Separate gut-brain circuits for fat and sugar reinforcement combine to promote overeating.

Food is a powerful natural reinforcer that guides feeding decisions. The vagus nerve conveys internal sensory information from the gut to the brain about nutritional value; however, the cellular and molecular basis of macronutrient-specific reward circuits is poorly understood. Here, we monitor in vivo calcium dynamics to provide direct evidence of independent vagal sensing pathways for the detection of dietary fats and sugars. Using activity-dependent genetic capture of vagal neurons activated in response to gut infusions of nutrients, we demonstrate the existence of separate gut-brain circuits for fat and sugar sensing that are necessary and sufficient for nutrient-specific reinforcement. Even when controlling for calories, combined activation of fat and sugar circuits increases nigrostriatal dopamine release and overeating compared with fat or sugar alone. This work provides new insights into the complex sensory circuitry that mediates motivated behavior and suggests that a subconscious internal drive to consume obesogenic diets (e.g., those high in both fat and sugar) may impede conscious dieting efforts.

Ultrasound-guided hepatic portal vein injection is not a reproducible technique for delivery of cell therapies to the liver in mice.

AIMS: Our aim was to determine if ultrasound-guided HPV injection in mice would provide reproducible and reliable results, as is currently obtained via open laparotomy techniques, and offer a surgical refinement to emulate islet transplantation in humans. METHODS: Fluorescent-polymer microparticles (20 µm) were injected (27G-needle) into the HPV via open laparotomy (n = 4) or under ultrasound-guidance (n = 4) using an MX550D-transducer with a Vevo3100-scanner (FUJIFILM VisualSonics, Inc.). Mice were culled 24-h post injection; organs were frozen, step sectioned (10 µm-slices) and 10 sections/mouse (50 µm-spacing) were quantified for microparticles in the liver and other organs by fluorescent microscopy. RESULTS: Murine HPV injection, via open laparotomy-route, resulted in widespread distribution of microparticles in the liver, lungs and spleen; ultrasound-guided injection resulted in reduced microparticle delivery (p < 0.0001) and microparticle clustering in distinct areas of the liver at the site of needle penetration, with very few/no microparticles being seen in lung and spleen tissues, hypothesised to be due to flow into the body cavity: liver median (interquartile range) 4.15 (0.00-4.15) versus 0.00 (0.00-0.00) particle-count mm-2 , respectively. CONCLUSIONS: Ultrasound-guided injection results in microparticle clustering in the liver, with an overall reduction in microparticle number when compared to open laparotomy HPV injection, and high variability in microparticle-counts detected between mice. Ultrasound-guided injection is not currently a technique that can replace open laparotomy HPV of islet transplantation in mice.

Glucose Sensing in the Hepatic Portal Vein and Its Role in Food Intake and Reward.

The detection of nutrients in the gut influences ongoing and future feeding behavior as well as the development of food preferences. In addition to nutrient sensing in the intestine, the hepatic portal vein plays a considerable role in detecting ingested nutrients and conveying this information to brain nuclei involved in metabolism, learning, and reward. Here, we review mechanisms underlying hepatic portal vein sensing of nutrients, particularly glucose, and how this is relayed to the brain to influence feeding behavior and reward. We additionally highlight several gaps where future research can provide new insights into the effects of portal nutrients on neural activity in the brain and feeding behavior.

Conservative treatment of hepatic portal vein gas after transarterial chemoembolization treatment for liver metastasis of postoperative esophageal cancer: a case report.

Background: Hepatic portal vein gas (HPVG), which is a rare clinical manifestation, is usually considered a sign of critical illness. If the treatment is not timely, it will lead to intestinal ischemia, intestinal necrosis, and even death. There is still no consensus on whether to adopt surgical or conservative treatment for HPVG. Herein, we report a rare case of conservative treatment of HPVG after transarterial chemoembolization (TACE) treatment in a patient with liver metastasis of postoperative esophageal cancer, who received long-term enteral nutrition (EN). Case Description: A 69-year-old male patient, who had undergone surgery for esophageal cancer, needed long-term use of jejunal feeding tube implantation for enteral nutritional support due to postoperative complications. About 9 months after the operation, multiple metastases of the liver were detected. To control the progress of the disease, TACE was conducted. EN was restored on the second day after TACE, and the patient was discharged on the fifth day. On the night of discharge, the patient suddenly experienced abdominal pain, nausea, and vomiting. Abdominal computed tomography (CT) showed that the abdominal intestinal lumen was obviously dilated, liquid and gas plane shadowing was visible, and gas was visible in the portal vein and its branches. The physical examination showed that peritoneal irritation was present, and bowel sounds were active. Blood routine examination showed an increase in neutrophil and neutrophil. Symptomatic treatment, including gastrointestinal decompression, anti-infection, and parenteral nutritional support, was provided. On the third day after the presentation of HPVG, abdominal CT reexamination showed that HPVG had disappeared and the intestinal obstruction was relieved. Repeated blood routine shows a decrease in neutrophil and neutrophil. Conclusions: Elderly patients who require long-term EN support should avoid early EN support after TACE, as this can prevent intestinal obstruction and HPVG. If the patient suddenly experiences abdominal pain after TACE, CT scan should be performed in a timely manner to determine whether there is intestinal obstruction and HPVG. If the above type of patient experiences HPVG, conservative treatments such as early gastrointestinal decompression, fasting, and anti-infection treatment can be provided first without high-risk factors.

A healthy young patient with hepatic portal vein gas due to acute gastric dilatation: a case report.

Hepatic portal vein gas (HPVG) is caused by the influx of gastrointestinal gas into the intrahepatic portal vein as a result of gastrointestinal wall fragility due to ischemia or necrosis. Gastrointestinal tract necrosis is fatal in severe cases. We observed a case of food intake-induced acute gastric dilatation (AGD) in a healthy young male who developed HPVG and underwent conservative treatment. A 25-year-old male presented to our hospital with epigastric pain and nausea the day after excessive food intake. Computed tomography (CT) revealed gas along the intrahepatic portal vein and marked gastric dilatation with large food residue. AGD-induced HPVG was considered. Esophagogastroduodenoscopy (EGD) was not performed at this stage because of the risk of HPVG and AGD exacerbation, and the patient was followed up with intragastric decompression via a nasogastric tube. Food residue and approximately 2 L of liquid without blood were vomited 1 h after the nasogastric tube placement. His symptoms improved after the vomiting episode. An EGD was performed 2 days after undergoing CT. Endoscopic findings revealed extensive erosions and the presence of a whitish coat extending from the fornix to the lower body of the stomach, indicating AGD. HPVG disappeared on the CT scan taken during EGD. Thereafter, symptom relapse and HPVG recurrence were not observed.

Imaging findings of hepatocellular carcinoma with portal vein tumor thrombosis secondary to hepatic portal vein collateral circulation: a cross-sectional study.

Background: Hepatic portal vein collateral circulation plays an important role in maintaining the perfusion of hepatic portal vein. However, at present, there is little research on collateral circulation of hepatic portal vein. Our study aims to analysis the imaging types and clinical value of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) invading and completely blocking different branches of portal vein, secondary to hepatic portal vein collateral circulation. Methods: This study retrospectively analyzed Hepatocellular carcinoma (HCC) with PVTT diagnosed with enhanced CT examination of the upper abdomen in our hospital from May 2020 to October 2021.The inclusion criteria for patients were the following: (I) ultimately diagnosed with HCC, (II) accompanied by complete obstruction of the main portal vein or left/right branches, and (III) with collateral circulation of the hepatic portal vein established. All images were postprocessed by multiplanar reconstruction (MPR), maximum intensity projection (MIP), and other reconstruction techniques to obtain images of the abnormal portal vein system and the collateral vessels running toward the hepatic portal veins. Three physicians jointly judged the imaging anatomical classification of each collateral vessel. The qualitative variables were compared by chi-squared test. Results: A total of 125 hepatic portal vein collateral vessels were observed in MPR and MIP reconstruction images of 71 patients with portal vein cancer thrombosis with established hepatic portal vein collateral circulation. Common hepatic collateral branches in patients with PVTT mainly include the biliary collateral branch, gastric collateral branch, mesenteric collateral branch, accessory portal vein system and the splenic branch. The incidence rate was respectively 77.5%, 36.6%, 32.4%, 28.2%, 1.41%. Conclusions: The correct understanding of the imaging anatomical classification of the collateral vessels of the hepatic portal vein can provide clinicians with more information for diagnosis and treatment planning.

Do extreme postprandial levels of oxygen, carbon dioxide, and ammonia in the digestive tract equilibrate with the bloodstream in the freshwater rainbow trout (Oncorhynchus mykiss)?

The gastrointestinal tract (GIT) lumen of teleosts harbors extreme conditions, especially after feeding: high PCO2 (20-115 Torr), total ammonia (415-3710 µM), PNH3 (79-1760 µTorr in the intestine), and virtual anoxia (PO2 < 1 Torr). These levels could be dangerous if they were to equilibrate with the bloodstream. Thus, we investigated the potential equilibration of O2, CO2, and ammonia across the GIT epithelia in freshwater rainbow trout by monitoring postprandial arterial and venous blood gases in vivo and in situ. In vivo blood was sampled from the indwelling catheters in the dorsal aorta (DA) and subintestinal vein (SIV) draining the posterior intestine in the fasting state and at 4 to 48 h following catheter-feeding. To investigate possible ammonia absorption in the anterior part of the GIT, blood was sampled from the DA, SIV and hepatic portal vein (HPV) from anaesthetized fish in situ following voluntary feeding. We found minimal equilibration of all three gases between the GIT lumen and the SIV blood, with the latter maintaining pre-feeding levels (PO2 = 25-49 Torr, PCO2 = 6-8 Torr, and total ammonia = 117-134 µM and PNH3 = 13-30 µTorr at 48 h post-feeding). In contrast to the SIV, we found that the HPV total ammonia more than doubled 24 h after feeding (128 to 297 µM), indicative of absorption in the anterior GIT. Overall, the GIT epithelia of trout, although specialized for absorption, prevent dangerous levels of PO2, PCO2 and ammonia from equilibrating with the blood circulation.

Maternal and perinatal outcome in pregnancies complicated with portal hypertension: a systematic review and meta-analysis.

BACKGROUND: Portal hypertension is secondary to either cirrhotic or non-cirrhotic causes, and complicating pregnancy poses a challenge to the treating team. A systematic review was performed to determine maternal and perinatal outcomes in women with portal hypertension. Outcomes were compared among those with cirrhotic (CPH) with non-cirrhotic portal hypertension (NCPH) as well as non-cirrhotic portal fibrosis (NCPF) with extra-hepatic portal vein obstruction (EHPVO). METHODS: Medline and EMBASE databases were searched for studies reporting outcomes among pregnant women with portal hypertension. Reference lists from relevant papers and reviews were hand-searched for appropriate citations. Data were extracted to describe maternal complications, obstetric and neonatal outcomes. A random-effects model was used to derive pooled estimates of various outcomes, and final estimates were reported as percentages with a 95% confidence interval (CI). Cumulative, sequential and sensitivity analysis was studied to assess the temporal trends of outcomes over the period. RESULTS: Information on 895 pregnancies among 581 patients with portal hypertension was included from 26 studies. Portal hypertension was diagnosed during pregnancy in 10% (95% CI 4-24%). There were 22 maternal deaths (0%, 95% CI 0-1%), mostly following complications from variceal bleeding or hepatic decompensation. Variceal bleeding complicated in 14% (95% CI 9-20%), and endoscopic interventions were performed in 12% (95% CI 8-17%) during pregnancy. Decompensation of liver function occurred in 7% (95% CI 3-12%). Thrombocytopenia was the most common complication (41%, 95% CI 23-60%). Miscarriages occurred in 14% (95% CI 8-20%), preterm birth in 27% (95% CI 19-37%), and low birth weights in 22% (95% CI 15-30%). Risk of postpartum hemorrhage was higher (RR 5.09, 95% CI 1.84-14.12), and variceal bleeding was lower (RR 0.51, 95% CI 0.30-0.86) among those with CPH compared to NCPH. Risk of various outcomes was comparable between NCPF and EHPVO. CONCLUSION: One in ten pregnancies complicated with portal hypertension is diagnosed during pregnancy, and thrombocytopenia is the most common complication. Hepatic decompensation and variceal bleeding remain the most common cause of maternal deaths, with reduced rates of bleeding and its complications reported following the introduction of endoscopic procedures during pregnancy. CPH increases the risk of postpartum hemorrhage, whereas variceal bleeding is higher among NCPH.

A Case Report on Hepatic Portal Venous Gas (HPVG).

Hepatic Portal Venous Gas (HPVG) is the abnormal presence of gas in the portal venous system. It is associated with life-threatening conditions and is a sinister radiological sign. This case report aims to evaluate the significance of HPVG as a radiological sign. Our case involves a 49-year-old man who was admitted to the hospital following a one-day history of severe epigastric pain and haematemesis. Investigations showed extensive HPVG, gastric pneumatosis, a large retroperitoneal haematoma, and an obstructive lesion between the first and second part of the duodenum. Our patient was managed conservatively in the High Dependency Unit (HDU). A repeat Computerised Tomography (CT) scan showed successful resolution of the HPVG and gastric pneumatosis without any invasive intervention.

Case report: Rare abernethy malformation with hepatopulmonary syndrome in a pediatric patient.

Abernethy malformation is a rare abnormality of the hepatic portal vein system with non-specific and diverse clinical manifestations. Here, we described a case of abernethy malformation with hepatopulmonary syndrome in a 10-year-old girl. On physical examination, cyanosed lips and acropachy could be found. Her oxygen saturation fluctuated at 89-94%, and the fasting blood ammonia was 98 umol/L. Furthermore, there were abnormalities in the imaging. The microbubble test with contrast echocardiography was positive. Computer tomography angiography (CTA) showed the splenic vein, and the superior mesenteric drained directly into the inferior vena cave after confluence. The same result was also observed in delayed splenic arteriography. Then, we discovered a tiny branch of the intrahepatic portal vein by the inferior vena cava balloon occlusion test, which could also show the confluence of the splenic vein and superior mesenteric vein with the inferior venacave. According to the evidence above, we concluded that the girl was a patient of type II abernethy malformation. For the severe dysplasia of the portal vein, the girl accepted partial ligation of portosystemic shunt and Rex shunt, which improved her oxygen saturation and exercise tolerance.

A rare case of duodenal variceal bleeding due to extrahepatic portal vein obstruction successfully treated with endoscopic injection sclerotherapy.

Primary extra-hepatic portal vein obstruction (EHPVO) is a disease that develops ectopic varices due to portal hypertension and obstruction of the portal vein. Since bleeding from ectopic varices is life-threatening, the management of ectopic varices is important for patients with primary EHPVO. Here, we report a case of duodenal variceal bleeding in a patient with primary EHPVO. A 39-year-old man was diagnosed with F2-shaped duodenal varices (DV) due to primary EHPVO and was first treated with endoscopic variceal ligation for temporary hemostasis. We then performed angiography to understand the detailed hemodynamics and subsequently conducted endoscopic injection sclerotherapy (EIS) with a sclerosing agent containing N-butyl-2-cyanoacrylate for further hemostasis. After the treatment, dynamic computed tomography and endoscopic ultrasound revealed that the blood flow to the causative DV disappeared, although the DV itself remained. The patient was discharged without any re-bleeding or adverse events. Since treatment for DV due to primary EHPVO differs depending on hemodynamics (hepatofugal or hepatopetal blood flow), evaluating detailed hemodynamics for optimal treatment selection is crucial. Although EIS for this patient was not a radical treatment, it was effective in managing acute bleeding from the DV. This case will serve as a reference for successful treatment in future cases.

Image quality enhancement of CT hepatic portal venography using dual energy blending with computer determined parameters.

BACKGROUND: Previous studies have shown that using some post-processing methods, such as nonlinear-blending and linear blending techniques, has potential to improve dual-energy computed (DECT) image quality. OBJECTIVE: To improve DECT image quality of hepatic portal venography (CTPV) using a new non-linear blending method with computer-determined parameters, and to compare the results to additional linear and non-linear blending techniques. METHODS: DECT images of 60 patients who were clinically diagnosed with liver cirrhosis were selected and studied. Dual-energy scanning (80 kVp and Sn140 kVp) of CTPV was utilized in the portal venous phase through a dual-source CT scanner. For image processing, four protocols were utilized including linear blending with a weighing factor of 0.3 (protocol A) and 1.0 (protocol B), non-linear blending with fixed blending width of 200 HU and set blending center of 150HU (protocol C), and computer-based blending (protocol D). Several image quality indicators, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and contrast of hepatic portal vein and hepatic parenchyma, were evaluated using the paired-sample t-test. A 5-grade scale scoring system was also utilized for subjective analysis. RESULTS: SNR of protocols A-D were 9.1±2.1, 12.1±3.0, 11.6±2.8 and 14.4±3.2, respectively. CNR of protocols A-D were 4.6±1.3, 8.0±2.3, 7.0±2.0 and 9.8±2.4, respectively. The contrast of protocols A-D were 37.7±11.6, 91.9±21.0, 66.2±19.0 and 107.7±21.3, respectively. The differences between protocol D and other three protocols were significant (P < 0.01). In subjective evaluation, the modes of protocols A, B, C, and D were rated poor, good, generally acceptable, and excellent, respectively. CONCLUSION: The non-linear blending technique of protocol D with computer-determined blending parameters can help improve imaging quality of CTPV and contribute to a diagnosis of liver disease.

Post-prandial respiratory gas and acid-base profiles in the gastrointestinal tract and its venous drainage in freshwater rainbow trout (Oncorhynchus mykiss) and seawater English sole (Parophrys vetulus).

The basic respiratory gas and acid-base conditions inside the lumen of the gastrointestinal tract (GIT) and blood draining the tract are largely unestablished in teleost fishes after feeding, though there have been some recent novel discoveries on freshwater rainbow trout (Oncorhynchus mykiss) and seawater English sole (Parophrys vetulus). The present study examined in greater detail the gas (PO2, PCO2, PNH3) and acid-base profiles (pH, [HCO3-], total [ammonia]) in the lumen of the stomach, the anterior, mid, and posterior intestine, as well as the venous drainage (subintestinal and/or hepatic portal vein) of the GIT in these two species 20 h post-feeding. Both species had high PCO2, PNH3, and total [ammonia], and low PO2 (virtual anoxia) in the lumens throughout all sections of the GIT, and high [HCO3-] in the intestine. Total [ammonia], PNH3, and [HCO3-] increased from anterior to posterior intestine in both species. P. vetulus had higher intestinal total [ammonia] and lower [HCO3-] than O. mykiss post feeding, but total [ammonia] was much higher in the stomach of O. mykiss. Despite the extreme conditions in the lumen, both arterial and venous blood showed relatively lower PCO2, total [ammonia] and higher PO2, implying limited equilibration between the two compartments. The higher [HCO3-] and lower total [ammonia] in the intestinal lumen of the freshwater O. mykiss than the seawater P. vetulus suggest the need for future comparative studies using conspecifics fed identical diets but acclimated to the two different salinities in order to understand the potential role of environmental salinity and associated osmoregulatory processes underlying these differences.

Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction.

BACKGROUND: Both noncirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHPVO) are important causes of noncirrhotic portal hypertension (PH) in the Asian region. In this study, we analyzed the histopathological changes of liver needle-core biopsies from patients with NCPF and EHPVO. PATIENTS AND METHODS: The patients were diagnosed as per the Asia Pacific Association for the Study of Liver (APASL) criteria. Minimum adequacy criteria for liver core biopsies were defined, and finally, 69 liver biopsies from patients with NCPF and 100 liver biopsies from patients with EHPVO were analyzed. All histological parameters were predefined, and three experienced pathologists analyzed the biopsies after reaching consensus. Institute ethics committee clearance was taken. RESULTS: Although some histological features were overlapping, phlebosclerosis of intra-hepatic branches of the portal vein (PV), periportal aberrant vascular channels, remnant portal tracts, and hepatic fibrosis beyond the portal tracts without the formation of complete hepatic nodules (P < 0.001 for all) were common histological characteristics of NCPF on core-needle liver biopsies; while maintained lobular architecture, nonspecific dilatation of PV branches, absence of intra-hepatic PV phlebosclerosis, aberrant vascular channels, and significant fibrosis were characteristics of EHPVO. CONCLUSIONS: Despite the considerable histological overlap between NCPF and EHPVO, careful histological evaluation, supplemented by clinical features, radiological and biochemical findings can help in making a conclusive diagnosis. Patients with NCPF and EHPVO with clinical jaundice show transaminitis, high serum alkaline phosphatase level, more variceal bleed, and histological evidences of nodular regenerative hyperplasia.

Comparative anatomo-radiological study of intrahepatic venous vascularization in the Spain.

BACKGROUND: Anatomic variations in the hepatic venous system are the least understood aspect of hepatic anatomy. The variations are diverse, and data are lacking with respect to the population of Spain and methods of detection. The objective was to examine morphological patterns of variations in hepatic venous vascularization using cadaveric dissections vs. radiological imaging, and to analyze the findings with respect to Spain and to published studies. METHODS: Thirty-one livers were anatomically dissected and analyzed for their hepatic venous anatomy and then compared to the venous anatomy of livers examined in 216 CT scans from 119 men and 97 women, ranging between 27 and 89 years of age. Statistical analysis was done using the Chi squared and Fisher homogeneity tests. RESULTS: The hepatic portal vein showed morphological variations in cadavers vs. CT of 67.3% vs. 67.6% (p-I), 29% vs. 12.2% (p-II), 0% vs. 14.6% (p-III), 0% vs. 14.6% (p-IV), 3.2% vs. 0.5% (p-V) and 6.5% vs. 1.9% (p-VI), respectively in cadavers vs. CT. Hepatic vein pattern variation were found in 64.5% vs. 50.7% (h-I), 32.2% vs. 31.5% (h-II), 0% vs. 2.3% (h-III), 0% vs. 4.7% (h-IV), respectively in dissections vs. CT). In Accessory Hepatic Veins the frequency in pattern variation was 64.5% vs. 18.8% (a-2.1), 29.0% vs. 8.0% (a-2.2), 58.1% vs. 11.3% (a-2.3), 9.7% vs. 0.9% (a-2.4), 67.7% vs. 16.9% (a-2.5), 9.7% vs. 4.2% (a-2.6) and 0% vs. 0.5% (a-2.7), respectively, in cadavers vs. CT. CT showed in 27.2% no accessory hepatic veins. Sex was not a factor influencing patterns of variation. CONCLUSION: Anatomical variants of the hepatic portal vein, the hepatic vein and accessory hepatic veins are very diverse and show greater variability in the specimens compared to those detected with radiological images, finding a wider spectrum of variations as it allows the clinician to have a more precise definition of the vasculature. A higher precision in the definition of anatomical variations is warranted for surgical planning in liver resection and transplantation.

Hepatic portal vein gas associated with intestinal ischemia and acute gastric dilatation: a case report.

Hepatic portal vein gas (HPVG) is a rare and alarming radiographic finding for patients especially those who had intestinal ischemia. Some surgeons may learn it from books, literature and internet while they may not treat it in a real patient. It often indicates a very serious infection which could result in septic shock even death within a very short time, even though the mortality of patients with HPVG went down with the increased use of computed tomography and ultrasound which allows early and highly sensitive detection of such severe illnesses. Here I report a case in which an 84-year-old man was admitted to emergency department for three days of vomiting and two days of abdominal distension after eating an apple who had HPVG associated with intestinal ischemia and acute gastric dilatation and then died of septic shock in a short time. And the pathogenesis of HPVG is not completely clear at present, while three hypotheses may explain the relation between them. Attention must be paid closely to the patient who has HPVG associated with intestinal ischemia, and something must be done because it may indicate a life-threatening acute abdomen.

Hypothalamic detection of macronutrients via multiple gut-brain pathways.

Food intake is tightly regulated by complex and coordinated gut-brain interactions. Nutrients rapidly modulate activity in key populations of hypothalamic neurons that regulate food intake, including hunger-sensitive agouti-related protein (AgRP)-expressing neurons. Because individual macronutrients engage specific receptors in the gut to communicate with the brain, we reasoned that macronutrients may utilize different pathways to reduce activity in AgRP neurons. Here, we revealed that AgRP neuron activity in hungry mice is inhibited by site-specific intestinal detection of different macronutrients. We showed that vagal gut-brain signaling is required for AgRP neuron inhibition by fat. In contrast, spinal gut-brain signaling relays the presence of intestinal glucose. Further, we identified glucose sensors in the intestine and hepatic portal vein that mediate glucose-dependent AgRP neuron inhibition. Therefore, distinct pathways are activated by individual macronutrients to inhibit AgRP neuron activity.

Serum proteome profiling provides a deep understanding of the 'gut-liver axis' in relation to liver injury and regeneration.

The gut-liver axis is one of the major contributors to the transport of products from the intestine or intestinal microbes with the progression of liver regeneration. However, the influence of proteins from the hepatic portal vein (HPV), the bridge of enterohepatic circulation, on liver regeneration is unclear. For first time, we applied a quantitative proteomics approach to characterize the molecular pathology of the HPV sera of mice with antibiotic-induced intestinal flora disorder during acute liver injury. The biological processes of lipid metabolism and wound healing were enriched in the HPV of mice with intestinal flora disorder, whereas energy metabolism, liver regeneration, and cytoskeletal processes were downregulated. Moreover, 95 and 35 proteins potentially promoting or inhibiting liver regeneration, respectively, were identified in HPV serum. Our findings will be beneficial to liver donors during liver transplantation.

Gastric Emphysema and Hepatic Portal Vein Gas as Complications of Noninvasive Positive Pressure Ventilation.

Gastric emphysema (GE) in association with hepatic portal vein gas (HPVG) is a rare, benign medical condition that is very seldom caused by noninvasive positive pressure ventilation (NIPPV). This report describes a patient who developed GE along with gastric vein gas and HPVG, most likely due to multiple episodes of vomiting in combination of using bilevel positive airway pressure (BiPAP), a form of NIPPV. The patient responded to conservative treatment with intravenous fluids, pantoprazole, and the urgent cessation of BiPAP and oral intake.