[A study on several surgical methods of pancreas guided by main pancreatic duct treatment].

With the gradual spread of laparoscopic and robotic technology, pancreatic surgery is developing toward reducing complications and preserving more pancreatic functions. The main pancreatic duct is an important outflow channel for pancreatic exocrine fluid, and precise management of the main pancreatic duct can effectively reduce the occurrence of postoperative pancreatic complications. This paper focuses on the difficulties of pancreatic-intestinal anastomosis, distal pancreatic resection, the relationship between the pancreatic pseudocyst and main pancreatic duct, and partial pancreatic resection, and introduces how to properly manage the main pancreatic duct in common pancreatic procedures under laparoscopic and robotic techniques. Besides, the "mucosa-to-mucosa six-stitch method" for mid-pancreatic resection and end-to-end anastomosis has been proposed, which can achieve the best surgical results with minimally invasive technology and benefit more patients.

[The influencing factors of cognitive impairment in patients with silicosis].

Objective: To explore the influencing factors of cognitive impairment in patients with silicosis, and to analyze the effect of brain-derived neurotrophic factor (BDNF) on cognitive function. Methods: In March 2021, 484 silicosis patients from April 2018 to April 2020 were included in the study. The Montreal Cognitive Assessment Scale of Chinese version was used to evaluate their cognitive function, and they were divided into the cognitive impairment group (n=282) and the non cognitive impairment group (n=202) , another 30 healthy persons from body check were served as control group. The concentrations of BDNF were compared between the three groups. And the receiver operating characteristic (ROC) curve was drawed to analyze the value of BDNF in predicting cognitive impairment in silicosis patients. And the logistic regression analysis was used to explore the risk factors of cognitive impairment. Results: The incidence of cognitive impairment in silicosis patients was 58.26% (282/484) . The level of BDNF in the cognitive impairment group[ (10.32±2.11) mg/L] was significantly lower than that in the non cognitive impairment group[ (13.43±3.45) mg/L] (t=-12.27, P<0.001) . The results of ROC curve analysis showed that the area unde the curve of BDNF in predicting cognitive impairment of silicosis patients was 0.763 (95%CI: 0.613-0.874, P=0.024) , the cut off value was 10 mg/L, the sensitivity was 0.88, and the specificity was 0.84. Logistic regression analysis showed that the level of BDNF (≤10 mg/L) , age (≥65 years old) , course of disease (≥5 years) and diabetes mellitus were the risk factors of cognitive impairment in silicosis patients (OR=2.346, 95%CI: 1.654-3.103; OR=1.757, 95%CI: 1.214-1.998; OR=1.346, 95%CI: 1.112-1.564; OR=1.165, 95%CI: 1.102-1.542, P=0.001, 0.012, 0.027, 0.036) . Conclusion: BDNF may be one of the indicator to predict the risk of cognitive impairment in patients with silicosis.

[Robotic versus laparoscopic distal pancreatectomy: a retrospective single-center study].

Objective: To compare the short-term clinical outcomes and cost differences of robotic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). Methods: The retrospective descriptive study was adopted.The clinical data of 158 patients underwent minimally invasive distal pancreatectomy who were admitted to Fujian Medical University Union Hospital between January 2016 and July 2018 were collected.A 1∶1 matched propensity score (PSM) analysis was performed for the RDP group and the LDP group.Observed indexes included operative time, blood loss, spleen-preserving rate, postoperative hospital stay, morbidity, incidence of pancreatic fistula and hospital costs. T test or rank sum test was used to compare measurement data, χ(2) test or Fisher exact test was used to compare count data. Results: A well-balanced cohort of 41 patients was analyzed.There were 14 males and 27 females in the RDP group, aged (45.2±16.4)years. There were 15 males and 26 females in the LDP group, aged (47.4±14.9) years.The operation time was (209.7±52.9) minutes for the RDP group and (186.5±56.7) minutes for the LDP group (P=0.073). Median blood loss was less in RDP (50(15-175)ml) compared with LDP (100(50-350)ml) (Z=-2.689, P=0.007). Thirty-eight cases of non-malignant diseases were observed in each group and spleen-preserving rate was higher in RDP (76.3%) compared to LDP(44.7%) (χ(2)=7.930, P=0.005).Postoperative hospital stay was similar in the RDP group and the LDP group (RDP: 9.4 days vs. LDP: 10.6 days; P=0.372). The overall morbidity and incidence of pancreatic fistula major complication rates (RDP: 12.2% vs. LDP: 14.6%, P=0.746; RDP: 7.3% vs. LDP: 9.8%, P=1.000) were similar.Total cost of RDP group was higher than that of LDP group ((80 563.7±10 641.8) yuan vs. (57 792.8±8 943.0) yuan, t=4.515, P<0.01). Conclusions: Both RDP and LDP are safe and feasible procedures. RDP is more expensive, but RDP is associated with significantly less blood loss and higher spleen-preserving rate, which is more suitable for the non-malignant diseases of pancreatic body and tail with an expectation of splenic preservation.

[Development status of three-dimensional printing technology in pancreatic surgery].

Three-dimensional printing springed up for the first time in the late 1970s. As one of the representative techniques of the world's third industrial revolution, three-dimensional printing technology has a rapid development in mechanical manufacturing, industrial design, architectural configuration, biomedical sciences and so on. This article is a summary of three-dimensional printing technology in pancreatic surgery, in order to recognize the developmental level and research progress of three-dimensional printing technology, and to give advices about the research prospect and development direction in pancreatic surgery field.

[Choices of methods in dividing the neck of pancreas in laparoscopic pancreaticoduodenectomy].

Objective: To discuss the methods, skills and experiences of dividing the neck of pancreas in laparoscopic pancreaticoduodenectomy(LPD). Methods: The clinical data of 58 patients with periampullary tumors who received LPD at the Union Hospital of Fujian Medical University from December 2014 to January 2017 were retrospectively analyzed.There were 26 males and 32 females, ranged from 18 to 65 years, with a mean age of (46±12)years. Results: All of the 58 patients underwent operation smoothly.Three cases underwent open anastomosis via an auxiliary incision after the total resection of specimen laparoscopically, due to the early learning curve of LPD.Two cases transformed into open operation as a result of tumor vascular invasion to portal vein(PV) or superior mesenteric vein(SMV). Fifty-three cases underwent laparoscopic or laparoscopic combined with robotic pancreaticoduodenectomy completely.Forty-two cases ligated gastroduodenal artery(GDA), fully penetrated the interspace between rear of pancreatic neck and SMV, suspended the pancreas and then divided the neck of pancreas from inferior to superior. Thirteen cases fully dissected the interspace between rear of pancreatic neck and SMV, divided the neck of pancreas from inferior to superior and then ligated GDA.Three cases ligated GDA, dissected PV and SMV at the superior and inferior margin of the neck of pancreas separately, and then divided pancreas from anterior to posterior.Mean time of dividing pancreas was (34.9±9.7)minutes, mean volume of blood loss while dividing pancreas was (30.1±8.2)ml.The main postoperative complications included pancreatic fistula(7 cases, Biochemical leak 2 cases, B grade 3 cases, C grade 2 cases), biliary fistula(3 cases), gastric fistula(1 case), delayed gastric emptying(1 case, C grade), abdominal infection(5 cases), hepatic failure (1 case), intra-abdominal hemorrhage(2 cases), reoperation(2 cases). One case died at the perioperative period while others recovered.The mean duration of postoperative stay was (14.2±5.1)days. Conclusions: Dividing the neck of pancreas is one of the most important steps in LPD, which deserved sufficient attention.At the meantime, a suitable method of dividing the neck of pancreas should be chosen according to intraoperative exploration and preoperative imageological examinations.

Effect of Hg, As and Pb on biomass production, photosynthetic rate, nutrients uptake and phytochelatin induction in Pfaffia glomerata.

Plantlets of Pfaffia glomerata (Spreng.) were exposed for 28 days to three different metal/metalloid (Hg, Pb and As) with different levels (Hg 1; As 25, 50, 100 and Pb 100 and 400 µM) to analyze the possible phytochelatin initiation and affects on growth and photosynthetic pigments vis-à-vis metal accumulation potential of plants. The plantlets showed significant Hg, As and Pb accumulation in roots (150, 1267.67 and 2129 µg g(-1) DW respectively); however, a low root to shoot metal translocation was observed. It was interesting to note that all tested macronutrient (Mg, K, Ca) was higher in shoots and just opposite in case of micronutrients (Cu, Fe, Zn), was recorded highest in roots. The growth of plantlets (analyzed in terms of length and dry weight) was negatively affected by various metal treatments. In addition, the level of photosynthetic pigments alters significantly in response to all metal/metalloid treatment. In response to all tested metal/metalloids in plants only As induced phytochelatins (PC2, PC3 and PC4) in roots, and in shoots, GSH was observed in all tested metal/metalloids. In conclusion, P. glomerata plantlets could not cooperatively induce phytochelatins under any of Hg and Pb levels.

Lead induced responses of Pfaffia glomerata, an economically important Brazilian medicinal plant, under in vitro culture conditions.

Plantlets of Pfaffia glomerata (Spreng.) were exposed in vitro for 30 days to five lead levels (0-400 µM) to analyze the effects on growth and oxidative stress and responses of various antioxidants vis-à-vis lead accumulation. The plantlets showed significant lead accumulation in roots (1,532 µg g(-1) DW) with a low root to shoot lead translocation (ca. 3.6%). The growth of plantlets was negatively affected by various lead treatments, although the level of photosynthetic pigments did not alter significantly in response to any lead treatment. However, plantlets suffered from oxidative stress as suggested by the significant increase in malondialdehyde levels in root (8.48 µmol g(-1) FW) and shoot (3.20 µmol g(-1) FW) tissues with increasing lead treatments. In response to the imposed toxicity, increases in the activities of catalase in root (4.14 ∆E min(-1) mg(-1) protein) and shoot (3.46 ∆E min(-1) mg(-1) protein) and superoxide dismutase in root (345.32 units mg(-1) protein) and shoot (75.26 units mg(-1) protein), respectively, were observed, while the levels of non-protein thiols and ascorbic acid were not affected significantly in either roots or shoots.

Long noncoding RNA LINC00511 promoted cell proliferation and invasion via regulating miR-124-3p/EZH2 pathway in gastric cancer.

OBJECTIVE: Growing evidence has shown that long non-coding RNAs (lncRNAs) can serve as prospective markers for survival in patients with gastric cancer (GC). In this study, we mainly focused on the potential roles of LINC00511 in the development process of GC. PATIENTS AND METHODS: RT-PCR was used to detect the expressions of LINC00511 and miR-124-3p in GC tumor tissues, adjacent tissues and GC cell lines. Furthermore, correlations between LINC00511 with miR-124-3p, and miR-124-3p with EZH2, were analyzed by Correlation analysis. Moreover, the overall survival (OS) of patients was analyzed using Kaplan-Meier method. Additionally, proliferation ability was measured by CCK-8 assay and invasion ability of GC cell line was detected by transwell assay. Besides, Western blot was performed to measure protein levels of GC tissues and GC cell lines. Finally, Dual-Luciferase reporter assay was performed to prove the potential binding sites between LINC00511 and miR-124-3p, miR-124-3p and EZH2. RESULTS: We found that LINC00511 was significantly increased in GC tissues and GC cell lines, which was associated with tumor growth, metastasis and predicted poor diagnosis of GC patients. MiR-124-3p was decreased in GC tissues and GC cell lines, which was negatively correlated with LINC00511 and EZH2. Furthermore, EZH2 was increased in GC tissues and GC cell lines, which was positively correlated with LINC00511. Moreover, LINC00511 inhibition repressed cell proliferation and invasion in MKN28 cells, the protein levels of Cyclin D1, ICAM-1, VCAM-1 and N-cadherin were repressed, while E-cadherin was increased. Besides, Luciferase gene reporter assay indicated that LINC00511 could sponge with miR-124-3p, which could directly target at EZH2, an oncogenic gene. We found that miR-124-3p/EZH2 axis regulated cell proliferation and invasion in MKN28 cells. Finally, the inhibited cell proliferation and invasion abilities were eliminated following with miR-124-3p inhibition in MKN28 cells with LINC00511 knockdown. CONCLUSIONS: According to the results, we found that LINC00511 was increased in GC tissues, which was associated with the poor OS in patients with GC. We uncovered a previously unappreciated LINC00511/miR-124-3p/EZH2 signaling axis in promoting cell proliferation and invasion in GC patients and GC cell lines, which suggested that it might be a potential target for treating human GC.

Chitosan ducts fabricated by extrusion-based 3D printing for soft-tissue engineering.

Three kinds of methods based on extrusion and 3D printing and different acidic solutions (formic acid (FA), acetic acid (AA), glycolic acid (GA) and lactic acid (LA)) were applied for manufacturing the CS ducts. The tensile properties and preliminary cytotoxicity were measured for selecting the optimal ratio of CS slurry. The 3D printability of CS slurry was also studied. The tensile strength, Young's modulus, and fracture strain were tested for evaluating the degree of mechanical matching to soft-tissue. The optimal solvent to CS was 30 wt.% GA solution. The CS slurry possessing shear-thinning properties was suitable for 3D printing. The tensile strength, Young's modulus, and fracture strain of the CS rods were 10.98 ±â€¯0.61 MPa, 12.38 ±â€¯1.19 MPa, and 146.03 ±â€¯15.05 %, correspondingly. The CS ducts manufactured by 3D printing had an excellent mechanical matching to soft-tissue, outstanding biocompatibility and have great potential for soft-tissue restorations.

[Quantity of Treg cells and Th17 cells in spleen of primary immune thrombocytopenic purpura patients].

Objective: To observe the quantity of Treg cells and Th17 cells in spleen of adult primary immune thrombocytopenic purpura (ITP) patients. Methods: 43 ITP cases with splenectomy treatment were enrolled from December 2008 to June 2016 at Union Hospital of Fujian Medical University, including 20 males and 23 females with a median age of 36 (18-76) years. The controls were thirty patients who underwent splenectomy because of pancreatic diseases or splenic impairment, including 21 males and 9 females with a median age of 47 (21-69) years. The quantity and ratio of Treg cells and Th17 cells were examined by immunohistochemistry between ITP patients and controls. Results: ①The quantity of Treg cells in ITP were less than controls[ (11.3±4.7) /mm(2) vs (59.0±15.0) /mm(2), t=-22.894, P<0.001], but Th17 cells were more than controls[ (235.2±69.4) /mm(2) vs (181.1±23.7) /mm(2), t=13.768, P<0.001]. So the ratio of Treg/Th17 in ITP was lower than controls (0.048±0.027 vs 0.328±0.086, t=19.522, P<0.001) . ② The quantity of Treg cells in cases without response after splenectomy were less than cases with response[ (9.5±5.0) /mm(2) vs (11.6±4.7) /mm(2), t=2.723, P=0.010], and there is no statistical differences between the two groups about the quantity of Th17 cells and the ratio of Treg/Th17 cells[ (232.3±80.8) /mm(2) vs (239.6±66.9) /mm(2), t=1.108, P=0.277; 0.040±0.024 vs 0.053±0.027, t=0.540, P=0.592]. Conclusions: There is a significant difference about the quantity of Treg cells and Th17 cells in spleen between ITP patients and healthy controls, and they are relevant to the response after splenectomy.

Lead tolerance in plants: strategies for phytoremediation.

Lead (Pb) is naturally occurring element whose distribution in the environment occurs because of its extensive use in paints, petrol, explosives, sludge, and industrial wastes. In plants, Pb uptake and translocation occurs, causing toxic effects resulting in decrease of biomass production. Commonly plants may prevent the toxic effect of heavy metals by induction of various celular mechanisms such as adsorption to the cell wall, compartmentation in vacuoles, enhancement of the active efflux, or induction of higher levels of metal chelates like a protein complex (metallothioneins and phytochelatins), organic (citrates), and inorganic (sulphides) complexes. Phyotochelains (PC) are synthesized from glutathione (GSH) and such synthesis is due to transpeptidation of γ-glutamyl cysteinyl dipeptides from GSH by the action of a constitutively present enzyme, PC synthase. Phytochelatin binds to Pb ions leading to sequestration of Pb ions in plants and thus serves as an important component of the detoxification mechanism in plants. At cellular level, Pb induces accumulation of reactive oxygen species (ROS), as a result of imbalanced ROS production and ROS scavenging processes by imposing oxidative stress. ROS include superoxide radical (O2(.-)), hydrogen peroxide (H2O2) and hydroxyl radical ((·)OH), which are necessary for the correct functioning of plants; however, in excess they caused damage to biomolecules, such as membrane lipids, proteins, and nucleic acids among others. To limit the detrimental impact of Pb, efficient strategies like phytoremediation are required. In this review, it will discuss recent advancement and potential application of plants for lead removal from the environment.

Rosiglitazone attenuates hyperglycemia-enhanced hemorrhagic transformation after transient focal ischemia in rats.

Hemorrhagic transformation (HT) has been claimed to represent the most feared complication of treatment with intravenous tissue plasminogen activator (t-PA) therapy. In this study, we tested the effect of rosiglitazone on HT in a rat focal cerebral ischemia model. Male Sprague-Dawley rats received an injection of 50% dextrose (6ml/kg intraperitoneally) and were subjected to middle cerebral artery occlusion (MCAO) 10 min later, with the regional cerebral blood flow monitored in vivo by laser-Doppler-flowmetry. Two groups were included: rosiglitazone treatment and vehicle group. In the treatment group, after 1.5h of ischemia, rosiglitazone (2mg/kg) was administered at the onset of reperfusion. Neurobehavioral scores, infarct volume, hemoglobin leakage, hemorrhage rate, the expression of collagen IV and glucose transporter 1 (GLUT1) were measured at 24h after ischemia. Rosiglitazone improved neurobehavioral deficits, reduced infarct volume and hemorrhage rate, and inhibited hemoglobin leakage, when compared with the vehicle group. In addition, it increased the expression of collagen IV and GLUT1 compared to the vehicle group. Our results suggest that rosiglitazone attenuated the hyperglycemia-induced HT after MCAO, possibly by preservation of GLUT1 expression.

Electrical stimulation affects metabolic enzyme phosphorylation, protease activation, and meat tenderization in beef.

The objective of this study was to investigate the response of sarcoplasmic proteins in bovine LM to low-voltage electrical stimulation (ES; 80 V, 35 s) after dressing and its contribution to meat tenderization at an early postmortem time. Proteome analysis showed that ES resulted in decreased (P < 0.05) phosphorylation of creatine kinase M chain, fructose bisphosphate aldolase C-A, ß-enolase, and pyruvate kinase at 3 h postmortem. Zymography indicated an earlier (P < 0.05) activation of µ-calpain in ES muscles. Free lysosomal cathepsin B and L activity increased faster (P < 0.05) in ES muscles up to 24 h. Immunohistochemistry and transmission electron microscopy further indicated that lysosomal enzymes were released at an early postmortem time. Electrical stimulation also induced ultrastructural disruption of sarcomeres. In addition, ES accelerated (P < 0.05) the depletion of ATP, creatine phosphate, and glycogen, as well as a pH decline and the more preferred pH/temperature decline mode. Finally, ES accelerated meat tenderization, resulting in lesser (P < 0.05) shear force values than the control over the testing time. A possible relationship was suggested between a change in the phosphorylation of energy metabolic enzymes and the postmortem tenderization of beef. Our results suggested the possible importance of the activation of µ-calpain, phosphorylation of sarcoplasmic proteins, and release of lysosomal enzymes for ES-induced tenderization of beef muscle.

The detoxification of lead in Sedum alfredii H. is not related to phytochelatins but the glutathione.

Two ecotypes of S. alfredii [Pb accumulating (AE) and Pb non-accumulating (NAE)] differing in their ability in accumulating Pb were exposed to different Pb levels to evaluate the effects on plant length, photosynthetic pigments, antioxidant enzymes (SOD and APX), cysteine, non-protein thiols (NP-SH), phytochelatins (PCs) and glutathione (GSH) vis-à-vis Pb accumulation. Both ecotypes showed significant Pb accumulation in roots, however only the AE showed significant Pb accumulation in shoots. We found that both AE and NAE of S. alfredii-induced biosynthesis of GSH rather than phytochelatins in their tissue upon addition of even high Pb levels (200 microM). Root and shoot length were mostly affected in both ecotypes after addition of higher Pb concentrations and on longer durations, however photosynthetic pigments did not alter upon addition of any Pb treatment. Both superoxide dismutase (SOD) and ascorbate peroxidase (APX) activities of AE were higher than NAE. The levels of cysteine and NP-SH were also higher in AE than in NAE. Hence, the characteristic Pb accumulation of ecotypes differed presumably in relation to their capacity for detoxification of Pb. These results suggest that enzymatic and non-enzymatic antioxidants play a key role in the detoxification of Pb-induced toxic effects in Sedum alfredii. This plant can be used as an indicator species for Pb contamination.