Laparoscopic left lateral sectionectomy in pediatric living donor liver transplantation by single-port approach: A case report

BACKGROUNDSingle-port laparoscopy has been used in a variety of abdominal operations. We report the first case of single-port laparoscopic left lateral sectionectomy in pediatric laparoscopic living donor liver transplantation.CASE SUMMARYA 28-year-old man volunteered for living liver donation to his daughter who was diagnosed with liver cirrhosis and portal hypertension after the Kasai procedure for biliary atresia. His body mass index was 20.5 kg/m². Liver dynamic computed tomography showed: (1) Left lateral graft volume of 232.76 cm³ with a graft-to-recipient weight ratio of 2.59%; and (2) Right hepatic artery derived from the superior mesenteric artery. A single-port access system was placed through a transumbilical incision, including four trocars: two 12-mm ports for a camera and endoscopic stapler and two 5-mm working ports. Liver parenchyma was dissected by a Harmonic and Cavitron Ultrasonic Surgical Aspirator, while bipolar was used for coagulation. The bile duct was transected above the bifurcation by indocyanine green fluorescence cholangiography. The specimen was retrieved from the umbilical incision. The total operation time was 4 h without blood transfusion. The final graft weight was 233.6 g with graft-to-recipient weight ratio of 2.60%. The donor was discharged uneventfully on postoperative day 4.CONCLUSIONSingle-port laparoscopic left lateral sectionectomy is feasible in pediatric laparoscopic living donor liver transplantation in an experienced transplant center.     

Recycling of Waste Facial Masks as a Construction Material,a Step towards Sustainability

Amid the COVID-19 pandemic, a sudden surge in the production and utilization of disposable, single-use facial masks has been observed. Delinquency in proper disposal of used facial masks endangers the environment with a new form of non-biodegradable plastic waste that will take hundreds of years to break down. Therefore, there is an urgent need for the resourceful recycling of such waste in an environmentally friendly way. This study presents an efficient solution by using waste masks in fibered or crushed form to produce environmentally friendly and affordable green concrete. This investigation assessed the mechanical and durability properties of waste masks-incorporated concrete. A total of six mixes were prepared for standardized tests to determine compressive strength, split cylinder tensile strength and rapid chloride penetration test (RCPT), and freeze-thaw resistance. The percentage of mask fibers used were 0.5, 1, 1.5, and 2% of concrete by volume, while crushed masks were used at 0.5% only. The mask waste in both forms was found suitable to be used in concrete. One percent of waste mask fibers was found as an optimum value to increase compressive and tensile strength, reduce chloride permeability, and increase freeze-thaw resistance. Besides this, 0.5% crushed mask fiber also performed well, especially for producing less permeable and highly durable concrete. It is thus corroborated that waste masks that increase pollution worldwide can be utilized sustainably to help build green buildings. By reutilizing waste masks to produce improved concrete with better strengths and higher durability, circular economy and sustainability are achieved, along with efficient waste management.     

Reduced Abundance of Nitrate-Reducing Bacteria in the Oral Microbiota of Women with Future Preeclampsia

The oral microbiota can contribute to the regulation of blood pressure by increasing the availability of nitric oxide through the reduction of nitrate to nitrite, which can be converted into nitric oxide in the stomach and then enter the circulation. It is unclear if the composition of the oral microbiota is different between women who do and do not develop preeclampsia. This study aimed to compare the composition of the buccal microbiota just prior to the development of symptoms at 36 weeks gestation in 12 women who developed late-onset preeclampsia and 24 matched women who remained normotensive throughout pregnancy by 16S rRNA gene amplicon sequencing. The abundance of the nitrate-reducing Veillonella spp V. parvula and V. dispar and a subunit of nitrate reductase narH was compared using real-time PCR. The abundance of bacteria was correlated with maternal blood pressure and dietary intake of nitrate-containing vegetables. The results showed that the abundance of nitrate-reducing bacteria including Veillonella, specifically V. parvula, and Prevotella was reduced in women who developed preeclampsia. Veillonella but not Prevotella abundance was negatively correlated with maternal blood pressure. The dietary intake of nitrate-containing vegetables did not differ between the groups and was not correlated with the abundance of Veillonella. There was no difference in the abundance of the nitrate reductase subunit narH between the groups. These results suggest that the abundance of nitrate-reducing bacteria is reduced in the oral microbiota of women who later develop preeclampsia, indicating a potential pathway for prevention.     

Indocyanine green fluorescence-navigated thoracoscopy versus traditional inflation-deflation approach in precise uniportal segmentectomy: a short-term outcome comparative study

BackgroundUniportal video-assisted thoracoscopic surgery (VATS) segmentectomy is widely used in the field of thoracic surgery. However, anatomical variations in the bronchi and lung vessels may be critical obstacles during precise pulmonary segmentectomy. Thus, it is necessary to optimize uniportal VATS segmentectomy and to accurately identify the plane between lung segments by precisely transecting the bronchi and blood vessels of the lung segments. The indocyanine green fluorescence (ICGF)-based method has the potential to be a feasible and effective technique to facilitate the uniportal VATS segmentectomy. The present study aims at comparing the short-term outcomes of ICGF versus the traditional inflation-deflation method for uniportal VATS segmentectomy.MethodsThe perioperative clinical data in 200 consecutive patients undergoing uniportal VATS segmentectomy from December 2018 to August 2020 at Shanghai Chest Hospital were analyzed retrospectively. The targeted segment structures were identified and dissected precisely by using ICGF-based (N=100) or the traditional inflation-deflation (N=100) methods. The parameters of intraoperative blood loss and operation time, postoperative drainage volume, air leakage time, drainage tube retention time, length of hospital stay, and complications in the ICGF group were collected. Further, the operation time between the ICGF and the inflation-deflation groups was compared. The data summary and statistical analysis were performed by SPSS 19.0. P value <0.05 was considered statistically significant.ResultsNo massive hemorrhage, hypoxemia, allergy, conversion to lobectomy, or wedge resection was noted during the surgery. ICGF groups resulted in a shorter operative time (90±11.46 vs. 118±10.59 min, P<0.001). No postoperative complications were observed, e.g., bronchopleural fistula, hemoptysis, or atelectasis. All patients were discharged as routinely scheduled. No disease recurrence or metastasis was found during the follow-ups.ConclusionsOur study indicated that the ICGF-based navigation approach is a simple, effective, and reliable technique that can greatly facilitate the uniportal VATS segmentectomy.     

制作细粒棘球绦虫原头蚴染色标本方法的初探

目的　探索制作结构清晰、颜色鲜明、能长期保存的细粒棘球绦虫原头蚴标本的方法。　方法　孔雀绿染色法 :将原头蚴分别用 1%、2 %和 4 %孔雀绿水溶液 ,在室温或 36℃染色 2 4 h、4 8h和 72 h。　结果　 4 %孔雀绿水溶液 ,36℃ ,染色 4 8h为最佳条件。染色后原头蚴头钩呈亮绿色 ,而吸盘和实质部分无色透明 ,标本的对比性和立体感强。　结论　用孔雀绿染色法制作原头蚴标本在临床诊断和教学中有实用价值。     

携带融合基因穿梭质粒的构建及在人肝癌细胞中的表达

构建携带胸苷激酶(tk)与增强型绿色荧光蛋白(EGFP)融合基因穿梭质粒,并观察其在肝癌细胞系HepG2细胞中的表达。应用基因重组技术,构建EGFP与tk的融合表达穿梭质粒载体,经限制酶切鉴定和测序分析,脂质体转染将其导入HepG2中,48h后用荧光显微镜观察荧光的表达,RT-PCR法检测融合蛋白tk和EGFP的mRNA表达,四甲基偶氮唑蓝(MTT)实验检测转染融合蛋白载体后不同浓度的更昔洛韦(GCV)对HepG2细胞的细胞毒作用。酶切鉴定和测序分析证实重组质粒中插入融合目的基因片断及载体DNA大小、方向和插入位点正确,在转染此穿梭质粒的HepG2细胞中检测到绿色荧光蛋白的表达,RT-PCR检测到融合蛋白tk和EGFP的mRNA表达;GCV对转染了携带tk与EGFP融合基因穿梭质粒载体有明显的细胞毒作用。成功构建携带tk与EGFP融合基因穿梭质粒载体,转染人肝癌细胞株HepG2中tk和EGFP的独立表达没有受到影响,该载体可利用绿色荧光蛋白作为报告基因监测tk的表达并可用于肝癌的自杀基因治疗。     

Dietary Natural Compounds and Vitamins as Potential Cofactors in Uterine Fibroids Growth and Development

An analysis of the literature generated within the past 20 year-span concerning risks of uterine fibroids (UFs) occurrence and dietary factors was carried out. A link between Vitamin D deficiency and UFs formation is strongly indicated, making it a potent compound in leiomyoma therapy. Analogs of the 25-hydroxyvitamin D3, not susceptible to degradation by tissue 24-hydroxylase, appear to be especially promising and tend to show better therapeutic results. Although research on the role of Vitamin A in the formation of fibroids is contradictory, Vitamin A-enriched diet, as well as synthetic retinoid analogues, may be preventative or limit the growth of fibroids. Unambiguous conclusions cannot be drawn regarding Vitamin E and C supplementation, except for alpha-tocopherol. Alpha-tocopherol as a phytoestrogen taking part in the modulation of estrogen receptors (ERs) involved in UF etiology, should be particularly avoided in therapy. A diet enriched in fruits and vegetables, as sources of carotenoids, polyphenols, quercetin, and indole-3-carbinol, constitutes an easily modifiable lifestyle element with beneficial results in patients with UFs. Other natural substances, such as curcumin, can reduce the oxidative stress and protect against inflammation in leiomyoma. Although the exact effect of probiotics on uterine fibroids has not yet been thoroughly evaluated at this point, the protective role of dairy products, i.e., yogurt consumption, has been indicated. Trace elements such as selenium can also contribute to antioxidative and anti-inflammatory properties of a recommended diet. In contrast, heavy metals, endocrine disrupting chemicals, cigarette smoking, and a diet low in antioxidants and fiber were, alongside genetic predispositions, associated with UFs formation.     

rAAV2载体介导GFP基因转染树突状细胞

目的:在诱导人骨髓CD34 细胞分化成树突状细胞(dendritic cells,DCs)的基础上,探讨2型重组腺相关病毒(Type 2 recombinant adeno-associated virus,rAAV2)载体介导绿色荧光蛋白(green fluorescent protein,GFP)基因转染DCs的条件.方法:采用免疫磁珠法分离纯化人骨髓来源的CD34 细胞.在含有IL-4和GM-CSF的培养体系中体外诱导CD34 细胞生成DCs,于第5天加入TNF-α诱导DCs成熟,在不同时间用rAAV2载体介导GFP基因转染未成熟和成熟的DCs.通过电子显微镜和流式细胞仪鉴定树突状细胞,荧光显微镜及流式细胞仪检测GFP的表达.结果:人骨髓CD34 细胞经诱导分化后,在光镜及透射电镜下均可观察到DCs的形态特征,流式细胞仪检测到DCs表型;荧光显微镜及流式细胞仪检测细胞培养第3天、第5天和加入TNF-α后的rAAV2-GFP转染率分别为0.45%,13.54%和0.25%.结论:本实验中所采用的培养体系可成功将人骨髓CD34 细胞诱导分化成DCs,rAAV2/GFP转染DCs效率随细胞诱导分化时间的延长而增高,且转染未成熟DCs的效率高于转染成熟DCs.