Investigation of the accuracy of magnetic resonance cholangiography and multi-slice spiral computed tomography in the diagnosis of cholangiocarcinoma.

Background: Cholangiocarcinoma (CCA) is a common malignant biliary tract tumor in clinical practice. The detection rate of multi-slice spiral computed tomography (MSCT) with a diameter of 10 mm is low, and it is easy to be misdiagnosed and missed. In addition, patients who are allergic to iodized contrast media are not eligible for MSCT screening. However, magnetic resonance cholangiopancreatography (MRCP) is non-invasive, does not require contrast injection, scans quickly, and is simple to perform. MRCP has good development rate and the ability to recognize human pancreas and biliary tract. MRCP is also non-invasive, does not require contrast injection, has fast scanning speed, and is easy to operate. In addition, MRCP has a good development rate and the ability to recognize human pancreas and biliary tract. Therefore, this study sought to analyze the accuracy of MRCP and MSCT in the diagnosis of CCA. Methods: In this paper, 186 patients with highly suspected CCA admitted to the Second Affiliated Hospital of Soochow University from March 2020 to May 2022 were selected for MSCT and MRCP examination. We compared the diagnostic accuracy, sensitivity and specificity of MSCT and MRCP with pathological diagnosis and the detection rate of lesions with different diameters between MSCT and MRCP. Finally, the imaging features of MSCT and MRCP of CCA were analyzed. Results: The results showed that (I) the diagnostic accuracy (95.70%), sensitivity (95.12%), and specificity (96.15%) of MRCP were higher than those of MSCT (69.89%, 60.98%, and 76.92%, respectively; P<0.05); (II) MSCT and MRCP were basically consistent with the datum (Kappa value =0.527, Kappa value =0.767, respectively); (III) the detection rate of lesions <0.5 cm in diameter of MRCP (32.05%) was higher than that of MSCT (14.00%; P<0.05); and (IV) the detection rates of lesions 0.5-1.0 cm (38.46%) and >1.0 cm (29.49%) in diameter of MRCP were lower those of MSCT (50.00%, and 36.00%, respectively; P>0.05). Conclusions: MRCP can provide relevant imaging feature information, improve the accuracy, sensitivity and specificity of the diagnosis of bile duct carcinoma, and has a high detection rate for small diameter lesions, which has good reference, promotion and reference value.

Exploration of three different nutritional scores in predicting postoperative complications after pancreaticoduodenectomy / Exploración de tres escalas nutricionales distintas para predecir complicaciones posoperatorias tras la pancreaticoduodenectomía

Objectives: we used the Controlling Nutritional Status score (CONUT), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI) to explore three different nutritional scores in predicting postoperative complications after pancreaticoduodenectomy (PD).Methods: data were retrospectively reviewed from 113 patients who underwent PD to treat pancreatic cancer and periampullary neoplasms at the Second Affiliated Hospital of Soochow University between 2015 and 2020. Nutritional status was assessed by the CONUT, GNRI, and PNI scores, and patients were categorized as either at risk or not at risk for malnutrition by each score. Postoperative complications were defined according to the Clavien-Dindo classification. Data were analyzed using Fisher's exact probability method and multivariate logistic regression analysis. The relationships between the three nutritional scoring systems and postoperative complications were examined.Results: CONUT, GNRI and PNI scores were closely related to the occurrence of postoperative complications. CONUT (OR = 0.92, 95 % CI, 0.75-1.12, p = 0.043), GNRI (OR = 0.98, 95 % CI, 0.93-1.02, p = 0.036), PNI (OR = 0.96, 95 % CI, 0.89-1.03, p = 0.024), and operation periods (OR = 1.01, 95 % CI, 0.99-1.02, p = 0.034) were independent risk factors for complications in patients after PD. The predictive value of the three nutritional screening methods for overall complications in patients with PD had a sensitivity of 31.8 %, 56.06 % and 74.24 %, a specificity of 85.10 %, 68.08 % and 76.81 %, a Youden index of 0.17, 0.24 and 0.71, and a kappa value of 0.460, 0.389 and 0.472, respectively. The predictive value of the three nutritional screening methods in predicting the severity of complications in patients with PD had a sensitivity of 82.11 %, 58.95 % and 65.26 %, a specificity of 38.89 %, 55.56 % and 66.67 %, a Youden index of 0.21, 0.15 and 0.36, and a kappa value of 0.664, ...

Objetivos: se utilizaron las escalas Controlling Nutritional Status (CONUT), Geriatric Nutritional Risk Index (GNRI) y Prognostic Nutritional Index (PNI) para explorar tres puntuaciones nutricionales diferentes en la predicción de las complicaciones posoperatorias después de la pancreaticoduodenectomía (PD).Métodos: en este estudio se revisaron retrospectivamente los datos de 113 pacientes después de una PD entre 2015 y 2020. El estado nutricional se evaluó mediante las puntuaciones CONUT, GNRI y PNI. Se examinaron las relaciones entre tres sistemas de puntuación nutricional y las complicaciones posoperatorias. Resultados: las puntuaciones CONUT, GNRI y PNI estuvieron estrechamente relacionadas con la aparición de complicaciones posoperatorias. CONUT (OR = 0,92, IC del 95 %: 0,75-1,12, p = 0,043), GNRI (OR = 0,98, IC del 95 %: 0,93-1,02, p = 0,036), PNI (OR = 0,96, IC del 95 %: 0,89-1,03, p = 0,024) y períodos de operación (OR = 1,01, IC del 95 %: 0,99-1,02, p = 0,034) fueron factores de riesgo independientes de aparición de complicaciones en los pacientes después de la DP. El valor predictivo de los tres métodos de cribado nutricional para las complicaciones globales de los pacientes con DP tuvo una sensibilidad del 31,8 %, 56,06 % y 74,24 %, una especificidad del 85,10 %, 68,08 % y 76,81 %, un índice de Youden de 0,17, 0,24 y 0,71, y un valor kappa de 0,460, 0,389 y 0,472, respectivamente. El valor predictivo de los tres métodos de cribado nutricional para predecir la gravedad de las complicaciones en pacientes con DP tuvo una sensibilidad del 82,11 %, 58,95 % y 65,26 %, una especificidad del 38,89 %, 55,56 % y 66,67 %, un índice de Youden de 0,21, 0,15 y 0,36, y un valor kappa de 0,664, 0,416 y 0,645, respectivamente. Entre los tres sistemas de puntuación nutricional, la puntuación PNI obtuvo una mejor eficiencia diagnóstica ...(AU)

A new gaseous cavitation model in a tilting-pad journal bearing.

With the higher rotational speeds and loads in bearings, the gaseous cavitation becomes more and cannot be ignorable in the bearing designs. However, there is no enough research in non-equilibrium gaseous cavitation model. This paper builds a new gaseous cavitation model based on the Bunsen solubility and bubble dynamics. The equilibrium pressure is calculated by the Bunsen solubility based on the local pressure and its pressure difference with the local pressure decides the cavitation mass transfer rate in this new model for gaseous cavitation. A titling-pad journal bearing at 3000 rpm and under 299 kN load is chosen as the research object with this new model and an original equilibrium model applied. As for the minimum film thickness and bearing force balance, this new model performs in better accordance with the experiment than the equilibrium model. According to the multiphase distributions in the bearing film, the gaseous cavitation rate in this new model can simulate the non-equilibrium processes of dissolution and cavitation under the high rotational speed, which is close to the physical gaseous cavitation process. This new model is developed and applied successfully in tilting-pad journal bearings for simulating the non-equilibrium gaseous cavitation.

Totally laparoscopic gallbladder-preserving surgery: A minimally invasive and favorable approach for cholelithiasis.

The aim of the present study was to investigate the effectiveness of laparoscopic gallbladder-preserving surgery (L-GPS) for cholelithiasis and the feasibility and value of totally laparoscopic GPS (TL-GPS). A total of 517 patients underwent L-GPS, including 365 cases of laparoscopy-assisted GPS (LA-GPS), 143 cases of TL-GPS (preservation rate, 98.3%) and nine conversions to laparoscopic cholecystectomy. The surgeries were all performed by one medical team and the mean operating time was 72 min. All macroscopic calculi were removed through endoscopy. The number of calculi observed in the patients was between one and several dozen; diameters ranged between 0.1 and 2.5 cm. Only three cases of incisional infection were noted in the LA-GPS group and long-term follow-up showed a low recurrence rate of 1.2%. L-GPS is, therefore, an excellent approach to cure cholelithiasis and TL-GPS is a feasible and effective option that could avoid incisional complications.

Disturbance of autophagy-lysosome signaling molecule expression in human gastric adenocarcinoma.

Autophagy is classified as type II programmed cell death and may participate in tumorigenesis. However, changes in autophagy-lysosome signaling and the relationship between the apoptotic cascade and gastric cancer cells have not been fully elucidated. The present study investigated the induction of autophagy in poorly differentiated human gastric adenocarcinoma. Immunoblotting revealed markedly induced autophagy in low grade differentiated gastric adenocarcinoma, indicated by elevation of microtubule-associated protein 1 light chain 3-I/II conversion and Beclin 1 in human gastric carcinomas. In addition, the diffuse (poorly differentiated) subtype showed significantly elevated Lamp2 and cathepsin B protein levels. Concomitantly, significant induction of anti-apoptotic events were indicated by changes in B-cell lymphoma 2 (Bcl-2) and X-linked inhibitor of apoptosis protein levels. Notably, confocal laser microscope data indicated co-expression of Bcl-2 and Beclin 1 in poorly differentiated human gastric adenocarcinoma. Results of this study indicate that the autophagy-lysosome signaling participates in poorly differentiated human gastric adenocarcinoma and there are intracellular links between autophagic signaling and the apoptotic cascade.

Blocking Bcl-2 leads to autophagy activation and cell death of the HEPG2 liver cancer cell line.

BACKGROUND: Apoptosis may be induced after Bcl-2 expression is inhibited in proliferative cancer cells. This study focused on the effect of autophagy activation by ABT737 on anti-tumor effects of epirubicin. METHODS: Cytotoxic effects of ABT737 on the HepG2 liver cancer cell line were assessed by MTT assay and cell apoptosis through flow cytometry. Mitochondrial membrane potential was measured by fluorescence microscopy. Monodansylcadaverin (MDC) staining was used to detect activation of autophagy. Expression of p53, p62, LC3, and Beclin1, apoptotic or autophagy related proteins, was detected by Western blotting. RESULTS: ABT737 and epirubicin induced growth inhibition in HepG2 cells in a dose- and time-dependent manner. Both ABT737 and epirubicin alone could induce cell apoptosis with a reduction in mitochondrial membrane potential as well as increased apoptotic protein expression. Further increase of apoptosis was detected when HepG2 cells were co- treated with ABT373 and epirubicin. Furthermore, our results demonstrated that ABT373 or epirubicin ccould activate cell autophagy with elevated autophagosome formation, increased expression of autophagy related proteins and LC3 fluorescent puncta. CONCLUSIONS: ABT737 influences cancer cells through both apoptotic and autophagic mechanisms, and ABT737 may enhance the effects of epirubicin on HepG2 cells by activating autophagy and inducing apoptosis.

Inhibition of proliferation of estrogen receptor­positive MCF­7 human breast cancer cells by tamoxifen through c­Jun transcription factors.

Activator of protein 1 (AP-1) is a heterodimeric transcription factor composed of various members of the Jun and Fos families and binds to DNA at specific AP-1 binding sites. AP-1 transcriptional activity is increased by phosphorylation at serine residues in the c­Jun component of AP-1. In the present study, the proliferation of MCF-7 breast cancer cells was found to be suppressed by tamoxifen (TAM)-activated c-Jun through the protein kinase C (PKC) pathway. The molecular mechanism by which c­Jun activation induces antiproliferative signals in estrogen receptor (ER)-positive MCF-7 human breast cancer cells remains unknown. TAM inhibited the proliferation of ER-positive MCF-7 human breast cancer cells and ER-negative MDA-MB-435 human breast cancer cells and 48 h incubation with 10 µM TAM led to inhibition of 80% of proliferation. In addition, no significant difference in c-Jun mRNA and protein levels was detected in MCF-7 and MDA-MB-435 cells stimulated by TAM for 48 h. TAM treatment of MCF-7 cells activated the transcriptional activity of AP-1, which responds specifically to phorbol ester. To determine the role of c-Jun in the antiproliferation of MCF-7 cells stimulated by TAM, the inhibition rates of MCF­7 cells were correlated with c­Jun expression and stimulation of TAM. Results showed that the inhibition rate of TAM-stimulated MCF-7 cells was positively regulated by overexpression of c-Jun and negatively regulated by underexpression of c-Jun. Overall, these results indicate that the TAM-stimulated antiproliferation of MCF-7 cells is positively regulated by c-Jun through activation of the PKC pathway.