Impact of preoperative therapy on surgical outcomes of laparoscopic total gastrectomy for gastric/gastroesophageal junction cancer.

Objective: As laparoscopic surgery is widely applied for primarily treated gastric cancer (GC)/gastroesophageal junction cancer (GEJC) and gains many advantages, the feasibility of laparoscopic total gastrectomy (LTG) for GC/GEJC patients who have received preoperative therapy (PT) has come to the fore. This study aims to analyze the safety and feasibility of LTG after PT for GC/GEJC patients. Methods: We retrospectively analyzed the data of 511 patients with GC/GEJC undergoing LTG, of which 405 received LTG (LTG group) and 106 received PT+LTG (PT-LTG group) at Nanfang Hospital between June 2018 and September 2022. The surgical outcomes were compared between the two groups. Results: The surgical duration was significantly longer in the PT-LTG group (P<0.001), while the incidence of intraoperative complications (P=1.000), postoperative complications (LTG group vs. PT-LTG group: 26.2% vs. 23.6%, P=0.587), the classification of complication severity (P=0.271), and postoperative recovery was similar between two groups. Notably, the incidence of anastomotic complications of esophagojejunostomy was also comparable between the two groups (LTG group vs. PT-LTG group: 5.9% vs. 5.7%, P=0.918). The univariate and multivariate analysis confirmed that positive proximal margin [positive vs. negative: odds ratio (OR)=14.094, 95% confidence interval (95% CI): 2.639-75.260, P=0.002], rather than PT, has an impact on anastomotic complications after LTG (OR=0.945, 95% CI: 0.371-2.408, P=0.905). Conclusions: PT did not increase the surgical risk of LTG for GC/GEJC. Therefore, considering the positive effect of PT on long-term survival, the broader application of PT and LTG for GC/GEJC is supported by our findings.

Positive Effect of a Pea-Clam Two-Peptide Composite on Hypertension and Organ Protection in Spontaneously Hypertensive Rats.

In the present study, we prepared pea peptides with high angiotensin-converting enzyme (ACE) inhibitory activity in vitro using an enzymatic hydrolysis of pea protein and compounded them with clam peptides to obtain a pea-clam double peptide. The effects of the two-peptide composite and pea peptides on hypertension and the damage-repair of corresponding organs were studied in spontaneously hypertensive rats (SHRs). We found that both pea peptides and the two-peptide composite significantly reduced the blood pressure upon a single or long-term intragastric administration, with the two-peptide composite being more effective. Mechanistically, we found that the two-peptide composite could regulate the renal renin-angiotensin system (RAS), rebalance gut microbial dysbiosis, decrease renal and myocardial fibrosis, and improve renal and cardiac function and vascular remodeling. Additionally, hippocampal lesions caused by hypertension were also eliminated after two-peptide composite administration. Our research provides a scientific basis for the use of this two-peptide composite as a safe antihypertension ingredient in functional foods.

Echocardiographic and morphological evaluation of the right heart after closure of atrial septal defects.

OBJECTIVE: To evaluate echocardiographically the function and morphology of the right heart subsequent to transcatheter closure of atrial septal defects. METHODS: We performed echocardiographic studies in 73 patients undergoing transcatheter closure of atrial septal defects 1 day prior to closure, and then 3 days and 3 months after closure. We calculated the antero-posterior diameter of the right ventricle, the transverse diameter and length of the right atrium, the pulmonary arterial pressure, and the velocities of systolic movement and early and late diastolic movement of the basal parietal walls of the right ventricle. RESULTS: The atrial septal defects varied in size between 8 and 33 millimetres, and were closed using occluders measuring from 10 to 40 millimetres. At 3 days after closure, the antero-posterior diameter of the right ventricle, the transverse diameter and length of the right atrium, the pulmonary arterial pressure, and the velocities of mural motion were all significantly decreased. After 3 months, the size of the right heart had more or less normalized. CONCLUSIONS: Transcatheter closure of atrial septal defects produces marked improvement in the function and geometry of the chambers of the right heart, reducing pulmonary arterial pressure as well as abolishing the interatrial shunt.

Effects of Guanfu total base on Bcl-2 and Bax expression and correlation with atrial fibrillation.

OBJECTIVE: This study sought to investigate the effects of Guanfu total base on Bcl-2 and Bax expression and the correlation of Bcl-2 and Bax expression with atrial fibrillation. METHODS: Twenty-four male Sprague-Dawley rats were randomly divided into control, model, and treatment groups (n = 8 each). A combined intravenous injection of CaCl2 (10 mg/mL) and acetylcholine (Ach; 66 µg/mL) was administered to the model and treatment groups for 7 consecutive days to induce atrial fibrillation. After 3 days, the treatment group was administered orally with Aconitum coreanum. Controls received saline for 7 consecutive days. Atrial fibrillation duration was monitored by using an electrocardiogram. Immunohistochemical analysis was used to measure the expression and distribution of Bcl-2 and Bax in the atrial myocardial tissues, RT-PCR was used to measure the Bcl-2 and Bax mRNA expression, and western blot was used to measure Bcl-2 and Bax expression in the atrial myocardial tissue. RESULTS: The model group showed prolonged atrial fibrillation, but this was absent in the control and treatment groups, indicating that treatment with A. coreanum effectively reduced atrial fibrillation duration. Immunohistochemical analysis showed that Bcl-2 expression in the atrial muscle tissue was significantly lower, but Bax expression was significantly higher in the model group compared to that in the control group. After treatment, Bcl-2 expression increased and Bax expression decreased (P < 0.01) in the treatment group compared to those in the model group. RT-PCR and western blot presented the same trends. CONCLUSION: Bcl-2 and Bax expression was correlated with atrial fibrillation. Guanfu total base was effective in treating atrial fibrillation, upregulating Bcl-2 expression, and downregulating Bax expression.

Effect of phlorotannins from Sargassum thunbergii on blood lipids regulation in mice with high-fat diet.

On the basis of activity screening on blood lipid regulation by animal study, we chose high molecular weight phlorotannins from Sargassum thunbergii (HMPs) as a drug to explore the regulating mechanism. The results showed that HMPs could significantly decrease TC and TG levels (p < 0.05), and very significantly decrease LDL-C level (p < 0.01). Results of a hypocholesterolemic mechanism study showed that HMPs could obviously increase liver LDL-R level (p < 0.05), but the fact that they failed to block the synthesis of HMG-CoA reductase excludes a relevant influence on cellular cholesterol biosynthesis. We propose that HMPs from Sargassum thunbergii have a profound hypocholesterolemic effect and the mechanism relies mainly on the increase of LDL-R level in liver.