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Abstract Background The purpose of the study was to evaluate renal quality and predict posttransplant graft function using ex vivo sound touch elastography (STE). Methods In this prospective study, 106 donor kidneys underwent ex vivo STE examination and biopsy from March 2022 to August 2023. The mean stiffness of the superficial cortex (STEsc), deep cortex (STEdc), and medulla (STEme) was obtained and synthesized into one index (STE) through the factor analysis method. Additionally, 100 recipients were followed up for 6 months. A random forest algorithm was employed to explore significant predictive factors associated with the Remuzzi score and allograft function. The performance of parameters was evaluated by using the area under the receiver operating characteristic curve (AUC). Results STE had AUC values of 0.803 for diagnosing low Remuzzi and 0.943 for diagnosing high Remuzzi. Meanwhile, STE had an AUC of 0.723 for diagnosing moderate to severe ATI. Random forest algorithm identified STE and Remuzzi score as significant predictors for 6-month renal function. The AUC for STE in predicting postoperative allograft function was 0.717, which was comparable with that of the Remuzzi score (AUC = 0.756). Nevertheless, the specificity of STE was significantly higher than that of Remuzzi (0.913 vs 0.652, p

Abstract Background Malignant liver tumors seriously endanger human health. Among different therapeutic approaches, high‐frequency irreversible electroporation (H‐FIRE) is a recently emerging tumor ablation technique. The objective of this study was to evaluate the feasibility and safety of ultrasound‐guided percutaneous H‐FIRE using four electrode needles in porcine livers. Methods Twelve experimental pigs underwent percutaneous H‐FIRE ablation using a compound steep‐pulse therapeutic device. Liver tissues adjacent to the gallbladder, blood vessels, and bile ducts were selected as the ablation targets. Pigs were randomly divided into three groups: (1) immediately after ablation (N = 4), (2) 2 days after ablation (N = 4), and (3) 7 days after ablation (N = 4). Blood routine, liver and kidney function, and myocardial enzyme levels were measured before and after ablation. Ultrasound, contrast‐enhanced ultrasound (CEUS), contrast‐enhanced magnetic resonance imaging (MRI), and hematoxylin–eosin staining were performed to evaluate the ablation performance. Results Ultrasound‐guided percutaneous H‐FIRE ablations using four electrode needles were successfully performed in all 12 experimental pigs. The general conditions of the pigs, including postoperative activities and feeding behaviors, were normal, with no significant changes compared with the preoperative conditions. The imaging features of ultrasound, CEUS, and MRI demonstrated no significant changes in the gallbladder walls, bile ducts, or blood vessels close to the ablation areas. Laboratory tests showed that liver function indices and myocardial enzymes increased temporarily after H‐FIRE ablation, but decreased to normal levels at 7 days after ablation. Histopathological examinations of porcine liver specimens showed that this technique could effectively ablate the target areas without damaging the surrounding or internal vascular systems and gallbladder. Conclusions This study demonstrated the feasibility and safety of ultrasound‐guided percutaneous H‐FIRE ablation in porcine livers in vivo, and proposed a four‐needle method to optimize its clinical application.

Abstract Background Robotic hepatectomy (RH) has gradually been accepted as it has overcome some of the limitations of open hepatectomy (OH). This study was to compare short-term outcomes in RH and OH for overweight (preoperative body mass index ≥ 25 kg/m²) patients with hepatocellular carcinoma (HCC). Methods Perioperative and postoperative data from these patients who underwent RH or OH between January 2010 and December 2020 were retrospectively analyzed. Propensity score matching (PSM) analysis was performed to determine the impact of RH versus OH on the prognosis of overweight HCC patients. Results All 304 overweight HCC patients were included, 172 who were underwent RH, and 132 who were underwent OH. After the 1:1 PSM, there were 104 patients in both RH and OH groups. After PSM, the RH group of patients had a shorter operative time, less estimated blood loss (EBL), a longer total clamping time, a shorter postoperative length of stay (LOS), less chance of surgical site infection and less rates of blood transfusion (all P

Objective: The da Vinci SP® surgical system offers improvements and refinements for the robotic single-site procedures. Here, we report the first case performing the single-port robotic-assisted left lateral sectionectomy (LLS) for hepatic tumor using the da Vinci SP® surgical system, and demonstrate the safety and technical feasibility of this platform. Methods: A 69-year-old female patient with hepatic tumor underwent single-port robotic-assisted LLS using the da Vinci SP® system at the Chinese People's Liberation Army (PLA) General Hospital on December 27, 2021. And the clinical data, preoperative preparations, surgical procedures, and postoperative recovery of this patients were summarized. Results: The patient with hepatic tumor underwent successful single-port robotic-assisted LLS. The intraperitoneal operation time was 49 minutes and the estimated blood loss was 10 ml. No significant intraoperative complications were observed. The Visual Analogue Scale (VAS) pain intensity score was 3/10 in the immediate postoperative period and 1/10 on postoperative day one. The patient was discharged on postoperative day four. Conclusion: Herein, we report the first case of single-port robotic-assisted LLS for hepatic tumor using da Vinci SP® system, and this operation is technically safe and feasible. The present case indicated that the single-port robotic-assisted surgery is expected to further improve the application prospect of single-port surgery.

Objective: To report the first experience of performing the single-port robotic-assisted hepatic caudate lobectomy via the da Vinci SP® surgical system and demonstrate the safety and technical feasibility of this platform. Methods: A 30-year-old female patient with diagnosis of hepatic hemangioma underwent single-port robotic-assisted caudate lobectomy using the da Vinci SP® system at the Chinese People's Liberation Army (PLA) General Hospital on January 20, 2022. The clinical data, preoperative preparations, surgical procedures, and postoperative recovery of this patient were summarized. Results: The patient underwent single-port robotic-assisted hepatic caudate lobectomy successfully. The intraperitoneal operation time was 97 minutes, and the estimated blood loss was 20 ml. No significant intraoperative complications were observed. The Visual Analogue Scale (VAS) pain intensity score was 3/10 in the immediate postoperative period and 1/10 on postoperative day one. The patient was discharged on postoperative day 2. Conclusion: Herein, we report the first case of single-port robotic-assisted caudate lobectomy using da Vinci SP® system, and this operation in complicated hepatectomy is technically safe and feasible. The present case indicated that the single-port robotic-assisted surgery is expected to further improve the application prospect of single-port surgery.

Abstract Background The surgical management of Mayo III/IV tumor thrombi is difficult and risky, and robotic surgery is even more difficult. The purpose of this study was to introduce the step-by-step and orderly lowering of the height of inferior vena cava tumor thrombus, which was the core technique of robot operation for Mayo III/IV tumor thrombus. Method A total of 18 patients were included in this study. The average tumor thrombus height was 2.4 cm above the level of the second porta hepatis (SPH), and 9 patients were prepared for cardiopulmonary bypass (CPB) before surgery. During the operation, the height of the tumor thrombus was lowered orderly for 2-3 times, and the blood flow blocking method was changed sequentially. The CPB was required when tumor thrombus in the atrium; After the height of the thrombus was lowered to the atrium entrance, CPB was stopped and the blood flow was blocked in the upper- and retro-hepatic inferior vena cava (IVC); After the tumor thrombus continued to descend to the lower part of the SPH, liver blood flow could be restored, and then, the blood flow was simply blocked in the retro-hepatic IVC to complete the removal of the thrombus and the repair or resection of the IVC. Finally, the diseased kidney and renal vein were removed. Results All operations were successfully completed, and 2 cases were transferred to laparotomy. Seven cases received CPB, while the other 11 did not. 15 patients underwent two times of the lowering of the tumor thrombus, 2 patients underwent one time and 1 patient underwent three times. The mean liver/IVC dissociation and vascular suspension time was 22.0 min. All patients had less than Clavien-Dindo grade III complications, no serious complications occurred during operation, and no patient died within 90 days. Conclusions The step-by-step and orderly decline of tumor thrombus height is the key to the success of robot Mayo III / IV tumor thrombus surgery. This method can shorten FPH and CPB time and improve the success rate of surgery.

Objective: To firstly report the single-port robotic-assisted pancreatectomy using the da Vinci SP system and demonstrate the technical feasibility of this platform. Methods: To summarize the clinical data, preoperative preparations, surgical procedures, and postoperative recovery of a female patient with pancreatic serous cystadenoma who underwent single-port robotic-assisted pancreatectomy using the da Vinci SP system in Chinese People’s Liberation Army (PLA) General Hospital on December 24, 2021. Results: The patient underwent successful single-port robotic-assisted pancreatectomy. The operation time was 55 minutes and the estimated blood loss was 20 ml. No significant intraoperative adverse events were observed. The Visual Analogue Scale (VAS) pain intensity score was 3/10 in the immediate postoperative period and 1/10 on postoperative day two. The patient was discharged on postoperative day three with a drainage tube after being confirmed by CT examination that there were no any surgical complications. Conclusion: In conclusion, we first report the single-port pancreatectomy with da Vinci SP system. The successful attempt indicated that the application of single-port robot in uncomplicated pancreas surgery is safe and feasible, but it still needs further clinical practice.

BackgroundHepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide, and CD4+ T lymphocytes can inhibit hepatocarcinogenesis and mediate tumor regression. However, few studies have focused on the prognostic power of CD4+ Tconv-related lncRNAs in HCC patients.MethodWe obtained data from TCGA and GEO databases and identified CD4+Tconv-related lncRNAs in HCC. The risk score was constructed using lasso regression and the model was validated using two validation cohorts. The RS was also assessed in different clinical subgroups, and a nomogram was established to further predict the patients’ outcomes. Furthermore, we estimated the immune cell infiltration and cancer-associated fibroblasts (CAFs) through TIMER databases and assessed the role of RS in immune checkpoint inhibitors response.ResultsWe constructed a CD4+ Tconv-related lncRNAs risk score, including six lncRNAs (AC012073.1, AL031985.3, LINC01060, MKLN1-AS, MSC-AS1, and TMCC1-AS1), and the RS had good predictive ability in validation cohorts and most clinical subgroups. The RS and the T stage were included in the nomogram with optimum prediction and the model had comparable OS prediction power compared to the AJCC. Patients in the high-risk group had a poor immune response phenotype, with high infiltrations of macrophages, CAFs, and low infiltrations of NK cells. Immunotherapy and chemotherapy response analysis indicated that low-risk group patients had good reactions to immune checkpoint inhibitors.ConclusionWe constructed and validated a novel CD4+ Tconv-related lncRNAs RS, with the potential predictive value of HCC patients’ survival and immunotherapy response.

Abstract Stable label movement and smooth label trajectory are critical for effective information understanding. Sudden label changes cannot be avoided by whatever forced directed methods due to the unreliability of resultant force or global optimization methods due to the complex trade-off on the different aspects. To solve this problem, we proposed a hybrid optimization method by taking advantages of the merits of both approaches. We first detect the spatial-temporal intersection regions from whole trajectories of the features, and initialize the layout by optimization in decreasing order by the number of the involved features. The label movements between the spatial-temporal intersection regions are determined by force directed methods. To cope with some features with high speed relative to neighbors, we introduced a force from future, called temporal force, so that the labels of related features can elude ahead of time and retain smooth movements. We also proposed a strategy by optimizing the label layout to predict the trajectories of features so that such global optimization method can be applied to streaming data.

Objective To explore the influence of splenectomy on liver homing and treatment of cirrhosis after adipose tissue derived mesenchymal stem cells (ADSCs) infusion. Methods The rats liver cirrhosis model was established and randomly divided into four groups, sham operation group (sham), sham operation + ADSCs infusion group (ADSCs), splenectomy group (Sp), splenectomy + ADSCs infusion group (Sp+ADSCs). The cell infusion was performed one week after sham or splenectomy. Then, liver function, pathological and homing changes were detected one week later. Results The isolated ADSCs were CD29 positive and underwent adipogenic and chondrogenic differentiation, the hepatic fibrosis area in ADSCs group was significantly smaller than that sham operation group (P＜0.05), and the fibrotic area in Sp+ADSCs group reduced as compared with that ADSCs group(P＜0.05). The expression of collagen Ⅰ mRNA in ADSCs group was significantly decreased as compared with that in sham group(P＜0.05), and mRNA coding collagen Ⅰ in Sp+ADSCs group was further decreased as compared with that in ADSCs group. As compared with ADSCs group[ALT: (280±56)U/L], Sp+ADSCs group [ALT: (213±89)U/L] had a significant difference in inhibiting liver injury (P＜0.05); Ex vitro fluorescence imaging showed that the fluorescence signal intensity in liver tissue of the Sp+ADSCs was significantly higher than that in ADSCs group (P＜0.05). Conclusions Splenectomy can significantly improve the live homing of ADSCs and improve their therapeutic effect on liver cirrhosis.

Abstract Background There is little objective information concerning the effect of steam-flaked grains on foal’s growth performance and faecal microbiota. To determine the effects of steam-flaked grains on foal’s growth performance and faecal microbiota, faecal samples were collection from 18 foals which had been fed either corn, oat or barley diets over the 60 days of the experiment. Body weight and conformation measurements were collected. Next-generation sequencing of the V3 + V4 region of the 16 S rRNA gene was used to assess the microbial composition of faeces. Alpha diversity, Venn graph, Relative abundance and beta diversity are presented. Results There was a significantly higher larger increase in the body weight of those foals fed barley compared to either corn or oats. There were also significant changes in the Alpha diversity of the gut microbiota. The Shannon and Simpson indices were significantly higher in the barley fed group than those fed corn or oats. The Chao1 index was significantly higher in the oat fed group than the corn or barley fed groups. There were significant changes in the relative abundance of bacteria in the microbiota in terms of phylum, family and genus. The histogram of LDA value distribution showed that the 12 statistically different biomarkers of the bacteria were present. Tax4Fun function annotation clustering heat map showed that functional information was detected from 26 species of bacteria in faecal samples from the foals. Conclusions Differences by starch sources were found in overall growth of the foals and in the faecal microbiota if either supplementary corn, oat or barley was fed. Further studies are required to determine the potential impact of the changes in the microbiota on the health and development of foals fed cereal starch of different sources.

ObjectiveThis study aimed to explore the molecular mechanism of cytoplasmic vacuolation caused by BK polyomavirus (BKPyV) and thus search for potential target for drug repurposing.MethodsMorphological features of BK polyomavirus-associated nephropathy (BKPyVAN) were studied under light and electron microscopes. Microarray datasets GSE75693, GSE47199, and GSE72925 were integrated by ComBat, and differentially expressed genes (DEGs) were analyzed using limma. Furthermore, the endoplasmic reticulum (ER)-related genes obtained from GenCLiP 2.0 were intersected with DEGs. GO and KEGG enrichment pathways were performed with intersection genes by R package clusterProfiler. The single-cell RNA sequencing (scRNA-seq) from a BKPyVAN recipient was analyzed with a dataset (GSE140989) downloaded from Gene Expression Omnibus (GEO) as control for gene set variation analysis (GSVA). Immunohistochemistry and electron microscopy of kidney sections from drug-induced ERS mouse models were performed to explore the association of ERS and renal tubular vacuolation. Protein–protein interaction (PPI) network of the intersection genes was constructed to identify hub target. AutoDock was used to screen Food and Drug Administration (FDA)-approved drugs that potentially targeted hub gene.ResultsLight and electron microscopes exhibited obvious intranuclear inclusions, vacuoles, and virus particles in BKPyV-infected renal tubular cells. Transcriptome analysis revealed 629 DEGs between samples of BKPyVAN and stable transplanted kidneys, of which 16 were ER-associated genes. GO analysis with the intersection genes illustrated that ERS-related pathways were significantly involved, and KEGG analysis showed a prominent enrichment of MAPK, Toll-like receptor, and chemokine signaling pathways. GSVA analysis of the proximal tubule revealed similar pathways enrichment. An electron microscope image of the kidney from ERS mouse models showed an obvious renal tubular vacuolation with prominent activation of ERS markers verified by immunohistochemistry. Furthermore, DDIT3 was identified as the hub gene based on PPI analysis, and ZINCOOOOO1531009 (Risedronate) was indicated to be a potential drug for DDIT3.ConclusionERS was involved in renal tubular cytoplasmic vacuolation in BKPyVAN recipients. Risedronate was screened as a potential drug for BKPyVAN by targeting DDIT3.

BackgroundBK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) causes renal allograft dysfunction and graft loss. However, the mechanism of BKPyV replication after kidney transplantation is unclear. Clinical studies have demonstrated that immunosuppressants and renal ischemia–reperfusion injury (IRI) are risk factors for BKPyV infection. Studying the pathogenic mechanism of BKPyV is limited by the inability of BKPyV to infect the animal. Mouse polyomavirus (MPyV) is a close homolog of BKPyV. We used a model of MPyV infection to investigate the core genes and underlying mechanism of IRI and immunosuppressants to promote polyomavirus replication.Materials and MethodsOne-day-old male C57BL/6 mice were intraperitoneally injected with MPyV. At week 9 post-infection, all mice were randomly divided into IRI, immunosuppressant, and control groups and treated accordingly. IRI was established by clamping the left renal pedicle. Subsequently, kidney specimens were collected for detecting MPyV DNA, histopathological observation, and high-throughput RNA sequencing. Weighted gene correlation network analysis (WGCNA), protein–protein interaction network analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to screen for core genes and common signaling pathways involved in promoting MPyV replication by IRI and immunosuppressants.ResultsAfter primary infection, MPyV established persistent infection in kidneys and subsequently was significantly increased by IRI or immunosuppressant treatment individually. In the IRI group, viral loads peaked on day 3 in the left kidney, which were significantly higher than those in the right kidney and the control group. In the immunosuppressant group, viral loads in the left kidney were significantly increased on day 3, which were significantly higher than those in the control group. Protein–protein interaction network analysis and WGCNA screened complement C3, epidermal growth factor receptor (EGFR), and FN1 as core genes. Pathway enrichment analysis based on the IRI- or immunosuppressant-related genes selected by WGCNA indicated that the NF-κB signaling pathway was the main pathway involved in promoting MPyV replication. The core genes were further confirmed using published datasets GSE47199 and GSE75693 in human polyomavirus-associated nephropathy.ConclusionsOur study demonstrated that IRI and immunosuppressants promote polyomavirus replication through common molecular mechanisms. In future studies, knockdown or specific inhibition of C3, EGFR, FN1, and NF-κB signaling pathway will further validate their critical roles in promoting polyomavirus replication.

Abstract Background Suturing the proximal pancreatic stump and performing pancreaticoenterostomy for the distal pancreatic stump following central pancreatectomy is a conventional procedure. This reconstruction after resection of the pathological pancreatic lesion brings changes in anatomy and physiology. In this study, an innovative one-stage robotic end-to-end pancreatic anastomosis was reported to replace the conventional pancreaticoenterostomy following central pancreatectomy. Materials and methods The clinical data of 11 consecutive patients who underwent robotic central pancreatectomy with end-to-end pancreatic anastomosis between August 2017 and December 2017 were analyzed retrospectively. Results All operations were completed successfully without any conversion to open surgery. Nine patients had benign tumors, one had a mass-forming chronic pancreatitis, and one had an isolated pancreatic metastasis from a renal cancer. The mean gap left after central pancreatectomy was 4.3 ± 1.0 cm. The median operative time was 121 (range, 105 to 199) min. The median blood loss was 50 (range, 20 to 100) ml. Seven (63.6%) patients developed complications which included Clavien–Dindo Grade I complications in five patients, a Grade II complication in one patient, and a Grade IIIa complication in one patient. Seven patients developed a Grade B postoperative pancreatic fistula, and two patients a biochemical leak. There was no Grade C or worse pancreatic fistula. Magnetic resonance cholangiopancreatography at postoperative 6 months showed no stricture in any of the main pancreatic ducts. Three patients had an asymptomatic and small pancreatic pseudocyst. Conclusion Robotic central pancreatectomy with end-to-end pancreatic anastomosis was safe and feasible. It restores the normal anatomy of the pancreas. With its good short-and long-term outcomes, it could be an alternative reconstructive method to pancreaticoenterostomy following central pancreatectomy.

Abstract Background An insulinoma is a functional neuroendocrine pancreatic tumor, and surgical resection is indicated. Robot-assisted laparoscopic surgeries have been shown to be generally safe and feasible for treatment of pediatric cases of urologic and digestive disease. Case presentation In July 2016, a 9-year-old girl (24 kg, 120 cm) was admitted with a pancreatic tail insulinoma and underwent robot-assisted spleen-preserving laparoscopic distal pancreatectomy. The total procedure time was 155 min, and the blood loss was about 10 ml. The patient recovered without complications. Conclusions This case supports that robot-assisted spleen-preserving laparoscopic distal pancreatectomy may be safe and feasible in pediatric insulinoma patients.

The silkworm, Bombyx mori Linnaeus, is an important economic insect and a representative model organism of Lepidoptera, which has been widely used in the study of reproduction and development. The development of the silkworm’s reproductive gland is easily affected by many external factors, such as chemical insecticides. After the silkworm larvae were treated with different concentrations of pyriproxyfen, the results showed that the number of eggs and hatching rate of eggs in the silkworm can be reduced by pyriproxyfen, and the concentration effects were displayed. Pyriproxyfen exposure could affect the normal development of the ovary tissue by reducing the number of oocytes and oogonia in the ovaries of silkworm fed with pyriproxyfen. We employed qRT-PCR, to detect the expressions of genes related to ovary development (Vg, Ovo, Otu, Sxl-S and Sxl-L) and hormone regulation (EcR and JHBP2) in silkworm. Our study showed that the transcription levels of Vg, Ovo, Otu, Sxl-S and Sxl-L in the treatment group were lower than those in the control group (6.08%, 61.99%, 83.51%, 99.31% and 71.95%, respectively). The transcription level of ECR was 70.22% for the control group, while that of JHBP2 was upregulated by 3.92-fold. Changes of transcription levels of these genes caused by pyriproxyfen exposure ultimately affect the absorption of nutrients, energy metabolism, ovary development and egg formation of the silkworm, thus leading to reproductive disorders of the silkworm. In general, our study revealed the response of silkworm reproduction to pyriproxyfen exposure and provided a certain reference value for the metabolism of the silkworm to pyriproxyfen.

Due to its portability, convenience, and low cost, incompletely closed near-infrared (ICNIR) imaging equipment (mixed light reflection imaging) is used for ultra thin sensor modules and have good application prospects. However, equipment with incompletely closed structure also brings some problems. Some finger vein images are not clear and there are sparse or even missing veins, which results in poor recognition performance. For these poor quality ICNIR images, however, there is additional fingerprint information in the image. The analysis of ICNIR images reveals that the fingerprint and finger vein in a single ICNIR image can be enhanced and separated. We propose a feature-level fusion recognition algorithm using a single ICNIR finger image. Firstly, we propose contrast limited adaptive histogram equalization (CLAHE) and grayscale normalization to enhance fingerprint and finger vein texture, respectively. Then we propose an adaptive radius local binary pattern (ADLBP) feature combined with uniform pattern to extract the features of fingerprint and finger vein. It solves the problem that traditional local binary pattern (LBP) is unable to describe the texture features of different sizes in ICNIR images. Finally, we fuse the feature vectors of ADLBP block histogram for a fingerprint and finger vein, and realize feature-layer fusion recognition by a threshold decision support vector machine (T-SVM). The experimentation results showed that the performance of the proposed algorithm was noticeably better than that of the single model recognition algorithm.

This multicenter, randomized, placebo-controlled study evaluated the efficacy and side effects of parecoxib during patient-controlled epidural analgesia (PCEA) after abdominal hysterectomy.A total of 240 patients who were scheduled for elective abdominal hysterectomy under combined spinal-epidural anesthesia received PCEA plus postoperative intravenous parecoxib 40 mg or saline every 12 h for 48 h after an initial preoperative dose of parecoxib 40 mg or saline. An epidural loading dose of a mixture of 6 mL of 0.25% ropivacaine and 2 mg morphine was administered 30 min before the end of surgery, and PCEA was initiated using 1.25 mg/mL ropivacaine and 0.05 mg/mL morphine with a 2-mL/h background infusion and 2-mL bolus with a 15-min lockout. The primary end point of this study was the quantification of the PCEA-sparing effect of parecoxib.Demographic data were similar between the two groups. Patients in the parecoxib group received significantly fewer self-administrated boluses (0 (0, 3) vs. 7 (2, 15), P < 0.001) and less epidural morphine (5.01 ± 0.44 vs. 5.95 ± 1.29 mg, P < 0.001) but experienced greater pain relief compared with the control group (P < 0.001). Patient global satisfaction was higher in the parecoxib group than the control group (P < 0.001). Length of hospitalization (9.50 ± 2.1, 95% CI 9.12~9.88 vs. 10.41 ± 2.6, 95% CI 9.95~10.87, P = 0.003) and postoperative vomiting (17% vs. 29%, P < 0.05) were also reduced in the parecoxib group. There were no serious adverse effects in either group.Our data suggest that adjunctive parecoxib during PCEA following abdominal hysterectomy is safe and efficacious in reducing pain, requirements of epidural analgesics, and side effects.ClinicalTrials.gov (NCT01566669).

The silkworm, Bombyx mori, an economically important insect, is also used as a model insect for investigation. However, pesticide exposure often causes huge economic losses to the sericulture. The fat body is an important intermediate metabolic tissue, which is involved in detoxification in insects. In this study, high-throughput transcriptome sequencing was performed to investigate the gene expression differences between two silkworm strains with different susceptibility after exposure to fenvalerate. The results showed that a total of 2363 differentially expressed genes were detected in the Lan5 DGE library and 1611 were detected in the Mysore DGE library, respectively. The possible functions of all DEGs were determined using the gene ontology (GO) classification system. Pathway enrichment analysis was carried out using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Furthermore, some selected differentially expressed genes (DEGs) were verified by qRT-PCR. Our results can facilitate the overall understanding of the mechanism of silkworm's tolerance to pesticides and provide a new control strategy of Lepidoptera pests. [ABSTRACT FROM AUTHOR]

Cervical spondylosis is a kind of frequently occurring and refractory disease with high recurrence rate and tends to be younger. It has become a multiple refractory disease at home and abroad, and its mechanism research and clinical diagnosis and treatment are still controversial. This article will discuss the etiology, pathogenesis, mechanism and treatment of cervical spondylosis from ancient Chinese medicine and modern western medicine, and focus on the research progress of modern prevention and treatment of cervical spondylosis, in order to provide reference for modern clinical treatment of cervical spondylosis. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide and has a very poor prognosis. Its occurrence has been on the increase in recent years. Surgical resection and liver transplantation are the primary methods of treatment for HCC patients, but can only be applied to 15% of patients. The median survival time of unresectable or metastasizing HCC patients is only a few months. Existing systemic treatment methods are not effective for advanced HCC patients and a new method of treatment is needed for these patients. It has been established that the HCC occurs in multiple stages, however, the pathogenesis at a molecular level is not clear and many key factors are yet to be determined. In the past 30 years, it has become evident that the Ras/Raf/MEK/extracellular signal-regulated k inase (ERK) signaling pathway plays a significant role in the occurrence and development of HCC. This review focused on the association between the Ras/Raf/MEK/ERK signaling pathway and HCC. [ABSTRACT FROM AUTHOR]

Stereoselective reduction of C-20 ketone of vitamin D CD-ring precursor using Corey's CBS reagents, (R)-(+)-2-methyl-CBS-oxazaborolidine and (S)-(-)-2-methyl-CBS-oxazaborolidine, led to the (20S)-alcohol 5 and (20R)-epimer 4 in approximately 17:1 selectivity. A new synthetic approach to the 22-oxa-25-hydroxy Grundmann's ketone 11 was developed through the Williamson etherification of (20S)-alcohol 5 with 1-bromomethyl-2,2-dimethyloxirane, followed by regioselective reductive epoxide ring opening with LiAlH4, the removal of the silyl protecting group by TBAF, and the environmentally benign TEMPO-mediated oxidation using inexpensive Oxone as a co-oxidizing agent. The preparation of drug maxacalcitol was achieved on gram scale by the convergent Lythgoe coupling via Wittig-Horner reaction of the A-ring phosphine oxide synthon with the CD-ring fragment. [ABSTRACT FROM AUTHOR]

In the present study, high-quality apatite-type La9.33Ge6O26 powders are successfully synthesized by a facile molten-salt synthesis method (MSSM) at low temperatures, using LiCl, LiCl/NaCl mixture (mass ratio 1:1) as molten salt, respectively. Experimental results indicate that the optimal mass ratio between reactant and molten salt is 1:2, and LiCl/NaCl mixed molten-salt is more beneficial for forming high-quality La9.33Ge6O26 powders than LiCl individual molten-salt. Comparing with the conventional solid-state reaction method (SSRM), the synthesis temperature of apatite-type La9.33Ge6O26 powders using the MSSM decreases more than 350 °C, which can effectively avoid Ge loss in the preparation process of precursor powders. Furthermore, the powders obtained by the MSSM are homogeneous, non-agglomerated and well crystallized, which are very favorable for gaining dense pellets in the premise of avoiding Ge loss. On the basis of high-quality precursor powders, the dense and pure ceramic pellets of La9.33Ge6O26 are gained at a low temperature of 1100 °C for 2 h, which exhibit higher conductivities (, and lower activation energies (, ) than that synthesized by the SSRM. [ABSTRACT FROM AUTHOR]