Laparoscopic Anatomical Cranial Sub-segmentectomy of Segment VII (S7) with Super-Selective Intra-arterial Nano-ICG Positive Staining-Guided Trans-Parenchymal Approach.

BACKGROUND: With introduction of "cone unit," which is the smallest resectable anatomical area supplied by a tertiary branch of Glissonean pedicle, more precise subsegmental anatomical resection has been proposed.1 Super-selective intra-arterial ICG staining, delivering ICG and lipiodol mixing to arterial branch using interventional radiology, has been proved feasibility especially for complicated anatomy.2-6 It was difficult to uniformly mix water-soluble ICG with lipophilic lipiodol, rendering to inconsistency development of liver segment between angiography and laparoscopy. Nano-ICG is a uniform mixing of ICG and lipiodol.7 We demonstrated an exclusive "two-step" method to perform LAR for cranial S7 via super-selective intra-arterial nano-ICG staining guidance. METHODS: A 70-year-old male was admitted. CT scan showed tumor was located in cranial S7 with 2.1*1.9 cm. Preoperative AFP was 4.66 ng/ml and PIVKA-II was 2332 mAU/ml. The liver function was Child-Pugh class A and ICG-15R was 7.8%. Given that tumor was confined to cranial S7, precise anatomical sub-segmentectomy was warranted. This study was approved by the West China Hospital, Sichuan University Ethics Committee (approval number: 2023-2327). RESULTS: The operation was performed "two step." "First step" was super-selective intra-arterial nano-ICG embolization in intervention room, while "second step" was performed in operation room. ICG demarcation line was clearly identified even after 7 hr. After full mobilization of right hemiliver, we performed transparenchymal approach to find and clamp pedicle of cranial S7 under fluorescence guidance. Operation time was 150 min with 20 ml of blood loss with uneventful course. CONCLUSIONS: Although LAR of S7 remains challenging, super-selective intra-arterial nano-ICG positive staining guidance might be a feasible and safe option.

Evaluation of TikTok videos on acute pancreatitis: content quality and reliability analysis.

BACKGROUND: Acute pancreatitis (AP) is a common acute digestive system disorder, with patients often turning to TikTok for AP-related information. However, the platform's video quality on AP has not been thoroughly investigated. OBJECTIVE: The main purpose of this study is to evaluate the quality of videos about AP on TikTok, and the secondary purpose is to study the related factors of video quality. METHODS: This study involved retrieving AP-related videos from TikTok, determining, and analyzing them based on predefined inclusion and exclusion criteria. Relevant data were extracted and compiled for evaluation. Video quality was scored using the DISCERN instrument and the Health on the Net (HONcode) score, complemented by introducing the Acute Pancreatitis Content Score (APCS). Pearson correlation analysis was used to assess the correlation between video quality scores and user engagement metrics such as likes, comments, favorites, retweets, and video duration. RESULTS: A total of 111 TikTok videos were included for analysis, and video publishers were composed of physicians (89.18%), news media organizations (13.51%), individual users (5.41%), and medical institutions (0.9%). The majority of videos focused on AP-related educational content (64.87%), followed by physicians' diagnostic and treatment records (15.32%), and personal experiences (19.81%). The mean scores for DISCERN, HONcode, and APCS were 33.05 ± 7.87, 3.09 ± 0.93, and 1.86 ± 1.30, respectively. The highest video scores were those posted by physicians (35.17 ± 7.02 for DISCERN, 3.31 ± 0.56 for HONcode, and 1.94 ± 1.34 for APCS, respectively). According to the APCS, the main contents focused on etiology (n = 55, 49.5%) and clinical presentations (n = 36, 32.4%), followed by treatment (n = 24, 21.6%), severity (n = 20, 18.0%), prevention (n = 19, 17.1%), pathophysiology (n = 17, 15.3%), definitions (n = 13, 11.7%), examinations (n = 10, 9%), and other related content. There was no correlation between the scores of the three evaluation tools and the number of followers, likes, comments, favorites, and retweets of the video. However, DISCERN (r = 0.309) and APCS (r = 0.407) showed a significant positive correlation with video duration, while HONcode showed no correlation with the duration of the video. CONCLUSIONS: The general quality of TikTok videos related to AP is poor; however, the content posted by medical professionals shows relatively higher quality, predominantly focusing on clinical presentations and etiologies. There is a discernible correlation between video duration and quality ratings, indicating that a combined approach incorporating the guideline can comprehensively evaluate AP-related content on TikTok.

Subtrochanteric fracture after core decompression for osteonecrosis of the femoral head: a case report and literature review.

BACKGROUND: Osteonecrosis of the femoral head (ONFH) is a common clinical disease. Improper treatment can lead to femoral head collapse and hip joint dysfunction. Core decompression is particularly important for early ONFH. However, subtrochanteric fractures after core decompression cause some clinical problems. CASE PRESENTATION: This article describes a 34-year-old male patient with early ONFH. After core decompression, he suffered a subtrochanteric fracture of the femur while bearing weight on the affected limb when going up stairs. He was subsequently treated with open reduction and intramedullary nail fixation. CONCLUSION: When core decompression is used to treat ONFH, the location or size of the drill hole, whether a tantalum rod or bone is inserted, and partial weight-bearing of the affected limb may directly affect whether a fracture occurs after surgery. It is hoped that this case report can provide a reference for clinical orthopedic surgeons in the treatment of early ONFH.

Comparison of bone ingrowth between two porous titanium alloy rods with biogenic lamellar structures and diamond crystal lattice on femoral condyles in rabbits.

PURPOSE: The comparison of bone ingrowth between two types of porous titanium alloy rods with different micro-architectures including diamond crystal lattice (Re-rod) and biogenic lamellar configurations (Bi-rod) on femoral condyles was investigated in this study. METHODS: Twelve rabbits were used. Re-rod (Re-rod group) and Bi-rod (Bi-rod group) were implanted randomly in femoral condyles of each rabbits respectively. Bone ingrowth of these two rods were investigated and compared. 4 and 12 weeks after the operation, X-ray, micro-CT and histological examinations were performed. RESULTS: No femoral condyle fracture and rod defluxion in the two groups was noted in the X-ray images during the observation period. Micro-CT images showed that all metal trabeculae in the Bi-rod group were covered by new bone at 4 and 12 weeks, whereas partial metal trabeculae in the Re-rod group were still uncovered at 12 weeks. Histological images showed that there was new bone growth in the centre and periphery of Bi-rods at 4 and 12 weeks, and there were several areas without new bone ingrowth at 4 and 12 weeks in the centre of Re-rods. In micro-CT analysis, the bone volume to total volume (BV/TV) of the volume of interest (VOI) of the Bi-rod group was higher than in the Re-rod group [(0.0794 ± 0.0021) % Vs (0.0521 ± 0.0032) % and (0.0875 ± 0.0039) % Vs (0.0702 ± 0.0028) % respectively, P < 0.05] at 4 weeks and 12 weeks. Whereas, the mean trabecular thickness (Tb.Th) values of VOI between the two groups were not significantly statistically different at 4 and 12 weeks. In histological analysis, the BV/TV of the VOI of the Bi-rod group was higher than in the Re-rod group [(0.0624 ± 0.0021) % Vs (0.0435 ± 0.0028) % and (0.0675 ± 0.0024) % Vs (0.0476 ± 0.0031) % respectively, P < 0.05] at 4 weeks and 12 weeks. CONCLUSION: These results showed that Bi-rods got better bone ingrowth in femoral condyles of rabbits compared with Re-rods.

Laparoscopic Anatomical Resection of Paracaval Portion of Caudate Lobe and Segment 8 for HCC in an HCV-Related Cirrhotic Patient.

BACKGROUND: Laparoscopic anatomical resection of caudate lobe remains poorly described due to deep location and connection with major vascular structures. The anterior transparenchymal approach might be safter and provide a better surgical view in cirrhotic cases.1,2 This report demonstrated this approach for anatomic laparoscopic resection of paracaval portion and segment eight (S8) for HCC in an HCV-related cirrhotic patient. METHODS: A 58-year-old man was admitted. The preoperative magnetic resonance imaging indicated that the mass with pseudo capsule was located in paracaval portion and S8 closed to IVC, RHV, and MHV with atrophic left lobe. The preoperative ICG-15R test was 16.2%. In this regard, right hemihepatectomy combined with caudate resection was aborted. We decided to perform an anatomical resection via anterior transparenchymal approach to reserve liver parenchyma as much as possible.3,4 RESULTS: After right lobe mobilization and cholecystectomy, the anterior transparenchymal approach was performed along Rex-Cantlie line by using Harmonic (Johnson & Johnson, USA). With the dissection and clamping of the Glissonean pedicles of S8, anatomical segmentectomy was performed according to the ischemic line and parenchymal transection was performed along hepatic veins. Finally, paracaval portion combined with S8 was en bloc resected. The operating time was 300 minutes with 150 ml of blood loss. The histopathologic report demonstrated the mass as HCC with negative resection margin. Furthermore, it showed a medium-to-high differentiation with no MVI and no microscopic satellite. CONCLUSIONS: The anterior transparenchymal approach for anatomic laparoscopic resection of paracaval portion and S8 might be a feasible and safe option for severe cirrhotic cases.

Identification of the multiple roles of enolase as an plasminogen receptor and adhesin in Mycoplasma hyopneumoniae.

Mycoplasma hyopneumoniae is the etiological agent underlying porcine enzootic pneumonia, a chronic respiratory disease worldwide. The recruitment of plasminogen to the surface and subsequently promotion of plasmin conversion by the surface-located receptor, have been reported to assist the adhesion and invasion of Mycoplasmas. The surface localization and plasminogen-binding ability of M. hyopneumoniae enolase were previously confirmed; however, the biological functions were not be determined, especially the role as a plasminogen receptor. Here, using ELISA and SPR analyses, we confirmed the stable binding of M. hyopneumoniae enolase to plasminogen in a dose-dependent manner. The facilitation of the activation of plasminogen in the presence of tPA and direct activation of plasminogen at low efficiency without tPA addition by M. hyopneumoniae enolase were also determined using a plasmin-specific chromogenic substrate. Notably, the C-terminal and N-terminal regions located in M. hyopneumoniae enolase play an important role in plasminogen binding and activation. Additionally, we demonstrate that M. hyopneumoniae enolase can competitively inhibit the adherence of M. hyopneumoniae to PK15 cells. These results provide insight into the role of enolase in M. hyopneumoniae infection, a mechanism that manipulates the proteolytic system of the host.

Resveratrol alleviates MSU-induced gouty arthritis in rats through inhibition of HIF-1α- and NLRP3-derived IL-1ß secretion in macrophages.

Gouty arthritis is an acute and chronic joint inflammatory joint disease characterized by the deposition of monosodium urate (MSU) crystals in joints and periarticular tissues. Resveratrol (3, 5, 4-trihydroxy-trans-stilbene, RV), a natural polyphenolic compound, has anti-inflammatory and antioxidant properties. The purpose of this study was to investigate the effect of resveratrol on rats with gouty arthritis and its molecular mechanism. THP-1-derived macrophages were induced by lipopolysaccharide (LPS) and MSU to create an in vitro gout cell inflammation model, and rats were injected with MSU crystals into the right ankle joint for an in vivo acute gouty arthritis model. We investigated the anti-inflammatory properties of resveratrol using these in vitro and in vitro models. Our findings suggested that resveratrol effectively reduced ankle swelling and synovial inflammation in a dose-dependent manner in rats with acute gouty arthritis, with almost the same effect as colchicine treatment. In MSU-treated THP-1-derived macrophages, resveratrol inhibited NLRP3 inflammasome activation and IL-1ß secretion. Furthermore, resveratrol and the HIF-1α inhibitor PX478 both inhibited the expression of the NLRP3 inflammasome, IL-1ß, and HIF-1α. This study demonstrated that resveratrol significantly improved the symptoms of acute gouty arthritis and its potential mechanism may be IL-1ß reduction via HIF-1α modulation and inhibition of NLRP3 inflammasome activation. Our study might offer a novel sight for the treatment of gouty arthritis.

Safety and efficacy of laparoscopic transperitoneal versus retroperitoneal resection for benign retroperitoneal tumors: a retrospective cohort study.

BACKGROUND AND OBJECTIVE: Benign retroperitoneal tumors (BRTs) are clinically rare solid tumors. This study aimed to compare the safety and efficacy of laparoscopic transperitoneal versus retroperitoneal resection for BRTs. METHODS: The clinical data of 43 patients who had pathologically confirmed BRTs and underwent laparoscopic resection in a single center from January 2019 to May 2022 were retrospectively analyzed. Patients were divided into two groups according to the surgical methods: the Transperitoneal approach group (n = 24) and the Retroperitoneal approach group (n = 19). The clinical characteristics and perioperative data between the two groups were compared. The baseline data and surgical variables were analyzed to determine the impact of different surgical approaches on the treatment outcomes of BRTs. RESULTS: No significant difference was observed between the two groups in gender, age, body mass index, the American Society of Anesthesiologists score, presence of underlying diseases, tumor size, tumor position, operation duration, intraoperative hemorrhage, postoperative hospital stay, intestinal function recovery time, and postoperative complication rate. The conversion rate from laparoscopic to open surgery was significantly lower in the Transperitoneal approach group than in the Retroperitoneal approach group (1/24 vs. 5/19, χ2 = 4.333, P = 0.037). Tumor size was an independent influencing factor for the effect of surgery (odds ratio = 1.869, 95% confidence interval = 1.135-3.078, P = 0.014) and had a larger efficacy on the retroperitoneal group (odds ratio = 3.740, 95% confidence interval = 1.044-13.394, P = 0.043). CONCLUSION: The laparoscopic transperitoneal approach has the inherent advantages of anatomical hierarchies and surgical space, providing a better optical perspective of the targeted mass and improved bleeding control. This approach may have better efficacy than the retroperitoneal approach, especially in cases of a large tumor or when the tumor is located near important blood vessels.

Research Advances in the Treatment of Bone Marrow Edema Syndrome.

Bone marrow edema syndrome (BMES) is a relatively uncommon clinical condition. It has been poorly reported in the literature. Hence, doctors are not sufficiently aware of the disease and are prone to misdiagnosis and mistreatment, which can undoubtedly prolong the course of the disease, reduce the quality of life of patients and even affect their function. This paper reviews the literature and summarizes the treatment options for bone marrow edema syndrome, such as symptomatic treatment, extracorporeal shock waves therapy (ESWT), pulsed electromagnetic fields (PEFs), hyperbaric oxygen (HBO), vitamin D, iloprost, bisphosphonates, denosumab, and surgery, etc. This informs clinicians in treating bone marrow edema syndrome, hopefully improving patients' quality of life and shortening the duration of their disease.

Ultrasound-guided erector spinae plane block for postoperative analgesia in Chinese patients undergoing laparoscopic cholecystectomy: a double-blind randomized controlled trial.

PURPOSE: Pain management after laparoscopic cholecystectomy (LC) is a main concern for Chinese clinicians. This study aims to explore the effect of erector spinae plane block (ESPB) on the postoperative analgesia of patients undergoing LC in China. METHODS: In this randomized controlled trial (RCT), 220 patients were randomized into the ESPB group and control group. Patients in the ESPB group received a bilateral ESPB, and patients in the control group were injected saline. Lornoxicam (0.08 mg/mL, 100 mL) was used as routine analgesia for both groups after the surgery. Visual analog scale (VAS) score at rest state at 12 h postoperative was the primary outcome and divided into no pain, mild pain, moderate pain, and severe pain. RESULTS: Finally, 197 patients were included for analysis. At postoperative 12 h, ESPB group observed less patients with moderate pain (0% vs. 8.91%) and severe pain (0% vs. 0.99%) than the control group (P < 0.001). Moreover, ESPB group found less dose of additional sufentanil (5.55 ± 1.37 µg vs. 10.67 ± 5.05 µg), less requirement for rescue analgesia (13.54% vs. 31.68%), earlier first time to leave bed (10 h vs. 18 h), and earlier first exhaust time (17.5 h vs. 25 h), less adverse reactions (5.21% vs. 17.82%), and higher satisfaction degree (78.13% vs. 31.68%) (all P < 0.05). CONCLUSIONS: ESPB was followed by better postoperative analgesia and less opioid consumption.

Rapid and sensitive detection of African swine fever virus in pork using recombinase aided amplification combined with QDMs-based test strip.

African swine fever virus (ASFV) is the pathogen of African swine fever, a highly contagious and fatal disease of wild boar and domestic pigs. The flow of ASFV through pork products is more concealed, higher risky, and more difficult to prevent and control. Presently, on-site ASFV detection methods in preclinical infected pigs and circulated pork products are lacking. Here, fluorescent test strip-based rapid ASFV detection method in pork was established combined with recombinase aided amplification (RAA) and quantum dot microspheres (QDMs). This method is specific to ASFV with no cross-reactivity to pseudorabies virus (PRV), porcine circovirus type 2 (PCV2), and porcine reproductive and respiratory syndrome virus (PRRSV). The method also showed highly sensitivity with a detection limit of 1 copy for ASFV plasmid templates containing B646L gene and 100 copies/g for DNA extracts from clinical pork samples within a short detection time of less than 25 min. Additionally, the method showed 99.17% consistency with real-time PCR in the ASFV detection of 120 clinical pork samples. Overall, the QDMs-based test strip method provides specific, sensitive, rapid, and simple detection of ASFV in pork, which may contribute to maintain the food safety of pork products, and facilitate ASFV traceability and prevention. Rapid and sensitive detection of African swine fever virus in pork by QDMs based test strip assay.

Trocar layouts in laparoscopic liver surgery.

BACKGROUND: Since the first laparoscopic wedge resection reported by Reich, laparoscopic liver resection (LLR) has been progressively developed, acquiring safety and feasibility. The time has witnessed a milestone leap for laparoscopic hepatectomy from pure laparoscopic partial hepatectomy to anatomical hepatectomy and from minor liver resection to major liver resection. The numerous previous studies have paid more attention to the short-time and long-time surgical outcomes caused by surgical techniques corresponding to various segments and approaches. However, focus on trocar layouts remains poorly described, but it plays an indispensable role in surgical process. METHODS: We have searched PubMed for English language articles with the key words "trocar," "laparoscopic liver resection," and "liver resection approaches." RESULTS: This review highlighted each type of trocar layouts corresponding to specific circumstances, including targeted resection segments with various approaches. Notably, surgeon preferences and patients body habitus affect the trocar layouts to some extent as well. CONCLUSIONS: Although there were fewer researches focus on trocar layouts, they determine the operation field and manipulation space and be likely to have an impact on outcomes of surgery. Therefore, further studies are warranted to firm the role of trocar layouts in LLR.

Association of bone-related biomarkers with femoral neck bone strength.

BACKGROUND: Femoral neck fractures are the worst consequence of osteoporosis (OP), and its early prevention and treatment have become a public health problem. This study aims to investigate the relationship of bone-related biomarkers, femoral neck bone mineral density (BMD) and maximum load (Lmax), selecting the indicator which can reflect femoral neck bone loss and reduced bone strength. METHODS: A total of 108 patients were recruited from January 2017 to December 2019. Venous blood samples were collected from patients before total hip replacement, and femoral neck samples were collected during the surgery. Femoral neck BMD, femoral neck Lmax, bone-related markers (serum levels of bone turnover markers, protein expression of type I collagen (COL-I) and osteopontin (OPN) in femoral neck) were all measured and analyzed. RESULTS: The expression of COL-I in femoral neck were significantly decreased, whereas other markers were all significantly increased with the decreasing of femoral neck BMD and Lmax (P < 0.05). Among them, serum C-terminal telopeptide of type I collagen (CTX) levels and OPN expression of femoral neck were increased in osteopenia. In multiple linear regression analysis, CTX and OPN were both negatively correlated with femoral neck BMD and Lmax, and they were independent factors of femoral neck BMD and Lmax, whereas COL-I was independent factor affecting Lmax (P < 0.05). Besides, CTX was negatively correlated with COL-I (ß = -0.275, P = 0.012) and positively correlated with OPN (ß = 0.295, P = 0.003). CONCLUSIONS: Compared with other indicators, serum CTX was more sensitive to differences in bone mass and bone strength of femoral neck, and could be considered as surrogate marker for OPN and COL-I.Early measurement of CTX could facilitate the diagnosis of osteopenia and provide a theoretical basis for delaying the occurrence of femoral neck OP and fragility fractures.

Adaptation and psychometric evaluation of the simplified Chinese version of the identification of functional ankle instability questionnaire in Chinese-speaking patients with chronic ankle instability disorders.

BACKGROUND: The aims of this study were to adapt the Identification of Functional Ankle Instability (IdFAI) questionnaire into a simplified Chinese version and to assess its reliability, validity, and responsiveness in Chinese-speaking patients with chronic ankle instability (CAI) disorders. METHODS: The simplified Chinese version of the IdFAI (SC-IdFAI) questionnaire was developed with a five-step procedure involving cross-cultural translation and adaptation. Three questionnaires, including the SC-IdFAI, Medical Outcomes Study Short-Form 36 (SF-36), and Foot and Ankle Ability Measure (FAAM), were administered to the recruited patients. Then, the Cronbach's alpha value, intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), Spearman's correlation coefficient (rs), effect size (ES), and standardized response mean (SRM) were calculated to evaluate the reliability, validity, and responsiveness of the SC-IdFAI questionnaire. RESULTS: A total of 131, 119, and 86 patients with CAI successfully completed the first, second, and third rounds of the questionnaires, respectively. Good or excellent internal consistency and test-retest reliability were found for the overall scale and subscales of the SC-IdFAI questionnaire. The values for the SEM (1.346) and MDC (3.73) were low, indicating that small clinical changes can be detected by the SC-IdFAI questionnaire. The correlations of the SC-IdFAI with FAAM and SF-36 were generally in agreement with the a priori hypotheses (85%, 34/40), suggesting the SC-IdFAI questionnaire has good construct validity. Moreover, the results suggest that the SC-IdFAI (ES = 1.123 and SRM = 1.554) has an acceptable level of responsiveness. CONCLUSION: The SC-IdFAI scale may be an effective tool, and it is responsive, reliable and valid for the assessment of Chinese patients suffering from CAI.

A 3D Printed Porous Titanium Alloy Rod with Diamond Crystal Lattice for Treatment of the Early-Stage Femoral Head Osteonecrosis in Sheep.

Instruments made of porous titanium alloy and fabricated with a 3D printed technique are increasingly used in experimental and clinical research. To date, however, few studies have assessed their use in early-stage osteonecrosis of the femoral head (ONFH). In this study, porous titanium alloy rods (Ti-Rod) with diamond crystal lattice, fabricated using an electron beam melting (EBM) technique, were implanted into sheep models (n=9) of early-stage ONFH for 6 months. Bone ingrowth and integration were investigated and compared with those of sheep (n=9) undergoing core decompression (CD) alone. Following Ti-Rod implantation, femoral heads showed fine osteointegration, with X-ray evaluation showing compact integration between peripheral bone and rods without radiolucent lines encircling the rods, as well as new bone growth along the metal trabeculae without the intervention of fibrous tissue. The regions of interest (ROIs) of femoral heads showed fine bone ingrowth after Ti-Rod implantation than CD alone. By micro-CT evaluation, the ratios of bone volume to total volume (BV/TV) of ROIs in Rod group was 930 % and 452 % higher than CD group after 3 (0.206 ± 0.0095 vs. 0.020 ± 0.0058, p < 0.05, n=3) and 6 (0.232 ± 0.0161 vs. 0.042 ± 0.0061, p < 0.05, n=3) months respectively. By histological evaluation, the BV/TV of ROIs in Rod group was 647 % and 422 % higher than CD group after 3 (0.157 ± 0.0061 vs. 0.021 ± 0.0061, p < 0.05, n=3) and 6 (0.235 ± 0.0145 vs. 0.045 ± 0.0059, p < 0.05, n=3) months respectively. The new bone grew along metal trabeculae into the center of the rod with a rapid bone ingrowth in Rod gorup. Whereas in CD group, new bone grew mainly at the periphery of the decompressive channel with a slow bone ingrowth. Mechanical analysis showed that maximum load on the femoral head-necks was 31 % greater 6 months after Ti-Rod implantation than after CD alone when the vertical press reached the apex (3751.75 ± 391.96 vs. 2858.25 ± 512.91 N, p < 0.05, n=3). The association of rod implantation with fine bone ingrowth, osteointegration, and favorable mechanical properties suggests that implantation of the porous titanium alloy rod with the diamond crystal lattice may be a beneficial intervention for patients with early-stage ONFH.

Assessement of postoperative long-term survival quality and complications associated with radical antegrade modular pancreatosplenectomy and distal pancreatectomy: a meta-analysis and systematic review.

BACKGROUND: This study evaluated the perioperative complications and the long-term pancreatic survival outcomes in patients treated with radical antegrade modular pancreatosplenectomy (RAMPS) and distal pancreatectomy (DP). METHOD: We performed a computer search on the PubMed, Embase and Cochrane Library databases to retrieve the RCT or clinical trials comparing RAMPS and DP published before July of 2018. The quality of the included trials was assessed according to the inclusion and exclusion criteria by two researchers independently. The RevMan 5.3 software was used to extract and analyze the data. RESULT: A total of 5 retroprospective clinical trial articles comprising 285 patients were included in the study. The number of patients who underwent RAMPS were 135 and 150 for DP. There were significant differences (P < 0.05) in the operation time [WMD = - 63.93, 95% CI (- 68.86 ~ - 58.99), P<0.00001], and bleeding volume [WMD = - 184.62, 95% CI (- 211.88 ~ - 157.37), P<0.00001] between the two groups. However, no significant differences were observed between RAMPS and DP in terms of pancreatic fistula, postoperative complications, postoperative hospital stay, and mortality (P>0. 05). As for pathological examination, there were statistically significant differences between RAMPS and DP in the R0 resection rate [RR = 2.37, 95% CI (1.19 ~ 4.72), P = 0.01] and the number of lymph node excision [WMD = 7.08, 95% CI (4.59 ~ 9.58), P<0.000013]. The one-year overall survival rate was higher in RAMPS patients compared to DP patients [RR = 1.20, 95% CI (1.02 ~ 1.41), P = 0.02]. But there were no significant difference in postoperative recurrence [RR = 0.85, 95% CI (0.70 ~ 1.04), P = 0.13] between the two groups. CONCLUSION: RAMPS is an effective procedure for clinical application. Nevertheless, large, multicenter prospective randomized controlled trias are required to validate these findings. CONCLUSION: The RAMPS procedure was associated with good postoperative outcomes and overall survival, indicating that it is an effective procedure for clinical application. Large, multicenter prospective randomized controlled trials are needed to validate these findings.

Substrate Determinants for Unwinding Activity of the DExH/D-Box Protein RNA Helicase A.

RNA helicase A (RHA) as a member of the DExH/D-box subgroup of helicase superfamily II is involved in virtually all aspects of RNA metabolism. It exhibits robust RNA helicase activity in vitro. However, little is known about the molecular and physical determinants for RHA substrate recognition and RHA translocation along the nucleic acids. Here, our nondenaturing polyacrylamide gel electrophoresis (PAGE)-based unwinding assays of chemical and structural modified substrates indicate that RHA translocates efficiently along the 3' overhang of RNA, but not DNA, with a requirement of covalent continuity. Ribose-phosphate backbone lesions on both strands of the nucleic acids, especially on the 3' overhang of the loading strand, affect RHA unwinding significantly. Furthermore, RHA requires RNA on the 3' overhang which directly or indirectly connects with the duplex region to mediate productive unwinding. Collectively, these findings propose a basic mechanism of the substrate determinants for RHA backbone tracking during duplex unwinding.

Oleanolic acid prevents cartilage degeneration in diabetic mice via PPARγ associated mitochondrial stabilization.

Hyperglycemia-induced cartilage degeneration induces osteoarthritis (OA). Since oleanolic acid (OLA) have several pharmacological effects such as anti-inflammatory, anti-oxidant, we hypothesized it possesses protection against high glucose injured cartilage. We now report that OLA decreased type X collagen and reversed the cartilage degeneration in growth plate from db/db mice. OLA increased type Ⅱ collagen expression in a concentration-dependent manner (10-50 µΜ) in high glucose-treated chondrocytes. OLA prevented the high glucose induced cell injury and decreased the level of MMP-13, PGE2 and IL-6 due to decreasing mitochondrial membrane potential and stimulated the ATP production. Moreover, OLA treatment inhibited apoptosis. And the reversed SOD2 expression and activity may be ascribed to decreased SOD2 protein degradation by OLA treatment, via PPPAγ. In conclusion, OLA protected against the high-glucose-induced cartilage injury via PPARγ/SOD2 pathway.