Nutrition, phytochemical profiling, in vitro biological activities, and in silico studies of South Chinese white pitaya (Hylocereus undatus).

Background: White pitaya, a popular tropical fruit, is known for its high nutritional value. It is commercially cultivated worldwide for its potential use in the food and pharmaceutical industries. This study aims to assess the nutritional and phytochemical contents and biological potential of the South Chinese White Pitaya (SCWP) peel, flesh, and seed extracts. Methods: Extract fractions with increasing polarity (ethyl acetate < acetone < ethanol < methanol < aqueous) were prepared. Antibacterial potential was tested against multidrug-resistant (MDR) bacteria, and antioxidant activity was determined using, 2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radical scavenging assays, and cytotoxic activity against human keratinocyte cells using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Pharmacological screening and molecular docking simulations were conducted to identify potential antibacterial compounds with druggable characteristics. Molecular dynamics simulation (MDS) was employed to validate the binding stability of the promising ligand-protein complexes. Results: All parts of the fruit exhibited a substantial amount of crucial nutrients (minerals, sugars, proteins, vitamins, and fatty acids). The ethanol (ET) and acetone (AC) fractions of all samples demonstrated notable inhibitory effects against tested MDR bacteria, with MIC50 ranges of 74-925 µg/mL. Both ET and AC fractions also displayed remarkable antioxidant activity, with MIC50 ranges of 3-39 µg/mL. Cytotoxicity assays on HaCaT cells revealed no adverse effects from the crude extract fractions. LC-MS/MS analyses identified a diverse array of compounds, known and unknown, with antibacterial and antioxidant activities. Molecular docking simulations and pharmacological property screening highlighted two active compounds, baicalein (BCN) and lenticin (LTN), showing strong binding affinity with selected target proteins and adhering to pharmacological parameters. MDS indicated a stable interaction between the ligands (BCN and LTN) and the receptor proteins over a 100-ns simulation period. Conclusion: Our study provides essential information on the nutritional profile and pharmacological potential of the peel, flesh, and seeds of SCWP. Furthermore, our findings contribute to the identification of novel antioxidants and antibacterial agents that could be capable of overcoming the resistance barrier posed by MDR bacteria.

Removal of hepatocellular carcinoma extending into the right atrium with extracorporeal circulation.

Hepatocellular carcinoma with tumor thrombus extending into the right atrium is rare and has an extremely poor prognosis. Surgery was once regarded as a contraindication, then as a palliative method to prevent emergencies such as pulmonary embolism or heart failure. With advances of imaging techniques, hepatectomy and widespread use of extracorporeal circulation, conventional viewpoint has gradually changed. For patients with adequate hepatic function reserve and no distant metastases, surgery is recommended. During the past four years, we experienced two such patients, for both of whom we simultaneously resected the hepatic tumor and tumor thrombus in the right atrium under cardiopulmonary circulation and total hepatic blood exclusion. Both of the patients survived the surgery. During the follow-up, one patient died 6 months later due to multiple lung metastases and tumor progression. The other patient experienced recurrence 4 months after surgery and underwent adjuvant treatment modalities including chemotherapy, radiofrequency ablation and transcatheter arterial chemoembolization. Thirty-eight months later, the patient died of multiple metastasis and hepatic failure.

Hepatic Resection Provides Survival Benefit for Selected Intermediate-Stage (BCLC-B) Hepatocellular Carcinoma Patients.

PURPOSE: The intermediate stage of hepatocellular carcinoma (HCC) (Barcelona Clinic Liver Cancer [BCLC] B) comprises a highly heterogeneous population, and the treatment strategy is still controversial. Because of the heterogeneity, a subclassification of intermediate-stage HCCs was put forward by Bolondi according to the 'beyond Milan and within up-to-7' criteria and Child-Pugh score. In this study, we aim to analyze the prognosis of BCLC-B stage HCC patients who received hepatic resection according to the Bolondi's subclassification. MATERIALS AND METHODS: One thousand and one hundred three patients diagnosedwith HCC and treatedwith hepatic resectionwere enrolled in our hospital between 2006 and 2012. According to Bolondi's subclassification, the BCLC-B patients were divided into four groups. Recurrence-free survival (RFS) and overall survival (OS) were analyzed. RESULTS: According to Bolondi's subclassification, the BCLC-B patients were divided into four groups: B1 (n=41, 18.7%), B2 (n=160, 73.1%), B3 (n=11, 5.0%), and B4 (n=7, 3.2%). Significant difference was observed between B1 and other groups (B1 vs. B2, p=0.022; B1 vs. B3, p < 0.001; B1 vs. B4, p < 0.001), but no difference for B2 vs. B4 (p=0.542) and B3 vs. B4 (p=0.542). In addition, no significant differences were observed between BCLC-A and BCLC-B1 group for both RFS (p=0.087) and OS (p=0.643). In multivariate analysis, BCLC-B subclassification was not a risk factor for both OS (p=0.263) and RFS (p=0.892). CONCLUSION: In our study, HCC patients at B1 stagewere benefited from hepatic resection and had similar survival to BCLC-A stage patients. Our study provided rationality of hepatic resection for selected BCLC-B stage HCC patients instead of routine transarterial chemoembolization.

The invasive malignancy from peritoneal epithelial cell: a report of four cases and review of literature.

To analyze the clinical characteristics, diagnosis and treatment of primary peritoneal carcinoma (PPC) and to review the literature, so as to raise the awareness of the disease. Four cases of PPC diagnosed in our department from March 2005 to September 2007 were retrospectively analyzed. Four cases were all treated with platinum-based chemotherapy. They were treated with intraperitoneal chemohyperthermia (IPCH) with cisplatin, carboplatin or oxaliplatin with a closed sterile circuit of 1,000 ml physiologic saline and inflow temperature is 43°C, while they were receiving high-intensity focused microwave hyperthermia (HIFMH) concomitantly. Intravenous paclitaxel or docetaxel was used in three patients, while cyclophosphamide and adriamycin injection in another patient. After two cycles of chemotherapy, ascites decreased significantly or even disappeared. Up to 6 January 2010, the four cases had survived for 38, 51, 33 and 29 months, respectively. PPC is a group of invasive malignancy derived from the peritoneal epithelium, it is common in women and is homogeneous with ovarian cancer in pathology. Diagnosis relies mainly on postoperative pathologic diagnosis and cytology after ruling out ovarian cancer and gastrointestinal cancer. Platinum-containing chemotherapy, IPCH and the administration of taxanes can improve the overall response rate and long-term survival.