[Clinical application of split liver transplantation: a single center report of 203 cases].

Objective: To investigate the safety and therapeutic effect of split liver transplantation (SLT) in clinical application. Methods: This is a retrospective case-series study. The clinical data of 203 consecutive SLT, 79 living donor liver transplantation (LDLT) and 1 298 whole liver transplantation (WLT) performed at the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to July 2023 were retrospectively analyzed. Two hundred and three SLT liver grafts were obtained from 109 donors. One hundred and twenty-seven grafts were generated by in vitro splitting and 76 grafts were generated by in vivo splitting. There were 90 adult recipients and 113 pediatric recipients. According to time, SLT patients were divided into two groups: the early SLT group (40 cases, from July 2014 to December 2017) and the mature SLT technology group (163 cases, from January 2018 to July 2023). The survival of each group was analyzed and the main factors affecting the survival rate of SLT were analyzed. The Kaplan-Meier method and Log-rank test were used for survival analysis. Results: The cumulative survival rates at 1-, 3-, and 5-year were 74.58%, 71.47%, and 71.47% in the early SLT group, and 88.03%, 87.23%, and 87.23% in the mature SLT group, respectively. Survival rates in the mature SLT group were significantly higher than those in the early SLT group (χ2=5.560,P=0.018). The cumulative survival rates at 1-, 3- and 5-year were 93.41%, 93.41%, 89.95% in the LDLT group and 87.38%, 81.98%, 77.04% in the WLT group, respectively. There was no significant difference among the mature SLT group, the LDLT group and the WLT group (χ2=4.016, P=0.134). Abdominal hemorrhage, infection, primary liver graft nonfunction,and portal vein thrombosis were the main causes of early postoperative death. Conclusion: SLT can achieve results comparable to those of WLT and LDLT in mature technology liver transplant centers, but it needs to go through a certain time learning curve.

[Oligonucleotide drugs and their progress in stomatology].

Oligonucleotide drugs have the characteristics of targeting, modifiability and high biosafety. Recent studies have shown that oligonucleotide can be used to make biosensors, vaccine adjuvants, and has the functions of inhibiting alveolar bone resorption, promoting jaw and alveolar bone regeneration, anti-tumor, destroying plaque biofilm, and precise control of drug release. Therefore, it has a broad application prospect in the field of stomatology. This article reviews the classification, action mechanism and research status of oligonucleotide in stomatology. The aim is to provide ideas for further research and application of oligonucleotide.

[Oligonucleotide drugs and their progress in stomatology].

Oligonucleotide drugs have the characteristics of targeting, modifiability and high biosafety. Recent studies have shown that oligonucleotide can be used to make biosensors, vaccine adjuvants, and has the functions of inhibiting alveolar bone resorption, promoting jaw and alveolar bone regeneration, anti-tumor, destroying plaque biofilm, and precise control of drug release. Therefore, it has a broad application prospect in the field of stomatology. This article reviews the classification, action mechanism and research status of oligonucleotide in stomatology. The aim is to provide ideas for further research and application of oligonucleotide.

Therapeutic Effects of Small Incision Open Reduction and Internal Fixation and Arthroscopic High Strength Non-Absorbable Suture on Tibial Insertion Avulsion Fracture of the Anterior Cruciate Ligament.

PURPOSE OF THE STUDY To evaluate the therapeutic effects of small incision open reduction and internal fixation and arthroscopic high strength non-absorbable suture on tibial insertion avulsion fracture of the anterior cruciate ligament (ACL). MATERIAL AND METHODS In this prospectively study, 72 patients with ACL tibial insertion avulsion fracture treated from December 2017 to June 2020 were enrolled and divided into group A (treated with small incision open reduction and cannulated screw internal fixation) and group B (treated with arthroscopic high strength non-absorbable suture) using a random number table (n=36). Their general data, surgical indices and incidence of postoperative adverse reactions were compared. Knee function indices were compared before and after treatment, and evaluated by random walk model. RESULTS No significant differences were found in the general data, intraoperative blood loss, preoperative Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner score, knee range of motion and difference of bilateral tibial forward displacement distance, and total incidence rate of postoperative adverse reactions between the two groups (P>0.05). Group B had significantly longer operation time, and significantly shorter hospital stay, time of first ambulation after operation and bone healing time than group A (P<0.05). Both groups had improved Lysholm score, IKDC score, Tegner score and knee range of motion after treatment, especially in group B (P<0.05). The difference of bilateral tibial forward displacement distance significantly reduced in both groups after treatment, particularly in group B (P<0.05). The random walk model revealed that group B had better improvement of knee function than group A. CONCLUSIONS Arthroscopic high strength non-absorbable suture in the treatment of ACL tibial insertion avulsion fracture can dramatically improve the knee function indices of patients, with rapid recovery and high safety, so it has a broad prospect of clinical application. Key words: small incision open reduction and internal fixation, arthroscopic high strength non-absorbable suture, tibial insertion avulsion fracture, anterior cruciate ligament, random walk model.

[The study of a key molecule Caspase-1 of inflammasome in hepatitis B virus-related diseases].

Objective: To investigate the expression and role of asparte-specific cysteine protease (Caspase)-1, inflammasomes key molecule, in hepatitis B virus (HBV)-related diseases. Methods: HBV-related liver disease patients' serum (438 cases) and liver tissue (82 cases) samples were collected from Beijing You'an Hospital affiliated with Capital Medical University. The mRNA expression level of caspase-1 in liver tissue was detected by real-time fluorescence quantitative PCR (qRT-PCR). The protein expression level of Caspase-1 in liver tissue was detected by the immunofluorescence method. The activity of Caspase-1 was detected using the Caspase-1 colorimetric assay kit. The level of Caspase-1 in the serum was detected by an ELISA kit. Results: The results of qRT-PCR showed that the mRNA level of Caspase-1 was downregulated in patients with chronic hepatitis B (CHB), cirrhosis (LC), and hepatocellular carcinoma (HCC), while up-regulated in patients with acute-on-chronic liver failure (ACLF) (P＜0.01) compared with normal subjects. Immunofluorescence assays showed that Caspase-1 protein levels were elevated in ACLF patients, decreased in HCC and LC patients, and slightly elevated in CHB patients. The activity of Caspase-1 was slightly higher in liver tissue from CHB, LC, and HCC patients than in the normal control group, and there was no statistically significant difference between the groups. Additionally, compared with the control group, Caspase-1 activity was significantly reduced in the ACLF group (P＜0.01). Serum Caspase-1 levels were significantly lower in patients with CHB, ACLF, LC, and HCC than in normal subjects, and serum Caspase-1 levels were lowest in patients with ACLF (P＜0.001). Conclusion: Caspase-1, a key molecule of inflammasomes, plays an important role in HBV-related diseases and has significant differences, showing distinct features for ACLF than other HBV-related diseases.

[The role of circulating tumor DNA in the diagnosis and prognosis of hepatocellular carcinoma].

Hepatocellular carcinoma (HCC) is one of the common malignant tumors. However, the detection of biomarkers can't meet the clinical needs for the diagnosis and prognosis of HCC now. Circulating tumor DNA (ctDNA) is a highly tumor-specific DNA molecule that exists in the blood circulation. It is part of Circulating cell free DNA (cfDNA) and originates from the primary tumor or metastasis of cancer patients. Now, with the developing of next-generation sequencing technology and a full understanding of HCC genetics or epigenetic changes, we can analyze ctDNA mutations and methylation more comprehensively. Through continuous exploration of ctDNA mutations and methylation and continuous innovation of detection methods, HCC diagnosis and prognosis can be greatly improved in terms of specificity and sensitivity.

[Inhibition of the Notch1/Jagged1 pathway promotes homing of bone mesenchymal stem cells to improve asthma in rats].

OBJECTIVE: To explore the association of the Notch1/Jagged1 pathway with the homing of mesenchymal stem cells (BMSCs) to regulate Th1/Th2 drift in asthma. METHODS: Twenty SD rats were randomly divided into normal control group, model group, BMSC transplantation group, and BMSC+Notch inhibitor group. Ovalbumin sensitization was used to establish rat models of asthma, and BMSCs were transplanted via the tail vein. The pathology of the lung tissue was examined with HE staining, and the contents of interleukin (IL)-5, IL-13, and interferon-γ (IFN-γ) in lung tissue homogenate were determined with enzyme-linked immunosorbent assay. The expressions of Notch1 and Jagged1 mRNA were detected with RT-PCR, and CXCR4 expression in the bronchial epithelial cells was examined using immunofluorescence staining; Western blotting was used to detect the protein expressions of T-bet, GATA-3, Notch1, and Jagged1 in the lung tissue. RESULTS: Compared with those in the control group, the expressions of IFN-γ and T-bet proteins decreased significantly and the pulmonary expressions of IL-5, IL-13, and GATA-3 proteins as well as Notch1 and Jagged1 mRNA and protein expressions all increased significantly in the model group (P < 0.05 or 0.01). Compared with those in the model group, CXCR4, IFN-γ, and T-bet protein expressions in BMSC group and BMSCs+Notch inhibitor group all increased significantly, and Notch1 and Jagged1 protein expressions in BMSCs group and IL-5, IL-13, Notch1, and Jagged1 mRNA and protein expressions in BMSCs + Notch inhibitor group all decreased significantly (P < 0.05 or 0.01). The expressions of CXCR4 and IFN-γ were significantly higher and the expressions of IL-13 and Notch1 mRNA were significantly lower in BMSCs+Notch inhibitor group than in BMSC group (P < 0.05). CONCLUSION: In asthmatic rats, the homing of the BMSCs to the lung tissue has a regulatory effect on Th1/Th2 drift, and the Notch1/Jagged1 pathway may participate in the homing of the BMSCs.

Yak milk-derived exosomes alleviate lipopolysaccharide-induced intestinal inflammation by inhibiting PI3K/AKT/C3 pathway activation.

Intestinal epithelial cells (IEC) are important parts of the mucosal barrier, whose function can be impaired upon various injury factors such as lipopolysaccharide. Although food-derived exosomes are preventable against intestinal barrier injuries, there have been few studies on the effect of yak milk-derived exosomes and the underlying mechanism that remains poorly understood. This study aimed to characterize the effect of exosomal proteins derived from yak and cow milk on the barrier function of IEC-6 treated with lipopolysaccharide and the relevant mechanism involved. Proteomics study revealed 392 differentially expressed proteins, with 58 higher expressed and 334 lower expressed in yak milk-derived exosomes than those in cow exosomes. Additionally, the top 20 proteins with a relatively consistent higher expression in yak milk exosomes than cow milk exosomes were identified. Protein CD46 was found to be a regulator for alleviating inflammatory injury of IEC-6. In vitro assay of the role of yak milk exosomes on survival of IEC-6 in inflammation by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay confirmed the effectiveness of yak milk exosomes to increase IEC-6 survival up to 18% for 12 h compared with cow milk exosomes (up to 12%), indicating a therapeutic effect of yak milk exosomes in the prevention of intestinal inflammation. Furthermore, yak and cow milk exosomes were shown to activate the PI3K/AKT/C3 signaling pathway, thus promoting IEC-6 survival. Our findings demonstrated an important relationship between yak and cow milk exosomes and intestinal inflammation, facilitating further understanding of the mechanisms of inflammation-driven epithelial homeostasis. Interestingly, compared with cow milk exosomes, yak milk exosomes activated the PI3K/AKT/C3 signaling pathway more to lower the incidence and severity of intestine inflammation, which might represent a potential innovative therapeutic option for intestinal inflammation.

Yak milk-derived exosomal microRNAs regulate intestinal epithelial cells on proliferation in hypoxic environment.

Intestinal epithelial cells (IEC) act as an important intestinal barrier whose function can be impaired upon induction by hypoxia. Although intestinal barrier injuries are preventable by milk-derived exosomal microRNAs (miRNAs), the underlying mechanism remains poorly understood. This study aimed to characterize the effect of yak and cow milk-derived exosomal miRNA on the barrier function of IEC-6 under hypoxic conditions, and explore the mechanism of yak milk exosomal miRNA to relieve the hypoxia stress. First, by Illumina HiSeq 2500 (Illumina Inc., San Diego, CA) sequencing, the miRNA expression was systematically screened, and differential expression of 130 miRNAs was identified with 51 being upregulated and 79 downregulated in yak and cow milk-derived exosomes. Furthermore, the top 20 miRNAs that had a relatively consistent high expression in yak milk exosome were identified, and bta-miR-34a was found to be an effective regulator for alleviating hypoxic injury of IEC-6. In vitro assay of the role of bta-miR-34a on survival of IEC-6 in hypoxia by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) confirmed its effectiveness to significantly increase IEC-6 survival up to 13% for 12 h, and up to 9.5% for 24 h. Investigation on the regulatory relationship between bta-miRNA-34a and the hypoxia-inducible factor/apoptosis signaling pathway provided insights into the possible mechanisms by which bta-miR-34a activated the hypoxia-inducible factor and apoptosis signaling pathway, thus promoting IEC-6 survival. The results of this study suggest an important relationship between miRNA expression and intestine barrier integrity, which facilitated further understanding of the physiological function of yak and cow milk exosomal miRNAs, as well as mechanisms of hypoxia-driven epithelial homeostasis.

Identification of novel peptides from goat milk casein that ameliorate high-glucose-induced insulin resistance in HepG2 cells.

In this study, we investigated the effect of goat milk casein hydrolysates on glucose consumption rate, intracellular glycogen concentration, and mRNA expression of gluconeogenesis-related genes, including phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase catalytic subunit (G6PC), in insulin-resistant HepG2 cells. From the obtained hydrolysates, we also purified and characterized novel peptides that ameliorated high-glucose-induced insulin resistance in HepG2 cells. The 3-h hydrolysate caused the highest glucose consumption rate in insulin-resistant HepG2 cells. It also showed positive effects on promoting intracellular glycogenesis and reducing mRNA expression of PCK1 and G6PC. We separated the obtained hydrolysates into 3 fractions (F1, F2, and F3) by gel filtration chromatography; we further purified F1 using reversed-phase HPLC and identified peptides using liquid chromatography-tandem mass spectrometry. The bioactive peptides identified were SDIPNPIGSE (αS1-casein, f195-204), NPWDQVKR (αS2-casein, f123-130), SLSSSEESITH (ß-casein, f30-40), and QEPVLGPVRGPFP (ß-casein, f207-219). Our findings indicated that specific bioactive peptides from goat milk casein hydrolysates ameliorated insulin resistance in HepG2 cells that had been treated with high glucose. This is a first step toward determining whether goat milk casein hydrolysates can be used as food ingredients to ameliorate insulin resistance.

Serum miR-133 as a novel biomarker for predicting treatment response and survival in acute myeloid leukemia.

OBJECTIVE: MiRNA-133 (miR-133) has been identified as a tumor suppressor in many types of human cancers. However, its clinical significance in acute myeloid leukemia (AML) is still unclear. The purpose of this study was to assess the correlation of miR-133 expression with clinical variables and prognosis in AML patients. PATIENTS AND METHODS: Quantitative Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR) was performed to analyze blood samples from 145 patients with AML and 70 healthy volunteers. RESULTS: Decreased miR-133 levels were observed in AML patients and closely associated with aggressive clinical parameters, such as white blood cells and poor Karyotype subgroups. In addition, receiver operator characteristic (ROC) analysis revealed that serum miR-133 could efficiently screen AML patients from normal controls with high sensitivity and specificity. More interestingly, serum miR-133 levels were remarkably elevated in the patients with favorable response after standard induction chemotherapy or achieving a complete remission. Furthermore, patients in the high serum miR-133 expression group had better overall survival and recurrence-free survival than those in the low serum miR-133 expression group. Meanwhile, multivariate analysis identified serum miR-133 as a significant independent predictor for survival. CONCLUSIONS: Low miR-133 expression was a common event and correlated with worse clinical outcome in AML, suggesting that serum miR-133 might serve as a promising indicator for the early detection and prognosis evaluation of AML.

Pancreatic sarcomatoid carcinoma: CT, MRI, and 18F-FDG PET/CT features.

AIM: To investigate computed tomography (CT), magnetic resonance imaging (MRI), and combined 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron-emission tomography (PET)/CT features of pancreatic sarcomatoid carcinoma (PSC). MATERIALS AND METHODS: The hospital database was searched retrospectively for the patients with PSC confirmed at histopathology after surgery. Ten patients who underwent unenhanced and enhanced CT (n=4), unenhanced and enhanced MRI (n=2), 18F-FDG PET/CT (n=2), and both enhanced CT and 18F-FDG PET/CT (n=2) were enrolled. Two patients underwent additional delayed PET/CT. The maximum standardised uptake value (SUVmax) was measured on PET/CT images. RESULTS: Eleven lesions were detected in 10 patients. Solid and cystic components (n=6), intratumoural haemorrhage (n=1), nodular calcification (n=2), main pancreatic duct dilatation resulted from lesion obstruction (n=5) or compression (n=3), cholangiectasis (n=5), vascular and peripheral organ invasion (n=5 and 6, respectively), hepatic and lymphatic metastases (n=4 and 2, respectively) were detected. All five lesions in four patients who underwent PET/CT showed intense FDG uptake on PET/CT with SUVmax (16, range 10.9-21.1). Increase of FDG uptake (SUVmax = 18.9, 20.1, and 27.3, respectively) was revealed on the delayed scan of three lesions in two patients. CONCLUSIONS: PSCs were more commonly ill-defined solid cystic masses, which caused pancreatic duct obstruction/compression without pancreatic parenchymal atrophy, and these masses on PET/CT showed high FDG uptake on both initial and delayed PET/CT.

Clinical application of flap or flapless buccal surgery on the extractions of mesially/horizontally impacted 3rd molar with high or medium position impact: A comparative study.

PURPOSE: To investigate and compare the clinical application of flap or flapless buccal surgery on the extractions of mesially/horizontally impacted 3rd molar with high or medium position impact in terms of the average surgery duration, number of root fracture, postoperative pain degree and duration, postoperative swelling degree and duration, degree of limitation of mouth opening. MATERIALS AND METHODS: The present study was conducted of 28 patients who were examined and underwent bilateral extraction of impacted mandibular 3rd molar. One molar was randomly extracted with flap buccal surgery (Control Group, CG) and the other one with flapless buccal surgery (Experimental Group, EG) in the same patient. RESULTS: Gender distribution, average age, average surgery duration and number of root fracture between the two groups were not statistically significant (P>0.05). The postoperative pain degree, swelling degree and degree of limitation of mouth opening were all significantly greater in CG than EG. Moreover, the duration of postoperative pain and swelling were all were all significantly longer in CG than EG (0.01