Identification of a circadian-based prognostic signature predicting cancer-associated fibroblasts infiltration and immunotherapy response in bladder cancer.

Circadian rhythm disruption impacts the efficiency of both chemotherapy and immunotherapy, yet identifying the key factors involved remains challenging. Circadian rhythm disruption can trigger aberrant fibroblasts activation, suggesting potential roles of cancer-associated fibroblasts (CAFs) in addressing this issue. In this paper, TCGA-BLCA patients were classified into two subgroups based on the expression of core circadian rhythm genes (CCRGs). The CCRG-based subgroups showed distinct fibroblast-related signals, from which a risk model composed of five fibroblast-related genes was finally established with excellent survival prognostic value in both TCGA and GEO datasets. The risk model was positively associated with the infiltration of CAFs and can efficiently predict the immunotherapy response in BLCA. Besides, high-risk score was associated with reduced sensitivity to a majority of traditional chemotherapeutic drugs such as oxaliplatin and gemcitabine. Further, the correlation between CCRGs and the risk genes was analyzed. Among the five risk genes, FAM20C displayed the most extensive correlation with the CCRGs and exhibited the strongest connection with CAFs infiltration. Moreover, FAM20C independently served as a predictor for the response to immunotherapy in BLCA. In conclusion, this study has identified a circadian-based signature for evaluating CAFs infiltration and predicting the efficacy of chemotherapy and immunotherapy. The central gene FAM20C has emerged as a promising candidate which merits further investigations.

Ionic titanium is expected to improve the nutritional quality of Tartary buckwheat sprouts through flavonoids and amino acid metabolism.

Tartary buckwheat sprouts are highly valued by consumers for their superior nutritional content. Ionic titanium (Ti) has been shown to enhance crop growth and improve nutritional quality. However, there is limited research on the impact of ionic Ti on the nutritional quality of Tartary buckwheat sprouts. This study cultivated Tartary buckwheat sprouts with ionic Ti and found that the high concentration of ionic Ti significantly increased the contents of chlorophyll a, chlorophyll b, and carotenoids (increased by 25.5%, 27.57%, and 15.11%, respectively). The lower concentration of ionic Ti has a higher accumulation of total flavonoids and total polyphenols. Metabolomics analysis by LC-MS revealed 589 differentially expressed metabolites and 54 significantly different metabolites, enriching 82 metabolic pathways, especially including amino acid biosynthesis and flavonoid biosynthesis. This study shows that ionic Ti can promote the growth of Tartary buckwheat sprouts, improve nutritional quality, and have huge development potential in food production.

Morphological, Physiological, and Photosynthetic Differences of Tartary Buckwheat Induced by Post-Anthesis Drought.

Tartary buckwheat (Fagopyrum tataricum (L.) Gaertn) is a crop of significant interest due to its nutritional value and resilience to drought conditions. However, drought, particularly following flowering, is a major factor contributing to yield reduction. This research employed two distinct Tartary buckwheat genotypes to investigate the effects of post-anthesis drought on growth and physicochemical characteristics. The study aimed to elucidate the response of Tartary buckwheat to drought stress. The findings indicated that post-anthesis drought adversely impacted the growth, morphology, and biomass accumulation of Tartary buckwheat. Drought stress enhanced the maximum photosynthetic capacity (Fv/Fm) and light protection ability (NPQ) of the 'Xiqiao-2' genotype. In response to drought stress, 'Dingku-1' and 'Xiqiao-2' maintained osmotic balance by accumulating soluble sugars and proline, respectively. Notably, 'Xiqiao-2' exhibited elevated levels of flavonoids and polyphenols in its leaves, which helped mitigate oxidative damage caused by drought. Furthermore, rewatering after a brief drought period significantly improved plant height, stem diameter, and biomass accumulation in 'Dingku-1'. Overall, 'Xiqiao-2' demonstrated greater long-term tolerance to post-anthesis drought, while 'Dingku-1' was less adversely affected by short-term post-anthesis drought.

Neutrophil-to-Lymphocyte Ratio and Early Tumor Shrinkage as Predictive Biomarkers in Unresectable Hepatocellular Carcinoma Patients Treated With Lenvatinib, PD-1 Inhibitors, in Combination With TACE.

Purpose: The purpose of this prospective observational study was to investigate the relationship between pretreatment neutrophil-to-lymphocyte ratio (NLR) and posttreatment early tumor shrinkage (ETS), and clinical outcomes in patients with unresectable hepatocellular carcinoma (uHCC) who received lenvatinib, programmed death-1 inhibitors plus transcatheter arterial chemoembolization. Patients and Methods: A total of 63 uHCC patients were treated with this triple combination. Multivariate analyses to determine the independent factors associated with overall survival (OS) were employed. The link between NLR and clinical results was further analyzed. Furthermore, the predictive value of combining NLR with ETS should be investigated to stratify patients receiving treatment for survival benefits. Results: Progression-free survival and OS were 9.8 and 23.0 months, respectively, with a median follow-up of 20.8 months. On a multivariate analysis of OS, NLR was the only independent prognostic factor. Patients with NLR low (NLR < 3.2) had longer progression-free survival (19.3 vs 7.3 months, P < 0.001) and OS (28.9 vs 16.9 months, P < 0.001), higher objective response rate (86.7% vs 39.4%, P < 0.001), and a higher chance of achieving ETS ≥ 10% (ETS high) (73.3% vs 21.1%, P < 0.001) compared with patients with NLR high (NLR ≥ 3.2). The Spearman correlation analysis also showed the strong consistency between NLR and ETS (R2 = 0.6751). In the subgroup analysis, greater OS benefit was found in the NLR low/ETS high group than the NLR high/ETS low group (χ2 = 31.258, P < 0.001), while there was no survival difference for patients in the NLR low/ETS low group compared with in the NLR high/ETS high group (χ2 = 0.046, P = 0.830). Conclusion: NLR has the potential to identify which patients would benefit from this triple therapy, and when combined with ETS, it has the potential to provide greater predictive power in selecting the appropriate candidates for this combination treatment.

NIR diagnostic imaging of triple-negative breast cancer and its lymph node metastasis for high-efficiency hypoxia-activated multimodal therapy.

BACKGROUND: Triple-negative breast cancer (TNBC) possesses special biological behavior and clinicopathological characteristics, which is highly invasive and propensity to metastasize to lymph nodes, leading to a worse prognosis than other types of breast cancer. Thus, the development of an effective therapeutic method is significant to improve the survival rate of TNBC patients. RESULTS: In this work, a liposome-based theranostic nanosystem (ILA@Lip) was successfully prepared by simultaneously encapsulating IR 780 as the photosensitizer and lenvatinib as an anti-angiogenic agent, together with banoxantrone (AQ4N) molecule as the hypoxia-activated prodrug. The ILA@Lip can be applied for the near-infrared (NIR) fluorescence diagnostic imaging of TNBC and its lymph node metastasis for multimodal therapy. Lenvatinib in ILA@Lip can inhibit angiogenesis by cutting oxygen supply, thereby leading to enhanced hypoxia levels. Meanwhile, large amounts of reactive oxygen species (ROS) were produced while IR 780 was irradiated by an 808 nm laser, which also rapidly exhausted oxygen in tumor cells to worsen tumor hypoxia. Through creating an extremely hypoxic in TNBC, the conversion of non-toxic AQ4N to toxic AQ4 was much more efficiency for hypoxia-activated chemotherapy. Cytotoxicity assay of ILA@Lip indicated excellent biocompatibility with normal cells and tissues, but showed high toxicity in hypoxic breast cancer cells. Also, the in vivo tumors treated by the ILA@Lip with laser irradiation were admirably suppressed in both subcutaneous tumor model and orthotopic tumor models. CONCLUSION: Utilizing ILA@Lip is a profound strategy to create an extremely hypoxic tumor microenvironment for higher therapeutic efficacy of hypoxia-activated chemotherapy, which realized collective suppression of tumor growth and has promising potential for clinical translation.

Research on a three-dimensional SERS substrate based on a CNTs/Ag@Au/SiO2 composite for detection of fipronil and imidacloprid pesticides.

Surface-enhanced Raman scattering (SERS) has a unique fingerprint spectrum, which allows for rapid, highly sensitive, and non-destructive detection without the need for sample pretreatment. However, SERS substrates have disadvantages such as short storage time and poor reproducibility. In this study, carbon nanotubes, gold, and silver were combined to take advantage of their inherent structural and characteristic properties that enhance the Raman effect. A new type of SERS composite substrate, CNTs/Ag@Au/SiO2, was prepared using a hydrothermal method and seed growth method. The substrate was characterized using transmission electron microscopy (TEM), and the average distance between the core-shell nanoparticles was found to be 3.1 nm, which is more suitable than other gold-silver combined core-shell structures and significantly improves the SERS enhancement factor. The substrate demonstrated high sensitivity even at low concentrations of probe molecules and good uniformity at five randomly selected locations. After storage for 45 days, the substrate still exhibited good stability. In most gold-silver combined core-shell structures, the detection limit for Rhodamine 6G (R6G) is 10-9 mol L-1, while in this substrate, the detection limit for R6G is 10-11 mol L-1. Furthermore, the contribution of the substrate's enhancement was deeply investigated using finite-difference time-domain (FDTD), which revealed that the substrate's hotspots were present in two forms: the "hotspots generated between Ag@Au nanoparticles" and the "hotspots generated between Ag@Au nanoparticles and carbon nanotubes". These two forms of hotspots also demonstrated that the performance brought about by the preparation of the substrate structure was reliable. The simulation results were compared with the experimental results, and the analysis showed that the real environment would have an impact on the substrate's structure during the actual substrate preparation process. Finally, the substrate was used for detecting the pesticide fipronil, and the results showed clear peaks even at a concentration of 0.1 mg L-1. The results indicated that the Raman intensity was linearly exponential with the fipronil solution concentration, with a determination coefficient of R2 = 0.991. This study provides a new SERS substrate for pesticide residue detection and further explores the improvement of pesticide detection limits.

Experimental and numerical study on gas production decline trend under ultralong-production-cycle from shale gas wells.

It is of engineering interest to explore recovered shale gas composition and its effects on total gas production trend over a long-term extraction period. However, there are previous experimental studies mostly focused on short term development for small scaled cores, which is less convincing to mimic reservoir-scaled shale production process. In addition, the previous production models mostly failed to account for comprehensive gas nonlinear effects. As a result, in this paper, to illustrate the full-life-cycle production decline phenomenon for shale gas reservoir, dynamic physical simulation was performed for more than 3433 days to simulate shale gas transport out of the formations over a relatively long production period. Moreover, a five-region seepage mathematical model was then developed and was subsequently validated by the experimental results and shale well production data. Our findings show that for physical simulation, both the pressure and production declined steadily at an annual rate of less than 5%, and 67% of the total gas in the core was recovered. These test data supported earlier finding that shale gas is of low flow ability and slow pressure decline in the shale matrices. The production model indicated that free gas accounts for the majority of recovered shale gas at the initial stage. Based on a shale gas well example, free gas extraction makes up 90% of produced total gas. The adsorbed gas constitutes a primary gas source during the later stage. Adsorbed gas contributes more than 50% of the gas produced in the seventh year. The 20-year-cumulative adsorbed gas makes up 21% of the EUR for a single shale gas well. The results of this study can provide a reference for optimizing production systems and adjusting development techniques for shale gas wells throughout the combinations of mathematical modeling and experimental approaches.

Multiple Gas Seepage Mechanisms and Production Development Research for Shale Gas Reservoirs from Experimental Techniques and Theoretical Models.

Shale gas seepage theory provides a scientific basis for dynamically analyzing the physical gas flow processes involved in shale gas extraction and for estimating shale gas production. Conventional experimental techniques and theoretical methods applied in seepage research are unable to accurately illustrate shale gas mass transfer processes at the micro- and nanoscale. In view of these scientific issues, the knowledge of seepage mechanisms and production development design was improved from the perspective of experimental techniques and theoretical models in the paper. First, multiple techniques (e.g., focused ion beam scanning electron microscopy and a combination of mercury intrusion porosimetry and adsorption measurement techniques) were integrated to characterize the micro- and nanopore distribution in shales. Then, molecular dynamics simulations were carried out to analyze the microscale distribution of gas molecules in nanopores. In addition, an upscaled gas flow model for the shale matrix was developed based on molecular dynamics simulations. Finally, the coupled flow and productivity models were set up according to a long-term production physical simulation to identify the production patterns for adsorbed and free gas. The research results show that micropores (diameter: <2 nm) and mesopores (diameter: 2-50 nm) account for more than 70% of all the pores in shales and that they are the primary space hosting adsorbed gas. Molecular simulations reveal that microscopic adsorption layers in organic matter nanopores can be as thick as 0.7 nm and that desorption and diffusion are the main mechanisms behind the migration of gas molecules. An apparent permeability model that comprehensively accounts for adsorption, diffusion, and seepage was developed to address the deficiency of Darcy's law in characterizing gas flowability in shale reservoirs. The productivity model results for a certain gas well show that the production in the first three years accounts for more than 50% of its estimated ultimate recovery and that adsorbed gas contributes more to the annual production than free gas in the eighth year. These research results provide theoretical and technical support for improving the theoretical understanding of shale gas seepage and optimizing shale gas extraction techniques in China.

Modeling a Multi-Parameter Interaction of Geophysical Controls for Production Optimization in Gas Shale Systems.

Well bottomhole pressure optimization issue has been a significant concern for efficiently developing unconventional systems due to strong stress sensitivity. Therefore, it is of practical interest to clarify influence mechanisms involved in stress sensitivity for gas shale, which is further included in the production model to determine main controlling factors for bottomhole pressure strategy optimization for long term hydrocarbon extraction. Currently, many production models were limited in exploring stress sensitivity mechanisms but adopted common empirical equations regarding net pore stress instead. In addition, geophysical control analysis for unconventional systems optimization was mostly conducted using local sensitivity qualitative analysis, which should be validated to be reliable and applicable to fields using multi-parameter interaction influence. As a result, in this paper, an efficient workflow to rationally optimize gas well production system was provided by combining the production model, orthogonal design approach, and response surface method. To be specific, the compound flow model for shale gas reservoirs, incorporating multiple stress sensitivity mechanisms, was proposed to function as a theoretical basis for production optimization simulation. Last but not least, local sensitivity analysis was conducted to qualitatively analyze the impact of influencing factors on 20 year-production of gas wells under different bottomhole production methods. The simulation results showed that the managed pressure drawdown scheme can be adopted for reservoirs with high reservoir pressure and tight matrix properties, while the high-pressure drawdown scheme is suitable for reservoir with better fracturing effect and high external water content. Finally, based on the proposed gas flow model and orthogonal design experiments, response surface design and single factor analysis as well, an optimization mathematical model for shale gas multi-parameter interaction was established, which intuitively quantified the effects of multi-geophysical controls on EUR increase in different production durations, including matrix properties, fracture properties, and production system indicator parameters. These findings provide a more reliable reference for production system optimization based on a series of mathematical approaches to improve overall long-term recovery from shale gas reservoirs.

Determination of Johnson-Cook Constitutive of 15-5 PH Steel Processed by Selective Laser Melting.

To obtain a Johnson-Cook model of 15-5 PH steel formed by selective laser melting (SLM), and to determine the difference between the forging process, in this work, mechanical testing, penetration testing and numerical simulations were used to study 15-5 PH steel formed by SLM and forging. Finally, the Johnson-Cook model parameters and failure parameters of the 15-5 PH steel formed by SLM and forging were obtained. We found that the SLM process was beneficial for refining the grain size of 15-5 PH steel and for improving the mechanical properties of 15-5 PH steel, where the yield strength of its specimens increased by 13.1% compared with the forged specimens. The error between the numerical simulations and penetration tests was less than 10%, which verified the validity of the numerical model parameters. It was also found that the penetration ability and abrasion resistance of the SLM-shaped projectiles were slightly superior to those of the forged projectiles.

Bottom-hole pressure drawdown management of fractured horizontal wells in shale gas reservoirs using a semi-analytical model.

Due to strong stress sensitivity resulted from unconventional tight formationsit is of practical interest to formulate a reasonable pressure drawdown plan to improve gas extraction recovery. The impact of water-shale interactions on the reservoir permeability was previously ignored in the managed pressure drawdown optimization. The controlled-pressure production dynamic analysis was mostly conducted using numerical simulation, lack of rigorous theoretical support. Hence in this paper, a theoretical production prediction model was proposed and verified with HIS RTA 2015by incorporating multiple pressure drawdown mechanisms and various non-linear gas flow process. The on-site production effects dominated by two different pressure drop methods was further compared, indicating that compared to depressurization production, the production reversion can occur in the controlled pressure production process and the EUR of single well can be increased by about 30% under the control of managed pressure drawdown approach. Finally, the pressure drawdown optimization strategy was carried out on the field test from the both production effect and economic benefits, which demonstrated that the best economic solution can generally be obtained in the early stage of production. The research results can be closely linked to the on-site production practice of shale gas wells, providing insights into designing optimized production strategy scheme.

MCM7 supports the stemness of bladder cancer stem-like cells by enhancing autophagic flux.

Autophagy plays critical roles in the pluripotent stemness of cancer stem cells (CSCs). However, how CSCs maintain the elevated autophagy to support stemness remains elusive. Here, we demonstrate that bladder cancer stem-like cells (BCSLCs) are at slow-cycling state with enhanced autophagy and mitophagy. In these slow-cycling BCSLCs, the DNA replication initiator MCM7 is required for autophagy and stemness. MCM7 knockdown inhibits autophagic flux and reduces the stemness of BCSLCs. MCM7 can facilitate autolysosome formation through binding with dynein to promote autophagic flux. The enhanced autophagy/mitophagy helps BCSLCs to maintain mitochondrial respiration, thus inhibiting AMPK activation. AMPK activation can trigger switch from autophagy to apoptosis, through increasing BCL2/BECLIN1 interaction and inducing P53 accumulation. In summary, we find that MCM7 can promote autophagic flux to support.

Effect of radiation processing on phenolic antioxidants in cereal and legume seeds: A review.

Phenolic compounds in cereal and legume seeds show numerous benefits to human health mainly because of their good antioxidant capacity. However, long-term storage and some improper preservation may reduce their antioxidant potential. It is necessary to retain or modify the phenolic antioxidants with improved technology before consumption. Radiation processing is usually applied as a physical method to extend the shelf life and retain the quality of plant produce. However, the effect of radiation processing on phenolic antioxidants in cereal and legume seeds is still not well understood. This review summarizes recent research on the effect of radiation, including ionizing and nonionizing radiation on the content and profile of phenolic compounds, and antioxidant activities in cereal and legume seeds, the influencing factors and possible mechanisms are also discussed. The article will improve the understanding of radiation effect on phenolic antioxidants, and promote the radiation modification of natural phenolic compounds in cereal and legume seeds and other sources.

Engineered Red Blood Cell Membrane-Coating Salidroside/Indocyanine Green Nanovesicles for High-Efficiency Hypoxic Targeting Phototherapy of Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) presents special biological behavior and clinicopathological characteristics and leads to a worse prognosis than other types of breast cancer. The development of an effective therapeutic method is significant to improve the survival rate of TNBC cancer patients. In this work, an engineered red blood cell membrane (RBCm)-coating salidroside/indocyanine green nanovesicle (ARISP) is successfully prepared for hypoxic targeting phototherapy of TNBC. Salidroside in ARISP effectively ameliorates hypoxia-induced tumorigenesis by downregulating the expression of hypoxia-inducible factor 1α (HIF-1α), which increases the killing effect of reactive oxygen species on tumor cells during photodynamic therapy (PDT) using the photosensitizer indocyanine green. Besides, ARISP has an anti-LDLR modified RBCm-coating that extends its circulation time in the blood and escapes from immune surveillance and enhances hypoxia-targeted cellular uptake via the overexpressed LDLR receptor in hypoxic tumor sites. Moreover, guided by near-infrared fluorescence imaging and photoacoustic imaging, ARISP can eliminate tumors via high-efficiency phototherapy and inhibit lung and liver metastasis in TNBC models. Cytotoxicity assay of ARISP indicates the excellent biocompatibility with normal cells and tissues. This study provides fulfilling insights into the anticancer mechanism of reducing HIF-1α for enhanced PDT and has a promising therapeutic potential for TNBC treatment.

Pressure Drawdown Management Strategies for Multifractured Horizontal Wells in Shale Gas Reservoirs: A Review.

The flow capacity of shale gas reservoirs is easily impaired during the depletion process due to strong stress sensitivity. Thereby, an adequate production system, namely, the managed pressure drop method, has been widely introduced to the industrial practice application by decelerating the wellbore pressure drop rate and ultimately improving the long-term production process. This work presents a review of the pressure drawdown management mechanisms for shale gas formations. However, clarifying the water-shale interaction physical chemistry process and developing a mathematical model that accurately describes the water-shale interaction mechanism remain a challenge. Moreover, different classifications of the managed production simulation research approaches are discussed in detail. Each approach has its own merits and demerits. Among them, numerical simulations are commonly seen in cognizance of characterizing the managed pressure drawdown production period but are found to be relatively time-consuming and also computationally expensive. An optimized theoretical model is therefore essential because it can lead to a precise estimation of the ultimate long-term production and capture instantaneously the actual shale gas reservoir depletion phenomenon with various production systems compared to other available methods. The key influence of managed pressured production for single wells in shale reservoirs is elaborated as well. As observed from the current review, an accurate description of the pressure drop management mechanism is crucial for the theoretical model of the pressure control production process for shale gas wells. The influence of water-rock interaction on the managed pressure drawdown mechanism cannot be ignored. There have thus been works to improve and enhance it for use in theoretical models for shale formations. On the other hand, the advancement of theoretical models presents an opportunity for better representation of the managed pressure drop production process.

Experimental Study on the Effects of Pore Pressure and Slippage on the Permeability of a Fracture Network during Depressurization of Shale Gas Reservoir Production.

Hydraulic fracturing technology is an important technical means to increase shale gas production. The seepage channels formed in the hydraulic fractures during hydraulic fracturing can help increase reservoir permeability. Therefore, it is of significance to study the seepage law of the fracture network after reservoir hydraulic fracturing. In this study, hydraulic fracturing is used to fracture full-diameter shale cores, and three typical forms of hydraulic fracture networks are obtained. The characteristics of the fracture networks are analyzed by X-ray CT scanning. The effects of pore pressure and slippage on the permeability of the fracture networks are simulated by conducting experiments. The experimental results show that in the direction of gas seepage, hydraulic fractures completely penetrate the sample, and the greater the diameter and volume of the fracture, the better the hydraulic fracture conductivity. When the confining pressure remains unchanged at 50 MPa, the apparent permeability values of the hydraulic fractures with the worst and best fracture morphologies increase by 44.4 times and 2.8 times, respectively, with the decrease in the pore pressure from 30 to 2 MPa. The apparent permeability of the shale samples has a power function relationship with the pore pressure. The test results also show that the absolute permeability is positively correlated with the number of effective seepage channels in the hydraulic fractures and the number of hydraulic fractures, whereas the Klinkenberg coefficient is negatively correlated. Our research results can provide a basis for shale gas production model research and for on-site production capacity improvement. The qualitative understanding and scientific explanation of the effects of pore pressure and slippage on fracture network permeability in the process of depressurization of reservoir production have been realized.

Norcantharidin Induces Immunogenic Cell Death of Bladder Cancer Cells through Promoting Autophagy in Acidic Culture.

The acidic tumor microenvironment stands as a major obstacle to the efficient elimination of tumor cells. Norcantharidin (NCTD) is a powerful antitumor agent with multiple bioactivities. However, the effect of NCTD under acidic conditions is still unclear. Here, we report that NCTD can efficiently kill bladder cancer (BC) cells in acidic culture, and more intriguingly, NCTD can induce immunogenic cell death (ICD), thereby promoting antitumor immunity. In NCTD-treated BC cells, the surface-exposed calreticulin (ecto-CALR) was significantly increased. Consistently, co-culture with these cells promoted dendritic cell (DC) maturation. The NCTD-induced ICD is autophagy dependent, as autophagy inhibition completely blocked the NCTD-induced ecto-CALR and DC maturation. In addition, the DC showed a distinct maturation phenotype (CD80high CD86low) in acidic culture, as compared to that in physiological pH (CD80 high CD86high). Finally, the NCTD-induced ICD was validated in a mouse model. NCTD treatment significantly increased the tumor-infiltrating T lymphocytes in MB49 bladder cancer mice. Immunizing mice with NCTD-treated MB49 cells significantly increased tumor-free survival as compared to control. These findings demonstrate that NCTD could induce ICD in an acidic environment and suggest the feasibility to combine NCTD with anticancer immunotherapy to treat BC.

Clinical Experience of Diagnosis and Surgical Treatment of 6 Cases of Acute Subhepatic Appendicitis.

To summarize the experience of diagnosis and surgical treatment of 6 cases of acute subhepatic appendicitis. The clinical data of 6 patients with subacute appendicitis in Zhejiang Provincial People's Hospital from July 2018 to December 2019 were analyzed retrospectively. Results. There were 5 males and 1 female. All 6 cases were diagnosed as appendicitis by abdominal CT before operation. All patients underwent laparoscopic appendectomy without conversion to laparotomy. One case of ectopic appendix was located under the liver with absence of ascending colon, one case of ectopic appendix was located under the liver with ectopic ascending colon of transverse colon, one case of appendix head was located in the liver cyst, and the resection of liver cyst was performed at the same time, and three cases of retrocolonic appendix head were located under the liver. Postoperative pathology confirmed appendicitis. For patients with right upper abdominal pain and tenderness, the possibility of subhepatic appendicitis should be considered before operation. Emergency abdominal CT has more advantages than ultrasound. Laparoscopy can not only make a definite diagnosis but also perform appendectomy at the same time.