Morphological Transformation and Surface Engineering of Glycovesicles Driven by Bioinspired Hydrogen Bonds of Nucleobases.

Glycopolymer-based supramolecular glycoassemblies with signal-driven cascade morphological deformation and accessible surface engineering toward bioinspired functional glycomaterials have attracted much attention due to their diverse applications in fundamental and practical scenarios. Herein, we achieved the cascade morphological transformation and surface engineering of a nucleobase-containing polymeric glycovesicle through exploiting the bioinspired complementary multiple hydrogen bonds of complementary nucleobases. First, the synthesized thymine-containing glycopolymers (PGal30-b-PTAm249) are capable of self-assembling into well-defined glycovesicles. Several kinds of amphiphilic adenine-containing block copolymers with neutral, positive, and negative charges were synthesized to engineer the glycovesicles through the multiple hydrogen bonds between adenine and thymine. A cascade of morphological transformations from vesicles to ruptured vesicles with tails, to worm-like micelles, and finally to spherical micelles were observed via continuously adding the adenine-containing polymer into the thymine-containing glycovesicles. Furthermore, the surface charge properties of these glyconano-objects can be facilely regulated through incorporating various adenine-containing polymers. This work demonstrates the potential application of a unique bioinspired approach to precisely engineer the morphology and surface properties of glycovesicles for boosting their biological applications.

Evaluating Modified Ultrasound-Guided Serratus Anterior Plane Block for Enhanced Postoperative Recovery in Thoracoscopic Lobectomy Patients.

BACKGROUND Thoracoscopic lobectomy is accompanied by intense trauma and pain due to impaired chest wall integrity. We aimed to introduce a modified ultrasound-guided serratus anterior plane block (MUG-SAPB) for postoperative analgesia in patients who underwent thoracoscopic lobectomy, and to determine whether it could effectively alleviate postoperative pain and improve recovery quality. MATERIAL AND METHODS Overall, 78 patients randomly received either combined MUG-SAPB (0.25% ropivacaine, 10 mg dexamethasone, 40 mL) with patient-controlled intravenous analgesia (PCIA) or received PCIA alone. The primary outcomes were visual analog scale (VAS) scores at rest and during movement at 4, 8, 12, 20, 24, 48, and 72 h postoperatively. The secondary outcomes included use of opioids during surgery, numbers of rescue analgesics (butorphanol), frequency of patient-controlled analgesia (PCA), comfort score within 24 h postoperatively, and postoperative complications within 72 h. RESULTS Compared to the PCIA group, in the MUG-SAPB group, resting VAS scores at 4-24 h (P<0.05) and movement VAS scores at 4-12 h postoperatively (P<0.05) were lower; intraoperative use of sufentanil and frequency of PCA were less, and less rescue analgesia was used (P=0.02, P=0.04 and P=0.03, respectively). Patients in the MUG-SAPB group had faster first mobilization (P=0.04). The MUG-SAPB group had higher comfort scores than the PCIA group (P=0.03). None of the MUG-SAPB patients had any SAPB-related complications. CONCLUSIONS MUG-SAPB effectively relieved postoperative pain, reduced opioid consumption, and accelerated early ambulation in comparison with PCIA alone in patients who underwent thoracoscopic lobectomy.

Clinical efficacy of laparoscopic modified Parks operation on the ultra-low rectal cancer / 中南大学学报(医学版)

OBJECTIVES@#To investigate the clinical efficacy of laparoscopic modified Parks operation on the patients with ultra-low rectal cancer.@*METHODS@#According to the preoperative stage and intraoperative anastomotic position, 98 patients with ultra-low rectal cancer above T2 stage underwent laparoscopic Dixon operation, modified Parks operation and Miles operation, respectively. All patients were divided into 3 groups: a Dixon operation group (@*RESULTS@#The patients were more obese, the distance between tumor and anal margin was closer, and the operation time was longer in the modified Parks operation group than those in the Dixon operation group (all @*CONCLUSIONS@#Laparoscopic modified Parks operation is a safe, economical and effective anus preservation operation, which can not only save the anus for some patients who had to perform Miles operation, but also recover better and faster after operation. Although the early anal function of patients performed with the modified operation is poor, it can gradually recover to the same level as the patients performed with the Dixon operation.

Vaspin protects rats against myocardial ischemia/reperfusion injury (MIRI) through the TLR4/NF-κB signaling pathway.

The purpose of our study was to investigate the effect of vaspin on myocardial ischemia reperfusion injury (MIRI) and explore the underlying mechanism. The MIRI model was induced with 30 min of left anterior descending (LAD) occlusion followed by 24 h of reperfusion. In vivo, the rats were randomly divided into five groups: (1) Sham, (2) MIRI, (3) MIRI + vaspin (10 mg/kg), (4) MIRI + vaspin (20 mg/kg) and (5) MIRI + vaspin (40 mg/kg). In vitro, H9C2 cells were assigned to five groups: (1) control, (2) hypoxia-re-oxygenation (H/R), (3) H/R + vaspin (1 µg/ml), (4) H/R + vaspin (2 µg/ml) and (5) H/R + vaspin (4 µg/ml). As a result, vaspin ameliorated MIRI and H/R in a dose-dependent manner, as evidenced by triphenyl tetrazolium chloride (TTC) staining, TUNEL Assay and MTT assay, respectively, meanwhile vaspin decreased the levels of creatine phosphokinase-isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in rat serum, moreover, vaspin could reduce the contents of interleukin-1ß (IL-1ß), IL-18 and tumor necrosis factor alpha (TNF-α) in serum of rats and supernatant of H9C2 cells. Furthermore, vaspin down-regulated the expression of toll-like receptor 4 (TLR4) and the phosphorylation of nuclear factor κB (NF-κB) in MIRI rats and H/R-induced H9C2 cells. In addition, patients with acute myocardial infarction (AMI) had lower levels of vaspin than patients without. In conclusion, vaspin might be a useful predictive biomarker in patients with AMI; furthermore, vaspin exhibits cardioprotective effects on MIRI which might act through inhibiting TLR4/NF-κB signaling pathway in vivo and in vitro.

Laparoscopy combined with total intersphincteric resection for extremely low rectal cancer / 中南大学学报(医学版)

To investigate the feasibility and therapeutic effect of laparoscopy combined with total intersphincteric resection (Total-ISR) for extremely low rectal cancer.
 Methods: We performed laparoscopy combined with Total-ISR in 45 patients with extremely low rectal cancer (1.0 cm≤the lower edge of tumor to the anal edge≤3.0 cm) from January 2014 to December 2016. The operation time, blood loss, resection margin and overall incidence of postoperative complications were observed. The rate of local recurrence and distant metastasis after surgery during the median following-up time of 20.5 months were observed. Anal function at 3, 6, and 12 months after operation were compared.
 Results: The operation for 45 cases were successful without perioperative death. The operation time was (220±33) min and blood loss was (110±31) mL. The surgical margins were all negative. The incidence of postoperative complication was 6.7% (3/45) and no one suffered anastomotic leakage. After a median follow-up of 20.5 (6-30) months, 2 cases developed local recurrence and 1 case developed distant metastasis. According to Kirwan grade, the grade II was 24.4% (11/45), grade III was 57.8% (26/45) in 3 months after operation, and the grade II increased to 51.1% (23/45), the grade III decreased to 35.5% (16/45) after 6 months. Seven out of 40 patients in 12 months after operation reached the grade I, and 25 patients reached the grade II. There were significant differences between 3 months and 6 months, 6 months and 12 months after operation (P<0.05) in the anal function situation.
 Conclusion: It is feasible, for appropriate patients, to perform laparoscopic combined with total-ISR, especially for the patients with extremely low rectal cancer that were in early stage without invasion to the extemal sphincter. The procedure has the advantages of radical sphincter-saving, minimal invasion and economy.

Current state and progress of preserving anal function in treatment of low or ultral-low rectal cancer / 中国内镜杂志

As the development of society, people pay more attention to life quality. Nowadays, the therapeutic strategy to low or ultra-low rectal cancer has turned to anussaving as important as radical resection. Following the deep research in biology rule-rs of rectal cancer and a series of important theories, such as the 2 cm distal resection margin, total mesorectal excision technique, pelvic autonomic nerve preservation, variet-y of surgical methods can be chose in dealing with low or ultra-low rectal cancer a-nd achieving the goal of anus preservation. But, because of so many organs around the low or ultra-low rectal cancer and complicated anatomy, we should select patients strictly in order to avoid preserve one's anus blindly. if not, patients will face the condition of residual neoplasms or severe incontinence.

An Atypically Large, Free-Floating Thrombus Extending From the Lung to the Left Atrium via a Pulmonary Vein: A Case Report.

An atypically large, free-floating thrombus extending from primary pulmonary malignancy into the left atrium (LA) is a rare phenomenon. Here, we report a 61-year-old man presenting with a large mass in the lower lobe of the left lung, extending to LA via the left inferior pulmonary vein.The thrombus remained clinically silent and was detected by computed tomography (CT) and transthoracic echocardiography. To prevent life-threatening complications including systemic embolism and sudden death, the patient underwent surgical excision of the mass under cardiopulmonary bypass. Pathology of the tumor and the embolus was confirmed as moderately differentiated squamous cell carcinoma. Furthermore, immunohistochemical studies demonstrated consistency of the tumor cells in this pathological category.The patient tolerated the surgery well and his condition began to improve gradually after the operation.