Tea polyphenol and epigallocatechin gallate ameliorate hyperlipidemia via regulating liver metabolism and remodeling gut microbiota.

Hyperlipidemia can directly cause metabolic diseases that seriously endanger disorder and metabolism and gut health. Tea polyphenol (TP) and epigallocatechin gallate (EGCG) was found to improve blood lipid levels and gut microbiota. This study aimed to investigate the effects of TP and EGCG on alleviating hyperlipidemia and liver fat accumulation with physiology, genomics, and metabolomics. Results showed that both TP and EGCG reduced body weight, and TP showed advantages in the decrease of serum cholesterol and triglycerides in hyperlipidemic rats induced by the high-fat diet. Moreover, EGCG may protect liver function via reducing the glycerophospholipids increased by high-fat diet intervention. TP remodeled the gut microbiota composition and enriched the abundance of beneficial bacteria (Bacteroides, Faecalibacterium, Parabacteroides, Akkermansia), and EGCG may improve gut health via promoting the acid-producing bacteria (such as Butyricimonas, Desulfovibrio). The above results provided new insights into the hypolipidemic mechanism of TP and EGCG.

miR-517b-3p promotes the progression of portal vein tumor thrombus via activating Wnt/ß-catenin signaling pathway in hepatocellular carcinoma.

AIMS: This study was aimed to investigate the expression patterns and prognostic value of microRNA-517b-3p (miR-517b-3p) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). METHODS: The expression of miR-517b-3p in PVTT tissues and cells was estimated using qRT-PCR. Through Kaplan-Meier survival analysis, Cox regression assay and ROC analysis, the significance of miR-517b-3p was explored. In addition, cell experiments were performed to examine the functional role of miR-517b-3p during progression of PVTT. Moreover, the biological process and biological pathway analysis analyses were conducted through GSEA and FunRich. Besides, the protein-protein interaction (PPI) network of the DEGs was established through cBioPortal website. RESULTS: Compared with the controls, the miR-517b-3p was upregulated in both PVTT tissues and cells. The upregulated miR-517b-3p, which served as a potential diagnostic biomarker to distinguish PVTT from PT and controls, was associated with poor overall survival and acted as an independent prognostic factor. The cell proliferation, migration and invasion were proved to be enhanced by overexpression of miR-517b-3p. Furthermore, Wnt/ß-catenin signaling was suppressed by miR-517b-3p knockdown and might be involved in the progression of PVTT. CONCLUSION: miR-517b-3p may promote PVTT cell proliferation, migration and invasion via activation of Wnt/ß-catenin signaling pathway. Meanwhile, miR-517b-3p has overexpression in PVTT samples, and serves as a candidate diagnostic and prognostic biomarker in HCC patients with PVTT.

Establishment of a Canine Training Model for Digestive Tract Reconstruction after Pancreaticoduodenectomy.

PURPOSE: Practical training models can be a viable and effective educational tool that allows surgeons to acquire specific surgical techniques or skills. However, a suitable animal training model for reconstruction after a pancreaticoduodenectomy (PD) has not yet been reported. Therefore, we explored the feasibility and safety of establishing an animal training model for digestive tract reconstruction after a simulated PD using mongrel dogs. METHODS: We used the anatomical similarity between the canine and human digestive tract to simulate the digestive tract reconstruction after pancreatoduodenectomy. A hepatobiliary surgeon performed simulated PD digestive reconstructions on 6 mongrel canines. Pancreaticojejunostomy (PJ), biliary-enteric anastomosis (BEA), and jejuno-jejunal anastomosis (JJ) were performed sequentially. The survival rate, surgical operation time, complications, body weight changes, gross specimen, and pathological examination of the anastomotic region were observed 30 days after surgery. RESULTS: The survival rate 30 days after surgery was 100%. Total mean operative time was 230.5 ± 39.7 min. The operative time for PJ, BEA, and JJ was calculated as 21.5 ± 7 min, 21.7 ± 8.7 min, and 13.2 ± 1.8 min, respectively. An incision infection occurred in 1 case (16.7%); there was 1 case of ascites (16.7%), and 1 case of vomiting (16.7%). The total protein and total bilirubin indicators of the 6 dogs and the serum amylase index of 5 dogs 30 days postoperatively were within the normal range. The 6th dog's serum amylase was approximately double the normal value, possibly due to pancreatitis. Observing the gross specimen, the mucosa of the anastomosis was intact and smooth. Masson staining showed that the bile duct and jejunum anastomosis, the pancreas, and jejunum of the 6 canines were all integrated with rich collagen. CONCLUSION: Establishing an animal model for digestive tract reconstruction after a simulated PD in canines is feasible and safe.

A new approach for the effective removal of NOx from flue gas by using an integrated system of oxidation-absorption-biological reduction.

A new process of NOx removal from flue gas, using an integrated system of oxidation-absorption-biological reduction (OABR), is introduced. The experimental results show that increasing the NOx oxidation ratio in flue gas can effectively improve the NOx removal efficiency of the OABR system. The NOx removal efficiency could reach 98.8% with 0.02 M NaHCO3 as the chemical absorbent and under the condition of the optimal NOx oxidation ratio of 50%. During stable operation, the OABR system could maintain a high NOx removal efficiency (above 94%) under the following conditions: 1-8 vol% (104-8 × 104 ppmv) O2, 200-800 ppmv NOx, 0.5-1.5 L/min gas flow rate and 100-800 ppmv SO2. The nitrogen equilibrium results showed that about 59% of the nitrogen in the inlet NOx were transformed to N2 through microbial denitrification, 37% of the nitrogen were converted to biological nitrogen for microbial growth, and only 1.1% of the nitrogen remained in the liquid phase. This new approach has an excellent NOx removal performance and great potential for industrial application.

[The Efficacy of 17 Cases of Pancreaticoduodenectomy Combined with Vascular Resection and Reconstruction by Using Robotic Operation System (with Video)].

OBJECTIVE: To explore the clinical efficacy of pancreaticoduodenectomy (PD) combined with vascular resection and reconstruction under robotic surgery system in the treatment of borderline resectable pancreatic cancer. METHODS: The clinical data of 17 patients with borderline resectable pancreatic cancer who underwent PD combined with vascular resection and reconstruction (see the Video 1 in Supplemental Contents, http://ykxb.scu.edu.cn/article/doi/10.12182/20200760202) under robotic surgery system between August 2011 and September 2018 was analyzed retrospectively. RESULTS: There were 4 cases required conversion because of serious tumor invasion and soft pancreas texture, the other 13 cases were successfully completed. 16 cases (94%) achieved margin-negative resection (R0 resection), 14 cases combined with vein resection, and 3 cases combined with arterial resection. The mean operation time was (401±170) min, the mean blood loss was (647±345) mL, the mean postoperative length of hospital stay was (20±8) d. There was no perioperative death. Postoperative pathology findings and follow-up outcomes were as follows: 1 patient was diagnosed as intraductal papillary mucinous neoplasm (IPMN) and 1 patient was diagnosed as pancreatic neuroendocrine tumors (PNET) (Grade 1), 8 patients with pancreatic ductal adenocarcinoma (PDAC). 1 patient with pancreatic neuroendocrine carcinoma (PNEC) died because of tumor recurrence and metastasis during the follow-up period, the median (Min-Max) survival time was 12 (8-26) months. 5 patients with PDAC and 1 patient with malignant IPMN were currently in the follow-up period. CONCLUSION: It is safe and feasible to perform RPD with vascular resection and reconstruction. The patient's condition should be fully evaluated before surgery to select the most appropriate treatment.

Ammonium removal characteristics of an acid-resistant bacterium Acinetobacter sp. JR1 from pharmaceutical wastewater capable of heterotrophic nitrification-aerobic denitrification.

A new acid-resistant bacterium Acinetobacter sp. JR1 was isolated, and its feasibility in nitrogen removal was investigated under acidic condition. Results show that JR1 indicated excellent ammonium and nitrate removal abilities with no accumulation of intermediates, and the maximum ammonium and nitrate removal efficiencies were 98.5% and 91.1%, respectively. Further experiments demonstrated that JR1 preferred to use ammonium with ammonium and nitrate as the mixed N-sources. For JR1, ammonium was assimilated directly as nutrients into cells and also converted into N2 through heterotrophic nitrification-aerobic denitrification. Under acidic condition, JR1 performed comparable nitrogen removal abilities to other strains under neutral or weak alkaline environment, and the efficient removal of ammonium occurred at pH 4.5-10, C/N 12-24, 20-40 °C, DO ≥4.72 mg/L, 0-1.5% of salinity, 10 mg/L Zn2+ or 20 mg/L Mn2+. All these make JR1 a promising candidate for treating acidic wastewater containing nitrogen.

Mirizzi syndrome complicated by common hepatic duct fistula and left hepatic atrophy: a case report.

BACKGROUND: Mirizzi syndrome is a rare complication of chronic cholecystitis, usually caused by gallstones impacted in the cystic duct or the neck of the gallbladder. Mirizzi syndrome results in compression of the hepatic duct or fistula formation between the gallbladder and common bile duct (or hepatic duct, right hepatic duct, or even mutative right posterior hepatic duct). Clinical features include abdominal pain, fever, and obstructive jaundice. Severe inflammation and adhesion at Calot's triangle are potentially very dangerous for patients with Mirizzi syndrome undergoing cholecystectomy. Case presentation: We report the case of a 68-year-old Asian woman who presented with abdominal pain and jaundice. She had a medical history of gallstones, but no fever. Magnetic resonance cholangiopancreatography revealed cholecystitis, cholelithiasis, common hepatic duct stones, and ascites. Findings at surgery included a porcelainized, atrophic gallbladder that was full of gallstones, fistula formation between the gallbladder and common hepatic duct, and left hepatic atrophy. The prominent feature was the left hepatic atrophy, but stones were not visible pre-operatively in the left liver by radiologic examination. CONCLUSIONS: This patient exhibited what can be considered a special type II of Mirizzi syndrome with a fistula of the common hepatic duct as well as left hepatic atrophy.

Endoscopic linear stapler-assisted resection of a giant solid pseudopapillary pancreatic tumor with concurrent regional portal hypertension: a case report.

Solid pseudopapillary tumor of the pancreas (SPTP) is a rare neoplasm with a low incidence and low rate of malignancy. We herein report a rare case of SPTP concurrent with regional portal hypertension (RPH) that was successfully treated by distal pancreatectomy and splenectomy. A 22-year-old woman presented with a left upper abdominal apophysis and normal liver function. She was diagnosed with an SPTP and RPH by abdominal ultrasound and computed tomography, and she subsequently underwent distal pancreatectomy and splenectomy. Noticeably, varicose vein plexus with wide range appeared on the upper edge of the pancreatic body and posterior gastric wall of the patient. Therefore, we created a path to avoid touching the varicose veins and took advantage of the endoscopic linear stapler to staple the veins. We herein report our surgical experience on SPTP assisted with the endoscopic linear stapler, which will be very realistic for the management of this rare clinical entity.