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Bile duct injury repair — earlier is not better

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《医学前沿（英文）》 2015年第9卷第4期页码 508-511 doi: 10.1007/s11684-015-0418-7

摘要：

Bile duct injury is a common complication of cholecystectomy. The timing of bile duct injury repair remains controversial. A recent review conducted in France reported 39% complications and 64% failure after immediate repair in 194 patients compared with 14% complications and 8% failure after late repair in 133 patients. A national review of 139 consecutive early repairs conducted at five hepatopancreaticobiliary centers in Denmark reported 4% mortality, 36% morbidity, and 42 restrictures (30%) at a median follow-up of 102 months, and only 64 patients (46%) demonstrated uneventful short-term and long-term outcomes. Most patients with bile duct injury present with bile leak and sepsis; thus, early repair is not recommended. Percutaneous drainage of bile and endoscopic stenting are the mainstays of treatment of bile leak because they convert acute bile duct injury into a controlled external biliary fistula. The ensuing benign biliary stricture should be repaired by a biliary surgeon after a delay of 4–6 weeks once the external biliary fistula has closed.

关键词： bile duct injury cholecystectomy laparoscopic cholecystectomy

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Strategies of minimally invasive treatment for intrahepatic and extrahepatic bile duct stones

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《医学前沿（英文）》 2017年第11卷第4期页码 576-589 doi: 10.1007/s11684-017-0536-5

摘要：

Cholelithiasis is a kind of common and multiple diseases. In recent years, traditional laparotomy has been challenged by a minimally invasive surgery. Through literature review, the therapeutic method, effect, and complications of minimally invasive treatment of intrahepatic and extrahepatic bile duct stones by combining our practical experience were summarized as follows. (1) For intrahepatic bile duct stones, the operation may be selected by laparoscopic liver resection, laparoscopic common bile duct exploration (LCBDE), or percutaneous transhepatic cholangioscopy. (2) For concomitant gallstones and common bile duct stones, the surgical approach can be selected as follows: laparoscopic cholecystectomy (LC) combined with endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilatation, LC plus laparoscopic transcystic common bile duct exploration, LC plus LCBDE, and T-tube drainage or primary suture. (3) For concomitant intrahepatic and extrahepatic bile duct stones, laparoscopic liver resection, choledochoscopy through the hepatic duct orifice on the hepatectomy cross section, LCBDE, EST, and percutaneous transhepatic cholangioscopic lithotripsy could be used. According to the abovementioned principle, the minimally invasive treatment approach combined with the surgical technique and equipment condition will be significant in improving the therapeutic effect and avoiding the postoperative complications or hidden dangers of intrahepatic and extrahepatic bile duct stones.

关键词： laparoscopy choledochoscopy duodenoscopy cholelithiasis minimally invasive treatment

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Effects of hydralazine and valproate on the expression of E-cadherin gene and the invasiveness of QBC

Hong LI, Shaoqin CHEN, Yi SHU, Yongjun CHEN, Ying SU, Xin WANG, Shengquan ZOU

《医学前沿（英文）》 2009年第3卷第2期页码 153-157 doi: 10.1007/s11684-009-0034-5

摘要： To clarify the effect of DNA methylation and histone deacetylase inhibitors on the expression of the E-cadherin gene and the invasiveness of the QBC cells, the QBC cells were separately treated with hydralazine, valproate, or combination of the two drugs. The mRNA expression of E-cadherin was examined with reverse transcription-polymerase chain reaction (RT-PCR), the protein of the gene with Western blotting. The methylation status of the promoter region of the gene was detected with methylation-specific PCR (MSP). The invasiveness of QBC cells was detected with transwell assay. It was found that the promoter region of the E-cadherin gene of QBC cells was hypermethylated. Valproate alone could not contribute to demethylation of the gene, whereas hydralazine could make them to be partly demethylated. However, the methylation status of the gene could be thoroughly reversed by using valproate and hydralazine in combination. What’s more, it was confirmed that the E-cadherin gene of QBC cells could not be transcriptionally reactivated by Valproate alone, whereas hydralazine alone could induce moderate reexpression of the gene. However, using valproate and hydralazine in combination could result in robust reexpression of the E-cadherin gene ( =0.000). Likewise, the invasiveness of the QBC939 cells was sharply decreased by treatment with two drugs in combination and slightly decreased with one drug alone. It could be concluded that the two drugs have synergistic effect on the demethylation and reexpression of the E-cadherin gene of QBC cells, and also on the reduction of the invasiveness of the QBC939 cells.

关键词： DNA methylation inhibitor histone deacetylase inhibitor bile duct carcinoma E-cadherin

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A giant Müllerian duct cyst in the perineum: a case report

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《医学前沿（英文）》 2012年第6卷第4期页码 440-443 doi: 10.1007/s11684-012-0222-6

摘要：

The authors present a case report of a giant Müllerian duct cyst in the perineum. A 37-year-old man presented with a mass with the size of 50 cm×40 cm×30 cm in the perineum. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the pelvis and perineum found a huge multilocular cystic mass. X-ray film of the pelvis showed a giant soft-tissue shadow of high density in the perineum. Voiding cystourethrogram did not show any cyst interlinked to posterior urethra. After related examinations, the patient underwent open surgical resection of the cyst. Pathologic examination confirmed the presence of a Müllerian duct cyst. Huge Müllerian duct cyst is uncommon in clinic. Treatments of Müllerian duct cysts depend on their sizes and symptoms.

关键词： Müllerian duct cyst clinical symptoms diagnosis

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Bile acids and their effects on diabetes

Cynthia Rajani, Wei Jia

《医学前沿（英文）》 2018年第12卷第6期页码 608-623 doi: 10.1007/s11684-018-0644-x

摘要： Diabetes is a widespread, rapidly increasing metabolic disease that is driven by hyperglycemia. Early glycemic control is of primary importance to avoid vascular complications including development of retinal disorders leading to blindness, end-stage renal disease, and accelerated atherosclerosis with a higher risk of myocardial infarction, stroke and limb amputations. Even after hyperglycemia has been brought under control, “metabolic memory,” a cluster of irreversible metabolic changes that allow diabetes to progress, may persist depending on the duration of hyperglycemia. Manipulation of bile acid (BA) receptors and the BA pool have been shown to be useful in establishing glycemic control in diabetes due to their ability to regulate energy metabolism by binding and activating nuclear transcription factors such as farnesoid X receptor (FXR) in liver and intestine as well as the G-protein coupled receptor, TGR5, in enteroendocrine cells and pancreatic -cells. The downstream targets of BA activated FXR, FGF15/21, are also important for glucose/insulin homeostasis. In this review we will discuss the effect of BAs on glucose and lipid metabolism and explore recent research on establishing glycemic control in diabetes through the manipulation of BAs and their receptors in the liver, intestine and pancreas, alteration of the enterohepatic circulation, bariatric surgery and alignment of circadian rhythms.

关键词： bile acids metabolic memory diabetes circadian rhythm bariatric surgery

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Diagnosis and treatment of thyroglossal duct carcinoma: Report of three cases with review of literatures

GAO Yan, CHEN Yan, SUN Zhipeng, GUO Chuanbin, YU Guangyan, ZHAN Yi

《医学前沿（英文）》 2008年第2卷第1期页码 58-62 doi: 10.1007/s11684-008-0011-4

摘要： Thyroglossal duct carcinoma, which is usually diagnosed postoperatively, is a rare malignant tumor arising in the thyroglossal duct cyst. The definitive diagnosis can be made only after microscopic examination. We retrospectively reviewed three cases of thyroglossal duct carcinoma diagnosed in Peking University School and Hospital of Stomatology from January 1986 to August 2006. Clinical and pathological features were investigated and the optimal treatment protocol was proposed. The constituent ratio of thyroglossal duct carcinoma among surgically excised thyroglossal duct lesions was 2.9%. The clinical presentation of thyroglossal duct carcinoma was very similar to that of its benign counterpart. Two cases were diagnosed as thyroglossal duct cyst prior to the operation, the remaining one as dermoid cyst. All three cases were diagnosed as papillary carcinoma of thyroid origin after microscopic examination. Primary thyroglossal duct carcinoma should conform to the following criteria: localization of the carcinoma to a clearly demonstrable thyroglossal duct cyst or tract; clinically or histologically confirmed absence of carcinoma of the thyroid gland. Papillary carcinoma is the most common histological type, which usually develops slowly with an excellent prognosis. The histological characteristics including: formation of papillary structure; nuclear morphological variations such as ground glass nuclei, pseudoinclusions, intranuclear grooves and filaments; concentrically calcified structures termed psammoma bodies which is regarded as a strong indication of papillary carcinoma; and positivity in immunohistological staining for thyroglobin. Sistrunk procedure of excision is the choice for treatment. A close follow-up is needed. In the presence of thyroid gland masses or cervical lymphadenopathy, thyroidectomy or neck dissection should be recommended. The effect of thyroid suppression therapy and radioactive iodine therapy is not conclusive.

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Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid

《医学前沿（英文）》 2021年第15卷第6期页码 887-902 doi: 10.1007/s11684-021-0879-9

摘要： Monocarboxylic acid transporter 1 (MCT1) maintains axonal function by transferring lactic acid from oligodendrocytes to axons. Subarachnoid hemorrhage (SAH) induces white matter injury, but the involvement of MCT1 is unclear. In this study, the SAH model of adult male Sprague-Dawley rats was used to explore the role of MCT1 in white matter injury after SAH. At 48 h after SAH, oligodendrocyte MCT1 was significantly reduced, and the exogenous overexpression of MCT1 significantly improved white matter integrity and long-term cognitive function. Motor training after SAH significantly increased the number of ITPR2⁺SOX10⁺ oligodendrocytes and upregulated the level of MCT1, which was positively correlated with the behavioral ability of rats. In addition, miR-29b and miR-124 levels were significantly increased in SAH rats compared with non-SAH rats. Further intervention experiments showed that miR-29b and miR-124 could negatively regulate the level of MCT1. This study confirmed that the loss of MCT1 may be one of the mechanisms of white matter damage after SAH and may be caused by the negative regulation of miR-29b and miR-124. MCT1 may be involved in the neurological improvement of rehabilitation training after SAH.

关键词： microRNAs monocarboxylate transporter 1 motor training subarachnoid hemorrhage white matter injury

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Risk factors of prognosis after acute kidney injury in hospitalized patients

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《医学前沿（英文）》 2017年第11卷第3期页码 393-402 doi: 10.1007/s11684-017-0532-9

摘要：

The risk factors, especially laboratory indicators, of prognosis after acute kidney injury (AKI) remain unclear. We conducted a retrospective survey of Chinese People’s Liberation Army General Hospital from January 1, 2012 to December 31, 2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes. The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis. Among 77 662 cases of hospitalized patients, 1387 suffered from AKI. The incidence rate and mortality of AKI were 1.79% and 14.56%, respectively. Multivariate logistic regression analysis revealed that high AKI stage, age greater than 80 years, neoplastic disease, low cardiac output, increased white blood cell count, and decreased platelet count and serum albumin levels were the risk factors affecting the mortality of AKI patients. Conversely, body mass index between 28 and 34.9 was a protective factor. Increased AKI stage, tumor disease, post-cardiopulmonary resuscitation, and RRT were the risk factors of renal function recovery upon discharge. In addition to traditional risk factors, white blood cell count, platelet count, albumin, and BMI were the predictors of the mortality of AKI patients. No laboratory indicators were found to be the risk factors of renal function recovery in AKI patients.

关键词： acute kidney injury risk factors prognosis

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Leonurine protects ischemia-induced brain injury via modulating SOD, MDA and GABA levels

Shilei ZHENG, Jingru ZHU, Jiao LI, Shuang ZHANG, Yunfei MA

《农业科学与工程前沿（英文）》 2019年第6卷第2期页码 197-205 doi: 10.15302/J-FASE-2018245

摘要：

The present study was designed to investigate the protective effects of leonurine, a compound purified from that is active on ischemic rat behavior and cortical neurons, and explore the underlying mechanism. The general rat activity, cortical neuron morphology, superoxide dismutase (SOD), malondialdehyde (MDA), -aminobutyric acid (GABA) and glutamate decarboxylase 67 (GAD67) levels were measured. We found leonurine significantly improve the general activity of rats in an open-field test, which was associated with attenuated neuronal damage induced by ischemia. Moreover, serum SOD activity was significantly greater, MDA level lower in the leonurine group as compared with ischemia group. In addition, GABA content in the cerebral cortex was significantly greater in high-dose leonurine group. Correspondingly, GAD67 protein level coincided with the GABA level. Taken together, our results demonstrated that leonurine attenuated brain injury during ischemia via antioxidative and anti-excitotoxicity effects by targeting GABA and leonurine might become a useful adjuvant neuroprotective agent.

关键词： cerebral ischemia GABA neuroprotection leonurine SOD

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Artificial Bear Bile: A Novel Approach to Balancing Medical Requirements and Animal Welfare

Yong Li,Yuhong Huang,Nan Feng,Heping Zhang,Jing Qu,Shuanggang Ma,Yunbao Liu,Jiang Li,Shaofeng Xu,Ling Wang,Mi Zhang,Jie Cai,Weiping Wang,Ru Feng,Hang Yu,Bo Yu,Dailiang Liang,Heping Qin,Suxiang Luo,Yanfen Li,

《工程（英文）》 doi: 10.1016/j.eng.2023.09.017

摘要： Bear bile has been a valuable and effective medicinal material in traditional Chinese medicine (TCM) for over 13 centuries. However, the current practice of obtaining it through bear farming is under scrutiny for its adverse impact on bear welfare. Here, we present a new approach for creating artificial bear bile (ABB) as a high-quality and sustainable alternative to natural bear bile. This study addresses the scientific challenges of creating bear bile alternatives through interdisciplinary collaborations across various fields, including resources, chemistry, biology, medicine, pharmacology, and TCM. A comprehensive efficacy assessment system that bridges the gap between TCM and modern medical terminology has been established, allowing for the systematic screening of therapeutic constituents. Through the utilization of chemical synthesis and enzyme engineering technologies, our research has achieved the environmentally friendly, large-scale production of bear bile therapeutic compounds, as well as the optimization and recomposition of ABB formulations. The resulting ABB not only closely resembles natural bear bile in its composition but also offers advantages such as consistent product quality, availability of raw materials, and independence from threatened or wild resources. Comprehensive preclinical efficacy evaluations have demonstrated the equivalence of the therapeutic effects from ABB and those from commercially available drained bear bile (DBB). Furthermore, preclinical toxicological assessment and phase Ⅰ clinical trials show that the safety of ABB is on par with that of the currently used DBB. This innovative strategy can serve as a new research paradigm for developing alternatives for other endangered TCMs, thereby strengthening the integrity and sustainability of TCM.

关键词： Artificial bear bile Chemical profile Formula optimization Pharmacodynamic consistency Preclinical toxicological assessment

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Progress and perspectives of neural tissue engineering

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《医学前沿（英文）》 2015年第9卷第4期页码 401-411 doi: 10.1007/s11684-015-0415-x

摘要：

Traumatic injuries to the nervous system lead to a common clinical problem with a quite high incidence and affect the patient’s quality of life. Based on a major challenge not yet addressed by current therapeutic interventions for these diseases, a novel promising field of neural tissue engineering has emerged, grown, and attracted increasing interest. This review provides a brief summary of the recent progress in the field, especially in combination with the research experience of the author’s group. Several important aspects related to tissue engineered nerves, including the theory on their construction, translation into the clinic, improvements in fabrication technologies, and the formation of a regenerative environment, are delineated and discussed. Furthermore, potential research directions for the future development of neural tissue engineering are suggested.

关键词： nerve injury tissue engineering nerve grafts

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Protective effect of N-acetylcysteine against lipopolysaccharide injury in hepatocytes of neonatal mice

WANG Lin, LIU Yalan, XU Jianbo, TIAN Yuan, WU Heshui

《医学前沿（英文）》 2008年第2卷第2期页码 182-185 doi: 10.1007/s11684-008-0034-x

摘要： The present study provides supportive evidence for the effective prevention and treatment of lipopolysaccharide (LPS)-induced hepatocyte injury in neonatal mice by N-acetylcysteine (NAC). Hepatocytes of neonatal mice were obtained through collagenase digestion of the liver. The hepatocytes were treated either with LPS (10 ?g/mL) alone or with NAC (5 mmol/L) for 1 h before the addition of LPS (10 ?g/mL). After LPS treatment, 12 wells of the cultured hepatocytes and supernatants were harvested at 0, 6, and 12 h, respectively. Levels of alanine aminotransferase (ALT) and nitric oxide (NO) in the supernatant were biochemically quantified and reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the expression of inducible nitric oxide synthase (iNOS) mRNA after different treatments. At 0 h following the treatment of primary cultured hepatocytes with LPS, the levels of ALT, NO and iNOS mRNA in the supernatant were (21.1 ± 4.78) u/L, (1.6 ± 0.31) ?mol/L and 0.17 ± 0.023, respectively; at 6 h, (59.8 ± 8.59) u/L, (6.6 ± 0.81) ?mol/L, and 0.71 ± 0.091; and at 12 h, (89.6 ± 15.30) u/L, (7.8 ± 1.01) ?mol/L, and 0.71 ± 0.097. The levels of ALT, NO and iNOS mRNA at 6 and 12 h increased significantly, compared to those at 0 h ( < 0.01). In contrast to LPS treatment alone, pretreatment with NAC before LPS addition significantly reduced the levels of ALT, NO and iNOS mRNA in the supernatant at 6 h to (40.8 ± 7.30) u/L, (3.2 ± 0.71) ?mol/L, and 0.41 ± 0.060; and at 12 h to (55.4 ± 5.48) u/L, (4.0 ± 0.71) ?mol/L, and 0.40 ± 0.067, respectively ( < 0.01). However, the levels of ALT, NO and iNOS mRNA at 0 h did not change significantly with both treatment approaches. NAC has protective effects in hepatocytes of neonatal mice against LPS-induced injury as shown by the reduced levels of ALT, NO and iNOS mRNA when primary hepatocytes were treated with NAC prior to LPS stimulation. We postulate that NAC exhibits its protective function by inhibiting LPS-induced transcription of iNOS, resulting in decreased levels of NO.

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Effect of oxytocin on gastric ischemia-reperfusion injury in rats

ZHANG Wenwen, ZHANG Jianfu, ZHANG Yongmei, XU Ming

《医学前沿（英文）》 2007年第1卷第4期页码 433-437 doi: 10.1007/s11684-007-0085-4

摘要： The effect of peripherally administered oxytocin (OT) on gastric ischemia-reperfusion injury (GI-RI) and its possible mechanism were investigated. The Sprague-Dawley (SD) rats were randomly divided into different treatment groups ( = 6). The animal GI-RI model was established by clamping the celiac artery for 30 min to induce ischemia and then released to allow reperfusion for 1 h, and the degree of GI-RI was assessed by scoring the gastric mucosal damage index (GMDI), the gastric fluid output, gastric fluid output, gastric acidity were measured and the surgical preparations of vagotomy and sympathectomy were used to investigate the possible mechanism of OT on GI-RI. The results were as follows. Compared with the control group (NS plus GI-R only, GMDI 121.33±10.40, = 6), the intra peritoneal (ip) administration of oxytocin (20, 100 μg/0.5 mL) obviously attenuated GI-RI (<0.05), GMDI were 82.33±14.26, 53.5±5.58 respectively ( = 6); the gastric fluid output and the gastric acidity (evaluated by pH) of the control group were (430.17±87.36) μL, 1.55±0.25 ( = 6), and those of the OT group were (102.45±48.00) μL, 2.65±0.40 ( = 6) res pectively; differences had statistical significance (<0.01). The effect of oxytocin was reversed by atosiban, a selective oxytocin receptor antagonist. The GMDI of the group given atosiban 10 min before OT was 138.17±24.06 ( = 6), which had no significant difference with the control group. Oxytocin further attenuated GI-RI after vagotomy and sympathectomy (GMDI 6.83±8.89, 29.67±5.54, = 6), compared with the GI-R group and the oxytocin group (<0.01). These results indicated that the oxytocin could significantly protect gastric mucosal against injury induced by ischemia-reperfusion, and the oxytocin receptor was involved. This effect of oxytocin may be mediated through the vagus and sympathetic nerve, and then lead to the reduction of gastric juice output and the depression of gastric acidity.

关键词： control significant difference surgical statistical significance Sprague-Dawley

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A mini review: Shape memory polymers for biomedical applications

Kaojin Wang, Satu Strandman, X. X. Zhu

《化学科学与工程前沿（英文）》 2017年第11卷第2期页码 143-153 doi: 10.1007/s11705-017-1632-4

摘要： Shape memory polymers (SMPs) are smart materials that can change their shape in a pre-defined manner under a stimulus. The shape memory functionality has gained considerable interest for biomedical applications, which require materials that are biocompatible and sometimes biodegradable. There is a need for SMPs that are prepared from renewable sources to be used as substitutes for conventional SMPs. In this paper, advances in SMPs based on synthetic monomers and bio-compounds are discussed. Materials designed for biomedical applications are highlighted.

关键词： shape memory polymer biodegradability biocompatibility biomedical application bile acids

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Rdh13 deficiency weakens carbon tetrachloride-induced liver injury by regulating Spot14 and Cyp2e1 expression

Xiaofang Cui, Benting Ma, Yan Wang, Yan Chen, Chunling Shen, Ying Kuang, Jian Fei, Lungen Lu, Zhugang Wang

《医学前沿（英文）》 2019年第13卷第1期页码 104-111 doi: 10.1007/s11684-017-0568-x

摘要： Mitochondrion-localized retinol dehydrogenase 13 (Rdh13) is a short-chain dehydrogenase/reductase involved in vitamin A metabolism in both humans and mice. We previously generated knockout mice and showed that Rdh13 deficiency causes severe acute retinal light damage. In this study, considering that Rdh13 is highly expressed in mouse liver, we further evaluated the potential effect of Rdh13 on liver injury induced by carbon tetrachloride (CCl ). Although Rdh13 deficiency showed no significant effect on liver histology and physiological functions under regular culture, the mice displayed an attenuated response to CCl -induced liver injury. Their livers also exhibited less histological changes and contained lower levels of liver-related metabolism enzymes compared with the livers of wild-type (WT) mice. Furthermore, the mice had Rdh13 deficiency and thus their liver cells were protected from apoptosis, and the quantity of their proliferative cells became lower than that in WT after CCl exposure. The ablation of gene decreased the expression levels of thyroid hormone-inducible nuclear protein 14 (Spot14) and cytochrome P450 (Cyp2e1) in the liver, especially after CCl treatment for 48 h. These data suggested that the alleviated liver damage induced by CCl in mice was caused by Cyp2e1 enzymes, which promoted reductive CCl metabolism by altering the status of thyroxine metabolism. This result further implicated Rdh13 as a potential drug target in preventing chemically induced liver injury.

关键词： retinol dehydrogenase 13 carbon tetrachloride acute liver injury Cyp2e1 Spot14