Gastric Peroral Endoscopic Pyloromyotomy for Infants With Congenital Hypertrophic Pyloric Stenosis.

INTRODUCTION: Congenital hypertrophic pyloric stenosis (CHPS), the most common infantile disease requiring surgical intervention, is routinely treated with open or laparoscopic pyloromyotomy. Recently, gastric peroral endoscopic pyloromyotomy (G-POEM) has been used for adult gastroparesis. We aimed to evaluate the efficacy and safety of G-POEM in treating infantile CHPS. METHODS: We reviewed data from 21 G-POEM-treated patients at 3 tertiary children's endoscopic centers in China between January 2019 and December 2020. Clinical characteristics, procedure-related parameters, perioperative management, and follow-up outcomes were summarized. RESULTS: G-POEM was performed successfully in all patients. The median operative duration was 49 (14-150) minutes. The submucosal tunnels were successfully established along the greater curvature of the stomach in 19 cases, and 2 cases were switched to the lesser curvature because of difficulty. No perioperative major adverse events occurred. Minor adverse events included inconsequential mucosal injury in 5 cases and unsatisfactory closure of the mucosal incision in 1 case. Upper gastrointestinal contrast radiography in all patients showed smooth passage of the contrast agent through the pylorus on postoperative day 3. The growth curves of the patients reached normal levels 3 months after the procedure. No recurrent clinical symptoms occurred in any patient during the median follow-up period of 25.5 (14-36) months. DISCUSSION: G-POEM is feasible, safe, and effective for infants with CHPS, with satisfactory clinical responses over a short-term follow-up. Further multicenter studies should be performed to compare the long-term outcomes of this minimally invasive technique with open or laparoscopic pyloromyotomy.

Case report: Peroral endoscopic myotomy for acute pandysautonomia-associated distal esophageal spasm in a child.

Acute pandysautonomia-associated distal esophageal spasm is a rare disease with an unclear etiology. Here, we describe a 12-year-old boy with an acute pandysautonomia-associated distal esophageal spasm who was treated using a peroral endoscopic myotomy (POEM). The patient's clinical features included recurrent dysphagia, nausea, vomiting, growth retardation, and signs of autonomic nerve dysfunction (e.g., a decreased production of tears and sweat, and an increased production of saliva). Signs of the distal esophageal spasm were visible in upper gastrointestinal radiography, endoscopy, and high-resolution esophageal manometry. After the POEM, the patient exhibited improvements in nausea and vomiting, and his dysphagia symptoms were relieved by the 6-month follow-up visit. However, the patient's neurological problems persisted. The satisfactory short-term clinical responses in our patient suggest that POEM is feasible, safe, and effective for the treatment of acute pandysautonomia-associated distal esophageal spasms in children.

Investigation of the influence of glycyrrhizin on the pharmacokinetics of celastrol in rats using LC-MS and its potential mechanism.

1. The aim of this study was to investigate the effects of glycyrrhizin on the pharmacokinetics of celastrol in rats. 2. Twelve male Sprague-Dawley rats were randomly assigned to two groups: control group and test group. Test group was pretreated with glycyrrhizin at a dose of 100 mg/kg/day for 10 days, and then the two groups were orally administered with celastrol at a dose of 1 mg/kg. The concentration of celastrol was determined using a sensitive and reliable LC-MS method. 3. The results showed that glycyrrhizin could significantly decrease the plasma concentration (from 64.36 ng/mL to 38.42 ng/mL) and AUC0-t (from 705.39 to 403.43 µg·h/L) of celastrol in rats. To investigate its potential mechanism, the effects of glycyrrhizin on the transport and metabolic stability of celastrol were investigated using Caco-2 cell monolayer transwell model and rat liver microsome incubation systems. The Caco-2 cell monolayer transwell experiments indicated that glycyrrhizin could increase the efflux ratio of celastrol (4.02 versus 6.51). However, the rat liver microsome incubation experiments showed that glycyrrhizin could significantly increase the intrinsic clearance rate of celastrol from 20.3 ± 3.37 to 38.8 ± 4.18 µL/min/mg protein. 4. In conclusion, these results indicated that the herb-drug interaction between glycyrrhizin and celastrol might occur when they were coadministered.

Inhibitory Effects of Triptolide on Human Liver Cytochrome P450 Enzymes and P-Glycoprotein.

BACKGROUND AND OBJECTIVES: Triptolide is an active component derived from Tripterygium wilfordii and it possesses numerous pharmacological activities. However, it remains unclear how triptolide influences the activity of human liver cytochrome P450 (CYP) enzymes and P-glycoprotein (P-gp). METHODS: In this study, the inhibitory effects of triptolide on the eight human liver CYP isoforms (i.e., 1A2, 3A4, 2A6, 2E1, 2D6, 2C9, 2C19, and 2C8) were investigated in vitro using human liver microsomes (HLMs), and the effects of triptolide on the activity of P-gp were investigated using a rhodamine-123 uptake assay. RESULTS: The results showed that triptolide inhibited the activity of CYP1A2 and CYP3A4, with 50 % inhibitory concentration (IC50) values of 14.18 and 8.36 µM, respectively, but that other CYP isoforms were not affected. Enzyme kinetic studies showed that triptolide was not only a non-competitive inhibitor of CYP1A2, but also a competitive inhibitor of CYP3A4, with inhibition constant (K i) values of 7.32 and 5.67 µM, respectively. In addition, triptolide is a time-dependent inhibitor for CYP1A2, and the concentration at 50 % maximum inactivation (K I) and maximum inactivation (K inact) values were 286.5 µM and 0.024 min-1, respectively. The rhodamine-123 uptake assay showed that triptolide could not affect the activity of P-gp. CONCLUSIONS: The in vitro studies of triptolide with CYP isoforms and P-gp indicate that triptolide has the potential to cause pharmacokinetic drug interactions with other co-administered drugs metabolized by CYP1A2 and CYP3A4. Further clinical studies are needed to evaluate the significance of this interaction.

[Over-expression of DLL4/Notch1 ligand inhibits proliferation of K562 cells].

This study was aimed to explore the effect of DLL4/Notch1 ligand on cell growth in leukemia cell line K562 and its relevant mechanism. The pBudCE4.1-DLL4 plasmid was transfected into K562 cells by lipofectamine 2 000, RT-PCR and Western blot were applied to monitor the mRNA and the protein expression of exogenous DLL4 gene, as well as the expression of Notch1-ICD and target gene Hes1. Expression levels of Rb, YY1 and C-MYC protein in K562 cells were also detected by Western blot. Cell counting Kit-8 was used to detect the proliferation of K562 cells, and flow cytometry with Annexin V staining was used to detect the cell apoptosis. The results showed that the mRNA and protein expression levels of DLL4, Notch1-ICD and Hes1 in cells of experimental group were significantly higher than those of control groups (P < 0.05), indicating the successful activation of the Notch1 signaling pathway. The protein expression levels of Rb, YY1 and C-MYC in cells of experimental group significantly increased when compared with that of control group cells (P < 0.05). After transfection, the proliferation of K562 cells was obviously inhibited, and apoptosis rate in DLL4-transfected cells was significantly enhanced. DLL4 transfection significantly increased the number of cells in G1 phase and decreased that in S phase. It is concluded that the over-expression of DLL4 ligand gene in K562 cells results in successful activation of the Notch1 signaling pathway, increases expression of Rb, YY1 and C-MYC genes, which induces apoptosis and reduces proliferation.

Molecular cloning and expression analysis of a F-type lectin gene from Japanese sea perch (Lateolabrax japonicus).

The techniques of homology cloning and anchored PCR were used to clone the fucose-binding lectin (F-type lectin) gene from Japanese sea perch (Lateolabrax Japonicus). The full-length cDNA of sea perch F-lectin (JspFL) contained a 5' untranslated region (UTR) of 39 bp, an ORF of 933 bp encoding a polypeptide of 310 amino acids with an estimated molecular mass of 10.82 kDa and a 3' UTR of 332 bp. The searches for nucleotides and protein sequence similarities with BLAST analysis indicated that the deduced amino acid sequence of JspFL was homological to the Fucose-binding lectin in other fish species. In the JspFL deduced amino acid sequence, two tandem domains that exhibit the eel carbohydrate-recognition sequence motif were found. The temporal expressions of gene in the different tissues were measured by real-time PCR. And the mRNA expressions of the gene were constitutively expressed in tissues including spleen, head-kidney, liver, gill, and heart. The JspFL expression in spleen was different during the stimulated time point, 2 h later the expression level became up-regulated, and 6 h later the expression level became down-regulated. The result indicated that JspFL was constitutive and inducible expressed and could play a critical role in the host-pathogen interaction.

[Faunal characteristics and distribution pattern of crustaceans in the vicinity of Pearl River estuary].

Based on the data of bottom trawl surveys in the vicinity of Pearl River estuary in August (summer), October (autumn), December (winter) 2006, and April (spring) 2007, the faunal characteristics and distribution pattern of crustaceans were analyzed. A total of 54 species belonging to 25 genera, 17 families, and 2 orders were collected, including 22 species of shrimps, 22 species of crabs, and 10 species of squills. Most of the crustaceans were tropical-subtropical warm-water species, a few of them were eurythermal species, and no warm-water and cold-water species occurred. Euryhaline species were most abundant, followed by halophile species, and the low-salinity species were the least. Most of the crustacean species belonged to the fauna of Indian Ocean-western Pacific Ocean. The faunal assemblages were closer to those of the East China Sea, Philippine Sea, Indonesia Sea, and the Japan Sea, and estranger with those of the Yellow Sea, Bohai Sea, and Korea Sea. The dominant species were Metapenaeus joyner, Oratosquilla oratoria, Charybdis miles, Portunus sanguinolentus, Harpiosquilla harpax, Charybdis feriatus, Charybdis japonica, Oratosquilla nepa, Solenocera crassicornis, Portunus trituberculatus, and Calappa philargius. The crustaceans had the largest species number (33) in autumn and the least one (26) in spring, and the highest stock density at the water depth of < 40 m, especially at 10-20 m. The average stock density of the crustaceans was estimated to be 99.60 kg x km(-2), with the highest (198.93 kg x km(-2)) in summer and the lowest (42.35 kg x km(-2)) in spring. Of the 3 species groups, crabs had the highest stock density (41.81 kg x km(-2)), followed by shrimps (38.91 kg x km(-2)), and squills (18.88 kg x km(-2)). The stock densities of the 3 species groups showed an obvious seasonal variation. Shrimps had the highest stock density (120.32 kg x km(-2)) in summer and the lowest density (0.67 kg x km(-2)) in spring, while crabs and squills had the highest density (62.01 and 29.49 kg x km(-2), respectively) in winter and the lowest density (24.64 and 6.30 kg x km(-2), respectively) in autumn.

Molecular cloning and mRNA expression analysis of interleukin-8 gene in Japanese sea perch (Lateolabrax japonicus).

Interleukin-8 (IL-8), the first known chemokine, is a CXC chemokine, which is cable of attracting neutrophils and inducing them to release lysozomal enzymes, triggering the respiratory burst. In the present study, the cDNA of an IL-8 was cloned from Japanese sea perch Lateolabrax japonicus (designated LjIL-8) by homology cloning and rapid amplification of cDNA ends (RACE) approaches. The full-length cDNA of LjIL-8 consisted of 803 nucleotides with a canonical polyadenylation signal sequence AATAAA and a poly(A) tail, and an open reading frame (ORF) of 300 bp encoding a polypeptide of 99 amino acid residues with a predicted molecular weight of 6.6 kDa. The high identity of LjIL-8 with IL-8 in other organisms indicated that LjIL-8 should be a new member of the IL-8 family. By fluorescent quantitative real-time PCR, mRNA transcript of LjIL-8 was detectable in all the examined tissues with higher level in spleen and head-kidney. The temporal expression of LjIL-8 mRNA in the spleen was up-regulated by lipopolyssacharide (LPS) stimulation and reached the maximum level at 6 h post-stimulation, and then dropped back to the original level gradually. These results indicated that LjIL-8 was a constitutive and inducible acute-phase protein that perhaps involved in the immune defense of L. japonicus.

[Ecological characteristics of phytoplankton in coastal area of Pearl River estuary].

Five cruises of phytoplankton survey were made in costal area of Pearl River estuary in 1998-1999. The results showed that 239 species were identified, 72.4% of which belonging to Bacillariophyta, 23.8% to Pyrrophyta, and 3.8% to others. The dominant species were warm and eurythermic species Thalassiothrix frauenfeldii, Nitzschia delicatissima, Thalassiothrix frauenfeldii and Thalassiosira subtilis, and changed with an obvious seasonal succession. The cell density ranged from 0.2 x 10(4) to 2,767.1 x 10(4) cell x m(-3), with an average of 98.7 x 10(4) cell x m(-3), and the mean cell density was obviously higher in summer and winter than in spring and autumn. The regional variation revealed that the cell density in shore area was visibly higher than that in offshore area, and the largest density area was at the southeast of Shangchuan Island all the year around. The range of mean Shannon-Wiener index, Pielou evenness index and biodiversity threshold was 2.63-3.17, 0.53-0.71 and 1.74-2.23, respectively. According to the diversity index, it was concluded that the diversity level of phytoplankton community in coastal area of Pearl River estuary was relatively high and stable.