HMGCR inhibition stabilizes the glycolytic enzyme PKM2 to support the growth of renal cell carcinoma.

Renal cell carcinoma (RCC) is responsible for most cases of the kidney cancer. Previous research showed that low serum levels of cholesterol level positively correlate with poorer RCC-specific survival outcomes. However, the underlying mechanisms and functional significance of the role of cholesterol in the development of RCC remain obscure. 3-Hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) plays a pivotal role in RCC development as it is the key rate-limiting enzyme of the cholesterol biosynthetic pathway. In this study, we demonstrated that the inhibition of HMGCR could accelerate the development of RCC tumors by lactate accumulation and angiogenesis in animal models. We identified that the inhibition of HMGCR led to an increase in glycolysis via the regulated HSP90 expression levels, thus maintaining the levels of a glycolysis rate-limiting enzyme, pyruvate kinase M2 (PKM2). Based on these findings, we reversed the HMGCR inhibition-induced tumor growth acceleration in RCC xenograft mice by suppressing glycolysis. Furthermore, the coadministration of Shikonin, a potent PKM2 inhibitor, reverted the tumor development induced by the HMGCR signaling pathway.

Family with sequence similarity 111 member B contributes to tumor growth and metastasis by mediating cell proliferation, invasion, and EMT via transforming acidic coiled-coil protein 3/PI3K/AKT signaling pathway in hepatocellular carcinoma.

As a complex systemic disease, primary liver cancer ranks third in death rate for solid tumors worldwide. Family with sequence similarity 111 member B (FAM111B), which was found to be aberrantly mutated in multiple cancers, is a candidate oncogene. We aimed to determine the function and mechanism of FAM111B in hepatocellular carcinoma (HCC). The expression of FAM111B was evaluated in HCC tissues, adjacent tissues, HCC cell lines. The impact of FAM111B on proliferation, invasion, apoptosis and EMT of HCC cells were detected by CCK-8, Transwell, flow cytometry and Western blot assays. The relationship between FAM111B and transforming acidic coiled-coil protein 3 (TACC3) was assessed by CoIP and Immunofluorescence (IF) staining assays. The effect of FAM111B on tumor growth was detected by using xenograft model of nude mice. The expression of FAM111B was upregulated in HCC tissues and cell lines, and the prognosis of HCC patients was worse in the high FAM111B expression group, and its expression level was associated with the TNM stage of HCC. FAM111B silencing inhibited HCC cell proliferation and invasion, EMT and induced apoptosis. Besides, TACC3 served as an interactor for FAM111B, which could enhance TACC3 expression, thus activing PI3K/AKT pathway. Rescue experiments revealed that elevated of TACC3 restored the inhibitory effect of FAM111B overexpression on the cell functions via PI3K/AKT pathway. In vivo, FAM111B inhibition hampered tumor growth and metastasis of HCC. This study highlighted a key player of FAM111B in modulating the malignant biological progression of HCC via TACC3/PI3K/AKT signaling pathway, displaying a potential therapeutic target for HCC.

A spaced retraining schedule with 2-day interval improves the acquisition and retention of simulation-based basic arthroscopic skills.

PURPOSE: To compare the effect of three differently spaced retraining schedules (1-day, 2-day, and 1-week intervals) on the acquisition of basic arthroscopic skills and skill retention after 3 months. METHODS: Thirty orthopaedic residents without arthroscopic experience were enrolled in a double-blind, randomised, parallel-controlled trial. Spaced retaining schedules were divided into massed training and retraining phases. Participants were required to obtain perfect scores in all tasks on the simulator in the massed training phase, followed by a pretest to evaluate the training effect. During the retraining phase, participants were randomly assigned to Groups A (1-day interval), B (2-day interval) or C (1-week interval). A posttest was used to evaluate the effect of different retraining patterns. Follow-up evaluations were conducted at 1 week, 1 month and 3 months after the completion of spaced retraining schedules to measure skill retention. One-way ANOVA and paired-sample t tests were used for statistical analysis. RESULTS: Significant between-group differences in diagnostic arthroscopy (137.0 ± 24.8 vs. 140.1 ± 21.3 vs. 175.3 ± 27.4 s, P(A-C) = 0.005, P(B-C) = 0.010) and loose body removal (193.1 ± 33.9 vs. 182.0 ± 32.1 vs. 228.7 ± 42.9 s, P(B-C) = 0.025) completion times were observed. No significant differences were found in other posttest metrics. An assessment of skill retention after the 3-month follow-up (Evaluation 3) showed significant differences in diagnostic arthroscopy completion time (202.5 ± 53.3 vs. 172.0 ± 27.2 vs. 225.5 ± 42.1 s, P(B-C) = 0.026). No significant differences were found in other Evaluation 3 metrics. CONCLUSION: The 2-day retraining schedule was the most effective for the acquisition and retention of basic arthroscopic skills and could be integrated into arthroscopic skills curricula. After a 3-month follow-up, residents who followed this schedule showed better skill retention than those who followed the 1-week interval schedule. LEVEL OF EVIDENCE: Level I.

Enhanced chiral sensing in achiral nanostructures with linearly polarized light.

Chiral plasmonic nanostructures can generate large superchiral near fields owing to their intrinsic chirality, leveraging applications for molecule chirality sensing. However, the large structural chirality of chiral nanostructures poses the risk of overshadowing molecular chiral signals, hampering the practical application of chiral nanostructures. Herein, we propose an achiral nanorod that shows no structural chirality and presents strong superchiral near-fields with linearly polarized incidence. The mechanism of the strong superchiral near-field originates from the coupling between the evanescent fields of the localized surface plasmon resonance and incident light. The enhanced near-field optical chirality at the corners of the nanorods reached 25 at a wavelength of 790 nm. Meanwhile, the sign of optical chirality can be tuned by the polarization of the incident light, which provides a convenient way to control the handedness of the light. Furthermore, the enantiomers of D- and L-phenylalanine molecules were experimentally characterized using an achiral platform, which demonstrated a promising nanophotonic platform for chiral biomedical sensing.

Elevated blood urea nitrogen-to-creatinine ratio increased the risk of Coronary Artery Disease in patients living with type 2 diabetes mellitus.

BACKGROUND: High Blood Urea Nitrogen (BUN) and high Serum Creatinine (SCr) levels are risk factors for Coronary Artery Disease (CAD). However, the relationship between the Blood Urea Nitrogen to Creatinine (BUN/SCr) ratio (UCR) and the risk of CAD in patients living with new-onset diabetes is unclear. This study aimed to examine the relationship between blood UCR and the risk of CAD in patients living with new-onset type 2 diabetes mellitus (T2DM). METHODS: We analyzed the data from the cohort of 12,299 patients living with type 2 diabetes mellitus. Primary endpoints were the events of CAD. The ANOVA test (continuous indicators) and χ2 test (categorical indicators) were used to assess the differences of baseline characteristics across the groups of UCR. In order to understand the correlation between variables, we performed correlation analysis on variables that have significant differences between CAD group and non-CAD group. Multivariate-adjusted Cox proportional hazard regression models were applied to estimate the association of the blood UCR with the risk of CAD in patients living with T2DM. The Kaplan-Meier survival function plotting and the log-rank test were used to evaluate the event-free survival according to the groups of UCR. The restricted cubic spline model was used to show the adjusted association between blood UCR and risk of CAD in patients living with T2DM. RESULTS: During a median follow-up of 2.66 years, 1173 CAD were recorded with an event rate of 28.49 events per 1000 person-years. In multivariate-adjusted Cox regression models, elevated blood urea nitrogen to creatinine ratio (UCR) was associated with higher risk of CAD in patients living with T2DM [hazard ratio (HR), 1.782; 95% confidence interval (CI), 1.237-2.567]. The Kaplan-Meier survival curves indicated that the high group of UCR tended to have a lower event-free survival than the low group and medium group. There was a nonlinear trend toward increasing risk of CAD across the groups of UCR. And cubic spline function graph suggested that the influence of UCR level on HR for CAD increased significantly at UCR levels above 6.67. CONCLUSIONS: An elevated UCR was significantly associated with an increased risk for CAD in patients living with T2DM.

Stretch-driven microfluidic chip for nucleic acid detection.

Molecular diagnosis is an essential means to detect pathogens. The portable nucleic acid detection chip has excellent prospects in places where medical resources are scarce, and it is also of research interest in the field of microfluidic chips. Here, the article developed a new type of microfluidic chip for nucleic acid detection where stretching acts as the driving force. The sample entered the chip by applying capillary force. The strain valve was opened under the action of tensile force, and the spring pump generated the power to drive the fluid to flow to the detection chamber in a specific direction. The detection of coronavirus disease 2019 (COVID-19) was realized on the chip. The RT-LAMP amplification system was adopted to observe the liquid color in the detection chamber to decide whether the sample tested positive or negative qualitatively.

An integrated microfluidic detection system for the automated and rapid diagnosis of high-risk human papillomavirus.

Human papillomavirus (HPV) causes the prevalent sexually transmitted infection that accounts for the majority of cervical cancer incidences. Therefore, the development of a rapid, accurate, automatic and affordable nucleic acid detection strategy is urgently required for HPV tests, among which microfluidic chip is a promising diagnostic method. In this work, we developed a microfluidic detection system consisting of a microfluidic chip and the corresponding detection equipment to diagnose high-risk HPV. The proposed method integrates nucleic acid purification, isothermal amplification and real-time fluorescence detection into one device. Moreover, it demonstrates good detection performance such as high specificity of primer sets (100%) and exceptional stability (coefficient of variation <6%) among five HPV genotypes. Besides, the microfluidic loop-mediated isothermal amplification (LAMP) assay is accurate (specificity of 91.7% and sensitivity of 100%) and fast (average time threshold = 10.56 minutes) when considering the conventional qPCR assay as the gold standard. The integrated microfluidic detection system offers automated and rapid diagnosis within 40 minutes and shows broad potential to deliver point-of-care detection in resource-limited circumstances owing to its simplicity and affordability.

Effects of multi-frequency ultrasound-assisted immersion freezing processing on myofibrillar protein structure and lipid oxidation of large yellow croaker (Larimichthys crocea) during long-time frozen storage.

In this study, large yellow croaker (Larimichthys crocea) was frozen using multi-frequency ultrasound-assisted freezing (MUIF) with different powers (160 W, 175 W, and 190 W, respectively) and stored at -18 °C for ten months. The effect of different ultrasound powers on the myofibrillar protein (MP) structures and lipid oxidation of large yellow croaker was investigated. The results showed that MUIF significantly slowed down the oxidation of MP by inhibiting carbonyl formation and maintaining high sulfhydryl contents. These treatments also held a high activity of Ca2+-ATPase in the MP. MUIF maintained a higher ratio of α-helix to ß-sheet during frozen storage, thereby protecting the secondary structure of the tissue and stabilizing the tertiary structure. In addition, MUIF inhibited the production of thiobarbituric acid reactive substances value and the loss of unsaturated fatty acid content, indicating that MUIF could better inhibit lipid oxidation of large yellow croaker during long-time frozen storage.

Effect of magnetic nano-particles combined with multi-frequency ultrasound-assisted thawing on the quality and myofibrillar protein-related properties of salmon (Salmo salar).

Multi-frequency ultrasound-assisted thawing (MUAT) has been proven to be an effective method of maintaining the quality of frozen food. The effects of magnetic nano-particles (MNPs) combined with MUAT and multi-frequency ultrasound-assisted sequential thawing (MUST) on water retention, myofibrillar protein (MP) structural characteristics, function characteristics, and MP aggregation and degradation of salmon (Salmo salar) were studied. The results showed that MNPs combined with multi-frequency ultrasound-assisted sequential thawing (MNPs-MUST) significantly improved the thawing rate and the retention of water and had better emulsifying and foaming properties. MNPs-MUST treatment reduced the oxidation and degradation of MP, increased sulfhydryl content, and protected the structure of MP. Confocal laser scanning microscopy (CLSM) indicated that the MP transformed into a filamentous polymer into more evenly distributed units, resulting in higher protein solubility, lower surface hydrophobicity, and lower protein turbidity. Therefore, MNPs combined with MUST has a potential application value in the thawing research of frozen salmon.

Complete mitochondrial genome data and phylogenetic analysis of Papilio macilentus Janson, 1877 (Lepidoptera: Papilionoidea: Papilionidae).

In the present study, the complete mitochondrial genome (mitogenome) of the Papilio macilentus (Lepidoptera: Papilionoidea: Papilionidae) was sequenced by next-generation sequencing method. The mitochondrial genome is a circular DNA molecule of 15,264 bp in size with 80.7% AT content, including 37 genes (13 protein-coding genes, 2 rRNA genes, and 22 tRNA genes), and a long non-coding region (Control region). All protein-coding genes are initiated by ATN codons, and terminated with TAA, TAG, or single T. All tRNAs can be folded into common clover leaf secondary structure, except trn-S1. Phylogenetic analyses based on 13 protein-coding genes and 2 rRNA genes using maximum likelihood and Bayesian inference confirmed that P. macilentus and Papilio memnon are clustered into a clade, and revealed the relationships between Papilionini, Troidini, Teinopaippini and Leptocircini.

Validity of A Novel Simulator for Percutaneous Transforaminal Endoscopic Discectomy.

BACKGROUND: Percutaneous transforaminal endoscopic discectomy (PTED) has steep learning curves and a high incidence of complications, but currently, efficient and economical training methods are lacking. This study aimed to validate a novel simulator for PTED. METHODS: The simulated PTED included puncturing and establishing the working channel (PEWC) and endoscopic discectomy, with the PEWC being the tested module. Eleven experts and 21 novices were included and introduced to the simulator and tasks; all participants completed the PEWC. Outcomes included: total operation time, number of fluoroscopy for positioning the working sheath, number of spinal risk region invasion, Global Rating Scale (GRS) and a modified GRS, etc. The Mann-Whitney U test was used to compare 2 groups. Spearman's correlation coefficient analyzed continuous variables. RESULTS: Experts outperformed novices in total operation time (P = 0.001), requiring fewer number of fluoroscopies for positioning the working sheath (P = 0.003). Additionally, experts had a lower number of spinal risk region invasions (P = 0.016) and higher scores on both the GRS (P < 0.001) and modified GRS (P < 0.001). PTED experience correlated with GRS scores (P = 0.001) and modified GRS (P < 0.001). The overall realism scored a median of 4 (3.75-5), and educational value had a median of 4 (range 3-5). CONCLUSIONS: This study demonstrates the validity of the novel simulator, revealing significant associations between PTED experience and performance metrics in a simulated PEWC setting. Furthermore, the PEWC module also offers a good realistic design and high education value according to experts.

A propensity score matching analysis of neutrophil to lymphocyte ratio forecasts the survival of individuals undergoing the transjugular intrahepatic portosystemic shunt.

The neutrophil-to-lymphocyte ratio (NLR) has been shown to predict patient outcomes in various disorders. This study was carried out to evaluate the value of NLR in predicting mortality in decompensated cirrhosis patients having transjugular intrahepatic portosystemic shunt (TIPS). The end-stage liver disease model (MELD) is a scoring system to evaluate the liver function reserve. Retrospective investigation was conducted on the clinical information of 244 decompensated cirrhosis individuals with a MELD score ≤15 who underwent TIPS production at two academic medical centres between January 2017 and August 2021. The main result was 12-month post-TIPS mortality. The area under the receiver operating characteristic curve (AUC) was used to investigate the predictive potential of prognostic markers correlated with 12-month mortality using a logistic regression approach. To minimize the effects of potential factors, a 1:2 propensity score matching (PSM) was carried out. The non-surviving group had 21 (8.6%) patients who passed away within 12mo, while the surviving group included 223 (91.4%) patients who survived for more than 12mo. According to the multivariate analyses, NLR>4.8 was an independent prognostic factor of 12-month mortality after PSM analysis (OR=3.4, 95%CI, 1.052-10.985, P =0.041). In comparison to the non-surviving group, the proportion of NLR-high (>4.8) cells in the surviving group were considerably greater (71.4%vs.38.1%, P =0.017). Whether Unmatched group or the Matched group, NLR exhibited the highest diagnostic performance (AUCs of 0.646 and 0.667, respectively, P <0.05). The NLR is a reasonable and effective indicator of 12-month mortality in decompensated cirrhosis patients with a MELD ≤15 receiving TIPS.

Different percutaneous transhepatic biliary stent placements and catheter drainage in the treatment of middle and low malignant biliary obstruction.

BACKGROUND: For cases of middle and low biliary obstruction with left and right hepatic duct dilatation, the type of approach and whether different approaches affect the difficulty of puncture operation and intraoperative and postoperative complications have not been discussed in detail. AIM: To compare the efficacy of different percutaneous transhepatic biliary stent placements and catheter drainage in treating middle and low biliary obstruction. METHODS: A retrospective analysis was performed on the medical records of 424 patients with middle and low biliary obstruction who underwent percutaneous liver puncture biliary stent placement and catheter drainage at the Department of Interventional Radiology, Shaanxi Provincial People's Hospital between March 2016 and March 2022. Based on the puncture path, patients were categorized into two groups: Subxiphoid left hepatic lobe approach group (Group A, 224 cases) and right intercostal, right hepatic lobe approach group (Group B, 200 cases). Liver function improvement, postoperative biliary bleeding incidence, postoperative pain duration, and abdominal effusion leakage around the drainage tube were compared between the two groups at 3 d and 1 wk after the surgery. Patient survival time was recorded during follow-up. RESULTS: All 424 surgeries were successful without adverse events. Group A comprised 224 cases, and Group B had 200 cases. There was no statistically significant difference in basic data between Group A and Group B (P > 0.05). No significant difference in postoperative biliary bleeding incidence was observed between the groups (P > 0.05). The decreased rates for total bilirubin (Group A: 69.23 ± 4.50, Group B: 63.79 ± 5.65), direct bilirubin (Group A: 79.30 ± 11.19, Group B: 63.62 ± 5.64), and alkaline phosphatase (Group A: 60.51 ± 12.23, Group B: 42.68 ± 23.56) in the 1st wk after surgery were significantly faster in Group A than in Group B. The decreased rate of gamma-glutamyl transpeptidase was also significantly faster in Group A at both 3 d (Group A: 40.56 ± 10.32, Group B: 32.22 ± 5.12) and 1 wk (Group A: 73.19 ± 7.05, Group B: 58.81 ± 18.98) after surgery (P < 0.05). Group A experienced significantly less peritoneal effusion leakage around the drainage tube than Group B (P < 0.05). The patient survival rate was higher in Group A compared to Group B (P < 0.05). CONCLUSION: In treating jaundice patients with middle and low biliary obstruction, a percutaneous left liver puncture demonstrated better clinical efficacy than a percutaneous right liver puncture.

Enhanced Faraday rotation by a Fano resonance in substrate-free three-dimensional magnetoplasmonic structures.

Three-dimensional magnetoplasmonic nanostructures possess more novel and richer optical and magneto-optical (MO) behaviors compared with planar nanostructures, and exhibit attractive potential applications in micro-nano non-reciprocal photonic devices. However, fabrication of three-dimensional magnetoplasmonic nanostructures is difficult using the usual nanofabrication methods. This work constructs three-dimensional substrate-free Au/Co/Au structures prepared using focused ion beam (FIB) technology. In the three-dimensional split-ring structure, with y-polarized light normal incidence, a three-dimensional coupling current is formed between the vertical split-ring and the bottom square hole, which causes excitation of the Fano resonance. The Fano resonance causes a significant enhancement of the local magnetic field, resulting in a larger Faraday rotation (FR). The resonance also brings about a sign reversal of FR, which is related to the direction of the Lorentz force on electrons. Similar effects also exist in the three-dimensional nanopillar structure and the three-dimensional nanoring structure in the simulation results. Due to the high flexibility of FIB machining, the height and shape of the three-dimensional split-ring can be arbitrarily changed, which means the FR intensity and the position of the FR null point are tunable. The designed three-dimensional structures provide a new route to regulate the Faraday effect, and broaden the possibilities for the design and construction of MO devices.

Full integration of nucleic acid extraction and detection into a centrifugal microfluidic chip employing chitosan-modified microspheres.

Microfluidic devices especially centrifugal ones have attracted great attention in the nucleic acid testing field, due to their automation, high efficiency, and simple operation. In which, nucleic acid extraction is the basic step, laying a foundation for the downstream amplification and detection procedures. Therefore, the integration of nucleic acid extraction on the chip is expected to achieve cost-efficiency, high-speed automation, diagnostic accuracy, and reaction robustness with the respect to real-time detection. In this work, we employ chitosan-modified magnetic microspheres for pH-induced nucleic acid extraction and integrate this approach into a centrifugal microfluidic chip. The microfluidic system comprises cell lysis, nucleic acids capture and release, isothermal amplification, and real-time fluorescence detection, which is manipulated by centrifugal force and magnetic control. The system exhibits comparable extraction and detection performance in respect of acceptable nucleic acid concentration and purity, high detection specificity and stability, as well as fast detection duration. These efforts to improve the integrated microfluidic detection chip could benefit the portable, efficient and simple nucleic acid diagnosis, especially under the resource-limited circumstance.

Observation of optical gyromagnetic properties in a magneto-plasmonic metamaterial.

Metamaterials with artificial optical properties have attracted significant research interest. In particular, artificial magnetic resonances with non-unity permeability tensor at optical frequencies in metamaterials have been reported. However, only non-unity diagonal elements of the permeability tensor have been demonstrated to date. A gyromagnetic permeability tensor with non-zero off-diagonal elements has not been observed at the optical frequencies. Here we report the observation of gyromagnetic properties in the near-infrared wavelength range in a magneto-plasmonic metamaterial. The non-zero off-diagonal permeability tensor element causes the transverse magneto-optical Kerr effect under s-polarized incidence that otherwise vanishes if the permeability tensor is not gyromagnetic. By retrieving the permeability tensor elements from reflection, transmission, and transverse magneto-optical Kerr effect spectra, we show that the effective off-diagonal permeability tensor elements reach 10-3 level at the resonance wavelength (~900 nm) of the split-ring resonators, which is at least two orders of magnitude higher than magneto-optical materials at the same wavelength. The artificial gyromagnetic permeability is attributed to the change in the local electric field direction modulated by the split-ring resonators. Our study demonstrates the possibility of engineering the permeability and permittivity tensors in metamaterials at arbitrary frequencies, thereby promising a variety of applications of next-generation nonreciprocal photonic devices, magneto-plasmonic sensors, and active metamaterials.

Percutaneous transhepatic intrahepatic portosystemic shunt for variceal bleeding: A series of six cases and literature review.

OBJECTIVES: To present a case series of modified transjugular intrahepatic portosystemic shunts (TIPS) and percutaneous transhepatic intrahepatic portosystemic shunts (PTIPS) in cirrhotic patients with variceal bleeding (VB). In addition, the scientific literature pertaining to PTIPS was reviewed. METHODS: This retrospective clinical case series included six cirrhotic patients with VB who were treated with PTIPS after the failure of endoscopic band ligation or endoscopic injection sclerotherapy combined with vasoactive drugs. The treatment was conducted between January 2017 and June 2019 at a single institution. Three patients suffered from severe atrophy of the right or left lobar of the liver as well as the main right or left branch of the portal vein. The remaining three patients showed severe atrophy of the whole liver and portal vein, resulting in widening of the liver fissure. A paired t-test was used to compare the changes in portal pressure gradient between before and after the PTIPS operation. The rebleeding rate, treatment efficacy, complications, and technical success rate were all assessed during follow-up. RESULTS: All six PTIPS procedures were performed successfully, with no severe procedural-related complications observed. None of the patients experienced VB during a mean follow-up of 22.8 (range, 18.0-28.0) months. The mean portosystemic pressure gradient decreased from 28.3 â€‹± â€‹4.3 â€‹mmHg pre-procedure to 12.3 â€‹± â€‹2.6 â€‹mmHg immediately post-procedure (P â€‹< â€‹0.001). At follow-up, one patient was found to have developed grade 2 hepatic encephalopathy thrice during the first year, according to the West Haven criteria. However, this was resolved following medical treatment. CONCLUSIONS: When the patient's portal venous anatomy is unconducive to the performance of TIPS using the transjugular approach, PTIPS can be considered as a safe, effective complementary surgical approach for patients with VB.

Comparison of embolic agents for varices during transjugular intrahepatic portosystemic shunt for variceal bleeding: Tissue gel or coil?

PURPOSE: We aimed to compare treatment efficacy, safety and material cost between tissue gel and coil regarding variceal embolization during transjugular intrahepatic portosystemic shunt (TIPS).Materials & Methods: This retrospective study including cirrhotic patients with variceal bleeding treated with TIPS combined with variceal embolization between January 2016 and August 2017. Patients were divided into three groups according to embolic agents used in variceal embolization: tissue gel group (Group A), combination group (Group B), and coil group (Group C). The primary endpoint was 1-year rebleeding rate after TIPS creation. The secondary endpoints included shunt dysfunction, overt hepatic encephalopathy, liver function, and embolic agents-related expense. RESULTS: A total of 60 patients (30, 10, and 20 in Group A, B, and C) were included. Variceal rebleeding occurred in 3 (10%), 0 (0%), and 4 (20%) patients within one year after TIPS creation in Group A, B, and C, respectively. Stent dysfunction occurred in 2 (3.3%) patients and 9 (15.0%) patients experienced overt hepatic encephalopathy. No significant differences were observed between three groups regarding primary and secondary endpoints except embolic agents-related expense, with a significantly lower cost in Group A when compared to the other two groups. Stent dysfunction occurred in two patients, with one patient in Group A developed acute occlusion caused by thrombus and another patient in Group C underwent stent stenosis during follow-up. CONCLUSIONS: Compares to coil alone or combines with coil, tissue gel has similar treatment efficacy and safety, but with significantly lower cost for variceal bleeding during TIPS.