Feasibility and Safety of ERCP in the Treatment of Biliary Strictures after Liver Transplantation: With a Report of 37 Cases.

Background: Liver transplantation (LT) is an effective treatment option for patients with end-stage liver disease; biliary complications are important cause of death in posttransplant patients. Endoscopic retrograde cholangiopancreatography (ERCP) has an irreplaceable role in the diagnosis and treatment of patients with biliary tract disease. Methods: The clinical data of patients with biliary strictures (BS) after LT treated with ERCP admitted to the Third Xiangya Hospital of Central South University from September 2016 to October 2021 were reviewed; the changes in temperature, bilirubin, and albumin before and after treatment and postoperative complications were analyzed. Results: A total of 41 patients were included in the study, and biliary stents were successfully placed in 37 cases (90.2%), while 4 cases (9.8%) were unsuccessful due to complete BS. Patients with ERCP guided biliary stenting had a significant improvement in bilirubin index compared to the preoperative period (P < 0.05). 27 patients (73.0%) had complete relief of symptoms after 1 ERCP-guided treatment, and 10 patients (27.0%) developed BS again at different times after the first ERCP treatment, among which 8 patients developed BS again within 1 year after the first treatment and 2 patients developed BS again after 1 year after the first treatment. The incidence of endoscopy-related adverse events was 35.14%, with no serious adverse events. Conclusion: ERCP-guided biliary stenting was an effective and safety treatment for BS after LT.

Hypoxia stimulates the migration and invasion of osteosarcoma via up-regulating the NUSAP1 expression.

Osteosarcoma is a highly aggressive malignant tumor, which most commonly occurs in children and adolescents. This study aims to reveal that hypoxia promotes the invasion of osteosarcoma cells by up-regulating the expression of NUSAP1. The expression of HIF-1α and NUSAP1 was significantly up-regulated in MG63 cells cultured in hypoxia for 6-36 h. Furthermore, hypoxia induced the migration and invasion of MG63 cells and regulated the level of E-cad, N-cad, Vimentin, Snail, Slug, MMP2, and MMP9 proteins. Importantly, knockdown of NUSAP1 inhibited hypoxia-induced cell migration and invasion. In the hypoxia microenvironment, the addition of HIF-1α inhibitor or the transfection of siRNA specifically targeting HIF-1α significantly reduced the expression of HIF-1α and NUSAP1 and markedly inhibited the migration and invasion of MG63 cells under the hypoxia microenvironment. In conclusion, hypoxia induced the expression of NUSAP1 in a HIF-1α-dependent manner, stimulating the migration and invasion of MG63 cells.

Bilateral total knee arthroplasty: Simultaneous or staged? A systematic review and meta-analysis.

BACKGROUND: Total knee arthroplasty (TKA) is one of the most successful orthopedic surgeries performed in recent decades. However, controversies still exist between conducting simultaneous or staged bilateral TKA. The objective of this study is to conduct a systematic review assessing the clinical outcome associated with simultaneous bilateral and staged bilateral total knee arthroplasty (BTKA). METHODS: A search was applied to CNKI, Embase, Medline, and Cochrane central database (January 2000-July 2018). All studies that compared simultaneous bilateral TKA (simBTKA) with staged bilateral TKA (staBTKA) without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle-Ottawa Scale. Data were pooled and a meta-analysis completed. RESULTS: The 18 studies were identified to be eligible. The 18 comparative studies published from 2001 to 2018, covered 73617 participants in the simBTKA group and 61838 in the staBTKA group, respectively. Results of meta-analyses indicated that simBTKA showed a lower risk of deep infection and respiratory complications, but increased mortality, pulmonary embolism (PE), and deep-vein thrombosis (DVT) compared with staBTKA. There were no significant differences in revision, superficial infection, arthrofibrosis, cardiac complications, neurological complications and urinary complications between procedures. CONCLUSIONS: Since there are risks and benefits to both procedures, these potential complications must be interpreted in light of each individual patient's needs and concerns. Further research must be conducted, in the form of a randomized clinical trial, to evaluate the outcomes mentioned in this review.

Therapeutic Effect of the Quinolone Levofloxacin on Inflammatory Fibroblast-like Synoviocytes.

OBJECTIVE: This study aims to analyze the effects of quinolones on synovium. METHODS: The present study explored the effects of levofloxacin on fibroblast-like synoviocyte (FLS) in vitro. After incubation with 10 ng/mL of interleukin-1ß (IL-1ß) for 24 hours, rabbit FLS were treated with serial concentrations of levofloxacin (0,14,28,56,112 and 224 µM) for 24 hours. The proliferation of FLS was assayed using the CCK-8 reagent. The mRNA expression levels of MMP-1, MMP-3, TIMP-1, COX-2, PEG2, IL-6, and caspase-3, -8 and -9 were evaluated using real-time PCR. In addition, active caspase-3 and MMP-3 were detected by immunocytochemical assay. RESULTS: When treated with levofloxacin for 24 hours, cell viability decreased in a concentration-dependent manner. Furthermore, the protein expression level of active caspase-3 increased, while the protein expression level of MMP-3 revealed no significant changes. In addition, the mRNA levels of MMP-1, MMP-3 and TIMP-1 all increased. Moreover, the mRNA levels of IL-6 and COX-2 decreased, while the mRNA levels of Caspase-3 and -8 increased, both in a concentration-dependent manner. CONCLUSIONS: The anti-inflammatory and anti-proliferative effects of levofloxacin on FLS are mediated by inhibiting inflammatory cytokines and inducing apoptosis in rabbits. Thus, quinolones might possess a special effect to treat synovitis and relieve inflammatory joint disease.

Association between MEFV polymorphisms and the susceptibility to ankylosing spondylitis in a Chinese Han population: A case-control study.

The aim of this study was to explore the genetic association of Mediterranean fever (MEFV) gene polymorphisms rs3743930 and rs11466023 with ankylosing spondylitis (AS) susceptibility in a cohort of Chinese Han population.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used for genotyping MEFV polymorphisms in 131 AS patients and 127 healthy controls. Chi-square test was employed to compare the genotype and allele distributions between the case and control groups. Odds ratio (OR) with 95% confidence interval (CI) was calculated to assess the association between MEFV gene polymorphisms and AS incidence.The frequency of the G allele of MEFV polymorphism rs3743930 in the AS group was significantly higher than that in the healthy control group (36.64% vs 28.35%, P < .05). And individuals carrying the GG genotype showed 2.896 folds higher risk of developing AS when compared with CC genotype carriers (OR = 2.896, 95% CI = 1.115-7.519). But no significant differences were detected in either genotype or allele distributions between case and control groups for the polymorphism rs11466023 (P > .05).MEFV gene polymorphism rs3743930 might be significantly associated with AS susceptibility in Chinese Han population, and its G allele might predict high risk of AS.