Limosilactobacillus reuteri peptidoglycan alleviates aflatoxin B1-induced toxicity through adsorbing toxins and improving growth, antioxidant status, immunity and liver pathological changes in chicks.

1. The objective of this study was to investigate the protective effects of a peptidoglycan produced by Limosilactobacillus reuteri against aflatoxin B1 (AFB1) induced toxicity in vitro and in vivo in broiler chicks.2. Toxin adsorption experiments were carried out firstly in vitro. These experiments indicated that the absorption efficiency of the peptidoglycan for AFB1 was 64.3-75.9%.3. In the in vivo experiments, Hy-Line Brown chicks were fed a diet containing AFB1 at 71.43 µg/kg with and without peptidoglycan supplementation at concentrations of 100, 200, or 300 g/kg feed from 0-42 d of age.4. The peptidoglycan supplementation in AFB1-contaminated diets resulted in significant improvements in terms of average daily gain, feed intake, feed conversion ratio, white blood cell count, haemoglobin content, glutathione peroxidase activity, immunoglobulin (Ig) A, IgG, IgM and Newcastle disease virus antibody titres (p < 0.05) and diminished liver steatosis.5. In conclusion, peptidoglycan supplementation alleviated AFB1-induced toxicity through adsorbing toxins and improving growth performance, antioxidant ability, immunity and liver pathological changes in chicks. The optimal supplemental dose was 200 mg/kg in feed.

MIR-147B Regulated Proliferation and Apoptosis of Gastric Cancer Cells by Targeting CPEB2 Via the PTEN Pathway.

The present study has been performed to illustrate the role and mechanism of microRNA-147b (miR-147b) in the cellular viability and apoptosis of gastric cancer (GC) cells. The GC tissues of 50 patients with complete data and the adjacent tissues were selected from Shanxi Cancer Hospital, and 3 pairs of tissues were randomly selected for microarray detection of high-expressing microRNAs. The expressions of miR-147b were quantified in numerous GC cell lines, i.e., BGC-823, SGC-7901, AGS, MGC-803 and MKN-45, normal tissue cell lines and 50 pairs of gastric cancer tissues. Moreover, two cell lines of miR-147b high-expressing used PCR quantitative analysis were selected for transfection experiments. The differentially expressed miR-147b was screened from 3 pairs of samples by miRNA chip. The expression ofmiR-147b was found highly expressed in gastric cancer tissues of 50 pairs of gastric cancer and adjacent tissues. The miR-147b found in diverse range in each of GC cell line. Therefore, two cell lines, BGC-823 and MGC-803, with relatively high expression levels of miR-147b were selected for further analysis and research. Scratch analysis results showed that compared with miR-147b NC, the miR-147b inhibitor group inhibited GC cell growth and reduced cell migration. The early apoptosis of MGC-803, and BGC-823 cells was enhanced by miR-147b inhibitor. miR-147b inhibitor significantly repressed the proliferation of BGC-823 and MGC-803 cells. Our study showed that the high expression of miR-147b is positively correlated with the occurrence and development of gastric cancer.

Circular ribonucleic acid circ-FADS2 promotes colorectal cancer cell proliferation and invasion by regulating miR-498/S100A16.

The aim of this study is to examine the role and functional mechanism of circ-FADS2 in colorectal cancer (CRC). The levels of expression of circ-FADS2 were detected in 48 patients with CRC and their paired normal tissue samples and cell lines (SW480, SW620, HCT116, HT29, and NCM460) using quantitative real-time polymerase chain reaction (qRT-PCR). Circ-FADS2 was then silenced in SW480 and HT29 cells using two small interfering ribonucleic acids. Themolecular mechanism of circ-FADS2 in CRC progression and migration was then examined by sponging miR-498 and promoting S100A16 expression. After this, the expression of miR-498 and S100A16 in CRC tissues was analyzed using a qRT-PCR. In results: circ-FADS2 was found to be significantly upregulated in CRC tissues, when compared with paired normal tissues. Higher circ-FADS2 expression was associated with advanced stages, lymphatic metastasis, and reduced overall survival (OS). In addition, silencing circ-FADS2 markedly inhibited the proliferation and invasion of CRC and increased the percentage of cancer cells in the G1 phase in vitro. Reducing circ-FADS2 decreased SW480 cell proliferation in vivo. By inhibiting miR-498 expression, circ-FADS2 promoted S100A16 expression leading to the activation of the AKT pathway, resulting in CRC progression. We conclude that Circ-FADS2 expression was upregulated in CRC tissues and cells and was found to be correlated with advanced cancer, metastasis, and poor OS. A study of the molecular mechanism suggests that a circ-FADS2/miR-498/S100A16/AKT signaling cascade may be a potential therapeutic target for the treatment of CRC.

[Influence of deep invasive tumor thrombus on the surgical treatment and prognosis of patients with non-metastatic renal cell carcinoma complicated with venous tumor thrombus].

OBJECTIVE: To evaluate the impact of deep invasive tumor thrombus on the surgical complexity and prognosis of patients with renal cell carcinoma complicated with inferior vena cava tumor thrombus. METHODS: We retrospectively reviewed the clinical data of 94 patients with non-metastatic renal cell carcinoma complicated with inferior vena cava tumor thrombus, who underwent surgical treatment in Peking University Third Hospital from January 2017 to June 2020. The patient's general condition, clinicopathological characteristics, surgery and survival information were collected. The patients were divided into two groups based on the intra-operative findings of tumor thrombus adhesion to the venous wall, of which 64 cases were in the deep invasive tumor thrombus (DITT) group and 30 cases were in the non-invasive tumor thrombus (NITT) group. Chi-square, t test and Mann-Whitney U test were used for categorical and continuous variables respectively. Kaplan-Meier plots and multivariable Cox regressions were performed to evaluate the influence of DITT on the prognosis of the patients with renal cell carcinoma with inferior vena cava tumor thrombus. RESULTS: DITT significantly increase the difficulty of surgery for the patients with renal cell carcinoma with venous tumor thrombus, which was mainly reflected in the longer operation time (362.5 vs. 307.5 min, P=0.010), more surgical bleeding (1 200 vs. 450 mL, P=0.006), more surgical blood transfusion (800 vs. 0 mL, P=0.021), more plasma transfusion (200 vs. 0 mL, P=0.001), a higher proportion of open surgery (70.3% vs. 36.7%, P=0.002), a longer post-operative hospital stay (9.5 vs. 8 days, P=0.036), and a higher proportion of post-operative complications (46.9% vs. 13.8%, P=0.002). DITT was associated with worse overall survival of the patients with renal cell carcinoma with inferior vena cava tumor thrombus (P=0.022). Even in the multivariate analysis, DITT was still a poor prognostic factor for the overall survival of these patients [HR: 4.635 (1.017-21.116), P=0.047]. CONCLUSION: For patients with non-metastatic renal cell carcinoma with inferior vena cava tumor thrombus, DITT will significantly increase the difficulty of surgery, and may lead to poor prognosis.

[Risk factors of renal sinus invasion in clinical T1 renal cell carcinoma patients undergoing nephrectomy].

OBJECTIVE: To summarize the clinicoradiological characteristics of clinical T1 renal cell carcinoma patients and to investigate the risk factors of renal sinus invasion in cT1 renal cell carcinoma patients undergoing nephrectomy. METHODS: A retrospective study was conducted in cT1 renal cell carcinoma patients from January 2016 to August 2019 in Department of Urology, Peking University Third Hospital, who underwent partial or radical nephrectomy by analyzing clinicopathological and radiological data. The influencing factors of renal sinus invasion for cT1 renal cell carcinoma were determined by χ2 test, Mann-Whitney U test and Logistic regression analysis. RESULTS: A total of 507 patients were enrolled, including 354 males (69.8%) and 153 females (30.2%). The median age was 59 years and the median body mass index (BMI) was 25.5 kg/m2. Eighteen patients (3.6%) had gross hematuria preoperatively. The median tumor diameter was 3.5 cm. Three hundred twenty-two patients (63.5%) were staged clinical T1a and 165 cases (36.5%) were staged clinical T1b. The median R.E.N.A.L. score was 8. Three hundred fifty-nine patients (70.8%) had regular tumor border and 148 (29.2%) irregular. All the patients underwent surgical treatment, including 186 (36.7%) partial nephrectomy and 321 (63.3%) radical nephrectomy. Postoperative pathology showed seventy-five patients (14.8%) had renal sinus invasion, including 18 in cT1a (5.6%) and 57 in cT1b (30.8%). Univariate analysis showed that age (P=0.020), R.E.N.A.L. score (R value, E value, N value, P < 0.001) and tumor border (P < 0.001) were associated risk factors for cT1 renal cell carcinoma with renal sinus invasion. On multivariate binary Logistic analysis, R.E.N.A.L. score (P≤0.020) and irregular tumor border (P=0.001) were independent risk factors. CONCLUSION: For cT1 renal cell carcinoma patients undergoing nephrectomy, about 15% had renal sinus invasion postoperatively. High R.E.N.A.L. score and irre-gular tumor border help predicting cT1 renal cell carcinoma renal sinus invasion.

[Analysis of the clinical confusion and controversy of esophagogastric junction tumor from basic anatomy].

There are still many controversies in the surgical treatment of esophagogastric junction tumors in terms of surgical approach, cleaning range, and resection scope. The reason is the confusion about the scope of the esophagogastric junction. The previous domestic and foreign anatomy descriptions of this part are not enough to solve the current problems. Based on a large number of basic anatomy and clinical operations, this article proposes that the esophagogastric junction may be wrapped by a complete and separate esophagogastric junction membrane with independent anatomy other than infracardiac bursa. The structure of the transitional tissue, mainly from the distribution of submucosal veins, explained the relationship and significance of tissue transitional changes and clinical operations, and made a reasonable analysis of the current controversy based on the anatomical characteristics, which is worthy of further investigation.

[Proximal gastrectomy and digestive tract reconstruction: status survey of perceptions and treatment selection in Chinese surgeons].

Objective: To understand the perceptions, attitudes and treatment selection of Chinese surgeons for proximal gastrectomy (PG) and digestive tract reconstruction. Methods: A cross-sectional survey was used in this study. Selection of subjects: (1) Domestic public grade IIIA (provincial and prefecture-level) tumor hospitals or general hospitals possessing the diagnosis and treatment qualifications for gastric cancer.(2) Surgeons with senior attending physician, associate chief physician and chief physician. The "Questionnaire Star" platform was used to design a questionnaire about cognition, attitude and treatment choice of "proximal gastrectomy and digestive tract reconstruction". The questionnaire contained 32 questions, such as the basic information of surgeons, the current status of gastric cancer surgery, the selection and management of surgical methods and related details for proximal gastric cancer, the choice of proximal gastrectomy and reconstruction of digestive tract, the related complications and nutritional status monitoring after proximal gastrectomy. A total of 76 questionnaires were linked to the respondents via WeChat between July 29 and August 25, 2019. Statistical analysis was performed using Chi-square test or Kruskal-Wallis test for categorical variables. Results: A total of 47 grade IIIA hospitals were included, and 76 questionnaires were sent out. The proportions of recovered and valid questionnaires were both 100%. For early and middle stage adenocarcinoma of esophagogastric junction (AEG), especially those smaller than 4 cm, 72.37% (55/76) of surgeons preferred proximal gastrectomy, while 22.37% (17/76) of surgeons chose total gastrectomy. For early AEG, 90.79% (69/76) of surgeons thought that endoscopic submucosal dissection (ESD) or proximal gastrectomy could be considered. For AEG below T3 stage and shorter than 4 cm, 60.53% (46/76) of surgeons gave priority to proximal gastrectomy, and 60.53% (46/76) of the surgeons believed that the advanced AEG with a higher radical cure should be treated with proximal gastrectomy, and the residual stomach should not be less than half stomach. Considering anti-reflux effect, postoperative weight recovery, clinical efficacy, wide application and easy popularization, surgeons preferred double-tract reconstruction. The surgeons in tumor hospitals had a higher approval rate for the application of proximal gastrectomy and the fact that the Kamikawa anastomosis was the most difficult to promote than the surgeons in provincial/municipal general hospitals. The surgeons with an annual surgical volume of more than 200 were more likely to choose proximal gastrectomy for early and middle stage AEG patients and the proportion was as high as 8/9. From the perspective of good clinical results, wide range of application, and easy popularization, the surgeons with a higher ratio (60.00%, 15/25) of double-tract reconstruction were those surgeons with 50-100 operations per year. Conclusions: The general level of cognition and acceptability of Chinese surgeons for proximal gastrectomy and reconstruction of digestive tract is suboptimal. In the future, it is urgent to promote the "Chinese consensus on digestive tract reconstruction after proximal gastrectomy" so as to guide and optimize treatment in proximal gastric cancer.

Analysis of clinical features and imaging signs of COVID-19 with the assistance of artificial intelligence.

OBJECTIVE: To explore the CT imaging features/signs of patients with different clinical types of Coronavirus Disease 2019 (COVID-19) via the application of artificial intelligence (AI), thus improving the understanding of COVID-19. PANTIENTS AND METHODS: Clinical data and chest CT imaging features of 58 patients confirmed with COVID-19 in the Fifth Medical Center of PLA General Hospital were retrospectively analyzed. According to the Guidelines on Novel Coronavirus-Infected Pneumonia Diagnosis and Treatment (Provisional 6th Edition), COVID-19 patients were divided into mild type (7), common type (34), severe type (7) and critical type (10 patients). The CT imaging features of the patients with different clinical types of COVID-19 types were analyzed, and the volume percentage of pneumonia lesions with respect to the lung lobes (where the lesion was located) and to the whole lung was calculated with the use of AI software. SPSS 21.0 software was used for statistical analysis. RESULTS: Common clinical manifestations of COVID-19 patients: fever was found in 47 patients (81.0%), cough in 31 (53.4%) and weakness in 10 (17.2%). Laboratory examinations: normal or decreased white blood cell (WBC) counts were observed in 52 patients (89.7%), decreased lymphocyte counts (LCs) in 14 (24.1%) and increased C-reactive protein (CRP) levels in 18 (31.0%). CT imaging features: there were 48 patients (94.1%) with lesions distributed in both lungs and 46 patients (90.2%) had lesions most visible in the lower lungs; the primary manifestations in patients with common type COVID-19 were ground-glass opacities (GGOs) (23/34, 67.6%) or mixed type (17/34, 50.0%), with lesions mainly distributed in the periphery of the lungs (28/34, 82.4%); the primary manifestations of patients with severe/critical type COVID-19 were consolidations (13/17, 76.5%) or mixed type (14/17, 82.4%), with lesions distributed in both the peripheral and central areas of lungs (14/17,82.4%); other common signs, including pleural parallel signs, halo signs, vascular thickening signs, crazy-paving signs and air bronchogram signs, were visible in patients with different clinical types, and pleural effusion was found in 5 patients with severe/critical COVID-19. AI software was used to calculate the volume percentages of pneumonia lesions with respect to the lung lobes (where the lesion was located) and to the whole lung. There were significant differences in the volume percentages of pneumonia lesions for the superior lobe of the left lung, the inferior lobe of the left lung, the superior lobe of the right lung, the inferior lobe of the right lung and the whole lung among patients with different clinical types (p<0.05). The area under the ROC curve (AUC) of the volume percentage of pneumonia lesions for the whole lung for the diagnosis of severe/critical type COVID-19 was 0.740, with sensitivity and specificity of 91.2% and 58.8%, respectively. CONCLUSIONS: The clinical and CT imaging features of COVID-19 patients were characteristic to a certain degree; thus, the clinical course and severity of COVID-19 could be evaluated with a combination of an analysis of clinical features and CT imaging features and assistant diagnosis by AI software.

[Progress in antiviral treatment of hepatitis C after liver transplantation].

Recipients who detect hepatitis C virus (HCV) ribonucleic acid during the liver transplantation will promptly infect the transplanted liver, so it is called recurrent HCV after liver transplantation. HCV recurrence can lead to the progression of fibrosis and cirrhosis to the transplanted liver, and thereby significantly reduce the transplanted liver survival rate. Therefore, the effective elimination of HCV is the key to improve the patients' prognosis. Patients should receive antiviral therapy as long as HCV RNA can be detected after liver transplantation, and treatment should be stopped as soon as the disease condition stabilizes. Currently, highly safe pan-genotypic direct-acting antiviral drugs (DAA) have been recommended to patients after liver transplantation, as their interaction with immunosuppressive drugs (DDI) is minimal. Clinically, different treatment scheme should be selected according to the hepatorenal function, and DDIs of the patient. This article reviews the current situation and progress of antiviral treatment for HCV infection after liver transplantation.

Minimal-access retroperitoneal pancreatic necrosectomy for infected necrotizing pancreatitis: a multicentre study of a step-up approach.

BACKGROUND: Various minimally invasive approaches have been described for infected necrotizing pancreatitis. This article describes a modified minimal-access retroperitoneal pancreatic necrosectomy (MARPN) procedure assisted by gas insufflation. METHODS: This retrospective, observational study documented patients who had undergone a step-up MARPN between 1 January 2010 and 31 December 2016. A minimum follow-up of 1 year was required for inclusion. The step-up approach involved percutaneous catheter drainage followed by the modified MARPN and necrosectomy. If more than one access site was needed it was categorized as complex MARPN. RESULTS: Of 212 patients with infected necrotizing pancreatitis, 164 (77·4 per cent) underwent a step-up approach. The median number of percutaneous catheter drains and MARPN procedures was 3 (range 1-7) and 1 (1-6) respectively. Ninety patients (54·9 per cent) underwent complex MARPN. For residual necrosis after MARPN, three patients (1·8 per cent) underwent sinus tract gastroscopy, and 11 (6·7 per cent) had sinography combined with a tube change. However, operations in 13 patients (7·9 per cent) required conversion to open surgery. Postoperative complications developed in 103 patients (62·8 per cent). The mortality rate was 6·1 per cent (10 deaths). CONCLUSION: A step-up approach using a modified MARPN for infected necrotizing pancreatitis is a reasonable option.

ANTECEDENTES: Los procedimientos mínimamente invasivos se han convertido en los más frecuentes para el tratamiento de necrosis pancreáticas infectadas. El objetivo de este estudio fue presentar un procedimiento de necrosectomía pancreática retroperitoneal de acceso mínimo (minimal-access retroperitoneal pancreatic necrosectomy, MARPN) modificado y asistido mediante insuflación de gases, así como evaluar su seguridad y eficacia. MÉTODOS: Se realizó un análisis retrospectivo y observacional de los datos de un hospital desde el 1 de enero de 2010 hasta el 31 de diciembre de 2016. Se incluyeron en el análisis todos los pacientes en los que realizó un abordaje por etapas, que consistía en el drenaje percutáneo mediante la colocación de un catéter seguido de un procedimiento MARPN modificado, en los que se dispusiese de un seguimiento postoperatorio mínimo de 1 año. El MARPN en el lado derecho y la necrosectomía realizada a través de más de un acceso se clasificaron como MARPN complejo. Se evaluaron los resultados radiológicos y quirúrgicos. RESULTADOS: De 212 pacientes con necrosis pancreática infectada, en 164 (77,4%) se realizó un abordaje por etapas. La mediana del número de drenajes percutáneos y procedimientos MARPN fue 3 (rango, 1-7) y 1 (rango, 1-6), respectivamente. En 90 pacientes (54,9%) se realizó un MARPN complejo. Para la exéresis de necrosis residual después de un MARPN, en 3 pacientes (1,8%) se realizó mediante gastroscopia y en 11 pacientes (6,7%) con un recambio de drenaje bajo control radiológico. En 13 pacientes (7,9%) fue necesaria la reconversión a cirugía abierta. Hubo complicaciones postoperatorias en 103 pacientes (62,8%). La tasa de mortalidad fue del 6,1% (n = 10). CONCLUSIÓN: El abordaje por etapas con un MARPN modificado es seguro y efectivo en el tratamiento de la necrosis pancreática infectada.

Corrosion fatigue behavior of additively manufactured biodegradable porous zinc.

Additively manufactured (AM) biodegradable porous zinc exhibits great potential as a promising bone-substituting biomaterial. However, there is no information whatsoever available regarding its corrosion fatigue behavior. In this study, we used direct metal printing to fabricate topologically ordered biodegradable porous zinc based on a diamond unit cell. We compared the compression-compression fatigue behavior of AM porous zinc in air and in revised simulated body fluid (r-SBF). The fatigue strength of AM porous zinc was high in air (i.e., 70% of its yield strength) and even higher in r-SBF (i.e., 80% of its yield strength). The high value of the relative fatigue strength in air could be attributed to the good ductility of pure zinc itself. The formation of corrosion products around the strut junctions might explain the higher fatigue strength of AM zinc in r-SBF. Furthermore, we compared the fatigue behavior of a uniform design of the AM porous zinc with a functionally graded design. The functionally graded structure exhibited higher relative fatigue strengths than the uniform structure. The inspection of the fatigue crack distribution revealed that the functionally graded design controlled the sequence of crack initiation, which occurred early in the thicker struts and moved towards the thinner struts over time. The theoretical fatigue life models suggest that optimizing the functionally graded structure could be used as an effective means to improve the fatigue life of AM porous zinc. In conclusion, the favorable fatigue behavior of AM porous zinc further highlights its potential as a promising bone-substituting biomaterial. STATEMENT OF SIGNIFICANCE: Additively manufactured (AM) biodegradable porous zinc exhibits great potential for the treatment of large bony defects. However, there is no information available regarding its corrosion fatigue behavior. Here, we compared the fatigue behavior of AM porous zinc in air and in revised simulated body fluid (r-SBF). The fatigue strength of AM porous Zn was even higher in r-SBF than in air, which were attributed to the formation of corrosion products. Furthermore, we found that the functionally graded structure controlled the sequence of crack initiation in differently sized struts and exhibited higher relative fatigue strengths than the uniform structure, suggesting that optimizing the functionally graded structure could be an effective means to improve the fatigue life of AM porous Zn.

MicroRNA-132 improves myocardial remodeling after myocardial infarction.

OBJECTIVE: To elucidate the potential role of microRNA-132 in myocardial infarction (MI) and its underlying mechanism. MATERIALS AND METHODS: The myocardial infarction model was established in WT and microRNA-132 KO mice using the LAD ligation method. WT mice were assigned into the control group (LAD ligation for MI) and sham group. After animal procedures, infarct size was calculated using hematoxylin and eosin (HE) staining and cardiac function was evaluated using echocardiography, respectively. By analyzing differentially expressed microRNAs relative to MI in a microarray, microRNA-132 was screened out and further verified by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Hemodynamic parameters and cardiac function indexes in mice were accessed, including scar length/LV length, FS, dp/dtmax, dp/dtmin, ESV, EDV, EF and Tau_w. RESULTS: QRT-PCR data showed a gradual decrease in microRNA-132 expression in the infarction zone, border zone and remote zone within 7 days after MI. Compared with mice in the control group, microRNA-132 KO mice showed a higher percentage of scar length/LV length at postoperative day 14 and day 28. MicroRNA-132 KO mice showed decreased FS, dp/dtmax and EF, but increased dp/dtmin, ESV and EDV. The injection of different concentrations of microRNA-132 mimics into mice (8 mg/kg, 16 mg/kg and 32 mg/kg) could reduce LVIDD, LVIDs, ESV, EDV, dp/dtmin and Tau_w. However, FS, EF and dp/dtmax increased by the injection of microRNA-132 mimics at postoperative day 28. The injection of 16 mg/kg microRNA-132 mimics significantly reduced the percentage of scar length/LV length in microRNA-132 KO mice than the control group and miR-CO group. After injection of 16 mg/kg microRNA-132 mimics, LVIDD and LVIDs markedly decreased at postoperative day 14 and day 28 compared with the control group and miR-CO group. However, FS was elevated by microRNA-132 mimics. CONCLUSIONS: MicroRNA-132 is involved in the development of myocardial infarction. The MicroRNA-132 expression is upregulated after myocardial infarction, influencing infarct size and cardiac function.

[Nasopharyngeal low grade papillary adenocarcinoma with squamous differentiation：a case report].

Summary Low grade papillary adenocarcinoma is especially rare tumor in nasopharynx. Here we reported a patient who had low grade papillary adenocarcinoma of the nasopharynx and was diagnosed by pathology. The patient complained for bilateral nasal congestion for 10 years and was hospitalized in recent 3 years. The patient received nasopharyngeal tumor resection, and the postoperative pathological examination showed low grade nasopharyngeal papillary adenocarcinoma with squamation. The patient was followed up for 9 months without recurrence or metastasis. We reported this case and reviewed the relevant literature in order to improve the diagnosis and treatment of this disease..

[Development status of biliary tract imaging technology].

Structure of biliary system is complex as well as various, making troubles for optimal surgical treatment of biliary disease. Remarkable imaging of biliary system helps surgeon evaluating patients and planning surgeries. There are several methods to obtain accurate anatomical information of biliary system, such as X-ray fluoroscopy, MRI and fluorescence-based imaging. Each has its own advantages and disadvantages. Combination of multi-model imaging technologies may improve visual result of anatomical information of biliary tract. More resolvable, legible, and sequential imaging technology of biliary system remains further study. This article reviews various cholangiography methods widely used in the clinical setting.

[Clinical study on two reconstruction methods of proximal gastrectomy and piggyback jejunal interposition for Siewert â ¡ or â ¢ adenocarcinoma of esophagogastric junction].

Objective: To evaluate the clinical efficacy of two different digestive tract reconstruction methods in the Siewert Ⅱ or Ⅲ adenocarcinoma of esophagogastric junction underwent proximal gastrectomy and piggyback jejunal interposition. Methods: A total of 84 patients with Siewert Ⅱ or Ⅲ AEG who underwent proximal gastrectomy and interposition jejunal anastomosis were enrolled prospectively according to the exclusion criteria, from October 2015 to August 2017 at Department of Digestive Minimally Invasive Surgery, Shanxi Cancer Hospital. There were 61 male and 23 female patients, aged 48-69 years with an average age of 59.7 years. They were divided into single-tract reconstruction group (n=41) and double-tract reconstruction group (n=43) according to random number table. Both groups underwent proximal gastrectomy and piggyback jejunal interposition. After side-to-side anastomosis of the remnant stomach and jejunum was performed in the single-tract group, jejunum 3 cm below the anastomosis was ligated or closed. The jejunum in the double-tract group was not treated during the operation. Relevant nutritional indicators were collected at 3 months and 6 months after operation. The data were analyzed by repeated measurement of variance analysis to determine the nutritional status. Results: There was no significant difference in preoperative general condition between single-tract reconstruction group and double-tract reconstruction group (P>0.05). There was no significant difference in perioperative related indicators (P>0.05). Nutritional indicators in single-channel reconstruction group were higher than those in double-channel reconstruction group (hemoglobin: F=23.374, P=0.000; albumin: F=6.149, P=0.003; total protein: F=18.362, P=0.000; weight: F=74.255, P=0.000). The quality of life was compared half year after operation, there was no significant difference in the incidence of subjective symptoms such as reflux, heart burning, nausea and vomiting, dysphagia and sternum discomfort in the two groups (P>0.05), as well as the results of QLQ-STO22 score (27.0±3.8 vs. 27.6±3.3, t=-0.688, P=0.494). The results of gastroscopy showed that the incidence and degree of the two groups were almost the same whether in the incidence of reflux esophagitis (2/41 vs. 2/43, P=1) or in the contrast of reflux degree (Z=-1.528, P=0.127). Conclusion: For patients with type Siewert Ⅱ or Ⅲ esophagogastric junction adenocarcinoma who underwent proximal gastrectomy and piggyback jejunal operation, single tract reconstruction is ideal.

[Quantitative comparison of diffusion weighted image in liver at two field strengths for chronic hepatitis B].

Objective: To evaluate whether there were differences between apparent diffusion coefficient (ADC) values derived from 3.0 T and 1.5 T MR diffusion-weighted imaging (DWI) in liver of patients with chronic hepatitis B. Methods: From January 2016 to November 2016, a total of 40 chronic hepatitis B prospectively underwent both 1.5 T and 3.0 T DWI before liver biopsy, the interval between two scans was within 15 minutes, the protocol was respiratory-triggered DWI(RT-DWI). The ADC values were measured at both field strengths using ROI method. Bland-Altman tests and paired t-tests were used to compare ADC values obtained at 1.5 T and 3.0 T. Results: The ADC values of different b values for patients with mild inflammation at 1.5 T were(1.22-1.48(1.35±0.08)×10(-3) mm(2)/s), the ADC values of different b values for patients with mild inflammation at 3.0 T were(1.18-1.45(1.30±0.08)×10(-3) mm(2)/s); the ADC values of different b values for patients with moderate to severe inflammation at 1.5 T were(1.11-1.37(1.25±0.06)×10(-3) mm(2)/s), the ADC values of different b values for patients with moderate to severe inflammation at 3.0 T were(1.08-1.31(1.20±0.06)×10(-3) mm(2)/s). There were significantly differences between the ADC values of different b values for patients with chronic hepatitis B obtained at two field strengths (P<0.01). Conclusions: Different field strengths have influence on ADC values in liver, the ADC values derived from 3.0 T are lower than the ADC values derived from 1.5 T.

[Study of diffusion weighted imaging in combination with conventional MRI signs for inflammation activity of chronic hepatitis B].

Objective: To study the correlation between ADC values of diffusion weighted imaging (DWI) and the pathological grading in inflammation activity of chronic hepatitis B, and combined with conventional MRI features to predict the diagnosis effectiveness. Methods: A total of 142 cases of patients with chronic hepatitis B were selected as inflammatory group in 302 Hospital of PLA from January 2014 to December 2015, while 20 cases of healthy subjects without history of liver disease were chosen as control group.All patients underwent MR plain scan and dynamic contrast enhancement and DWI examinations (b=0, 800 s/mm(2)) for liver, and were performed liver biopsy within two days.According to the degree of inflammation activity (G), the inflammation group was divided into G1, G2 and G3-4 level.The apparent diffusion coefficient (ADC) value, and the MRI features of each group were analyzed. Results: The ADC values showed statistical difference (F=8.392, P<0.01) within inflammation group of chronic hepatitis B from different pathologic grading, and there was significant negative correlation between ADC values and liver inflammation activity grading (r=-0.613, P<0.01). The ADC value of inflammation group and control group was (1.31±0.16), (1.12±0.15)×10(-3) mm(2)/s, the difference was statistically significant (P<0.05). The ADC value of G1, G2 and G3-4 level was (1.22±0.12), (1.05±0.12), (0.98±0.10)×10(-3) mm(2)/s respectively, and there was statistical difference (P<0.05) between G1 and G2, G1 and G3-4. The receiver operating characteristic (ROC) curve in diagnosis of equal and above G2 level showed the area under the curve (AUC) was 0.880, the sensitivity and the specificity was 82.4% and 76.8% respectively, the diagnostic cut-off value was 1.09×10(-3) mm(2)/s.Besides, the detection rate of portal around its orbit and gallbladder wall edema in inflammation group had statistical difference (P<0.05), and there was no statistical difference in the detection rate of abnormal liver arterial enhancement, hilus lymph node increases and ascites in inflammation group(P>0.05). The ROC in diagnosis of equal and above G2 level by ADC values combined with the MRI characteristic signs showed AUC was 0.938, the sensitivity and the specificity was 88.4% and 88.9% respectively. Conclusions: ADC values can predict the inflammation activity of chronic hepatitis B with quantitatively and non-invasively.Combining with characteristic MRI signs, ADC values can improve the diagnosis efficiency.

[Advances in perioperative antiviral therapy for HBV/HCV-associated hepatocellular carcinoma].

Chronic viral hepatitis has a high prevalence rate in China, and the presence or absence of hepatitis virus replication is closely associated with the surgical outcome of patients. Therefore, perioperative antiviral therapy becomes an important method for improving patients' outcome. On the basis of treatment modalities and features of different viral infections, this article elaborates on the strategies and effects of perioperative antiviral therapy, in order to guide clinical practice and improve patients' prognosis.

[The progress of the IL-12 cytokine family in allergic rhinitis].

As the IL-12 family plays an important role in immune regulation, it arouses the attention of the researchers increasingly. There are mainly four members in the IL-12 family, including IL-12, IL-23, IL-27 and IL-35 at present. The family members share many similar structures, but they have their own distinctive biological characteristics and play different roles to balance the functional effects of their own family. IL-12 and IL-23 are positive regulators and mainly play pro-inflammatory effect while IL-27 and IL-35 are negative regulators and mainly play anti-inflammatory effect. Thus, IL-12 family plays an important role in the regulation of the immune response and this function may be better than other cytokine family. IL-12 family has an important regulatory effect on multiple T cell subsets and also has an impact on their differentiation and function. So, we postulate that the IL-12 family may have an intense relationship with the generation and development of the allergic rhinitis. This article will mainly talk about the unique structure and role of the IL-12 cytokine family and discuss its immune regulation effect in the allergic rhinitis.