Intraoperative hepatic subcapsular spider-like telangiectasia sign for the definitive diagnosis of biliary atresia.

OBJECTIVE: To evaluate the accuracy of intraoperative hepatic subcapsular spider-like telangiectasia (HSST) sign for differentiating biliary atresia (BA) from other causes of hepatic cholestasis. METHODS: The data of 69 patients with jaundice treated from January 2019 to December 2021 were retrospectively analyzed. Based on intraoperative cholangiography (IOC), the patients were divided into two groups: the BA group (n = 49) and the non-BA group (n = 20). The biochemistry tests, liver ultrasound, liver stiffness value and HSST sign of the two groups were compared. RESULTS: The incidence of abnormal gallbladder, elevated γ-glutamyl transpeptidase (γ-GGT) > 182.0U/L and abnormal liver stiffness (> 6.4 kPa) in BA group were significantly higher than those in non-BA group (P < 0.001). The HSST sign was present in all BA patients and not found in non-BA group. The area under receiver operating curve of direct bilirubin(DBIL), γ-GGT, abnormal gallbladder, liver stiffness value and HSST sign were 0.53, 0.84, 0.78, 0.96, and 1.00, respectively. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of HSST sign in the diagnosis of BA were all 100%. CONCLUSION: Presence of HSST sign on diagnostic laparoscopy is highly suggestive of BA.It can be used in the differential diagnosis of BA and non-BA. LEVEL OF EVIDENCE: Level III.

Relationship between the expression levels of CD4+ T cells, IL-6, IL-8 and IL-33 in the liver of biliary atresia and postoperative cholangitis, operative age and early jaundice clearance.

OBJECTIVE: To investigate the expression levels of CD4+ T cells, IL-6, IL-8 and IL-33 in liver tissue of BA, and the relationship with postoperative cholangitis, operative age and early jaundice clearance. METHODS: 45 cases of jaundice treated in the hospital from June 2018 to May 2020 were analyzed retrospectively. The expression and distribution of these factors were detected by HE staining and immunohistochemistry, the total bilirubin level and the incidence of cholangitis were recorded, and the relationship between liver inflammation level and the postoperative incidence of cholangitis, age of operation and early jaundice clearance were compared. RESULTS: Immunohistochemistry showed that the expression of CD4+ T cells, IL-6, IL-8 and IL-33 in the BA group were higher than those in the CBD group. ROC curve analysis showed the AUC of CD4+ T cells, IL-6 and IL-8 were 0.869, 0.886 and 0.838, respectively. The expression level of CD4+ T cells was negatively correlated with the decline rate of TBIL 3 months after operation, and the expressions of IL-8 and IL-33 were negatively correlated with the decline rate of TBIL 1 week after operation. CONCLUSION: The high expression of CD4+ T cells, IL-6, IL-8 and IL-33 in the BA liver tissue may lead to cholangitis and can be used as a predictor of early jaundice clearance. The degree of liver inflammation infiltration had nothing to do with the age of operation and is not a risk factor for postoperative cholangitis.

A review of clinical use of surface-enhanced Raman scattering-based biosensing for glioma.

Glioma is the most common malignant tumor of the nervous system in recent centuries, and the incidence rate of glioma is increasing year by year. Its invasive growth and malignant biological behaviors make it one of the most challenging malignant tumors. Maximizing the resection range (EOR) while minimizing the impact on normal brain tissue is crucial for patient prognosis. Changes in metabolites produced by tumor cells and their microenvironments might be important indicators. As a powerful spectroscopic technique, surface-enhanced Raman scattering (SERS) has many advantages, including ultra-high sensitivity, high specificity, and non-invasive features, which allow SERS technology to be widely applied in biomedicine, especially in the differential diagnosis of malignant tumor tissues. This review first introduced the clinical use of responsive SERS probes. Next, the sensing mechanisms of microenvironment-responsive SERS probes were summarized. Finally, the biomedical applications of these responsive SERS probes were listed in four sections, detecting tumor boundaries due to the changes of pH-responsive SERS probes, SERS probes to guide tumor resection, SERS for liquid biopsy to achieve early diagnosis of tumors, and the application of free-label SERS technology to detect fresh glioma specimens. Finally, the challenges and prospects of responsive SERS detections were summarized for clinical use.

Value of gallbladder length-to-width ratio for diagnosis of biliary atresia by correlation with age.

The objective is to explore the correlation between ultrasonic gallbladder length-width ratio (LTWR) and age, and the value of differential diagnosis between biliary atresia (BA) and other hepatic cholestasis. From January 2016 to June 2022, the data of 183 patients with jaundice who underwent abdominal ultrasound and surgical exploration in the Affiliated Hospital of Zunyi Medical University were analyzed retrospectively. The demographic data, liver function, and ultrasonic parameters were recorded and analyzed. There were statistically significant differences between BA group and non-BA group in maximum length, maximum width and LTWR of gallbladder (P < 0.001). In all age groups (I: ≤ 30 days; II: 31-60 days; III: 61-90 days; IV: 91-120 days; V: ≥ 121 days), in which group III (61-90 days) had the highest area under the curve (AUC) of 0.843, and group V (≥121 days) had the lowest AUC of 0.548. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of gallbladder LTWR > 3.26 for BA in group II (31-60 days) were 78.9%, 75.0%, 75.0%, 78.9% and 76.9%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of gallbladder LTWR > 3.69 for BA in group III (61-90 days) were 76.6%, 84.6%, 92.5%, 59.5% and 78.9%, respectively. Ultrasonography LTWR of gallbladder has certain value in the diagnosis of BA. The diagnostic value of gallbladder LTWR in infants with different ages was quite different, and it was relatively high in infants with 31-90 days.

Unveiling the In Situ and Solvent Polymerization Engineering for Highly Efficient and Flexible Thermally Activated Delayed Fluorescence Organic Light-Emitting Diodes.

Thermally activated delayed fluorescence (TADF) polymer has great potential for the construction of flexible solution-processed organic light-emitting diodes (OLEDs). However, the relationship between polymerization engineering and device functions has rarely been reported. Here, two novel TADF polymers, P-Ph4CzCN and P-Ph5CzCN, with a small energy gap between the first excited singlet and triplet states (ΔEST; <0.16 eV) were newly developed by both solvent and in situ polymerization of a styrene component. Detailed device performance testing indicates that both polymerization strategies ensure that the TADF polymer achieves comparable high efficiencies in commonly rigid devices, and the maximum external quantum efficiencies (EQEmax) were 11.9%, 14.1%, and 16.2% for blue, green, and white OLEDs, respectively. Although in situ polymerization provides a simplified device fabrication process, which avoids the complicated synthesis and purification of the polymer, the inevitable high-temperature annealing makes it fail in a plastic substrate device. In contrast, P-Ph5CzCN achieved by solvent polymerization enables the successful fabrication of a flexible device on a poly(ethylene terephthalate) (PET) substrate, which was the first reported flexible OLED based on a TADF polymer. This work provides a strong guideline for the simple fabrication of TADF polymer devices and the application of TADF polymer materials in OLED flexible panels and flexible lighting.

Ratiometric pH-responsive SERS strategy for glioma boundary determination.

Glioma is one of the most common intracranial malignant tumors worldwide. Since the glioma is invasive and lacks a clear boundary with normal brain tissue, the neurosurgeon can only determine the extent of surgical resection based on empirical experience. Thus, accurately demarcating its boundaries has become a major challenge for surgeons. Owing to the high glycolysis metabolism of glioma cells, the acidification of the extracellular fluid has become an indicator of glioma evolution. Herein, a ratiometric pH-responsive surface-enhanced Raman scattering (SERS) strategy was developed for the rapid identification of glioma boundaries. A sensing chip composed of silver nanoparticles self-assembled film was fabricated, followed by the self-assembly of a pH-responsive SERS reporter, 4-mercaptopyridine (4-MPY). The characteristic SERS peak ratios of 4-MPY change regularly under different pH conditions. The boundary of glioma invasion was determined by measuring the pH of waterdrops infiltrated by interstitial fluids. The technology enables accurate, non-invasive, and rapid determination of local pH, thereby maximizing the removal of tumor tissue while minimizing damage to normal tissue. This technique is more rapid and simple than intraoperative pathological detection and can be possibly used for intraoperative navigation.

Case report: A case of giant accessory hepatic lobe torsion combined with left hepatic vein branch thrombosis in a child.

The accessory hepatic lobe (AHL) is a rare congenital malformation of the hepatic tissue, among which the giant AHL is the rarest in children. Patients without complications are usually asymptomatic, and most auxiliary examinations cannot provide a definitive preoperative diagnosis. Surgical procedure is the only recommended management for patients who suffered from the complications of AHL. We report the case of a rare pediatric giant AHL torsion combined with left hepatic vein branch thrombosis which was successfully treated by laparoscopic lobectomy followed by excision of AHL.

Thoracoscopic surgery for congenital diaphragmatic hernia in neonates: Should it be the first choice?

Objective: Congenital diaphragmatic hernia (CDH) is an uncommon but potentially life-threatening surgical condition in neonates. Surgery can be performed by either open or thoracoscopic techniques. In this study, we compared the clinical efficacy, safety, and effectiveness of thoracoscopic and open CDH repair. Methods: A retrospective review of neonates with CDH who underwent operations at our hospital from 2013 to 2021 was performed. The various perioperative parameters were compared between neonates undergoing thoracoscopic and open surgery. Results: There were 50 neonates in this study (37 in the thoracoscopic group and 13 in the open group). Thoracoscopic surgery was associated with significantly shorter hospital stay (13.32 vs. 18.77 days, p < 0.001); shorter duration of postoperative mechanical ventilation (3.70 vs. 5.98 days, p < 0.001); early feeding (4.34 vs. 7.46 days, p < 0.001); and shorter time to reach optimal feeding (8.21 vs. 13.38 days, p < 0.001). There was one postoperative death in the open group and no death in the thoracoscopic group. The median follow-up time of the two groups was 23.8 months (20.5 months in open group and 25.0 months in thoracoscopic group). Thoracoscopic surgery was associated with lower recurrence rates, but the difference was not statistically significant (2.7% vs. 7.7%, p = 0.456). Conclusion: Thoracoscopy CDH repair, a safe and effective surgical technique for neonates, has better cosmesis, faster postoperative recovery, and a lower recurrence rate than other procedures. It can be considered the first choice for CDH treatment for neonates among experienced surgeons.

Highly Efficient Quasi-2D Perovskite Light-Emitting Diodes Incorporating a TADF Dendrimer as an Exciton-Retrieving Additive.

Although small organics or polymer additives have been introduced to enhance film formation and radiative recombination of perovskite light-emitting diodes (PeLEDs), the exciton utilization and quantum efficiency need further optimization. Here, we introduce a thermal-activated delayed fluorescence (TADF) dendrimer as an additive to enhance the surface coverage and reduce the trap state of the grain boundary. More importantly, the TADF nature of such an additive can retrieve the exciton dissociated from perovskite or trapped by the grain boundary and then transfer the energy back to emissive perovskite through the Förster energy transfer process. Since the triplets can be reused by reverse intersystem crossing in such a TADF additive, the theoretical exciton utilization is 100%. As a result, the optimized PeLEDs cooperating with a TADF additive achieved a high current efficiency of 39.0 cd A-1 and an ultrabright luminescence of 18,000 cd m-2, which are almost 5 times higher than those of the control device without an additive. Moreover, the device stability monitored by half-lifetime at 1000 cd m-2 enhanced 2 times after introducing the TADF dendrimer as an additive. The parent dendrimer without a TADF feature was also synthesized as an additive to explore the mechanism action, which found that 54% enhancement of device efficiency can be attributed to defect passivating, while 46% was assigned to retrieved energy. This research first demonstrates that the TADF dendrimer is a promising exciton-retrieving additive for enhancing the performance of PeLEDs by passivating defect, filling up grain boundary, and retrieving leakage exciton.

Defects and Surface Electrical Property Transformation Induced by Elemental Interdiffusion at the p-n Heterojunction via High-Temperature Annealing.

Heterojunction annealing is widely used to improve the efficiency of kesterite thin-film solar cells. However, the efficiency will decrease when the annealing temperature is high, and the reason why high-temperature postdeposition annealing results in the deterioration of device performance is not well-studied, which restricts the efficiency promotion of kesterite solar cells. This study investigates the effect of high-temperature postdeposition annealing on the p-n heterojunction and, thus, on the performance of the solar cell. The surface potential of the absorber layer inverts, the number of deep-level defects increases, and the CdS/CZTSe interface barrier height increases after high-temperature postdeposition annealing. A combination of different characterization methods reveals that excessive elemental diffusion at the p-n heterojunction during high-temperature postdeposition annealing is the key reason for deterioration of the performance of CZTSe devices. This study discloses the mechanism for the change in device properties with high-temperature postdeposition annealing and will also be helpful for understanding the mechanism of efficiency change as the solar cell keeps working.

Study on the gas desorption law and indicator influencing factors of fixed-size coal samples.

The prediction of dangerous hazards in working faces is an important link to prevent coal and gas outbursts. Improving the accuracy of predictive indicators is of great significance for reducing the phenomenon of being prominently below the critical value and ensuring safe production. The fixed-size desorption index K1 is one of the important indicators for coal face and gas outburst prediction. Based on the diffusion theory and the physical meaning of fixed-size coal samples, the mathematical expression of K1 is established by the self-developed high/low temperature pressure swing adsorption-desorption experimental system. According to the equation, the effects of gas pressure, loss time, coal particle size and diffusion coefficient on K1 are studied. The results show that the K1 index is logarithmically related to the gas pressure. Under the same conditions, the longer the loss time is, the smaller the measured K1 is, and the smaller the particle sizes of the drill cuttings are, the more notable the performance is; the diffusion coefficient represents the ability of gas to bypass micropores and the coal matrix. The greater the ability to bypass the matrix is, the larger the diffusion coefficient under the same conditions is, and the larger K1 is; the coal particle size has a greater influence on K1, and the smaller the size is, the more likely it is that the phenomenon of being prominently below the critical value occurs. Therefore, the particle size composition of coal during on-site measurements is crucial for obtaining the true K1 and the exact critical values.

A study on effect of curcumin on anticerebral aneurysm in the male albino rats.

INTRODUCTION: This study investigated the curcumin effect on the cerebral aneurysm. Apoptosis is known to play a fundamental role in the pathogenesis of a cerebral aneurysm. Therefore, we investigated the effect of curcumin on apoptosis of smooth muscle cells of a cerebral aneurysm-induced male albino rats. METHODS: In this study, the cerebral aneurysm has been induced in the male albino rats by the CaCl2 administration. After cerebral aneurysm induction, smooth muscle cells were isolated. Cells were treated with curcumin (25 & 50 mg/kg bwt) for 48 hr. RESULTS: Curcumin reduced altered mitochondrial morphology significantly, evidenced through fluorescence and confocal study. Curcumin treatment reduced the expression of p53, caspase-3, and bax/bxl-2 ratio significantly. Curcumin treatment also reversed the cellular architecture of smooth muscle cell wall significantly. Fluorescence and the confocal study confirmed the reduction in apoptosis in a cerebral aneurysm-induced smooth muscle cells of male albino rats. CONCLUSION: Taking all these data together, it may suggest that the curcumin could significantly reduce the CaCl2-induced cerebral aneurysm through the inhibition of cell apoptosis in the cells.

Epilysin is overexpressed in glioblastoma and related to clinical outcome of patients.

As the newest identified member of the matrix metalloproteinase (MMP) family, the expression pattern and function of epilysin (MMP-28) are still not well understood. Although epilysin was found to play an evolutionarily conserved role in neural development, the expression and function of epilysin in malignant glioma are unknown. Therefore, the aim of the present study was to quantitatively evaluate the expression level of epilysin in glioblastoma (GBM) and its association with clinical outcome of patients. For this purpose, a total of 216 GBM specimens and 31 normal brain specimens were collected in the present study. Expression level of epilysin was determined by immunohistochemistry assay and immunoreactivity score system. MGMT promoter methylation and IDH1/2 mutation status in GBM were also evaluated. Results showed that the positive rate of epilysin staining in GBM was significantly elevated compared with that in normal brain. Positive epilysin staining was associated with low KPS score, unmethylated MGMT promoter and wild-type IDH. Kaplan-Meier analysis showed that patients with GBM of positive epilysin staining were more likely to have unfavorable overall survival. Multivariate analysis revealed that epilysin was an independent and significant prognostic marker of GBM. These results proved for the first time that epilysin expression was significantly elevated in GBM and can be potentially used to predict prognosis in patients with GBM.

Restoration and protection of brachial plexus injury: hot topics in the last decade.

Brachial plexus injury is frequently induced by injuries, accidents or birth trauma. Upper limb function may be partially or totally lost after injury, or left permanently disabled. With the development of various medical technologies, different types of interventions are used, but their effectiveness is wide ranging. Many repair methods have phasic characteristics, i.e., repairs are done in different phases. This study explored research progress and hot topic methods for protection after brachial plexus injury, by analyzing 1,797 articles concerning the repair of brachial plexus injuries, published between 2004 and 2013 and indexed by the Science Citation Index database. Results revealed that there are many methods used to repair brachial plexus injury, and their effects are varied. Intervention methods include nerve transfer surgery, electrical stimulation, cell transplantation, neurotrophic factor therapy and drug treatment. Therapeutic methods in this field change according to the hot topic of research.

ß-diketone-cobalt complexes inhibit DNA synthesis and induce S-phase arrest in rat C6 glioma cells.

ß-diketone-cobalt complexes, a family of newly synthesized non-platinum metal compounds, exhibit potential antitumor activity; however, the antitumor mechanism is unclear. The current study investigated the mechanism by which ß-diketone-cobalt complexes inhibit rat C6 glioma cell proliferation. It was found that ß-diketone-cobalt complexes suppress rat C6 glioma cell viability in a dose-dependent manner (3.125-100 µg/ml). In rat C6 glioma cells, the IC50 value of ß-diketone-cobalt complexes was 24.7±3.395 µg/ml and the IC10 value was 4.37±1.53 µg/ml, indicating a strong inhibitory effect. Further investigation suggested that ß-diketone-cobalt complexes inhibit rat C6 glioma cell proliferation, which is associated with S-phase arrest and DNA synthesis inhibition. During this process, ß-diketone-cobalt complexes decreased cyclin A expression and increased cyclin E and p21 expression. In addition, ß-diketone-cobalt complexes exhibit a stronger antitumor capability than the antineoplastic agent, 5-fluorouracil.

miR-21 promotes the differentiation of hair follicle-derived neural crest stem cells into Schwann cells.

Hair follicle-derived neural crest stem cells can be induced to differentiate into Schwann cells in vivo and in vitro. However, the underlying regulatory mechanism during cell differentiation remains poorly understood. This study isolated neural crest stem cells from human hair follicles and induced them to differentiate into Schwann cells. Quantitative RT-PCR showed that microRNA (miR)-21 expression was gradually increased during the differentiation of neural crest stem cells into Schwann cells. After transfection with the miR-21 agonist (agomir-21), the differentiation capacity of neural crest stem cells was enhanced. By contrast, after transfection with the miR-21 antagonist (antagomir-21), the differentiation capacity was attenuated. Further study results showed that SOX-2 was an effective target of miR-21. Without compromising SOX2 mRNA expression, miR-21 can down-regulate SOX protein expression by binding to the 3'-UTR of miR-21 mRNA. Knocking out the SOX2 gene from the neural crest stem cells significantly reversed the antagomir-21 inhibition of neural crest stem cells differentiating into Schwann cells. The results suggest that miR-21 expression was increased during the differentiation of neural crest stem cells into Schwann cells and miR-21 promoted the differentiation through down-regulating SOX protein expression by binding to the 3'-UTR of SOX2 mRNA.