Cell fusing agent virus isolated from Aag2 cells does not vertically transmit in Aedes aegypti via artificial infection.

BACKGROUND: Cell fusing agent virus (CFAV) was the first insect-specific virus to be characterized, and has been reported to negatively influence the growth of arboviruses such as dengue, Zika, and La Cross, making it a promising biocontrol agent for mosquito-borne disease prevention. Aedes aegypti Aag2 cells were naturally infected with CFAV. However, the ability of this virus to stably colonize an Ae. aegypti population via artificial infection and how it influences the vector competence of this mosquito have yet to be demonstrated. METHODS: CFAV used in this study was harvested from Aag2 cells and its complete genome sequence was obtained by polymerase chain reaction and rapid amplification of complementary DNA ends, followed by Sanger sequencing. Phylogenetic analysis of newly identified CFAV sequences and other sequences retrieved from GenBank was performed. CFAV stock was inoculated into Ae. aegypti by intrathoracic injection, the survival of parental mosquitoes was monitored and CFAV copies in the whole bodies, ovaries, and carcasses of the injected F0 generation and in the whole bodies of the F1 generation on different days were examined by reverse transcription-quantitative polymerase chain reaction. RESULTS: The virus harvested from Aag2 cells comprised a mixture of three CFAV strains. All genome sequences of CFAV derived from Aag2 cells clustered into one clade but were far from those isolated or identified from Ae. aegypti. Aag2-derived CFAV efficiently replicated in the mosquito body and did not attenuate the survival of Ae. aegypti. However, the viral load in the ovarian tissues was much lower than that in other tissues and the virus could not passage to the offspring by vertical transmission. CONCLUSIONS: The results of this study demonstrate that Aag2-derived CFAV was not vertically transmitted in Ae. aegypti and provide valuable information on the colonization of mosquitoes by this virus.

Potential Global Distribution of the Invasive Mosquito Aedes koreicus under a Changing Climate.

Invasive alien species are a growing threat to natural systems, the economy, and human health. Active surveillance and responses that readily suppress newly established colonies are effective actions to mitigate the noxious consequences of biological invasions. Aedes (Hulecoeteomyia) koreicus (Edwards), a mosquito species native to East Asia, has spread to parts of Europe and Central Asia since 2008. In the last decade, Ae. koreicus has been shown to be a competent vector for chikungunya virus and Dirofilaria immitis. However, information about the current and potential distribution of Ae. koreicus is limited. Therefore, to understand the changes in their global distribution and to contribute to the monitoring and control of Ae. koreicus, in this study, the MaxEnt model was used to predict and analyze the current suitable distribution area of Ae. koreicus in the world to provide effective information.

Does the "10-Point Water Plan" reduce the intensity of industrial water pollution? Quasi-experimental evidence from China.

The Action Plan for Water Pollution Prevention and Control (i.e., the "10-Point Water Plan") is a regulation formulated by China to prevent and control water pollution and ensure China's water safety. To test the policy effect of the "10-Point Water Plan", we use data from 269 cities for the period from 2012 to 2017 to examine whether the implementation of the plan can help reduce the intensity of industrial water pollution. The results show that the industrial water pollution intensity in Central and Western China is significantly higher than that in other regions, and the implementation of the "10-Point Water Plan" significantly reduces industrial water pollution intensity in China. We further find that upgrading industrial structures and technological innovation are effective ways to ameliorate the intensity of industrial water pollution. In terms of spatial heterogeneity, the impact of the "10-Point Water Plan" on reducing industrial water pollution is smaller in areas with high environmental regulation intensity than in areas with low environmental regulation intensity. We also find a strong inhibitory effect of environmental regulations on industrial water pollution intensity in areas with low environmental regulation intensity. Our findings support the positive policy effect of the "10-Point Water Plan" and provide significant policy implications for water pollution prevention and control actions in China and other countries.

FXYD6: a novel therapeutic target toward hepatocellular carcinoma.

FXYD6, FXYD domain containing ion transport regulator 6, has been reported to affect the activity of Na(+)/K(+)-ATPase and be associated with mental diseases. Here, we demonstrate that FXYD6 is up-regulated in hepatocellular carcinoma (HCC) and enhances the migration and proliferation of HCC cells. Up-regulation of FXYD6 not only positively correlates with the increase of Na(+)/K(+)-ATPase but also coordinates with the activation of its downstream Src-ERK signaling pathway. More importantly, blocking FXYD6 by its functional antibody significantly inhibits the growth potential of the xenografted HCC tumors in mice, indicating that FXYD6 represents a potential therapeutic target toward HCC. Altogether, our results establish a critical role of FXYD6 in HCC progression and suggest that the therapy targeting FXYD6 can benefit the clinical treatment toward HCC patients.

Robotic surgery twice performed in the treatment of hilar cholangiocarcinoma with deep jaundice: delayed right hemihepatectomy following the right-hepatic vascular control.

OBJECTIVE: To explore and find a new method to treat hilar cholangiocarcinoma with deep jaundice assisted by Da Vinci robot. METHODS: A hilar cholangiocarcinoma patient of type Bismuch-Corlette IIIa was found with deep jaundice (total bilirubin: 635 µmol/L). On the first admission, we performed Da Vinci robotic surgery including drainage of left hepatic duct, dissection of right hepatic vessels (right portal vein and right hepatic artery), and placement of right-hepatic vascular control device. Three weeks later on the second admission when the jaundice disappeared we occluded right-hepatic vascular discontinuously for 6 days and then sustained later. On the third admission after 3 weeks of right-hepatic vascular control, the right hemihepatectomy was performed by Da Vinci robot for the second time. RESULTS: The future liver remnant after the right-hepatic vascular control increased from 35% to 47%. The volume of left lobe increased by 368 mL. When the total bilirubin and liver function were all normal, right hemihepatectomy was performed by Da Vinci robot 10 weeks after the first operation. The removal of atrophic right hepatic lobe with tumor in bile duct was found with no pathologic cancer remaining in the margin. The patient was followed up at our outpatient clinic every 3 months and no tumor recurrence occurs by now (1 y). CONCLUSIONS: Under the Da Vinci robotic surgical system, a programmed treatment can be achieved: first, the hepatic vessels were controlled gradually together with biliary drainage, which results in liver's partial atrophy and compensatory hypertrophy in the other part. Then a radical hepatectomy could be achieved. Such programmed hepatectomy provides a new treatment for patients of hilar cholangiocarcinoma with deep jaundice who have the possibility of radical heptolobectomy.

Management of bleeding gastric varices in patients with sinistral portal hypertension.

BACKGROUND AND AIM: Sinistral portal hypertension (SPH) is a rare cause of upper gastrointestinal hemorrhage. Besides splenectomy, there is no consensus on the role of sclerotherapy and splenic embolization for bleeding gastric varices (GVs). This retrospective study summarizes our experience in managing GV bleeding from SPH in patients with pancreatic diseases. METHODS: Patients with pancreatic diseases who had bleeding GVs from SPH in two tertiary hospitals were reviewed from January 2001 to December 2011. The etiology, clinical manifestations, diagnostic and therapeutic modalities were analyzed. RESULTS: Twenty-one patients (15.2 %) complicating bleeding GVs among 139 patients with SPH secondary to pancreatic diseases were enrolled. The etiologies were acute pancreatitis in one patient, chronic pancreatitis in seven patients, and pancreatic tumors in 13 patients. Emergent endoscopic sclerotherapy was initially performed in five patients, and succeeded in two patients, while one patient died of massive hemorrhage. Initial transcatheter artery embolization using Gianturco coils was successfully performed in six patients. Splenectomy combined with other surgical procedures was undertaken for 15 patients. The patients undergoing artery embolization or splencetomy achieved hemostasis. The survivors had no recurrent bleeding during a median 72-month follow-up period. CONCLUSIONS: The incidence of bleeding GVs from SPH is relatively rare. Splenic artery embolization could be selected as a first-line choice for bleeding SPH, especially for patients in poor conditions, and sclerotherapy may not be preferentially recommended. Further studies are required to evaluate the optimum treatment algorithm for bleeding GVs from SPH.

FXYD6 is a new biomarker of cholangiocarcinoma.

Members of the FXYD domain-containing ion transport regulator protein family, including FXYD3 and FXYD5, play an important role in the pathogenesis of numerous tumors. However, the correlation between the expression of FXYD6 and tumors remains poorly understood. In the current study, the expression of FXYD6 was examined immunohistochemically in 72 cholangiocarcinoma tissues and 30 distal normal bile duct tissues matched with the tumors. The results show that the positive expression rate of FXYD6 was significantly higher in cholangiocarcinoma than that in normal bile duct tissue (69 vs. 33.3%; P=0.002). Furthermore, the positive expression rate of FXYD6 in well- and moderately-differentiated cholangiocarcinoma was clearly higher than that in poorly-differentiated and mucinous cholangiocarcinoma (85.7 vs. 40%; P=0.000). However, there was no significant correlation between the expression of FXYD6 and gender (P=0.393), age (P=0.174), histological type (P=0.123), T stage (P=0.164), lymph node metastasis (P=0.343), perineural invasion (P=0.088) and tumor location (P=0.238). The results of this study indicate that FXYD6 may be a new biomarker for cholangiocarcinoma and may be associated with a favorable prognosis in this malignant disease.

Direct manipulation of tool-like masters for controlling a master-slave surgical robotic system.

BACKGROUND: Robotic-assisted minimally invasive surgery (MIS) can benefit both patients and surgeons. However, the learning curve for robotically assisted procedures can be long and the total system costs are high. Therefore, there is considerable interest in new methods and lower cost controllers for a surgical robotic system. METHODS: In this study, a knife-master and a forceps-master, shaped similarly to a surgical knife and forceps, were developed as input devices for control of a master-slave surgical robotic system. In addition, a safety strategy was developed to eliminate the master-slave orientation difference and stabilize the surgical system. RESULTS: Master-slave tracking experiments and a ring-and-bar experiment showed that the safety tracking strategy could ensure that the robot system moved stably without any tremor in the tracking motion. Subjects could manipulate the surgical tool to achieve the master-slave operation with less training compared to a mechanical master. CONCLUSIONS: Direct manipulation of the small, light and low-cost surgical tools to control a robotic system is a possible operating mode. Surgeons can operate the robotic system in their own familiar way, without long training. The main potential safety issues can be solved by the proposed safety control strategy.

Da Vinci robot-assisted anatomic left hemihepatectomy and biliary reconstruction.

BACKGROUND: Since the introduction of Da Vinci robotic surgery, more and more complicated surgeries can now be performed robotically, yet there have been very few on robotic hepatectomy, especially when billiary reconstruction is involved. The video shows our initial experience with an anatomic hepatectomy using Da Vinci surgical robot. In this case, we also conducted billiary reconstruction due to the anatomic abnormality of bile duct, while applying the choledochoscopy. The preoperative diagnosis is primary liver carcinoma, tumor thrombi in bile duct, and hepatitis B. METHODS: First, the gallbladder was resected, and cystic artery and duct were identified. After opening of the common bile duct above the junction, the choledochoscopy was performed. Tumor thrombi were found in common bile duct and left hepatic duct, and they were all removed. Left branches hepatic artery and portal vein were dissected, ligated, and divided. Thrombi in the left hepatic duct were removed also. After marking the cutting line along the ischemic boarder, liver parenchyma was transected using robotic harmonic scalpel. Branches of ducts were encountered and managed by either direct coagulating or dividing after clipping. The left hepatic vein was visualized, exposed, and divided during hepatectomy. Two T tubes were placed into common hepatic duct and the proximal cutting end of right anterior bile duct which was found to join the left hepatic duct, respectively. RESULTS: The operation went on successfully. The operation time was 410 minutes, the blood loss was 200 mL. The pathologic diagnosis was introductal papillary adenocarcinoma of left hepatic duct. The patient went on well postoperatively and was followed up for 22 months till now. Postoperative computed tomography examination showed no recurrence. CONCLUSIONS: Da Vinci-assisted robotic hepatectomy can be performed safely in the hands of experienced hepatobilliary surgeons, and choledochoscopy can be combined for bile duct exploration. With the advantages of Da Vinci robot system, complicated billiary reconstruction can be performed (http://links.lww.com/SLE/A74).

Radiofrequency ablation of splenic tumors: a case series.

Radiofrequency ablation (RFA) for treatment of splenic tumors has rarely been reported. Here we describe our experiences of undergoing RFA in three patients with solitary metastatic (n=2) and benign (n=1) tumors of the spleen. Two patients also had underlying cirrhotic hypersplenism. A 53-year-old male with solitary splenic metastasis from hepatocellular carcinoma underwent laparoscopical RFA of the splenic tumor. Another 61-year-old female with intraabdominal recurrence, focal splenic metastasis from colon cancer and cirrhotic hypersplenism underwent cytoreductive surgery and RFA of splenic tumors. On the third patient, a 32-year-old man with severe hypersplenism, splenic artery steal syndrome and a solitary splenic hemangioma, a laparoscopical RFA of the splenic tumor was performed. The three patients recovered uneventfully. The concurrent hypersplenism of the latter two patients improved significantly. The results indicate that RFA of splenic tumors is feasible and safe, and could be evaluated as an alternative to splenectomy in selected patients with solitary splenic tumors.

Purification and characterization of an antitumor polysaccharide from Portulaca oleracea L.

In the present study, we purified a unique polysaccharide component (POP) from Portulaca oleracea and found that it had pronounced anti-tumor effects in vivo model. Tumor weight, immune organ index and T lymphocyte subsets were employed to detect the immunoregulatory and antitumor effects of POP after administration. Hematological and biochemical analyses were also investigated in order to evaluate the toxicological aspects related to POP treatment. POP could significantly inhibit the growth of transplantable sarcoma 180 and potentiate the animal's immune responses including an increase in the number of white blood cell (WBC) and CD4(+) T-lymphocytes, as well as the ratio of CD4(+)/CD8(+). Furthermore the serum aspartate transanimase (AST), alanine transaminase (ALT), urea nitrogen (BUN), and creatinine levels in S180-bearing mice were significantly reversed by POP. Considering all these results, it is suggested that the anti-tumor effect elicited by POP could be associated with its immunostimulating properties.

Immunopontentiating activities of the purified polysaccharide from evening primrose in H22 tumor-bearing mice.

A water-soluble polysaccharide named as EPP was isolated and purified from evening primrose by hot water extraction, alcohol-precipitation, anion exchange and gel permeation chromatography. EPP had a weight-average molecular weight of about 9.8 kDa and was composed of glucose (Glc), galactose (Gal), mannose (Man), arabinose (Ara) and rhamnose (Rha) in a molar ratio of 2.4:3.1:1.3:1.9:1.0. After 10 days of administration with EPP to H22 tumor-bearing mice, a significant increase in tumor growth inhibitory rate, body weight, relative spleen weight, lymphocytes proliferation, natural killer (NK) cell activity, macrophage phagocytosis, delayed type hypersensitivity (DTH), white blood cell and lymphocyte counts were observed at the dose of 25, 50 and 100 mg/kg. Meanwhile EPP treatment decreased the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkalines phosphatases (ALP), creatinine and urea of tumor-bearing mice to normal levels. Thus, these data proved that EPP might be employed as effective therapeutic agents in the regulation of diverse immune reactions implicated in cancer.

Incidence of port-site metastasis after undergoing robotic surgery for biliary malignancies.

AIM: To investigate the incidence of clinically detected port-site metastasis (PSM) in patients who underwent robotic surgery for biliary malignancies. METHODS: Using a prospective database, the patients undergoing fully robotic surgery for biliary malignancies between January 2009 and January 2011 were included. Records of patients with confirmed malignancy were reviewed for clinicopathological data and information about PSM. RESULTS: Sixty-four patients with biliary tract cancers underwent robotic surgery, and sixty patients met the inclusion criteria. The median age was 67 year (range: 40-85 year). During a median 15-mo follow-up period, two female patients were detected solitary PSM after robotic surgery. The incidence of PSM was 3.3%. Patient 1 underwent robotic anatomatic left hemihepatectomy and extraction of biliary tumor thrombi for an Klatskin tumor. She had a subcutaneous mass located at the right lateral abdominal wall near a trocar scar. Patient 2 underwent robotic pancreaticoduodenectomy for distal biliary cancer. She had two metachronous subcutaneous mass situated at the right lateral abdominal wall under a same trocar scar at 7 and 26 mo. The pathology of the excised PSM masses confirmed metastatic biliary adenocarcinoma. CONCLUSION: The incidence of PSMs after robotic surgery for biliary malignancies is relatively low, and biliary cancer can be an indication of robotic surgery.

XRCC1 Arg399Gln gene polymorphism and hepatocellular carcinoma risk in the Chinese Han population: a meta-analysis.

PURPOSE: Numerous studies have evaluated the association between XRCC1 Arg399Gln gene polymorphism and hepatocellular carcinoma risk in the Chinese Han population. However, the results have been inconsistent. We therefore here examined whether the XRCC1 Arg399Gln gene polymorphism confers hepatocellular carcinoma risk by conducting a meta-analysis. METHODS: PubMed, Google scholar and China National Knowledge Infrastructure databases were searched for eligible articles in English and Chinese that were published before April 2012. RESULTS: 6 studies involving 1,246 patients with hepatocellular carcinoma and 1,953 controls were included. The association between XRCC1 Arg399Gln gene polymorphism and hepatocellular carcinoma in the Chinese Han population was significant under GG vs AA (OR = 1.48, 95% CI = 1.13 to 1.94). Limiting the analysis to the studies with controls in the Hardy-Weinberg equilibrium, the results were persistent and robust. CONCLUSIONS: In the Chinese Han population, the XRCC1 Arg399Gln gene polymorphism is associated with an increased hepatocellular carcinoma risk.

Design of an integrated master-slave robotic system for minimally invasive surgery.

BACKGROUND: Minimally invasive surgery (MIS) robots are commonly used in hospitals and medical centres. However, currently available robotic systems are very complicated and huge, greatly raising system costs and the requirements of operating rooms. These disadvantages have become the major impediments to the expansion of MIS robots. METHODS: An integrated MIS robotic system is proposed based on the analysis of advantages and disadvantages of different MIS robots. In the proposed system, the master manipulators, slave manipulators, image display device and control system have been designed as a whole. Modular design is adopted for the control system for easy maintenance and upgrade. The kinematic relations between the master and the slave are also investigated and embedded in software to realize intuitive movements of hand and instrument. Finally, animal experiments were designed to test the effectiveness of the robot. RESULTS: The robot realizes natural hand-eye movements between the master and the slave to facilitate MIS operations. The experimental results show that the robot can realize similar functions to those of current commercialized robots. CONCLUSIONS: The integrated design simplifies the robotic system and facilitates use of the robot. Compared with the commercialized robots, the proposed MIS robot achieves similar functions and features but with a smaller size and less weight.

A monoclonal antibody against human FXYD6.

Previous research has shown that FXYD6 (FXYD domain-containing ion transport regulator 6) is highly increased in bile duct tumor. However, the biological function of FXYD6 is unclear. We aim to prepare and identify a monoclonal antibody against FXYD6, which will be used in diagnostics and as a tool in understanding the role of FXYD6 in pathogenesis of hepatobiliary cancer. In this study, hybridoma cell fusion technology is used for production of FXYD6 monoclonal antibody. BALB/c mice are immunized with FXYD6 synthetic peptide fragment. Hybridoma clones are screened using indirect enzyme-linked immunosorbent assay (ELISA). FXYD6 monoclonal antibody is produced by ascites revulsion. Protein A affinity chromatography is used for the purification of FXYD6 monoclonal antibody. Titer and specificity of monoclonal antibody are assessed by ELISA. Expression of FXYD6 in pancreatic cancer is detected by immunohistochemistry. As a result, one stable hybridoma cell clone producing FXYD6 monoclonal antibody has been established. 2.86 mg monoclonal antibody against FXYD6 with high specificity is prepared with titer of 1:5400. Immunohistochemistry shows that FXYD6 positive staining occurs in the cell membrane of pancreatic cancer, which results in an advantage in investigating the tissue distribution and biological function of FXYD6.

Outcomes of pancreatoduodenectomy with robotic surgery versus open surgery.

BACKGROUND: Pancreatoduodenectomy (PD) for pancreatic cancer is very challenging to many surgeons. Information regarding the advantage of using the Da Vinci robotic system over conventional open surgery for PD is rare. Therefore, a comparison of the outcomes of PD performed using the Da Vinci robotic system with outcomes using open surgery was conducted. METHODS: Between January 2009 and December 2009 sixteen patients underwent PD, eight patients receiving robot-assisted surgery using the Da Vinci surgical robotic system (Group I) and eight being treated using conventional open surgery (Group II). RESULTS: There was no significant difference in radical resection (R0) rate between the two groups, 87.5% vs 100%, P = 0.05. The operative time in group I was longer than in group II, 718 ± 186 vs 420 ± 127 min, P = 0.011, while the surgical blood loss in group I was less than in group II, 153 ± 43 vs 210 ± 53 mL, P = 0.045. The length of bed time and hospital stay after surgery in group I were shorter than in group II, 27.5 ± 7.1 vs 96 ± 18.1 h, P = 0.000; 16.4 ± 4.1 vs 24.3 ± 7.1 days, P = 0.04, respectively). Complication rate of group I was lower than that of group II, 25% vs 75%, P = 0.05. CONCLUSION: It is feasible and safe to perform PD using the Da Vinci robot-assisted surgical system; patients recovered faster postoperatively with less blood loss during surgery.

Complications after pancreaticoduodenectomy for pancreatic cancer: a retrospective study.

Postoperative complications, such as pancreatic fistulae, after pancreaticoduodenectomy for pancreatic cancers are associated with surgical outcomes of patients with pancreatic cancers. A total of 160 patients with pancreatic cancers undergoing pancreaticoduodenectomy were retrospectively analyzed. Patients were grouped into a fistulae group (n = 34) and a nonfistulae group (n = 126). The fistulae group had a significantly higher morbidity rate than the nonfistulae group (P < 0.0001), but hospital mortality was not different in both groups (P = 0.481). There was a higher incidence of intra-abdominal hemorrhage in patients with pancreatic fistulae than in those without fistulae. Two patients in fistulae group underwent reoperation. Patients with pancreatic fistulae had significantly longer hospital stay than those without fistulae. Pancreatic duct diameter, smoking, years of tobaccos consumption, preoperative jaundice, and surgical hours were associated with risk of fistulae on univariate analysis. In a multivariate analysis, diameter of pancreatic duct, surgical hours, and preoperative jaundice were independent risk factors of pancreatic fistulae. Incidence of pancreatic fistulae after pancreaticoduodenectomy is significantly influenced by the size of pancreatic duct diameter, surgical time, and preoperative jaundice. Early postoperative hemorrhage could be cautiously prevented. The survival is not significantly impacted by pancreatic fistulae.