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1.
Nature ; 588(7837): E19, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33230335

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

2.
Nature ; 586(7831): 720-723, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33116288

RESUMO

Limiting the rise in global mean temperatures relies on reducing carbon dioxide (CO2) emissions and on the removal of CO2 by land carbon sinks. China is currently the single largest emitter of CO2, responsible for approximately 27 per cent (2.67 petagrams of carbon per year) of global fossil fuel emissions in 20171. Understanding of Chinese land biosphere fluxes has been hampered by sparse data coverage2-4, which has resulted in a wide range of a posteriori estimates of flux. Here we present recently available data on the atmospheric mole fraction of CO2, measured from six sites across China during 2009 to 2016. Using these data, we estimate a mean Chinese land biosphere sink of -1.11 ± 0.38 petagrams of carbon per year during 2010 to 2016, equivalent to about 45 per cent of our estimate of annual Chinese anthropogenic emissions over that period. Our estimate reflects a previously underestimated land carbon sink over southwest China (Yunnan, Guizhou and Guangxi provinces) throughout the year, and over northeast China (especially Heilongjiang and Jilin provinces) during summer months. These provinces have established a pattern of rapid afforestation of progressively larger regions5,6, with provincial forest areas increasing by between 0.04 million and 0.44 million hectares per year over the past 10 to 15 years. These large-scale changes reflect the expansion of fast-growing plantation forests that contribute to timber exports and the domestic production of paper7. Space-borne observations of vegetation greenness show a large increase with time over this study period, supporting the timing and increase in the land carbon sink over these afforestation regions.


Assuntos
Atmosfera/química , Dióxido de Carbono/análise , Sequestro de Carbono , Monitoramento Ambiental , Mapeamento Geográfico , China , Materiais de Construção , Análise de Dados , Ásia Oriental , Combustíveis Fósseis , Modelos Teóricos , Plantas , Imagens de Satélites
3.
EMBO J ; 40(24): e108080, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34747049

RESUMO

Altered intestinal microbial composition promotes intestinal barrier dysfunction and triggers the initiation and recurrence of inflammatory bowel disease (IBD). Current treatments for IBD are focused on control of inflammation rather than on maintaining intestinal epithelial barrier function. Here, we show that the internalization of Gram-negative bacterial outer membrane vesicles (OMVs) in human intestinal epithelial cells promotes recruitment of caspase-5 and PIKfyve to early endosomal membranes via sorting nexin 10 (SNX10), resulting in LPS release from OMVs into the cytosol. Caspase-5 activated by cytosolic LPS leads to Lyn phosphorylation, which in turn promotes nuclear translocalization of Snail/Slug, downregulation of E-cadherin expression, and intestinal barrier dysfunction. SNX10 deletion or treatment with DC-SX029, a novel SNX10 inhibitor, rescues OMV-induced intestinal barrier dysfunction and ameliorates colitis in mice by blocking cytosolic LPS release, caspase-5 activation, and downstream signaling. Our results show that targeting SNX10 may be a new therapeutic approach for restoring intestinal epithelial barrier function and promising strategy for IBD treatment.


Assuntos
Membrana Externa Bacteriana/química , Caspases/metabolismo , Colite/patologia , Lipopolissacarídeos/metabolismo , Nexinas de Classificação/genética , Nexinas de Classificação/metabolismo , Animais , Células CACO-2 , Colite/induzido quimicamente , Colite/genética , Citosol/metabolismo , Modelos Animais de Doenças , Endossomos/metabolismo , Endossomos/transplante , Feminino , Deleção de Genes , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Lipopolissacarídeos/efeitos adversos , Masculino , Camundongos , Fosfatidilinositol 3-Quinases/metabolismo , Fosforilação , Transdução de Sinais/efeitos dos fármacos , Quinases da Família src/metabolismo
4.
Am J Pathol ; 194(1): 85-100, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37918798

RESUMO

Sleep deficiency is associated with intestinal inflammatory conditions and is increasingly recognized as a public health concern worldwide. However, the effects of sleep deficiency on intestinal goblet cells (GCs), which play a major role in intestinal barrier formation, remain elusive. Herein, the effects of sleep deprivation on intestinal GCs were determined using a sleep-deprivation mouse model. Sleep deprivation impaired the intestinal mucosal barrier and decreased the expression of tight junction proteins. According to single-cell RNA sequencing and histologic assessments, sleep deprivation significantly reduced GC numbers and mucin protein levels in intestinal tissues. Furthermore, sleep deprivation initiated endoplasmic reticulum stress by activating transcription factor 6 and binding Ig protein. Treatment with melatonin, an endoplasmic reticulum stress regulator, significantly alleviated endoplasmic reticulum stress responses in intestinal GCs. In addition, melatonin increased the villus length, reduced the crypt depth, and restored intestinal barrier function in mice with sleep deprivation. Overall, the findings revealed that sleep deprivation could impair intestinal mucosal barrier integrity and GC function. Targeting endoplasmic reticulum stress could represent an ideal strategy for treating sleep deficiency-induced gastrointestinal disorders.


Assuntos
Enteropatias , Melatonina , Camundongos , Animais , Células Caliciformes/metabolismo , Privação do Sono/complicações , Privação do Sono/metabolismo , Privação do Sono/patologia , Melatonina/metabolismo , Melatonina/farmacologia , Mucosa Intestinal/metabolismo , Enteropatias/metabolismo , Estresse do Retículo Endoplasmático
5.
J Am Chem Soc ; 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38943576

RESUMO

Manipulating single electrons at the atomic scale is vital for mastering complex surface processes governed by the transfer of individual electrons. Polarons, composed of electrons stabilized by electron-phonon coupling, offer a pivotal medium for such manipulation. Here, using scanning tunneling microscopy and spectroscopy (STM/STS) and density functional theory (DFT) calculations, we report the identification and manipulation of a new type of polaron, dubbed van der Waals (vdW) polaron, within mono- to trilayer ultrathin films composed of Sb2O3 molecules that are bonded via vdW attractions. The Sb2O3 films were grown on a graphene-covered SiC(0001) substrate via molecular beam epitaxy. Unlike prior molecular polarons, STM imaging observed polarons at the interstitial sites of the molecular film, presenting unique electronic states and localized band bending. DFT calculations revealed the lowest conduction band as an intermolecular bonding state, capable of ensnaring an extra electron through locally diminished intermolecular distances, thereby forming an intermolecular vdW polaron. We also demonstrated the ability to generate, move, and erase such vdW polarons using an STM tip. Our work uncovers a new type of polaron stabilized by coupling with intermolecular vibrations where vdW interactions dominate, paving the way for designing atomic-scale electron transfer processes and enabling precise tailoring of electron-related properties and functionalities.

6.
Anal Chem ; 96(17): 6794-6801, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38624007

RESUMO

Identification of protein profiling on plasma exosomes by SERS can be a promising strategy for early cancer diagnosis. However, it is still challenging to detect multiple exosomal proteins simultaneously by SERS since the Raman signals of exosomes detected by conventional colloidal nanocrystals or two-dimensional SERS substrates are incomplete and complex. Herein, we develop a novel three-dimensional (3D) surround-enhancing SERS platform, named 3D se-SERS, for the multiplex detection of exosomal proteins. In this 3D se-SERS, proteins and exosomes are covered with "hotspots" generated by the gold nanoparticles, which surround the analytes densely and three-dimensionally, providing sensitive and comprehensive SERS signals. Combining this 3D se-SERS with a deep learning model, we successfully quantitatively profiled seven proteins including CD63, CD81, CD9, CD151, CD171, TSPAN8, and PD-L1 on the surface of plasma exosomes from patients, which can predict the occurrence and advancement of lung cancer. This 3D se-SERS integrating deep learning technique benefits from high sensitivity and significant multiplexing ability for comprehensive analysis of proteins and exosomes, demonstrating the potential of deep learning-driven 3D se-SERS technology for plasma exosome-based early cancer diagnosis.


Assuntos
Aprendizado Profundo , Exossomos , Ouro , Análise Espectral Raman , Humanos , Exossomos/química , Ouro/química , Detecção Precoce de Câncer/métodos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/sangue , Nanopartículas Metálicas/química
7.
Nat Mater ; 22(9): 1078-1084, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37537352

RESUMO

Two-dimensional (2D) semiconductors are promising channel materials for next-generation field-effect transistors (FETs). However, it remains challenging to integrate ultrathin and uniform high-κ dielectrics on 2D semiconductors to fabricate FETs with large gate capacitance. We report a versatile two-step approach to integrating high-quality dielectric film with sub-1 nm equivalent oxide thickness (EOT) on 2D semiconductors. Inorganic molecular crystal Sb2O3 is homogeneously deposited on 2D semiconductors as a buffer layer, which forms a high-quality oxide-to-semiconductor interface and offers a highly hydrophilic surface, enabling the integration of high-κ dielectrics via atomic layer deposition. Using this approach, we can fabricate monolayer molybdenum disulfide-based FETs with the thinnest EOT (0.67 nm). The transistors exhibit an on/off ratio of over 106 using an ultra-low operating voltage of 0.4 V, achieving unprecedently high gating efficiency. Our results may pave the way for the application of 2D materials in low-power ultrascaling electronics.

8.
Am J Pathol ; 193(8): 1029-1045, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37236504

RESUMO

IL-33, a member of the IL-1 family, acts as an alarmin in immune response. Epithelial-mesenchymal transition and transforming growth factor-ß (TGF-ß)­induced fibroblast activation are key events in the development of renal interstitial fibrosis. The current study found increased expression of IL-33 and interleukin-1 receptor-like 1 (IL1RL1, alias ST2), the receptor for IL-33, in human fibrotic renal tissues. In addition, IL-33­ or ST2-deficient mice showed significantly reduced levels of fibronectin, α-smooth muscle actin, and vimentin, and increased E-cadherin levels. In HK-2 cells, IL-33 promotes the phosphorylation of the TGF-ß receptor (TGF-ßR), Smad2, and Smad3, and the production of extracellular matrix (ECM), with reduced expression of E-cadherin. Blocking TGF-ßR signaling or suppressing ST2 expression impeded Smad2 and Smad3 phosphorylation, thereby reducing ECM production, suggesting that IL-33­induced ECM synthesis requires cooperation between the two pathways. Mechanistically, IL-33 treatment induced a proximate interaction between ST2 and TGF-ßRs, activating downstream Smad2 and Smad3 for ECM production in renal epithelial cells. Collectively, this study identified a novel and essential role for IL-33 in promoting TGF-ß signaling and ECM production in the development of renal fibrosis. Therefore, targeting IL-33/ST2 signaling may be an effective therapeutic strategy for renal fibrosis.


Assuntos
Interleucina-33 , Nefropatias , Camundongos , Humanos , Animais , Interleucina-33/metabolismo , Receptores de Fatores de Crescimento Transformadores beta/metabolismo , Receptores de Fatores de Crescimento Transformadores beta/uso terapêutico , Proteína 1 Semelhante a Receptor de Interleucina-1/metabolismo , Nefropatias/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Proteína Smad3/metabolismo , Fibrose , Caderinas/metabolismo , Fatores de Crescimento Transformadores/metabolismo , Fatores de Crescimento Transformadores/farmacologia , Fatores de Crescimento Transformadores/uso terapêutico , Fator de Crescimento Transformador beta1/metabolismo , Transição Epitelial-Mesenquimal
9.
Opt Lett ; 49(10): 2621-2624, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748120

RESUMO

Fluorescence fluctuation super-resolution microscopy (FF-SRM) has emerged as a promising method for the fast, low-cost, and uncomplicated imaging of biological specimens beyond the diffraction limit. Among FF-SRM techniques, super-resolution radial fluctuation (SRRF) microscopy is a popular technique but is prone to artifacts, resulting in low fidelity, especially under conditions of high-density fluorophores. In this Letter, we developed a novel, to the best of our knowledge, combinatory computational super-resolution microscopy method, namely VeSRRF, that demonstrated superior performance in SRRF microscopy. VeSRRF combined intensity and gradient variance reweighted radial fluctuations (VRRF) and enhanced-SRRF (eSRRF) algorithms, leveraging the enhanced resolution achieved through intensity and gradient variance analysis in VRRF and the improved fidelity obtained from the radial gradient convergence transform in eSRRF. Our method was validated using microtubules in mammalian cells as a standard biological model system. Our results demonstrated that VeSRRF consistently achieved the highest resolution and exceptional fidelity compared to those obtained from other algorithms in both single-molecule localization microscopy (SMLM) and FF-SRM. Moreover, we developed the VeSRRF software package that is freely available on the open-source ImageJ/Fiji software platform to facilitate the use of VeSRRF in the broader community of biomedical researchers. VeSRRF is an exemplary method in which complementary microscopy techniques are integrated holistically, creating superior imaging performance and capabilities.


Assuntos
Algoritmos , Microscopia de Fluorescência , Microscopia de Fluorescência/métodos , Microtúbulos , Processamento de Imagem Assistida por Computador/métodos , Animais , Software
10.
Br J Nutr ; 131(5): 860-867, 2024 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-37840236

RESUMO

There is a strong association between soya food consumption and health, but there are few studies on the association with muscular strength, especially in adolescent groups. This study was conducted to understand the status of soya food consumption and its association with muscular strength among secondary school students in southern China. A stratified whole-group sampling method was used to investigate and test the status of soya food consumption and muscular strength of 13 220 secondary school students in southern China. Linear regression analysis and logistic regression analysis were used to analyse the correlations between soya food consumption and muscular strength. Logistic regression analysis showed that compared with secondary school students with soya food consumption ≥ 3 times/week, male students with soya food consumption ≤ 1 time/week (OR = 1·896, 95 % CI: 1·597,2·251) and female students with soya food consumption ≤ 1 time/week (OR = 2·877, 95 % CI: 2·399, 3·449) students had a higher risk of developing lower grip strength (P < 0·001). The frequency of soya food consumption among secondary school students in southern China was 49·00 %, 28·77 % and 22·23 % for ≥ 3 times/week, 2-3 times/week and ≤ 1 time/week, respectively. There is a positive association between soya food consumption and muscle strength among secondary school students in southern China. In the future, increasing the consumption of soybean products can be considered for the improvement of muscle strength.


Assuntos
Glycine max , Estudantes , Humanos , Masculino , Feminino , Adolescente , Estudos Transversais , Força da Mão , Projetos de Pesquisa
11.
Org Biomol Chem ; 22(4): 699-702, 2024 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-37999925

RESUMO

A novel and efficient metal-free cascade oxidative radical addition of styrenes is developed for the construction of 1,3-dichloro-1,5-diarylpentan-5-ones. This protocol presents a practical one-pot procedure that delivers highly functionalized 1,3-dichloro-1,5-diarylpentan-5-ones in moderate-to-good yields with a broad substrate scope under mild conditions.

12.
Mar Drugs ; 22(6)2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38921566

RESUMO

Recently, there has been a growing interest in collagen peptides derived from marine sources for their notable ability to protect skin cells against apoptosis induced by oxidants. Therefore, the current study aimed to investigate the fundamental properties of collagen peptides, including their physicochemical, thermal, structural, stem-cell-regenerative, and skin-cell-protective effects, in comparison to commercial collagen peptides. The acid-soluble (ASC) and pepsin-soluble (PSC) collagens exhibited three distinct bands on SDS-PAGE, namely α (α1 and α2), ß, and γ chains, confirming a type I pattern. The thermal profiles obtained from TG and DSC analyses confirmed the denaturation of PSC and ASC at temperatures ranging from 51.94 to 56.4 °C and from 52.07 to 56.53 °C, respectively. The purified collagen peptides were analyzed using SDS-PAGE and MALDI-TOF mass spectrometry, revealing a mass range of 900-15,000 Da. Furthermore, the de novo peptide sequence analysis confirmed the presence of the Gly-X-Y repeating sequence in collagen peptides. Collagen peptide treatments significantly enhanced HFF-1 cell proliferation and migration compared to the control group. ELISA results confirmed the potential interactions between collagen peptides and HFF-1 cells through α2ß1, α10ß1, and α11ß1 integrin receptors. Notably, collagen peptide treatment effectively restored the proliferation of HFF-1 cells damaged by H2O2. Consequently, the advantageous characteristics of squid skin collagen peptides highlight their promising role in regenerative medicine.


Assuntos
Colágeno , Decapodiformes , Fibroblastos , Peróxido de Hidrogênio , Peptídeos , Pele , Animais , Peróxido de Hidrogênio/farmacologia , Peróxido de Hidrogênio/toxicidade , Colágeno/metabolismo , Fibroblastos/efeitos dos fármacos , Decapodiformes/química , Pele/efeitos dos fármacos , Pele/metabolismo , Humanos , Peptídeos/farmacologia , Peptídeos/química , Peptídeos/isolamento & purificação , Proliferação de Células/efeitos dos fármacos , Células-Tronco/efeitos dos fármacos , Linhagem Celular , Substâncias Protetoras/farmacologia , Substâncias Protetoras/química , Movimento Celular/efeitos dos fármacos
13.
Sensors (Basel) ; 24(2)2024 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-38257449

RESUMO

Improving underwater image quality is crucial for marine detection applications. However, in the marine environment, captured images are often affected by various degradation factors due to the complexity of underwater conditions. In addition to common color distortions, marine snow noise in underwater images is also a significant issue. The backscatter of artificial light on marine snow generates specks in images, thereby affecting image quality, scene perception, and subsequently impacting downstream tasks such as target detection and segmentation. Addressing the issues caused by marine snow noise, we have designed a new network structure. In this work, a novel skip-connection structure called a dual channel multi-scale feature transmitter (DCMFT) is implemented to reduce information loss during downsampling in the feature encoding and decoding section. Additionally, in the feature transfer process for each stage, iterative attentional feature fusion (iAFF) modules are inserted to fully utilize marine snow features extracted at different stages. Finally, to further optimize the network's performance, we incorporate the multi-scale structural similarity index (MS-SSIM) into the loss function to ensure more effective convergence during training. Through experiments conducted on the Marine Snow Removal Benchmark (MSRB) dataset with an augmented sample size, our method has achieved significant results. The experimental results demonstrate that our approach excels in removing marine snow noise, with a peak signal-to-noise ratio reaching 38.9251 dB, significantly outperforming existing methods.

14.
Molecules ; 29(5)2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38474592

RESUMO

This article reports three new two-photon absorption (TPA) materials that are quinolinium-carbazole derivates. They are 3-(N-methyl-4-ethylquinolinium iodide)-9-ethylcarbazole (M4), 3-(N-methyl-4-ethylquinolinium iodide)-9-ethylcarbazole (H2), and 3-(N-methyl-4-ethylquinolinium iodide)-9-ethylcarbazole (H4). Their TPA cross-sections are 491, 515, and 512 GM, respectively. Under the excitation of near-infrared light, their fluorescence emission is about 650 nm. The compounds can stain nucleic acid DNA with the same level of nuclear localization as Hoechst 33342. Under continuous irradiation with a near-infrared laser, the three new compounds showed less fluorescence decay than DAPI, and the average fluorescence decay rates were 0.016%/s, 0.020%/s, and 0.023%/s. They are expected to become new two-photon fluorescent probes of nucleic acid DNA because of their excellent performance.


Assuntos
Iodetos , Fótons , Fluorescência , Carbazóis , DNA , Raios Infravermelhos , Sondas de Ácido Nucleico , Corantes Fluorescentes
15.
Chemistry ; 29(12): e202203460, 2023 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-36445789

RESUMO

Insulin, a main medication to control glycemia of type 1 and advanced type 2 diabetes, faces problems of a short half-life and poor stability during its clinical use. Zwitterionic polymer shows unique properties of antifouling and low immunogenicity. Here, we have synthesized a new insulin-zwitterionic polymer conjugate (INS-PMPC) through grafting-from strategy by controlled radical polymerization. Apart from showing excellent stability upon mechanical agitation, the resulting INS-PMPC conjugate provided over 20 h of glycemic control due to improved pharmacokinetics in diabetic mice with one single subcutaneous injection. Most importantly, this insulin-zwitterionic polymer conjugate significantly decreases the incidence of hypoglycemia.


Assuntos
Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Hipoglicemia , Animais , Camundongos , Insulina de Ação Prolongada , Polímeros , Hipoglicemia/epidemiologia , Insulina
16.
Biomacromolecules ; 24(2): 909-920, 2023 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-36629517

RESUMO

Following brain trauma, secondary injury from molecular and cellular changes causes progressive cerebral tissue damage. Acute/chronic neuroinflammation following traumatic brain injury (TBI) is a key player in the development of secondary injury. Rapidly elevated cell-free DNAs (cfDNAs) due to cell death could lead to production of inflammatory cytokines that aggravate TBI. Herein, we designed poly(amino acid)-based cationic nanoparticles (cNPs) and applied them intravenously in a TBI mice model with the purpose of scavenging cfDNA in the brain and suppressing the acute inflammation. In turn, these cNPs could effectively eliminate endogenous cfDNA, inhibit excessive activation of inflammation, and promote neural functional recovery.


Assuntos
Aminoácidos , Lesões Encefálicas Traumáticas , Camundongos , Animais , Inflamação/metabolismo , Encéfalo/metabolismo , Citocinas/metabolismo , Camundongos Endogâmicos C57BL
17.
J Appl Microbiol ; 134(10)2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37777841

RESUMO

AIMS: The gut microbiome has been recognized as a significant contributor to primary hepatocellular carcinoma (HCC), with mounting evidence indicating associations between bacterial components and cancers of the digestive system. METHODS AND RESULTS: Here, to characterize gut bacterial signature in patients with primary HCC and to assess the diagnostic potential of bacterial taxa for primary HCC, 21 HCC patients and 21 healthy first-degree relatives (control group) were enrolled in this study. Bacterial DNA in the fecal samples was quantified by 16S rRNA gene sequencing. We found that 743 operational taxonomic units (OTUs) were shared between patients with primary HCC and healthy controls. Of these, 197 OTUs were unique to patients with primary HCC, while 95 OTUs were unique to healthy subjects. Additionally, we observed significant differences in the abundance of Ruminococcaceae_UCG-014 and Romboutsia between patients with primary HCC and their healthy first-degree relatives. Besides, the relative abundance of Ruminococcaceae_UCG-014 and Prevotella_9 was positively correlated with physiological indicators including AST, ALT, ALB, or TBIL. Signature bacterial taxa could serve as non-invasive biomarkers, of which Romboutsia and Veillonella were identified as differential taxa in fecal samples from patients with HCC compared to healthy controls. Romboutsia showed a strong association with HCC (AUC = 0.802). Additionally, the combination of Romboutsia and Veillonella (AUC = 0.812) or the grouping of Fusobacterium, Faccalibacterium, and Peptostreptococcacae together (AUC = 0.762) exhibited promising outcomes for the diagnosis of HCC. CONCLUSIONS: The composition of gut microbes in patients with HCC was found to be significantly altered. Differential taxa Romboutsia, Veillonella, and Peptostreptococcacae could be tested for identification of HCC.


Assuntos
Carcinoma Hepatocelular , Microbioma Gastrointestinal , Lactobacillales , Neoplasias Hepáticas , Humanos , Microbioma Gastrointestinal/genética , RNA Ribossômico 16S/genética , Neoplasias Hepáticas/genética , Bactérias/genética , Lactobacillales/genética
20.
Surg Endosc ; 37(3): 1700-1709, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36207648

RESUMO

BACKGROUND: The need for intraoperative endoscopic nasobiliary drainage during laparoscopic cholecystectomy and laparoscopic common bile duct exploration with primary closure is controversial in the treatment of cholecystolithiasis combined with choledocholithiasis. The aim of this study was to evaluate the safety and efficacy of laparoscopic cholecystectomy + laparoscopic common bile duct exploration + intraoperative endoscopic nasobiliary drainage + primary closure (LC + LCBDE + IO-ENBD + PC). The safety of different intubation methods in IO-ENBD was also evaluated. METHOD: From January 2018 to January 2022, 168 consecutive patients with cholecystolithiasis combined with choledocholithiasis underwent surgical treatment in our institution. Patients were divided into two groups: group A (n = 96) underwent LC + LCBDE + IO-ENBD + PC and group B (n = 72) underwent LC + LCBDE + PC. Patient characteristics, perioperative indicators, complications, stone residual, and recurrence rates were analyzed. Group A was divided into two subgroups. In group A1, the nasobiliary drainage tube was placed in an anterograde way, and in group A2, nasobiliary drainage tube was placed in an anterograde-retrograde way. Perioperative indicators and complications were analyzed between subgroups. RESULTS: No mortality in the two groups. The operation success rates in groups A and B were 97.9% (94/96) and 100% (72/72), respectively. In group A, two patients were converted to T-tube drainage. The stone clearance rates of group A and group B were 100% (96/96) and 98.6% (71/72), respectively. Common bile duct diameter was smaller in group A [10 vs. 12 mm, P < 0.001] in baseline data. In perioperative indicators, group A had a longer operation time [165 vs.135 min, P < 0.001], but group A had a shorter hospitalization time [10 vs.13 days, P = 0.002]. The overall complications were 7.3% (7/96) in group A and 12.5% (9/72) in group B. Postoperative bile leakage was less in group A [0% (0/96) vs. 5.6% (4/72), P = 0.032)]. There were no residual and recurrent stones in group A. And there were one residual stone and one recurrent stone in group B (all 1.4%). The median follow-up time was 12 months in group A and 6 months in group B. During the follow-up period, 2 (2.8%) patients in group B had a mild biliary stricture. At subgroup analysis, group A1 had shorter operation time [150 vs. 182.5 min, P < 0.001], shorter hospitalization time [9 vs. 10 days, P = 0.002], and fewer patients with postoperative elevated pancreatic enzymes [32.6% (15/46) vs. 68% (34/50), P = 0.001]. CONCLUSION: LC + LCBDE + IO-ENBD + PC is safer and more effective than LC + LCBDE + PC because it reduces hospitalization time and avoids postoperative bile leakage. In the IO-ENBD procedure, the antegrade placement of the nasobiliary drainage tube is more feasible and effective because it reduces the operation time and hospitalization time, and also reduces injury to the duodenal papilla.


Assuntos
Colecistectomia Laparoscópica , Colecistolitíase , Coledocolitíase , Laparoscopia , Humanos , Coledocolitíase/complicações , Coledocolitíase/cirurgia , Colecistolitíase/complicações , Colecistolitíase/cirurgia , Ducto Colédoco/cirurgia , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Drenagem/métodos , Laparoscopia/métodos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Colangiopancreatografia Retrógrada Endoscópica/métodos
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