Detection of the intraoperative bile leakage in laparoscopic cholecystectomy using indocyanine green fluorescence imaging: A case report.

Herein, we report two cases of successful application of indocyanine green (ICG) fluorescence imaging for detecting intraoperative bile leakage during laparoscopic cholecystectomy (LC). Bile leakage was detected rapidly and accurately using fluorescence guidance. Based on our findings, we recommend using ICG fluorescence imaging during LC because it is effective and feasible for detecting intraoperative bile leakage.

Partial hepatectomy vs. transcatheter arterial chemoembolization for multiple hepatocellular carcinomas of BCLC-B stage: A meta-analysis of high-quality studies.

BACKGROUND/AIM: The Barcelona Clinic Liver Cancer (BCLC) recommends that transcatheter arterial chemoembolization (TACE) are indicated in patients with multiple hepatocellular carcinomas (HCCs) of BCLC-B stage. However, partial hepatectomy (PH) has increasely performed in these patients. The purpose of this meta-analyses is to illustrate the comparative survival benefits of PH and TACE for patients with multiple HCCs of BCLC-B stage. METHOD: Electronic databases were systematically searched for eligible studies that compared PH and TACE performed in patients with multiple HCCs of BCLC-B stage. Studies that met the inclusion criteria were reviewed systematically. The reported data were aggregated statistically using the RevMan5.3 software. Primary endpoint was overall survival (OS), and secondary endpoint were the 1-, 3-, and 5-year survival rates, postoperative 30-day mortality and postoperative complications. RESULTS: A total of seven high-quality studies (one randomized controlled trial [RCT], six propensity-score matching (PSM) nonrandomized comparative trials [non-RCTs] that met the inclusion criteria, which comprised of 2487 patients (1245 PH and 1242 TACE) in the meta-analysis. When compared with the TACE group, the PH group had a significantly higher OS (HR, 1.65; 95% CI, 1.48-1.84; P = 0.26; I2 = 22%) and 1-, 3-, 5-year survival rates (OR, 1.96; 95% CI, 1.59-2.41; P = 0.0005; I2 = 75%; P < 0.00001; OR, 2.92; 95% CI, 1.94-4.42; P = 0.0001; I2 = 78%; P < 0.00001; OR, 2.60; 95% CI, 2.17-3.11; P = 0.13; I2 = 44%; P < 0.00001; respectively). Survival benefits persisted across sensitivity and subgroup analyses; High heterogeneity remained after sensitivity and subgroup analyses for 3-year survival rates. CONCLUSION: PH can provide more survival benefit for patients with multiple HCCs of BCLC-B stage compared with TACE.

Lignin Biopolymer for the Synthesis of Iron Nanoparticles and the Composite Applied for the Removal of Methylene Blue.

In the current study, lignin, an abundant natural polymer, was dissolved in ethylene glycol and acidic H2O to form nanoscale lignin. Then, zero-valent iron (ZVI) nanoparticles were synthesized in nanoscale lignin, producing a nZVI/n-lignin composite, via the borohydride reduction method. The use of nZVI/n-lignin for environmental remediation was tested by the removal of methylene blue in aqueous solutions at room temperature. The nZVI/n-lignin composite achieved a higher methylene blue removal ratio than that achieved by traditional nZVIs. Moreover, its excellent dispersibility in water and stability against oxidation in the air were observed. The functions of the nanoscale lignin in the composite material are (1) prevention of further growth and aggregation of the nZVI nanoparticles, (2) protection of nZVI from serious oxidation by H2O/O2, and (3) allowing better dispersibility of nZVI in aqueous solutions. These three functions are important for the field applications of nZVI/n-lignin, namely, to travel long distances before making contact with environmental pollutants. The present method for producing nZVI/n-lignin is straightforward, and the combination of nZVI and lignin is an efficient and environmentally friendly material for environmental applications.

Implantation of Bone Marrow Mesenchymal Stem Cells into Small Intestinal Submucosa Improves Bile Duct Injury in Rabbits.

BACKGROUND: Bile duct injury (BDI), which may occur during cholecystectomy procedures and living-donor liver transplantation, leads to life-altering complications and significantly increased mortality and morbidity. Tissue engineering, as an emerging method, has shown great potential to treat BDI. Here, we aimed to explore the application of small intestinal submucosa (SIS) matrix composites with bone marrow mesenchymal stem cells (BMSCs) to treat BDI in a rabbit model. METHODS: Rabbit-derived BMSCs were used as seed cells. Porcine SIS was used as the support material. Five centimetres of the common bile duct was dissected, and 1/3-1/2 of the anterior wall diameter was transversely incised to construct the rabbit BDI model. Then, SIS materials without/with BMSCs were inserted into the common bile duct of the BDI rabbits. After 1, 2, 4, and 8 weeks of implantation, the common bile duct was removed. Haematoxylin and eosin (HE) staining was used to assess pathological alterations in the common bile duct, while immunohistochemical staining and western blotting were used to detect expression of the epithelial cell markers CK19 and E-cadherin. Scanning electron microscopy was used to evaluate BMSC growth. RESULTS: Compared with BMSCs alone, SIS-attached BMSCs had increased growth. HE staining showed that the injured bile duct healed well and that the complex gradually degraded as the time from implantation increased. Immunohistochemical staining and western blotting showed that compared with the control group, the in vivo complex group had significantly elevated expression levels of CK19 and E-cadherin. CONCLUSION: BMSC implantation into SIS could improve BDI in rabbits, which might have clinical value for BDI treatment.

Solid pseudopapillary neoplasm (SPN) of the pancreas presenting with ascites misdiagnosed as pancreatic tuberculosis: a case report and literature review.

INTRODUCTION: Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor that mainly affects young women. It is a low-grade malignant neoplasm, with an excellent prognosis after surgical treatment. We report herein a case of SPN presenting with ascites that was misdiagnosed as pancreatic tuberculosis (TB). CASE REPORT: A 16-year-old female initially presented with a large volume of ascites. Contrast-enhanced ultrasound and computed tomography found a heterogeneous lesion in the pancreatic body, which had slight contrast enhancement on the arterial phase. Analysis of ascites showed it was exudative. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the mass only revealed a few blood clots. The diagnosis was highly suggestive of a pancreatic TB. However, after 6 months of anti-TB therapy, the pancreatic lesion remained essentially unchanged. Subsequently, magnetic resonance imaging indicated a mixed solid and cystic lesion with a well-defined margin in the pancreatic body. Further EUS-FNA showed monomorphic neoplastic cells with papillary architecture and immunohistochemical analysis revealed that the tumor cells were positive for ß-catenin, CD10, vimentin, cytokeratin, and synaptophysin. These findings were consistent with SPN. After distal pancreatectomy with splenectomy, postoperative pathology and immunohistochemical staining confirmed the diagnosis of SPN. CONCLUSION: Clinicians should consider the possibility of SPN for pancreatic heterogeneous masses. Multiple diagnostic imaging modalities and EUS-FNA may contribute to the preoperative diagnosis of this disease.

TNM stages and prognostic features of colorectal mucinous adenocarcinomas: a meta analysis.

AIM: The significance of the mucinous adenocarcinoma in TNM staging and prognosis for colorectal tumor patients is still controversial. The aim was to provide a meta-analysis for TNM staging and prognostic features of colorectal tumors. METHODS: 30 individual case-control studies were finally included into this meta-analysis, involving a total of 444,489 cancer cases and 45,050 mucinous adenocarcinomas, of relations with TNM staging and prognostic features. RESULTS: Compared to non-mucinous adenocarcinoma patients, the TNM IV stage accounted for a larger percentage of mucinous adenocarcinomas (OR=1.48, 95%CI 1.28-1.71, POR<0.001) and the prognosis was significantly poor (HR=1.06, 95%CI 1.04-1.08, P<0.001). After heterogeneity testing, the results was similar to the holistic approach outcome (HR=1.48, 95%CI 1.35-1.62, P<0.001). CONCLUSION: Compared to patients with non-mucinous adenocarcinomas, mucinous adenocarcinoma patients with later TNM staging make up a big percentage, and mucinous adenocarcinoma is an independent risk factor for poor prognosis.

[Prokaryotic expression of HPV 16L1 and optimization of expression conditions].

OBJECTIVE: To construct the HPV16 L1 prokaryotic expression plasmid and to optimize its expression. METHODS: A pair of primers was designed according to plasmid sequences of pGEX-KG and the HPV16L1 genes published by GeneBank. The DNA fragment of 1500 bp was amplified by PCR from the HPV recombinant plasmid with HPV16L1 gene, then cloned into pGEX-KG and transformed into the host E.coli strain JM109. The pGEX-KG-HPV16L1 plasmid was taken and transformed into BL21(DE3) for expression. Induced by IPTG at 37 degree, the expression product of HPV16L1 gene was identified by SDS-PAGE and Western blot. RESULTS: HPV16L1 fusion protein was expressed successfully in the form of inclusion bodies. The molecular weight was 83 kD. Meanwhile, the optimum condition of HPV16L1 fusion protein expression was induced with 1.0 mmol*L(-1) IPTG for 4 h. The fusion protein reacted specifically with antibodies against HPV16L1. CONCLUSION: The prokaryotic expression vector of HPV16L1 gene has been constructed and expressed in E.coli successfully.

[Kinetic analysis of laccase catalyze phenolic and aniline compounds and detecting catechol in wastewater].

Phenolic or aniline compounds were important pollutants in the industrial wastewaters to seriously polluted water environment. This research developed a detecting method of phenolic and aniline compounds based on the kinetic parameters of the substrates of laccase. Catalytic reaction between laccase and phenolic and aniline compounds was characterized using spectrophotometic method, which resulted 0-10 mg/L substrate reaction rate and calibration curve of substrate concentration and reaction rate. And then the non-volatile phenols in three kinds of coking wastewater were screened and the contents were detected. The result showed that polyhydric phenol, multi-amine and aminophenol were the main substrates of laccase. The optimum pH of phenols was around 7.0 and anilines 4.5-5.0, K(m) values of each substrates was 0.4-10 mmol/L. The calibration curve performed good first order kinetics linear relationship except benzidine with correlation coefficients above 0.96. Using laccase method, the contents of catechol in three kinds of coking wastewater were respectively detected to be 190.5, 265.8 and 155.3 mg/L with recoveries ranged from 89.9% to 115.8%.