Dexmedetomidine protects against lipopolysaccharide-induced early acute kidney injury by inhibiting the iNOS/NO signaling pathway in rats.

Increasing evidence has demonstrated that dexmedetomidine (DEX) possesses multiple pharmacological actions. Herein, we explored the protective effect and potential molecular mechanism of DEX on lipopolysaccharide (LPS)-induced early acute kidney injury (AKI) from the perspective of antioxidant stress. We found that DEX (30 µg/kg, i.p.) ameliorated the renal dysfunction and histopathological damage (tubular necrosis, vacuolar degeneration, infiltration of inflammatory cells and cast formation) induced by LPS (10 mg/kg). DEX also attenuated renal oxidative stress remarkably in LPS-induced early AKI, as evidenced by reduction in production of reactive nitrogen species, decreasing malondialdehyde levels, as well as increasing superoxide dismutase activity and glutathione content. DEX prevented activator protein-1 translocation, inhibited phosphorylation of I-kappa B (IκB) and activation of nuclear factor kappa B (NF-κB) in LPS-induced early AKI, as assessed by real-time quantitative polymerase chain reaction and protein levels of c-Jun, c-Fos, IκB and NF-κB. Notably, DEX pretreatment had the same effect as intraperitoneal injection of an inhibitor of inducible nitric oxide synthase inhibitor (1400W; 15 mg/kg), and inhibited the activity of renal inducible nitric oxide synthase (iNOS) and decreased the expression of iNOS mRNA and NO production. However, the protective effect of DEX on LPS-induced early AKI was reversed by the alpha 2 adrenal receptor (α2-AR) inhibitor atipamezole, whereas the imidazoline receptor inhibitor idazoxan did not. Taken together, DEX protects against LPS-induced early AKI in rats by inhibiting the iNOS/NO signaling pathway, mainly by acting on α2-ARs instead of IRs.

MicroRNA-30a-3p is overexpressed in the placentas of patients with preeclampsia and affects trophoblast invasion and apoptosis by its effects on IGF-1.

OBJECTIVE: Preeclampsia (PE) affects many women globally and remains a primary cause of neonatal and maternal morbidity and mortality. Aberrant placental microRNA (miRNA) expression might be associated with PE. Previously, 33 PE-related miRNAs, 11 up-regulated and 23 down-regulated, were detected in placentas of women with severe PE when compared with those of normal patients. One of the most up-regulated miRNAs in PE is miR-30a-3p. The predicted target of it is insulin-like growth factor 1 (IGF-1), which has been reported to have a relatively low expression level in PE patients. This study was conducted to determine the aberrant increased of miR-30a-3p in the placentas of women with preeclampsia and to elucidate the target and function of it in trophoblast cells. STUDY DESIGN: miR-30a-3p expression in placenta tissues was compared between women with preeclampsia (n = 25) and normal pregnant women (n = 20). The miRNA target was studied by in silico and functional assay. The effects of the miRNA were verified by apoptosis assay and invasion assay in the trophoblast cell line. RESULTS: miR-30a-3p was increased significantly in the placenta of women with preeclampsia when compared to those with normal pregnancies. Luciferase assay confirmed direct regulation of miR-30a-3p on the expression of IGF-1. Forced expression of miR-30a-3p suppressed IGF-1 protein expression in the HTR-8/SVneo cells. The functional assay suggests that the over-expression of miR-30a-3p alter the invasive capacity of JEG-3 cells and induce the apoptosis of HTR-8/SVneo cells (Figure). CONCLUSION: Expression of miR-30a-3p was significantly increased in the placentas of patients with preeclampsia. miR-30a-3p might be involved in the pathogenesis of preeclampsia by targeting IGF-1 and regulating the invasion and apoptosis of trophoblast cells.

Hydrogen sulfide attenuates isoflurane-induced neuroapoptosis and cognitive impairment in the developing rat brain.

BACKGROUND: Isoflurane-induced neuroapoptosis and cognitive impairment has been previously reported. Hydrogen sulfide (H2S) has been shown to be a neuromodulator that is thought to have anti-apoptotic, anti-inflammatory, and anti-oxidative benefits. However, it is not known if H2S is protective against anesthesia-induced apoptosis and cognitive defects. METHODS: In this study, postnatal day 7 (P7) Sprague-Dawley rats were randomly divided into four groups: control group (normal saline), H2S group (NaHS 28 µM/kg), isoflurane group (normal saline +0.75% isoflurane) and H2S preconditioning group (NaHS 28 µM/kg + 0.75% isoflurane). After exposure to isoflurane for 6 h, half the numbers of rats in each group were euthanized, and the hippocampus and cerebral cortex were dissected and examined for apoptosis by the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) technique and western blot. After 6 weeks, the remaining rats were subjected to a Morris water maze (MWM) test for behavioral assessment. RESULTS: The TUNEL assay and western blot showed that when rats were preconditioned with NaHS, neuroapoptosis decreased significantly both in hippocampus and cerebral cortex compering with the isofulrane group. The MWM showed that P7 rats administration of NaHS improved cognitive impairments induced by isoflurane. CONCLUSIONS: The current study demonstrates that H2S attenuates isoflurane-induced neuroapoptosis and improves cognitive impairments in the developing rat brain.

Behavioral and cardiopulmonary effects of dexmedetomidine-midazolam and dexmedetomidine-midazolam-butorphanol in the silver fox (Vulpes vulpes).

OBJECTIVE: To evaluate the behavior and some cardiopulmonary variables of dexmedetomidine-midazolam or dexmedetomidine-midazolam-butor-phanol in the silver fox (Vulpes vulpes). STUDY DESIGN: Blinded, randomized design. ANIMALS: Sixteen adult silver foxes, aged 7-9 months, weighting 6.0-9.2 kg. METHODS: Animals were randomly assigned to dexmedetomidine (50 µg kg-1) and midazolam (0.45 mg kg-1) (group DM) or to dexmedetomidine (30 µg kg-1), midazolam (0.45 mg kg-1) and butorphanol (0.25 mg kg-1) (group DMB), administered intramuscularly. Pulse rate (PR), respiratory rate (fR), noninvasive arterial pressures, oxygen saturation (SpO2), rectal temperature (T) and behavioral scores (posture, sedation, antinociception, jaw relaxation and auditory response) were measured at 5, 10, 20, 30, 40, 50 and 60 minutes after injection. Time from drug injection to recumbency with no response to stimuli (IT) and time from administration of atipamezole (0.2 mg kg-1) to standing with coordination (RT) were recorded. The occurrences of adverse events were recorded. Data were analyzed by two-tailed unpaired t-tests and Bonferroni post hoc tests. Significant differences were accepted at p<0.05. RESULTS: There were no statistically significant differences between the groups for IT or RT. Arterial pressures were higher in DMB at each time point except at 5 minutes. PR was lower in DM at each time point except at 10 and 60 minutes. No significant difference was found between the groups for fR, SpO2 and T. The behavioral scores were significantly lower (lower quality immobilization) in DMB at 5,10 and 60 minutes. CONCLUSIONS AND CLINICAL RELEVANCE: IT and RT were not different between the groups. Both protocols provided immobilization for 30-40 minutes with excellent muscle relaxation and analgesia adequate for clinical examinations and some simple surgical procedures.

[Study on the Analysis of the Proportion of Mixed Samples with Near Infrared Spectroscopy and Non-Negative Coefficients Regression].

In the process of practical production, it is important to accurately analyze the proportion of mixed samples with high speed, which plays a great role for quality control and formulation design in food and agricultural processing. Traditional solution is to build statistical model with a large number of representative samples, which is both labor-intensive and time-consuming. In this paper, the proportion of alcohol and acids mixed samples, and their dilute solution mixed samples(used carbon tetrachloride (CCl4) which has no near-infrared absorption characteristics as the solvent medium)，as well as sheet tobacco leaf mixed samples are respectively analyzed by using near infrared spectroscopy, SG smooth and non-negative coefficients regression, which verifies the feasibility of analyzing the proportion of the mixed samples. The results show that, the analytic proportion of transmission spectra of alcohol and acids according to non-negative coefficients regression is closer to actual molar proportion with result error less than 4%. The result of the dilute solution is much better with error less than 4%. The analytic proportion of diffuse reflectance spectra of sheet tobacco leaf according to non-negative coefficients regression is highly accurate with error less than 10%. In the meantime, it has a highly consistency between actual spectra and analytic spectra of mixed samples; and the result of F-test and T-test shows that there is no significant difference between them and the confidence level is 0.01. It has the reliability of analytical proportion in theory. With the spectral data of several pure samples, the proportion of mixed samples can be thus analyzed, which has a good application prospect for quality control and formulation design in food and agricultural processing.

[Determination of Wine Varieties with NIR and Fusion of Multiple Classifiers].

The conventional qualitative analysis of near infrared spectroscopy (NIR) commonly uses one single classification model. This paper focused on the fusion of multiple classifiers based on different single classifiers by using the fused classifier to determine different varieties of red-wines. NIR spectra of 170 red-wine samples were collected by using Fourier transform near-infrared spectrometer. Red-wine classification models were established respectively, based on PLS-DA, SVM, Fisher and Ada-Boost. Then these models were selected to obtain some different base classifiers according to Diversity Measure Feature Selective (DMFS). The highest accuracy rate of determining different varieties of red-wine test samples of four single base classifiers was up to 88.24%, and at the same time the lowest discriminant accuracy rate was 81.18%. At last, we got the fused classifier, which combined four base classifiers with weighted voting principle, and determined its test set again by using the fused classifier. The final classification accuracy rate for red-wine varieties increased to 92.94%, In contrast with one single classifier, the lowest misjudged number of fused classifiers decreased from 9 to 6.These results suggested that the performance of fused classifier is superior to one single classifier. It is feasible to use fused classifier combined with near infrared spectroscopy to determine different varieties of red-wines.

An increased proportion of circulating Th22 and Tc22 cells in psoriasis.

Psoriasis is a common dermatosis mediated by T cells. This study investigated the correlation of Th22 cells and Tc22 cells with psoriasis. A total of 30 psoriasis patients and 11 age- and sex-matched healthy controls were recruited for this study. The proportions of circulating Th22 and Tc22 cells, expression of aryl hydrocarbon receptor, and IL-22 levels in the psoriasis patients were significantly higher than those in the control subjects (p<0.05). There was a positive correlation between the proportion of circulating Th22 cells, IL-22 levels, and PASI score. The IL-22 levels and PASI score were also positively correlated. There was no correlation between the proportion of circulating Tc22 cells and IL-22 level or PASI score. These data are consistent with Th22 cells involvement in the pathogenesis of psoriasis.

Personal treatment experience for severe generalized pustular psoriasis of pregnancy: two case reports.

Generalized pustular psoriasis of pregnancy (GPPP) is a rare and severe variant of pustular psoriasis. It has been called the most dangerous and life-threatening dermatosis in pregnant woman. To explore the treatment of GPPP, we conducted a retrospective study of two cases of GPPP in our clinic and other related reported cases and manuscripts. In 1992, a GPPP patient came to our clinic. We prescribed her antibiotics and dexamethasone. The pregnancy was artificially terminated. After delivery, she took a retinoid and a topical steroid and recovered progressively. In 2012, we treated another GPPP patient. Methylprednisolone and cyclosporine were administered. Maternal and fetal statuses were monitored closely. The treatment was effective and a healthy baby was delivered. We compared our two GPPP cases and found that cyclosporine and a sufficient dosage of steroid were an effective treatment. Antibiotics could be tried in mild cases or the initial stages before excluding sepsis. Based on other reported GPPP cases, TNF-α antagonists are used as rescue therapy in GPPP refractory to steroid and cyclosporine therapy, but careful consideration of the advantages and disadvantages is warranted before using them. Supportive measures are necessary to maintain pregnancy and prevent complications in cases of GPPP.

Phenolic profiles and antioxidant properties of young wines made from Yan73 (Vitis vinifera L.) and Cabernet Sauvignon (Vitis vinifera L.) grapes treated by 24-epibrassinolide.

The grape berries of two varieties, Yan73 (Vitis vinifera L.) and Cabernet Sauvignon (CS) (Vitis vinifera L.) were treated with 0.40 mg/L 24-epibrassinolide (EBR), 1.00 mg/L brassinazole (Brz), and deionized water (control), at the veraison period. The EBR treatment significantly increased total phenolic content (TPC), total tannin content (TTC) and total anthocyanin content (TAC) of Yan73 and CS wines, whereas Brz treatment decreased TPC, total flavonoid content (TFC), TAC in the two wines. Moreover, the content of most of the phenolic compounds identified by HPLC-DAD/ESI-MS in EBR-treated wines was significantly higher than that in control. The antioxidant capacities, which determined using DPPH, ABTS and HRSA methods, of the wines were increased by EBR treatment as well. There was a good correlation between the antioxidant capacity and phenolic content. The results demonstrated that EBR could enhance the phenolic compounds and antioxidant capacity of Yan73 and CS wines, but the effects may vary by different cultivars.

Harmonizing the craft of crafting clinically endorsed small-molecule BCR-ABL tyrosine kinase inhibitors for the treatment of hematological malignancies.

The advancement and practical use of small-molecule tyrosine kinase inhibitors (TKIs) that specifically target the BCR-ABL fusion protein have introduced a revolutionary era of precision medicine for the treatment of chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). This review offers a comprehensive exploration of the synthesis, mechanisms of action, and clinical implementation of clinically validated TKIs in the context of BCR-ABL, emphasizing the remarkable strides made in achieving therapeutic precision. We delve into the intricate design and synthesis of these small molecules, highlighting the synthetic strategies and modifications that have led to increased selectivity, enhanced binding affinities, and reduced off-target effects. Additionally, we discuss the structural biology of BCR-ABL inhibition and how it informs drug design. The success of these compounds in inhibiting aberrant kinase activity is a testament to the meticulous refinement of the synthetic process. Furthermore, this review provides a detailed analysis of the clinical applications of these TKIs, covering not only their efficacy in achieving deep molecular responses but also their impact on patient outcomes, safety profiles, and resistance mechanisms. We explore ongoing research efforts to overcome resistance and enhance the therapeutic potential of these agents. In conclusion, the synthesis and utilization of clinically validated small-molecule TKIs targeting BCR-ABL exemplify the transformative power of precision medicine in the treatment of hematological malignancies. This review highlights the evolving landscape of BCR-ABL inhibition and underscores the continuous commitment to refining and expanding the therapeutic repertoire for these devastating diseases.

Exogenously applied abscisic acid to Yan73 (V. vinifera) grapes enhances phenolic content and antioxidant capacity of its wine.

Yan73 is a 'teinturier' red wine variety cultivated in China and widely used in winemaking to strengthen red wine colour. The objective of this study was to evaluate the effect of exogenous abscisic acid (ABA) applied to the grapevine cluster on the antioxidant capacity and phenolic content of the wine made from Yan73. Two hundred mg/l ABA was applied on Yan73 grapevine cluster during veraison. As they mature, these ABA-treated and untreated grape berries were transformed into wines, respectively, and the phenolic content and antioxidant capacity of these wines were compared. The results showed that phenolic content (total phenolics, tannins, flavonoids and anthocyanins) and antioxidant capacity were higher in the wine produced with ABA-treated Yan73 grapes than those in the wine from untreated grapes. Compared to Cabernet Sauvignon wine, Yan73 wine had higher phenolic content and stronger antioxidant capacity. These strongly suggest that exogenously applied ABA to Yan73 grapes can enhance phenolic content and antioxidant capacity of its wine, and Yan73 wine has the higher utilization value and potential for development.

[Preparation and in vitro evaluation of curcumin CTPP-PEG-PCL micelles].

To synthetize 3-carboxypropyl-triphenylphosponium bromide-polycaprolacton-CTPP-PEG-PC, and prepare curcumin CTPP-PEG-PCL micelles by using the self-assembled emulsion solvent evaporation method, in order to determine the critical micelle concentration (CMC) with the pyrene fluorescent probe technology, detect the particle size, entrapment efficiency (%), morpheme and in vitro release rate, and evaluate the cytotoxicity of hepatic stellate cells with MTT assay. The structure of CTPP-PEG-PCL had been identified by 1H-NMR spectra. Specifically, the CMC of polymer was 2.25 mg x L(-1), the average size was 190 nm, the drug content was (0.66 +/- 0.008) g x L(-1), and the entrapment efficiency was (94 +/- 0.6)%. The in vitro release results showed curcumin micelles had a significant higher inhibition ratio in the growth of hepatic stellate cells than crude curcumin (P < 0.05). This suggested that CTPP-PEG-PCL micelles feature low CMC, high encapsulation efficiency and notable inhibition effect in growth of hepatic stellate cells.

Laparoscopic Techniques in Treatment of Inguinal Hernia in Patients with Peritoneal Dialysis: Experiences from 15 Cases.

Objective: This study aimed to investigate the feasibility, efficacy, and safety of laparoscopic transabdominal preperitoneal (TAPP) repair in the treatment of inguinal hernia in patients on peritoneal dialysis, and the optimal timing for initiating postoperative peritoneal dialysis. Methods: We conducted a retrospective analysis of the clinical data pertaining to patients on peritoneal dialysis with inguinal hernias treated with TAPP repair in the First Affiliated Hospital of Shandong First Medical University from July 15, 2020 to December 15, 2022. Follow-up observations of the treatment effect were also analyzed. Results: A total of 15 patients underwent TAPP repair with success. Contralateral occult hernias were found in 3 cases intraoperatively and were treated simultaneously. During the operation, it was found that the peritoneal dialysis tube was completely wrapped in the omentum majus in 1 case and incompletely wrapped in 5 cases and was separated smoothly under laparoscopy. Conclusion: For patients on peritoneal dialysis with inguinal hernia, TAPP repair has the advantages of less trauma, simultaneous treatment of contralateral occult hernias, adjustment and fixation of peritoneal dialysis tubes, lower incision complication rates, and lower recurrence rates, compared with open surgery. With the gradual resumption of peritoneal dialysis 7 days postoperatively, TAPP repair can be performed safely and effectively in this population group; thus it is a procedure worth promoting.

Synthetic approaches and application of clinically approved small-molecule Anti-HIV drugs: An update.

Application of chemotherapeutic agents to inhibit the HIV replication process has brought about a significant metamorphosis in the landscape of AIDS. Substantial declines in morbidity and mortality rates have been attained, accompanied by notable decreases in healthcare resource utilization. However, treatment modalities do not uniformly inhibit HIV replication in every patient, while the emergence of drug-resistant viral strains poses a substantial obstacle to subsequent therapeutic interventions. Furthermore, chronic administration of therapy may lead to the manifestation of toxicities. These challenges necessitate the exploration of novel pharmacological agents and innovative therapeutic approaches aimed at effectively managing the persistent viral replication characteristic of chronic infection. This review examines the role of clinically approved small-molecule drugs in the treatment of HIV/AIDS, which provides an in-depth analysis of the major classes of small-molecule drugs, including nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), integrase inhibitors, entry inhibitors, and pharmacokinetic enhancers. The review mainly discusses the application, synthetic routes, and mechanisms of action of small-molecule drugs employed in the treatment of HIV, as well as their use in combination with antiretroviral therapy, presenting viewpoints on forthcoming avenues in the development of novel anti-HIV drugs.

Does the National Fitness Policy Promote National Health?-An Empirical Study from China.

The influence of national health level in the stability and sustainable development of national society is increasingly prominent. The purpose of this study is to examine whether, when, and how national fitness policies exert influence on national health. Panel data from 2008 to 2017 of 30 Chinese provinces (cities) (except the Tibet autonomous region) were used to systematically reveal the direct impact of national fitness policies on national health and its characteristics in different regions, as well as the interaction mechanisms of human capital and finance health expenditures in public sports. This study found that first, national fitness policies had a positive effect on adult health. Second, sports human capital weakens the health effect of national fitness policies, while public finance health expenditures strengthen this effect. Lastly, the health effect of national fitness policies varies significantly across regions due to uneven regional economic development, and the differences in the effects on different age groups (adults and children) are equally pronounced. This study suggests that national fitness public service system and diverse national fitness plans improving national health level are important for a new dynamic balance and high quality coordinated development in both Chinese economic growth and social welfare.

Betulinic acid increases lifespan and stress resistance via insulin/IGF-1 signaling pathway in Caenorhabditis elegans.

Numerous studies reported that betulinic acid (BA), a natural product extracted from birch bark, exhibited various beneficial effects in vitro. However, its pharmacological activities in aging are rarely understood. In this study, Caenorhabditis elegans was deployed as a whole animal model to investigate the impacts of BA on lifespan and stress resistance. Wild-type C. elegans were fed in the presence or absence of BA and tested for a series of phenotypes, including longevity, mobility, reproductive capacity, pharyngeal pumping, heat stress, and oxidative stress. BA at the optimal dose (50 µg/mL) extended the lifespan, improved the healthspan, and significantly evoked the increased oxidative stress resistance in C. elegans. Incorporating the genetic analysis with different types of longevity mutants, DAF-16, the downstream effector of the Insulin/IGF-1 receptor signaling, was revealed to mediate the protective effects of BA on lifespan and antioxidant activity. Together, these data showcased the potential of BA in promoting healthy aging, which shall facilitate its further development in the food and pharmaceutical industries.

Surgical treatment strategy for recurrent parastomal hernia: Experiences from 17 cases.

Purpose: This study aimed to investigate the surgical treatment strategy of recurrent parastomal hernia (PH) and show its safety, feasibility, and outcomes at a mid-term follow-up. Methods: A total of 17 cases of recurrent PH treated at our hospital between January 2016 and October 2021 were included in this retrospective analysis. Patient characteristics were recorded, and the classification of PH, operative time, intraoperative blood loss, hernia repair techniques, follow-up times, complications, as well as recurrence were compared and analyzed. Results: Altogether, 17 patients with recurrent PH underwent successful hernia repair via surgical treatment at The First Affiliated Hospital of Shandong First Medical University and Shandong University Qilu Hospital. No recurrence or severe complications were noted during follow-ups (mean 32.8 ± 3.77 [range 3-68] months). Conclusions: For recurrent PH, selecting a suitable repair approach based on intraperitoneal conditions such as infection, abdominal adhesions, or the length of the bowel loop, can help in achieving better therapeutic results. The lap-redo + Sugarbaker technique is worth recommending when the appropriate conditions are met.

Familial gastrointestinal stromal tumors with KIT germline mutation in a Chinese family: A case report.

BACKGROUND: Familial gastrointestinal stromal tumors (GISTs) is a rare autosomal dominant disorder characterized by an array of clinical manifestations. Only 35 kindreds with germline KIT mutations and six with germline PDGFRA mutations have been reported so far. It is often characterized by a series of manifestations, such as multiple lesions and hyperpigmentation. However, the effect of imatinib treatment in these patients is still uncertain. CASE SUMMARY: Here, we report two patients (father and daughter) in a Chinese family (for the first time) with germline KIT mutation, and described their pathology, genetics and clinical manifestations. A 25-year-old Chinese woman went to hospital because of abdominal pain, and computed tomography showed multiple tumors in the small intestine. Small pigmented spots appeared on the skin within a few months after birth. Her father also had multiple pigmented spots and a history of multifocal GISTs. Multiple GISTs associated with diffuse interstitial Cajal cells (ICCs) hyperplasia were positive for CD117 and DOG-1. Gene sequencing revealed a germline mutation at codon 560 of exon 11 (p.V560G) of KIT gene in these two patients. Imatinib therapy showed the long-lasting disease stability after resection. Remarkably, the hypopigmentation of the skin could also be observed. Luckily germline KIT mutation has not been identified yet in the 3-year-old daughter of the female patient. CONCLUSION: Diagnosis of familial GISTs depends on combination of diffuse ICCs hyperplasia, germline KIT/PDGFRA mutation, hyperpigmentation and family history.

Treatment of Chronic Traumatic Diaphragmatic Hernia Based on Laparoscopic Repair: Experiences From 23 Cases.

Background: We aimed to investigate the safety and effectiveness of laparoscopic repair for treating chronic traumatic diaphragmatic hernia (CTDH). Methods: In this retrospective analysis, we included 23 cases with CTDH underwent laparoscopy in our hospital between June 2015 and October 2019 was performed. The patient characteristics were recorded. We compared the diameter of hernia ring, surgery duration, intraoperative bleeding volume, means of repairing, as well as the follow-up data. Results: All the patients underwent laparoscopic diaphragmatic hernia repair, without conversion to laparotomy or thoracotomy. The operation time ranged from 60 min to 200 min (mean, 108.04 ± 42.93 min). The blood loss volume ranged from 10 to 300 ml (mean volume, 63.48 ± 71.69 ml). The postoperative hospital stayed ranged from 5 to 15 days (mean, 6.22 ± 2.11 days). The patients were followed up for 1-50 months (mean, 17.5 ± 10.90 months). No recurrence of diaphragmatic hernia was found. Conclusions: Laparoscopic repair of CTDH is featured by fast recovery, high security, and effectiveness. Reducing the hernia contents and close of the hernia ring are crucial for the surgery that is performed based on the size and location of the diaphragmatic hernia.

Multiple data revealed two new species of the Asian horned toad Megophrys Kuhl & Van Hasselt, 1822 (Anura, Megophryidae) from the eastern corner of the Himalayas.

Multiple disciplines can help to discover cryptic species and resolve taxonomic confusions. The Asian horned toad genus Megophrys sensu lato as a diverse group was proposed to contain dozens of cryptic species. Based on molecular phylogenetics, morphology, osteology, and bioacoustics data, the species profiles of Megophrys toads in the eastern corner of Himalayas in Medog County, Tibet Autonomous Region, China was investigated. The results indicated that this small area harbored at least four Megophrys species, i.e., M. medogensis, M. pachyproctus, Megophrys zhoui sp. nov., and Megophrys yeae sp. nov., the latter two being described in this study. Additionally, the mitochondrial DNA trees nested the low-middle-elevation and high-elevation groups of M. medogensis into a monophyletic group, being in discordance with the paraphyletic relationship between them revealed in the nuclear DNA trees. The findings highlighted the underestimated biodiversity in Himalayas, and further indicated that the Megophrys toads here have been probably experienced complicated evolutionary history, for example, introgression between clades or incomplete lineage sorting and niche divergences in microhabitats. Anyway, it is urgent for us to explore the problems because these toads are suffering from increasing threats from human activities and climatic changes.