A systematic review of safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers

AbstractObjectivesTo review the evidence on the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.MethodsMedline and EMBASE were systematically searched for papers of hepatopancreatoduodenectomy in patients with biliary and gallbladder cancers.ResultsEighteen studies involving 397 patients were reviewed. Major hepatectomy was undertaken in 81.3% of the 397 patients and the R0 resection rate was 71.3%. The morbidity and mortality rates were 78.9% and 10.3%, respectively. The 5-year overall survival rate ranged from 3% to 50% (median = 31%). The 5-year survival rate in patients who underwent curative resection was 18–68.8% (median = 51.3%), and 0% in patients who received non-curative resection.ConclusionsHepatopancreatoduodenectomy is a challenging procedure with high morbidity and mortality rates. However, this procedure can provide a chance of long-term survival in patients in whom curative resection is feasible

Electrical stimulation therapy for peripheral nerve injury

Peripheral nerve injury is common and frequently occurs in extremity trauma patients. The motor and sensory impairment caused by the injury will affect patients' daily life and social work. Surgical therapeutic approaches don't assure functional recovery, which may lead to neuronal atrophy and hinder accelerated regeneration. Rehabilitation is a necessary stage for patients to recover better. A meaningful role in non-pharmacological intervention is played by rehabilitation, through individualized electrical stimulation therapy. Clinical studies have shown that electrical stimulation enhances axon growth during nerve repair and accelerates sensorimotor recovery. According to different effects and parameters, electrical stimulation can be divided into neuromuscular, transcutaneous, and functional electrical stimulation. The therapeutic mechanism of electrical stimulation may be to reduce muscle atrophy and promote muscle reinnervation by increasing the expression of structural protective proteins and neurotrophic factors. Meanwhile, it can modulate sensory feedback and reduce neuralgia by inhibiting the descending pathway. However, there are not many summary clinical application parameters of electrical stimulation, and the long-term effectiveness and safety also need to be further explored. This article aims to explore application methodologies for effective electrical stimulation in the rehabilitation of peripheral nerve injury, with simultaneous consideration for fundamental principles of electrical stimulation and the latest technology. The highlight of this paper is to identify the most appropriate stimulation parameters (frequency, intensity, duration) to achieve efficacious electrical stimulation in the rehabilitation of peripheral nerve injury

A new IL6 isoform in Chinese soft-shelled turtle (Pelodiscus sinesis) discovered: Its regulation during cold stress and infection

The Chinese soft-shelled turtle (Pelodiscus sinesis) is a widely cultured commercial species in East and Southeast Asian countries. The turtles frequently suffer from acute cold stress during farming in China. Stress-induced factor such as Interleukin-6 (IL6) is a multifunctional molecule that plays important roles in innate and adaptive immune response. In the present study, we found that the turtle possessed two IL6 transcripts, where one IL6 transcript contained a signal peptide sequence (psIL6), while the other IL6 transcript (psIL6ns) possessed no such signal peptide gene. To test any differential expression of the two isoforms during temperature and microbial stress, turtles were adapted to optimal environmental water temperature (25 °C), stressed by acute cooling for 24 h, followed with the challenge of Aeromonas hydrophila (1.8 × 108 CFU) or Staphylococcus aureus (5.8 × 108 CFU). Gene characterization revealed that psIL6ns, a splicer without codons encoding a signal peptide and identical to the one predicted from genomic sequence, and psIL6, a splicer with codons encoding a signal peptide, were both present. Inducible expression was documented in primary spleen cells stimulated with ConA and poly I: C. The splenic and intestinal expression of psIL6ns and psIL6 was increased in response to temperature stress and bacterial infection

Trained Innate Immunity of Fish Is a Viable Approach in Larval Aquaculture

The general understanding has been that only adaptive immunity is capable of immunological memory, but this concept has been challenged in recent years by studies showing that innate immune systems can mount resistance to reinfection—as the innate immune system can adapt its function following an insult. Innate immune training offers an attractive approach in intensive fish larval rearing, especially since the adaptive immune system is not fully developed. Trained innate immunity will potentially favor robust fish in terms of resistance to viral and bacterial diseases. So-called immunostimulants such as ß-glucans have for decades been used both in laboratories and in intensive fish aquaculture. Treatment of fish by ß-glucans (and by other substances with pathogen-associated molecular patterns) often induces activation of non-specific/innate immune mechanisms and induces higher disease resistance. The reported effects of e.g., ß-glucans fit nicely into the concept “trained innate immunity,” but the research on fish does not yet include analysis of epigenetic changes that may be a prerequisite for long-lasting trained innate immunity. In this “perspective,” we will discuss how in practical terms and based on prior knowledge one can introduce innate immune training in brood stock fish, and their offspring, and whether innate immune training by ß-glucans is a viable approach in larval aquaculture

Review of rehabilitation protocols for brachial plexus injury

Brachial plexus injury (BPI) is one of the most serious peripheral nerve injuries, resulting in severe and persistent impairments of the upper limb and disability in adults and children alike. With the relatively mature early diagnosis and surgical technique of brachial plexus injury, the demand for rehabilitation treatment after brachial plexus injury is gradually increasing. Rehabilitation intervention can be beneficial to some extent during all stages of recovery, including the spontaneous recovery period, the postoperative period, and the sequelae period. However, due to the complex composition of the brachial plexus, location of injury, and the different causes, the treatment varies. A clear rehabilitation process has not been developed yet. Rehabilitation therapy that has been widely studied focusing on exercise therapy, sensory training, neuroelectromagnetic stimulation, neurotrophic factors, acupuncture and massage therapy, etc., while interventions like hydrotherapy, phototherapy, and neural stem cell therapy are less studied. In addition, rehabilitation methods in some special condition and group often neglected, such as postoperative edema, pain, and neonates. The purpose of this article is to explore the potential contributions of various methods to brachial plexus injury rehabilitation and to provide a concise overview of the interventions that have been shown to be beneficial. The key contribution of this article is to form relatively clear rehabilitation processes based on different periods and populations, which provides an important reference for the treatment of brachial plexus injuries

Enabling the Discovery of Recurring Anomalies in Aerospace System Problem Reports using High-Dimensional Clustering Techniques

This paper describes the results of a significant research and development effort conducted at NASA Ames Research Center to develop new text mining techniques to discover anomalies in free-text reports regarding system health and safety of two aerospace systems. We discuss two problems of significant importance in the aviation industry. The first problem is that of automatic anomaly discovery about an aerospace system through the analysis of tens of thousands of free-text problem reports that are written about the system. The second problem that we address is that of automatic discovery of recurring anomalies, i.e., anomalies that may be described m different ways by different authors, at varying times and under varying conditions, but that are truly about the same part of the system. The intent of recurring anomaly identification is to determine project or system weakness or high-risk issues. The discovery of recurring anomalies is a key goal in building safe, reliable, and cost-effective aerospace systems. We address the anomaly discovery problem on thousands of free-text reports using two strategies: (1) as an unsupervised learning problem where an algorithm takes free-text reports as input and automatically groups them into different bins, where each bin corresponds to a different unknown anomaly category; and (2) as a supervised learning problem where the algorithm classifies the free-text reports into one of a number of known anomaly categories. We then discuss the application of these methods to the problem of discovering recurring anomalies. In fact the special nature of recurring anomalies (very small cluster sizes) requires incorporating new methods and measures to enhance the original approach for anomaly detection. ?& pant 0

Identification of novel pathways and immune profiles related to sarcopenia

IntroductionSarcopenia is a progressive deterioration of skeletal muscle mass strength and function.MethodsTo uncover the underlying cellular and biological mechanisms, we studied the association between sarcopenia's three stages and the patient's ethnicity, identified a gene regulatory network based on motif enrichment in the upregulated gene set of sarcopenia, and compared the immunological landscape among sarcopenia stages.ResultsWe found that sarcopenia (S) was associated with GnRH, neurotrophin, Rap1, Ras, and p53 signaling pathways. Low muscle mass (LMM) patients showed activated pathways of VEGF signaling, B-cell receptor signaling, ErbB signaling, and T-cell receptor signaling. Low muscle mass and physical performance (LMM_LP) patients showed lower enrichment scores in B-cell receptor signaling, apoptosis, HIF-1 signaling, and the adaptive immune response pathways. Five common genes among DEGs and the elastic net regression model, TTC39DP, SLURP1, LCE1C, PTCD2P1, and OR7E109P, were expressed between S patients and healthy controls. SLURP1 and LCE1C showed the highest expression levels among sarcopenic Chinese descent than Caucasians and Afro-Caribbeans. Gene regulatory analysis of top upregulated genes in S patients yielded a top-scoring regulon containing GATA1, GATA2, and GATA3 as master regulators and nine predicted direct target genes. Two genes were associated with locomotion: POSTN and SLURP1. TTC39DP upregulation was associated with a better prognosis and stronger immune profile in S patients. The upregulation of SLURP1 and LCE1C was associated with a worse prognosis and weaker immune profile.ConclusionThis study provides new insight into sarcopenia's cellular and immunological prospects and evaluates the age and sarcopenia-related modifications of skeletal muscle

Effect of infrahepatic inferior vena cava clamping on bleeding during hepatic resection: A meta-analysis

Summary: This meta-analysis aimed to explore the effect of infrahepatic vena cava (IVC) clamping on bleeding during hepatic resection. PubMed and Embase databases were searched systematically to identify randomized controlled trials (RCTs) comparing infrahepatic IVC clamping to IVC nonclamping during hepatic resection. A random-effects model was used to calculate weight and outcome measures. Five RCTs involving a total of 596 patients were identified for inclusion: 299 in infrahepatic IVC clamping group and 297 in nonclamping group. Infrahepatic IVC clamping was associated with a statistically significant reduction in total intraoperative blood loss (weighted mean difference [WMD] -181.72, 95% confidence interval [95% CI] −329.03 to −34.4; P = 0.02) and blood loss during parenchymal transaction (WMD -160.58, 95% CI, −261.9 to −59.27; P = 0.002). Postoperative morbidity, mortality, and hospital stay were comparable in both groups. Data from currently available literature suggest that infrahepatic IVC clamping is a safe procedure that facilitates intraoperative bleeding control during hepatic resection. Keywords: Infrahepatic vena cava clamping, Bleeding, Hepatic resection, Meta-analysi

Development and application of nano-flavor-drug carriers in neurodegenerative diseases

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