the mechanism underlying ferroptosis and provide a corresponding reference for the treatment of related diseases.

Dynamics of carbon stocks of different pools in Huzhong National Nature Reserve, Northeast China under the disturbance of various severity fires.

In this study, the FireBGCv2 model was used to simulate the dynamics of forest carbon pools of Huzhong Nature Reserve within the next 100 years under various forest fire severity scena-rios. The aim of this study was to explore the responses of different forest carbon pools to fire disturbance, and to provide scientific basis for forest fuel management. The results showed that forest fire significantly reduced forest carbon storage, with the greatest reduction under the scenario of high-severity forest fire. Fire disturbance affected carbon storage in different pools, and relocated carbon among those pools. Forest fire disturbance reduced carbon storage of living trees and duff, increased that of coarse woody debris in the early and middle stages of simulation, and decreased that in late stage. The carbon storage of shrub and herb strata increased significantly in the late simulation period. The higher the fire severity, the lower the carbon storage of living tree and shrub-herb carbon pools, with snag and coarse woody debris showing the opposite trend. The impact of forest fire disturbance on the total carbon pool distribution was as follows: forest fire increased the proportion of shrub and herb strata, snag, coarse woody debris and soil carbon pool, and reduced the proportion of living tree and duff. The higher severity forest fire was, the lower the proportion of carbon pool of shrub-herb, and the higher the proportion of carbon pool of coarse wood debris. The severity of forest fire had less impact on the proportion of other carbon pools. In addition, our results demonstrated periodic change of litter carbon that reached a high value within 20 years and then dropped to a low value within 10 years. Our results could provide sound basis for determining the forest fuel treatment interval. We suggested performing prescribed burning every 20 years in the Great Xing'an Mountains area to protect forest resources.

Anterior abdominal abscess - a rare manifestation of severe acute pancreatitis: A case report.

BACKGROUND: Severe acute pancreatitis (SAP) is a common critical disease of the digestive system. In addition to the clinical manifestations and biochemical changes of acute pancreatitis, SAP is also accompanied by organ failure lasting more than 48 h. SAP is characterized by focal or extensive pancreatic necrosis, hemorrhage and obvious inflammation around the pancreas. The peripancreatic fat space, fascia, mesentery and adjacent organs are often involved. The common local complications include acute peripancreatic fluid collection, acute necrotic collection, pancreatic pseudocyst, walled off necrosis and infected pancreatic necrosis. After reviewing the literature, we found that in very few cases, SAP patients have complications with anterior abdominal wall abscesses. CASE SUMMARY: We report a 66-year-old Asian male with severe acute pancreatitis who presented with intermittent abdominal pain and an increasing abdominal mass. The abscess spread from the retroperitoneum to the anterior abdominal wall and the right groin. In the described case, drainage tubes were placed in the retroperitoneal and anterior abdominal wall by percutaneous puncture. After a series of symptomatic supportive therapies, the patient was discharged from the hospital with a retroperitoneal drainage tube after the toleration of oral feeding and the improvement of nutritional status. CONCLUSION: We believe that patients with SAP complicated with anterior abdominal abscess can be treated conservatively to avoid unnecessary exploration or operation.

Extracellular vesicles and pancreatitis: mechanisms, status and perspectives.

Comprehensive reviews and large population-based cohort studies have played an important role in the diagnosis and treatment of pancreatitis and its sequelae. The incidence and mortality of pancreatitis have been reduced significantly due to substantial advancements in the pathophysiological mechanisms and clinically effective treatments. The study of extracellular vesicles (EVs) has the potential to identify cell-to-cell communication in diseases such as pancreatitis. Exosomes are a subset of EVs with an average diameter of 50~150 nm. Their diverse and unique constituents include nucleic acids, proteins, and lipids, which can be transferred to trigger phenotypic changes of recipient cells. In recent years, many reports have indicated the role of EVs in pancreatitis, including acute pancreatitis, chronic pancreatitis and autoimmune pancreatitis, suggesting their potential influence on the development and progression of pancreatitis. Plasma exosomes of acute pancreatitis can effectively reach the alveolar cavity and activate alveolar macrophages to cause acute lung injury. Furthermore, upregulated exosomal miRNAs can be used as biomarkers for acute pancreatitis. Here, we summarized the current understanding of EVs in pancreatitis with an emphasis on their biological roles and their potential use as diagnostic biomarkers and therapeutic agents for this disease.

Characterization of Endothelial Cells Associated with Cerebral Arteriovenous Malformation.

INTRODUCTION: Cerebral arteriovenous malformation (cAVM) is a disease characterized by the angiogenesis and remodeling of veins. However, whether vascular endothelial cells (ECs) exhibit morphological and functional changes during cAVM remains unclear. This study aimed to investigate the role of ECs in the pathogenesis of cAVM. METHODS: Rat model of cAVM was established by anastomosing the common carotid artery with the external jugular vein. The digital subtraction angiography (DSA), HE, Masson and immunohistochemical staining were performed to evaluate the model. ECs were isolated from AVM rat model or control rats, and characterized by MTT, cell scratch, and tube formation assays. The secretion of vascular endothelial growth factor (VEGF) was detected by ELISA. RESULTS: AVM rat model showed typical pathological characteristics of cAVM. In addition, the proliferation, migration and tube formation abilities of ECs of arterialized vein (AV-ECs) were significantly better than those of ECs of normal vein (NV-ECs). Moreover, the levels of secreted VEGF were significantly higher in AV-ECs than in NV-ECs. CONCLUSION: AV-ECs isolated from AVM rat model showed increased proliferation, migration and angiogenesis and may be potential target for the treatment of cAVM.

The value and limitation of transcatheter arterial chemoembolization in preventing recurrence of resected hepatocellular carcinoma.

AIM: To evaluate the value and limitation of postoperative transcatheter arterial chemoembolization (TACE) in preventing recurrence of hepatocellular carcinoma (HCC). METHODS: In the first group, 987 postoperative patients with HCC, who did not have any evidence of recurrence in the first preventative TACE but were found to have recurrence at different times during the follow-up survey, were analyzed. In the second group, 643 postoperative patients with HCC had no TACE for compared study. To study the relationship between the recurrence time and the number of TACE treatments was analyzed. RESULTS: The 6-, 12-, and 18-mo recurrence rates in the first and second groups were 22.2% (210 cases) vs 61.6% (396 cases), 78.0% (770 cases) vs 74.7% (480 cases) and 88.6% (874 cases) vs 80.1% (515 cases). There were significant differences between the recurrence rates of the two groups at 6 mo (P<0.0001). CONCLUSION: The principal role of TACE after HCC operation is to suppress, detect early and treat micro-metastasis. It has a good effect of preventing recurrence of HCC in 6 mo, but such an effect is less satisfactory in a longer period. When it is uncertain whether HCC is single-central or multi-central and if there is cancer residue or metastasis after operation, TACE is valuable to prevent recurrence.

[Evaluation of transcatheter arterial chemoembolization in the prevention of postoperative recurrence in 1630 patients with hepatocellular carcinoma].

OBJECTIVE: To evaluate postoperative transcatheter arterial chemoembolization (TACE) in the prevention of postoperative recurrence of hepatocellular carcinoma (HCC). METHODS: In TACE group, 987 HCC patients without any evidence of recurrence at the first TACE were treated by prophylactic TACE postoperatively within one or two months. In the control group, 643 HCC patients were not treated by prophylactic TACE for comparison. The correlation between the first recurrence and prophylactic TACE was analyzed. RESULTS: Recurrence rate in the TACE and control group was 22.2% (219/987) and 61.6% (396/643) within 6 months (P < 0.01); 78% (770/987) and 74.7% (480/643) within 12 months (P > 0.05); 88.6% (874/987) and 80.1% (515/643) within 18 months (P < 0.01), respectively. CONCLUSION: Postoperative prophylactic TACE may be able to suppress the recurrence formation for HCC patients with or without definite residual lesion within 6 months.

Adjustment of lipiodol dose according to tumor blood supply during transcatheter arterial chemoembolization for large hepatocellular carcinoma by multidetector helical CT.

AIM: To work out an individualized lipiodol dose in transcatheter arterial chemoembolization (TACE) for large hepatocellular carcinoma (HCC) according to its blood supply evaluated by CT. METHODS: One hundred patients with large HCC (more than 8 cm in diameter) were studied by multidetector helical CT. Patterns of blood supply of HCC were divided into sufficient blood supply, poor blood supply, mixed blood supply and arteriovenous (A-V) shunt. The dose of ultra-fluid lipiodol was determined by diameter and blood supply type of HCC. Patients were divided into two groups (50 cases each): lipiodol perfusion group and iodized oil perfusion group according to tumor diameter and the blood supply type of tumor. RESULTS: The confirmation and effective rates were 82%, 84% in the first group and 36%, 46% in the second group (P<0.01). CONCLUSION: A relatively individualized lipiodol dose may be determined according to the blood supply pattern and the tumor diameter by CT imaging.

Plane and weighted tri-phase helical CT findings in the diagnosis of liver focal nodular hyperplasia.

OBJECTIVE: To analyze the pre- and post-contrast CT findings of liver focal nodular hyperplasia (FNH) so as to improve their diagnostic accuracy. METHODS: Pre- and post-contrast tri-phase (arterial, portal venous and delayed) scans were performed in 21 patients with FNH proved surgically and pathologically. Transcatheter arterial angiography was performed in 2 patients. RESULTS: Pre-contrast scans showed hypodensity in 16 patients, isodensity in 5, and punctate, streak and radial scars in 12. Except central scar, all lesions were markedly and homogeneously enhanced in the arterial phase. Nine of the 21 patients showed dilated and tortuous arteries in the central and peripheral areas of the focus. In the portal venous phase, focal density was decreased, though still higher or slightly higher in FNH than in parenchyma. In the delayed phase, the lesions showed isodensity or slight hypodensity. Enhanced capsules were seen in 3 patients. Dilated arteries and drainage veins were seen on angiographic images. CONCLUSION: The characteristic manifestations of FNH on multiphasic helical CT scan are of great significance in diagnosing FNH and choosing viable therapy.

Multi-slice three-dimensional spiral CT cholangiography: a new technique for diagnosis of biliary diseases.

OBJECTIVE: To validate multi-slice three-dimensional spiral CT cholangiography (3-D CTC) in clinical diagnosis of biliary diseases. METHODS: This study included 146 patients with biliary diseases, involving 73 cases of biliary tumor, 87 cases of radioparent calculus, 12 cases of post cholangio-jejunostomy and one case of congenital choledochocyst. The data of thin-slice volumetric CT scan were sent to the workstation (GE Advantage Windows 3.1). Rational 3-D CTC including maximum intensity projection, minimum intensity projection, surface shaded display, CT virtual endoscopy and ray sumption was performed. The diagnostic accuracy of 3-D CTC was compared with that of conventional CT, ultrasonography and endoscopic retrograde cholangiopancreaticography (ERCP). RESULTS: Different biliary diseases showed distinct imaging manifestations on 3-D CTC. As a new technique for assessing the status of post cholangio-jejunostomy, 3-D CTC was superior to conventional CT, ultrasonography and ERCP in diagnosis of negative biliary calculus, extrahepatic cholangiocarcinoma, cancer embolus of the biliary duct, carcinoma of the pancreas head and periampullar carcinoma. It was also superior to conventional CT, ultrasonography or equal to ERCP in diagnosis of hilar cholangiocarcinoma, but inferior to conventional CT and ultrasonography in diagnosis of gallbladder cancer. CONCLUSION: 3-D CTC as a non-invasive and sensitive technique for the diagnosis of biliary diseases with high diagnostic accuracy will greatly increase the detection rate of biliary diseases.

[Adjustment of lipiodol dose according to tumor blood supply during the transcatheter arterial chemoembolization for large hepatic carcinoma by mulitdetector helical CT].

OBJECTIVE: To work out an individualized lipiodol dose in transcatheter arterial chemoembolization (TACE) for large hepatic carcinoma (HCC) according to its blood supply evaluated by CT. METHODS: One hundred patients with HCC (diameter more than 8 cm) were studied by triphasic 5-mm-thick-section scan of multidetector helical CT. Patterns of HCC blood supply were divided into sufficient blood supply, poor blood supply, mixed blood supply and arterial-venous shunt. The dose of ultra-fluid lipiodol was determined by diameter and blood supply type of HCC. The patients were divided two groups (50 cases each), with the lipiodol perfused according to the diameter and the blood supply of tumor in one group and the iodized oil perfused according to the actual tumor diameter in the other. The filling of lipiodol in HCC was observed and conformation rate was compared in the two groups. When the diameter of HCC was less than 10 cm, 10 - 20 ml and 5 - 10 ml lipiodol was injected in to the sufficient blood supply and the poor supply groups. When the diameter of HCC was more than 10 cm, 20 - 30 ml iodized oil was injected in the sufficient blood supply group. The lipiodol dose in the mixed blood supply group was determined by the diameter of sufficient blood supply area. RESULTS: The conformation and effective rate were 82%, 84% in the first group and 36%, 46% in the second group (P < 0.01). CONCLUSION: A relative individualized lipiodol dose may be determined according to the blood supply pattern and the tumor diameter by CT imaging.