IiAGL6 participates in the regulation of stamen development and pollen formation in Isatis indigotica

The AGL6 (AGMOUSE LIKE 6) gene is a member of the SEP subfamily and functions as an E-class floral homeotic gene in the development of floral organs. In this study, we cloned IiAGL6, the orthologous gene of AGL6 in Isatis indigotica. The constitutive expression of IiAGL6 in Arabidopsis thaliana resulted in a late-flowering phenotype and the development of curly leaves during the vegetative growth period. Abnormal changes in floral organ development were observed during the reproductive stage. In woad plants, suppression of IiAGL6 using TRV-VIGS (tobacco rattle virus-mediated virus-induced gene silencing) decreased the number of stamens and led to the formation of aberrant anthers. Similar changes in stamen development were also observed in miRNA-AGL6 transgenic Arabidopsis plants. Yeast two-hybrid and BiFC tests showed that IiAGL6 can interact with other MADS-box proteins in woad; thus, playing a key role in defining the identities of floral organs, particularly during stamen formation. These findings might provide novel insights and help investigate the biological roles of MADS transcription factors in I. indigotica.

The Therapeutic Effect of Swallow Training with a Xanthan Gum-Based Thickener in Addition to Classical Dysphagia Therapy in Chinese Patients with Post-Stroke Oropharyngeal Dysphagia: A Randomized Controlled Study

Objective

In patients with post-stroke oropharyngeal dysphagia (PSOD), classical dysphagia therapy (CDT) continues to provide unsatisfactory outcomes and makes it challenging for them to remove the nasal feeding tube. Increasing bolus viscosity helps prevent aspiration in PSOD. However, conventional starch thickeners enhance post-digestion residue. This study aims to evaluate the efficacy of swallow training with xanthan gum-based thickener (XGT) (Softia G, NUTRI Co., Ltd., Yokkaichi, Japan) additional to CDT in Chinese PSOD patients with a nasogastric tube when compared to CDT alone.

Methods

Patients with PSOD who had a nasogastric tube were randomly assigned to either the experimental group (E-group) or the control group (C-group) in this randomized controlled, single-blind, parallel-group study. Both groups received CDT for 4 weeks. The E-group cases received additional swallow training with a Softia G-prepared hydrogel training material. The Functional Oral Intake Scale (FOIS) and modified volume-viscosity swallow test (M-VVST) for swallowing safety and efficacy according to adjusted Chinese dietary habits were administered before and after treatment. Post-training, both groups' nasogastric tube removal rates were calculated.

Results

One hundred sixty-seven participants (E-group: 82 and C-group: 85) completed the study. The E-group's median score of FOIS improved significantly than the C-group after training (median = 5 vs. 3, P < 0.001). The incidence of coughing, voice changes, oxygen desaturation of 3% or more, pharyngeal residue and piecemeal deglutition in the E-group was significantly lower than that in the C-group (P < 0.05). The E-group had 100% nasogastric tube removal, while the C-group had 28.24% (P < 0.001).

Conclusion

Swallow training with XGT Softia G in addition to CDT can promote swallowing safety and efficacy in Chinese patients with PSOD more effectively than CDT alone.

[Clinical analysis of immunotherapy rechallenge in advanced gastric cancer]

Objective: To evaluate the efficacy and influencing factors of programmed death protein 1 (PD-1) monoclonal antibody rechallenge therapy in advanced gastric cancer (GC). Methods: The clinical data of patients with advanced GC who were treated with anti-PD-1 rechallenge in Henan Cancer Hospital from January 2020 to December 2021 were collected retrospectively. The progression-free survival (PFS) was defined as the time from the first or second used of anti-PD-1 treatment to the date of disease progression or the last follow-up, named PFS(1) and PFS(2), respectively. Kaplan-Meier method and Log rank test were used for survival analysis, Cox proportional hazard model was used to analyze the influencing factors. Results: A total of 60 patients with anti-PD-1 rechallenge therapy were collected, the median follow-up time was 12.2 months. The median progression-free survival (PFS(2)) of anti-PD-1 rechallenge therapy was 2.9 months, the objective response rate (ORR) was 16.7%, and the disease control rate (DCR) was 55.0%. The median PFS(2) of the first and second anti-PD-1 identical and different rechallenge treatment was 3.5 months and 1.9 months (P=0.007) respectively. The median PFS(2) of positive PD-L1 expression in rechallenge therapy was 3.4 months, ORR was 22.7%, and DCR was 63.6%; the median PFS(2) was 4.5 months, ORR was 27.3%, and DCR was 54.5% in patients with median PFS(1)≥6 months. Multivariate analysis showed that peritoneal metastasis was independently associated with anti-PD-1 rechallenge therapy with PFS(2) (HR=2.327, 95% CI, 1.066-5.082, P=0.034). The incidence of adverse reactions in grade 1-2 and grade 3-4 of anti-PD-1 rechallenge therapy was 83.3%, and 35.0%, respectively, and the safety was controllable. Conclusion: Rechallenge therapy with anti-PD-1 is a feasible treatment in advanced GC, but the screening of suitable population for rechallenge therapy still needs prospective data analysis and verification.

Self-assembled supramolecular artificial light-harvesting nanosystems: construction, modulation, and applications

Artificial light-harvesting systems, an elegant way to capture, transfer and utilize solar energy, have attracted great attention in recent years. As the primary step of natural photosynthesis, the principle of light-harvesting systems has been intensively investigated, which is further employed for artificial construction of such systems. Supramolecular self-assembly is one of the feasible methods for building artificial light-harvesting systems, which also offers an advantageous pathway for improving light-harvesting efficiency. Many artificial light-harvesting systems based on supramolecular self-assembly have been successfully constructed at the nanoscale with extremely high donor/acceptor ratios, energy transfer efficiency and the antenna effect, which manifests that self-assembled supramolecular nanosystems are indeed a viable way for constructing efficient light-harvesting systems. Non-covalent interactions of supramolecular self-assembly provide diverse approaches to improve the efficiency of artificial light-harvesting systems. In this review, we summarize the recent advances in artificial light-harvesting systems based on self-assembled supramolecular nanosystems. The construction, modulation, and applications of self-assembled supramolecular light-harvesting systems are presented, and the corresponding mechanisms, research prospects and challenges are also briefly highlighted and discussed.

IiSVP of Isatis indigotica can reduce the size and repress the development of floral organs

IiSVP of Isatis indigotica was cloned and its expression pattern was analyzed. Ectopic expression of IiSVP in Arabidopsis could delay the flowering time and reduce the size of the floral organs. SVP (SHORT VEGETATIVE PHASE) can negatively regulate the flowering time of Arabidopsis. In the present work, the cDNA of IiSVP, an orthologous gene of AtSVP in I. indigotica, was cloned. IiSVP was highly expressed in rosette leaves, inflorescences and petals, but weakly expressed in sepals, pistils and young silicles. The results of subcellular localization showed that IiSVP was localized in nucleus. Bioinformatics analysis indicated that this protein was a MADS-box transcription factor. Constitutive expression of IiSVP in Arabidopsis thaliana resulted in decrease of the number of petals and stamens, and curly sepals were formed. In IiSVP transgenic Arabidopsis plants, obvious phenotypic variations in flowers could be observed, especially the size of the floral organs. In comparison with the wild-type plants, the size of petals, stamens and pistil in IiSVP transgenic Arabidopsis plants was decreased significantly. In some transgenic plants, the petals were wrapped by the sepals. Yeast two-hybrid experiments showed that IiSVP could form higher-order complexes with other MADS proteins, including IiSEP1, IiSEP3, IiAP1 and IiSEP4, but could not interact with IiSEP2. In this work, it was proved that the flowering process and the floral development in Arabidopsis could be affected by IiSVP from I. indigotica Fortune.

Light-Driven Aqueous Dissipative Pseudorotaxanes with Tunable Fluorescence Enabling Deformable Nano-Assemblies

Developing an artificial dynamic nanoscale molecular machine that dissipatively self-assembles far from equilibrium is fundamentally important but is significantly challenging. Herein, we report dissipatively self-assembling light-activated convertible pseudorotaxanes (PRs) that show tunable fluorescence and enable deformable nano-assemblies. A pyridinium-conjugated sulfonato-merocyanine derivative (EPMEH) and cucurbit[8]uril (CB[8]) form the 2EPMEH ⊂ CB[8] [3]PR in a 2:1 stoichiometry, which phototransforms into a transient spiropyran containing 1:1 EPSP ⊂ CB[8] [2]PR when exposed to light. The transient [2]PR thermally relaxes (reversibly) to the [3]PR in the dark accompanied by periodic fluorescence changes that include near-infrared emission. Moreover, octahedral and spherical nanoparticles are formed through the dissipative self-assembly of the two PRs, and the Golgi apparatus is dynamically imaged using fluorescent dissipative nano-assemblies.

Synchronous Imaging in Golgi Apparatus and Lysosome Enabled by Amphiphilic Calixarene-Based Artificial Light-Harvesting Systems

Artificial supramolecular light-harvesting systems have expanded various properties on photoluminescence, enabling promising applications on cell imaging, especially for imaging in organelles. Supramolecular light-harvesting systems have been used for imaging in some organelles such as lysosome, Golgi apparatus, and mitochondrion, but developing a supramolecular light-harvesting platform for imaging two organelles synchronously still remains a great challenge. Here, we report a series of lower-rim dodecyl-modified sulfonato-calix[4]arene-mediated supramolecular light-harvesting platforms for efficient light-harvesting from three naphthalene diphenylvinylpyridiniums containing acceptors, Nile Red, and Nile Blue. All of the constructed supramolecular light-harvesting systems possess high light-harvesting efficiency. Furthermore, when the two acceptors are loaded simultaneously in a single light-harvesting donor system for imaging in human prostate cancer cells, organelle imaging in lysosome and Golgi apparatus can be realized at the same time with distinctive wavelength emission. Nile Red receives the light-harvesting energy from the donors, reaching orange emissions (625 nm) in lysosome while Nile Blue shows a near-infrared light-harvesting emission at 675 nm in Golgi apparatus in the same cells. Thus, the light harvesting system provides a pathway for synchronously efficient cell imaging in two distinct organelles with a single type of photoluminescent supramolecular nanoparticles.

Light-fueled transient supramolecular assemblies in water as fluorescence modulators

Dissipative self-assembly, which requires a continuous supply of fuel to maintain the assembled states far from equilibrium, is the foundation of biological systems. Among a variety of fuels, light, the original fuel of natural dissipative self-assembly, is fundamentally important but remains a challenge to introduce into artificial dissipative self-assemblies. Here, we report an artificial dissipative self-assembly system that is constructed from light-induced amphiphiles. Such dissipative supramolecular assembly is easily performed using protonated sulfonato-merocyanine and chitosan based molecular and macromolecular components in water. Light irradiation induces the assembly of supramolecular nanoparticles, which spontaneously disassemble in the dark due to thermal back relaxation of the molecular switch. Owing to the presence of light-induced amphiphiles and the thermal dissociation mechanism, the lifetimes of these transient supramolecular nanoparticles are highly sensitive to temperature and light power and range from several minutes to hours. By incorporating various fluorophores into transient supramolecular nanoparticles, the processes of aggregation-induced emission and aggregation-caused quenching, along with periodic variations in fluorescent color over time, have been demonstrated. Transient supramolecular assemblies, which act as fluorescence modulators, can also function in human hepatocellular cancer cells.

Dissipative self-assembly, which requires a continuous supply of fuel to maintain the assembled states far from equilibrium, is the foundation of biological systems but it remains a challenge to introduce light as fuel into artificial dissipative self-assemblies. Here, the authors report an artificial dissipative self-assembly system that is constructed from light-induced amphiphiles.

[Retrospective study of diagnosis and treatment of renal oncocytoma]

OBJECTIVE

To summarize the experience of diagnosis and surgical treatment of renal oncocytoma, and to evaluate the surgical results based on follow-up results, in order to find the best strategy.

METHODS

In the study, 21 cases with renal oncocytoma from December 2003 to April 2016 in Peking University Third Hospital were retrospectively analyzed, including 4 males, and 17 females, with 10 cases on the right side and 11 cases on the left side. Their age was between 15 to 80 years (average: 58 years). Ultrasound or CT examination after admission was conducted. Ultrasound examination showed solid nodules. CT manifestations were solid masses with enhancement, and the tumor size was between 1.5 cm to 6.5 cm (average: 3.3 cm). Of the 21 cases, 9 were located in the middle of kidney, 7 were located in the upper pole, and 5 were located in the lower pole. After preoperative examination, according to the size and location of the tumor, laparoscopic partial nephrectomy or laparoscopic nephrectomy was performed, respectively.

RESULTS

All the operations were successful, in which 17 cases underwent laparoscopic partial nephrectomy (including 3 cases which were converted to open surgery), and 4 cases underwent laparoscopic radical nephrectomy. The operation time ranged from 75 to 274 min (mean: 144 min), and the blood loss ranged from 10 to 1 000 mL (mean: 115 mL). The postoperative hospital stay time ranged from 6 to 13 d (average: 8.2 d). The pathological results were all renal oncocytoma. In the study, 17 cases were followed up while 4 cases were lost to follow-up. The follow-up time ranged from 12 to 175 months (mean: 44 months). One case died in 20 months after operation with unknown reason, and there were no recurrence or metastasis in the other 16 cases.

CONCLUSION

Renal oncocytoma is a benign tumor with good prognosis. Enhanced CT is an effective diagnostic method in assistant examination, but it is difficult to differentiate clear cell carcinoma only from the naked eye. It is worthwhile to measure CT value at different stages of the tumor by picture archiving and communication systems (PACS), and to compare with CT value of adjacent kidney tissue may improve the diagnostic efficiency of CT. Laparoscopic surgery is an effective treatment for renal oncocytoma. We recommend laparoscopic partial nephrectomy for the patients with renal oncocytoma as the best choice if conditions permit.

[Diagnosis and surgical treatment of massive adrenal area tumor with tumor thrombus]

OBJECTIVE

To summarize the experience of diagnosis and operation related to massive adrenal area tumor with venous tumor thrombus in clinic.

METHODS

From October 2017 to March 2019, a total of 8 cases of massive adrenal area tumor (>7 cm) with venous tumor thrombus were admitted at Peking University Third Hospital including 5 males and 3 females with mean age 50.6 years (31-62 years). There were 6 cases on the right side and 2 cases on the left side. The first symptoms included abdominal discomfort, hypertension, Cushing syndrome and abnormal menstruation; special past history included cirrhosis and lung cancer. Computed tomography (CT) and routine endocrine hormone tests were examined. Preoperative imaging confirmed 5 cases masses with tumor thrombus in inferior vena cava (IVC) and 1 case with tumor thrombus in left renal vein. Two cases presented with tumor thrombus in central adrenal vein were found intraoperatively. Open adrenalectomy and thrombectomy were performed in 4 cases of right side complicated with high tumor thrombus of inferior vena cava. Laparoscopic adrenalectomy and thrombectomy were performed in 3 cases, including 2 cases on the right and 1 case on the left. The case with tumor thrombus in left renal vein gave up operation. The patients were followed up with outpatient and telephone.

RESULTS

The mean size of the tumor was 8.9 cm (7-11 cm), the mean operative time was 319 min (120-510 min), while the estimated blood loss was 629 mL (50-1 200 mL). Intraoperative blood transfusion was required in 2 cases and 1 case encountered wound infection. The pathological types included pheochromocytoma, adrenocortical carcinoma, adrenal metastases of haptic carcinoma, and leiomyosarcoma. The case with left lung carcinoma who underwent left pneumonectomy one month before was highly suspected adrenal metastases of lung carcinoma. Tumor thrombus of pheochromocytoma was combined with blood thrombus. Capsule of adrenocortical carcinoma was fragile in adrenocortical carcinoma. Abundant blood supply existed in adrenal metastases. The leiomyosarcoma had unabundant blood supply and invaded IVC to form tumors thrombus. The mean follow-up time was 8.4 months (1-15 months). One case with adrenocortical carcinoma died after 1 year in the follow-up.

CONCLUSION

We present the rare cases of different pathological types of massive adrenal tumors with tumor thrombus extending into the IVC extension or other vein. Preoperative diagnosis needs comprehensive evaluation and perfect preoperative preparation. Surgery is difficult and varied. Open approach as well as retroperitoneal laparoscopic approach is feasible.

[Role of Th17 Cells, Interleukin-17 and Matrix Metalloproteinase-13 in Pathogenesis of Henoch-Schonlein Purpura]

OBJECTIVE

To explore the immunopathogenesis of Henoch-Schonlein purpara (HSP) by detecting the levels of Th17 cells, IL-17 and matrix metallo proteinase-13 (MMP-13) in peripheral blood and the expression of IL-17 in skin lesions at acate phase of HSP.

METHODS

Th17 cell ratio in peripheral blood of HSP group and healthy control group was defected by flow cytometry, the plasma levels of IL-17 and MMP-13 in HSP group and healthy control group were defected by ELISA, and expression level of IL-17 in skin lesion of HSP group and skin tissue of healthy control group was deternined by: immunohistochemistry method.

RESULTS

the ratio of Th17 cells in periphral blood of HSP group (1.21±0.59%) was very signif cantly higher than that in peripheral blood of control group (0.71±0.26%) ( t=4.907, P<0.01). The plasma levels of IL-17 and MMP-13 at acute phase of HSP were very significantly higher than those in control group (64.58±36.21) pg/ml vs (26.16±14.90) pg/ml and (17.57±5.40) pg/ml vs (11.53±4.40) pg/ml respectively (t=6.183, P<0.01 and t=5.022, P<0.01). The integrool optical density of IL-17 in skin lesin tissue of HSP group (7.26±2.34) was higher than that in control group (4.61±1.82) ( t=2.877, P<0.01).

CONCLUSION

Th17 cells, IL-17 and MMP-13 may be involved in the immunological pathogenesis of HSP.

[Single-center study of laparoscopic radical nephrectomy with Mayo 0-2 level inferior vena cava thrombectomy]

OBJECTIVE

To investigate the safety and feasibility of laparoscopic treatment for renal carcinoma with Mayo 0-2 level venous thrombosis.

METHODS

From January 2015 to February 2018, 58 renal carcinoma cases with venous thrombus underwent laparoscopic radical nephrectomy with inferior vena cava thrombectomy in Department of Urology, Peking University Third Hospital, of which, 51 cases were male, and 7 female, aged 29-82 years. According to the Mayo grade classification, 20 cases were level 0, 20 cases were level 1, and 18 cases were level 2, with left side being 22 cases, and right side 36 cases. The patients except for those complicated with hemorrhagic diseases, cardiac and pulmonary insufficiency, or those who could not tolerate anesthesia and surgical contraindications, underwent the operation after comprehensive examinations.

RESULTS

The 58 cases of renal tumor with venous tumor emboli were successfully completed with the surgeries, including 50 cases of totally laparoscopic surgery, 8 cases of laparoscopy surgery from convert to open (among the patients who were converted to open surgery, 7 were complicated with grade 2 tumor thrombus and 1 with grade 1 tumor thrombus). The main reasons for converting to open surgery were huge tumors (the largest of which was about 16 cm in diameter), severe adhesion and difficulty of separation. For different patients, different surgical methods and procedures were adopted according to the tumor direction and the different grade of tumor thrombus. Radical nephrectomy combined with vena cava tumor thrombus removal was performed in 55 cases and segmental resection of vena cava in 3 cases. The operation time was 132-557 min, and blood loss was 20-3 000 mL. Post-operative pathological types: 51 cases were clear cell carcinoma, 5 cases were type 2 of papillary carcinoma, 1 case was squamous cell carcinoma, and 1 case was chromophobe cell tumor. In the study, 47 cases were followed up for 1-36 months, and 4 cases died (the survival time was 5-15 months, with an average of 10.2 months).

CONCLUSION

Laparoscopic radical nephrectomy with inferior vena cava thrombectomy is a reasonable choice for renal tumor with Mayo 0-2 level venous thrombosis. For different tumor directions and different grades of tumor thrombus, an appropriate operation plan can give the maxim benefit to the patients with skillful surgeons.

[Laparoscopic ureterovesical reimplantation for ureteral stricture after renal transplantation]

OBJECTIVE

To discuss the safety and efficacy of laparoscopic ureterovesical reimplantation in the treatment of transplanted ureteral stenosis.

METHODS

One case of laparoscopic ureterovesicalre implantation in the treatment of ureteral stenosis after renal transplantation was reported, and related literatures was reviewed. A 54-year-old woman was admitted to our hospital with main complaint of hydronephrosis of transplanted kidney for five years after renal transplantation. Her physical examination showed slightly bulging in the transplanted kidney area without tenderness. The magnetic resonance urography (MRU) showed that the transplanted kidney and ureter were dilated obviously, with significant dilatation of renal pelvis and calyx, about 5 cm at the widest point of renal pelvis expansion, and the end of ureter was narrow, without abnormal filling defect in the ureter. The primary diagnosis was distal transplanted ureteral stenosis. After twice endoscopic ureteral dilatation by multi-endoscopic technique, there was no improvement in the hydronephrosis after the removal of the stent. After thorough preoperative preparation, laparoscopic ureterovesical reimplantation was performed under general anesthesia. Firstly, the median umbilical ligament, the lateral umbilical ligament and the peritoneal fold were cut off, and the anterior bladder space was dissociated distally. The space of left side wall of the bladder and the pubic bone was gradually dissociated, and the space of anterior bladder wall and the pubic bone was dissociated. Secondly, the right side wall of the bladder was dissociated from the head to the tail, and the surrounding structure was carefully identified to avoid injury of the ureter of the transplanted kidney. The transplanted ureter was sought between the right side of the bladder and the lower pole of the transplanted kidney. The distal end of the ureter was cut open, and the narrow section was cut off, confirming that no stenosis in the proximal ureter. The ureterocystic anastomosis was performed by Lich-Gregoir method (extra-bladder). Finally, the bladder tissue around the anastomosis site was fixed to the right pelvic wall to reduce tension.

RESULTS

The operation was completed successfully, the operation time was 210 min, the amount of bleeding was about 30 mL, and there was no surgical complication. The creatinine was stable after operation, with serum creatinine declining to 68 μmol/L, and serum creatinine 94 μmol/L before operation. The patient was discharged 5 days after operation. After follow-up of 3 months, KUB indicated that the position of ureteral stent was good and the function of renal transplantation was stable.

CONCLUSION

Laparoscopic ureterovesical reimplantation is a safe and effective treatment for ureteral ureteral stricture after renal transplantation. Compared with open surgery, laparoscopic surgery has less impact on renal renal allograft, with faster recovery, less bleeding, fewer complications, less postoperative pain and minimally invasive wound. This surgical procedure is difficult and requires an experienced urologist with high laparoscopic skills to perform.

[Retrospective study of young bladder urothelial carcinoma from a single center within 16 years]

OBJECTIVE

To evaluate the clinical and pathological features, treatment and prognosis for bladder urothelial carcinoma in relative young patients under 40 years.

METHODS

A retrospective study involved a total of 43 consecutive patients of bladder urothelial carcinoma, which were under 40 years old from January 2001 to December 2016.

RESULTS

The incidence rate of bladder urothelial carcinoma in the patients under 40 years was 2.2%, and 35 males and 8 females were included. The average age was 33 years (ranging from 23 to 40 years). At initial visit, 62.8% of the patients presented with painless gross hematuria, 9 patients were discovered by routine examination, and 7 patients experienced lower urinary tract symptoms. Solitary tumor occurred in 34 cases whereas multiple carcinomas had been discovered in 9 cases，and all the 9 multiple cases were from 31-40-year-old subgroups. All the patients received proper surgical intervention according to their own clinical stages. Post-operative pathological results showed 29 low-grade urothelial carcinoma and 14 high-grade cases which included 31 Ta cases, with 7 cases of T1, 1 case of T3, and 3 cases of T4 and one case of T1 plus Tis. The total follow-up was from 5 to 165 months, 3 cases were lost. The overall recurrence rate was 12.5% (5 cases from 40). One patient developed distal metastasis, one died of metastasis after 13 months, and the other three received secondary trans-urethral resection of bladder tumors. The average recurrence time was 39 months (ranging from 3 to 105 months). The progression rate was 5% among all the followed-up patients (2 cases from 40). The recurrence rate in multiple lesions group (33%, 3/9) was significantly higher than that (5.9%, 2/34) in solitary lesion group (P=0.000 3).

CONCLUSION

The incidence rate of bladder urothelial carcinoma in young patients under 40 years becomes increasingly higher over years. The major initial presentation is painless gross hematuria among these young patients, but lower urinary tract symptoms should also be noticed for young patients to rule out tumor. Postoperative tumor recurrence might be associated with multiple lesions, which is not related to the tumor size or pathological features.

Sulfonato-β-Cyclodextrin Mediated Supramolecular Nanoparticle for Controlled Release of Berberine

A kind of supramolecular assemblies was constructed from two water-soluble and biocompatible saccharides, sulfonato-β-cyclodextrin (SCD) and chitosan, and characterized by dynamic light scattering (DLS), UV-vis, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The results showed that such nanoparticles presented good stability and controlled loading/release property, which enabled them as good drug carrier for berberine chloride (BE), a representative drug from traditional Chinese herbs. That is, the nanoparticles can load BE with high stability in a low-pH environment like that of the stomach but released BE when moved to a high-pH environment like that of the intestine.

[Technical improvement in retroperitoneal laparoscopic living donor nephrectomy: report of 193 cases]

OBJECTIVE

To summarize our experience of retroperitoneal laparoscopic living donor nephrectomy, our continuous technical improvements and refinement of this skill and standardization of each procedure of this operation.

METHODS

Having approved by hospital ethical committee and local government administration, a total of 193 living donors underwent retroperitoneal laparoscopic living donor nephrectomy from Dec.2003 to Feb. 2016 in our department. Under general anaesthesia, the operation was performed through 3 lumbar ports. After the kidney was liberated fully and the ureter was severed 7-8 cm under the lower pole of the kidney, the renal artery and vein were blocked with endo-cut or hem-o-lok separately and then severed. Then the kidney was taken out quickly and flushed with 4 °C kidney preserving fluid immediately, the donor kidneys were then preserved in iced saline until kidney transplantation. Clinical data about operation time, volume of blood loss, perioperative complications, renal function of both donors and recipients before and after operation were collected.

RESULTS

The 193 retroperitoneal laparoscopic living donor nephrectomy operations were successful with only one operation was converted to open living donor nephrectomy because of hemorrhage and unclear operation field during the operation. The average operation time was 85 min (55-135 min), the average blood loss was 60 mL (20-200 mL), and no donor needed blood transfusion during or after operation. Three donors were found to have hematoma of renal fossa after operation and none of them required further treatment. The average hospital stay after operation was 5.7 days (4-9 days). In the study, 162 donors were followed up for an average of 42 months (1-58 months) and they were all healthy. Two kidney recipients had urinary bladder anastomosis leakage after operation and both needed surgical repair, a new anastomosis of ureter and bladder were made. Three kidney recipients had kidney subcapsular hematoma but required no further treatment. One kidney recipient had delayed graft function and recovered finally and the renal function of other recipients were all normal. Renal function of both donors and recipients during the follow up period were normal.

CONCLUSION

Retroperitoneal laparoscopic living donor nephrectomy is a safe and reliable technique, it may become a standardized operation for living kidney transplantation after continuous technical improvement. Precautions must be taken to avoid complications and a skilled hand is necessary for success.

[Radical nephrectomy and thrombectomy for Mayo clinic stage III tumor thrombus: a surgical technique and clinical experience]

OBJECTIVE

To evaluate the effectiveness and safety of radical nephrectomy and inferior vena cava thrombectomy in the treatment of patients with Mayo III tumor thrombus, and to introduce our experience and surgical technique.

METHODS

The clinical data of 8 patients with Mayo III tumor thrombus from October 2014 to September 2016 were analyzed retrospectively. Of the 8 patients, 3 were male and 5 were female. The average age was (50.8±18.7) years (18 to 77 years). The average body mass index (BMI) was (22.7±4.4) kg/m2 (15.2 to 30.8 kg/m²). Imaging suggested the right renal tumor in all the 8 cases. The average tumor size was (7.9±2.5) cm. Open radical nephrectomy and inferior vena cava thrombectomy was conducted in 5 cases and laparoscopic surgery in 3 cases, and 1 case was converted to open surgery.

RESULTS

All the 8 surgeries were completed successfully with no death case. The average surgery time was (370.3±101.6) min, ranging from 272-567 min. The average vena cava blocked time was (41.0±12.1) min, ranging from 17-55 min. The blood loss volume was (1 181.3±915.7) mL, ranging from 200-3 000 mL. During the operation, 5 cases were infused with suspended red blood cells, the amount of blood transfusion was 800-2 000 mL. 3 cases were infused of plasma with 400-1 000 mL. The average hospital stay was 9-23 d, with an average of (14.1±4.0) d. In the 8 patients, 4 cases underwent inferior vena cava wall resection because of invasion by tumor thrombus. Preoperative serum creatinine was 60-101 μmol/L, with an average of (76.4±15.3) μmol/L. Serum creatinine 1 week after the operation was 74-127 μmol/L, with an average of (100.8±21.1) μmol/L. Pathological diagnosis showed 6 cases of clear cell carcinoma, 1 case of papillary carcinoma type II, and 1 case of Ewing's sarcoma. Among the 8 patients, early postoperative complications occurred in 5 cases. Postoperative complications were graded as level II, according to the Clavien classifications. The 8 cases were followed up for 2 to 24 months with an average of 11.3 months. There was 1 patient who suffered from lung metastasis.

CONCLUSION

Our initial clinical results show that radical nephrectomy and inferior vena cava thrombectomy is safe and effective for patients with Mayo III tumor thrombus. The wide extension of grade III vein tumor thrombus leads to the difficulty of operation technique. Sufficient preoperative preparation, rich operative experience and skills can improve the safety of operation.

[Retroperitoneal laparoscopic nephrectomy with autotransplantation for severe iatrogenic ureteral injury]

OBJECTIVE

To evaluate the safety and efficacy of retroperitoneal laparoscopic nephrectomy with autotransplantation in cases of severe iatrogenic proximal ureteral damage.

METHODS

From July 2011 to March 2015, two patients, aged 44 (female) and 54 years (male), underwent retroperitoneal laparoscopic nephrectomy and autotransplantation for treatment of severe iatrogenic proximal ureteral injuries. Both injuries were proximal ureteral avulsion during ureterolithotomy with the holmium laser for ureteral calculi. computed tomography angiography (CTA) and computed tomography urography (CTU) was performed in both patients before operation. A 3-port retroperitoneal technique was used for the patients placed in a lateral decubitus position. A retroperitoneal laparoscopic nephrectomy with autotransplantation approach was used in both the patients, and the kidneys were removed to the right iliac fossa. Case 1's kidney was removed through the right Gibson incision, while Case 2's kidney was removed through the left lumbar incision. The renal artery and renal vein were ligated using the Hem-o-lok. The kidneys were taken out quickly from the patients and infused with 4 °C kidney preserving fluid immediately.

RESULTS

The retroperitoneal laparoscopic nephrectomy with autotransplantations was performed 4 hours in Case 1 and 2 years in Case 2 after atrogenic proximal ureteral injuries. Case 2 was associated with dense perinephric and perihilar fibrosis. The procedures were successful, with immediate return of renal function in both the patients. After ex vivo graft preparation, ureteral and vessel length and quality were adequate for transplantation in both the cases. A direct ureterovesical anastomosis was performed in both patients. In the 2 patients, the warm ischemia time was 3 and 5 minutes, the total operation time 185 and 246 minutes, and the estimated blood loss 70 and 200 mL, respectively. No perioperative complications occurred. At the end of the follow-up, the transplanted kidneys were functional, and the patients had returned to their normal activity.

CONCLUSION

Retroperitoneal laparoscopic nephrectomy with autotransplantation is an excellent alternative to nephrectomyor bowel interposition in patients with proximal ureteral loss. This procedure is associated with acceptable morbidity and preserves the renal function. This report supports the safety and efficacy of retroperotoneal laparoscopic nephrectomy with autotransplantation in experienced hands.

[Retroperitoneal laparoscopic nephrectomy with autotransplantation for severe iatrogenic ureteral injury]

OBJECTIVE

To evaluate the safety and efficacy of retroperitoneal laparoscopic nephrectomy with autotransplantation in cases of severe iatrogenic proximal ureteral damage.

METHODS

From July 2011 to March 2015, two patients, aged 44 (female) and 54 years (male), underwent retroperitoneal laparoscopic nephrectomy and autotransplantation for treatment of severe iatrogenic proximal ureteral injuries. Both injuries were proximal ureteral avulsion during ureterolithotomy with the holmium laser for ureteral calculi. computed tomography angiography (CTA) and computed tomography urography (CTU) was performed in both patients before operation. A 3-port retroperitoneal technique was used for the patients placed in a lateral decubitus position. A retroperitoneal laparoscopic nephrectomy with autotransplantation approach was used in both the patients, and the kidneys were removed to the right iliac fossa. Case 1's kidney was removed through the right Gibson incision, while Case 2's kidney was removed through the left lumbar incision. The renal artery and renal vein were ligated using the Hem-o-lok. The kidneys were taken out quickly from the patients and infused with 4 °C kidney preserving fluid immediately.

RESULTS

The retroperitoneal laparoscopic nephrectomy with autotransplantations was performed 4 hours in Case 1 and 2 years in Case 2 after atrogenic proximal ureteral injuries. Case 2 was associated with dense perinephric and perihilar fibrosis. The procedures were successful, with immediate return of renal function in both the patients. After ex vivo graft preparation, ureteral and vessel length and quality were adequate for transplantation in both the cases. A direct ureterovesical anastomosis was performed in both patients. In the 2 patients, the warm ischemia time was 3 and 5 minutes, the total operation time 185 and 246 minutes, and the estimated blood loss 70 and 200 mL, respectively. No perioperative complications occurred. At the end of the follow-up, the transplanted kidneys were functional, and the patients had returned to their normal activity.

CONCLUSION

Retroperitoneal laparoscopic nephrectomy with autotransplantation is an excellent alternative to nephrectomyor bowel interposition in patients with proximal ureteral loss. This procedure is associated with acceptable morbidity and preserves the renal function. This report supports the safety and efficacy of retroperotoneal laparoscopic nephrectomy with autotransplantation in experienced hands.

Effect of head/tail groups on molecular induced aggregation of polycationic cyclodextrin towards anionic surfactants

A polycationic cyclodextrin significantly decreased the critical aggregation concentrations of anionic surfactants with different head/tail groups by a factor of 14–467 through the molecular induced aggregation.

Enzyme-responsive protein/polysaccharide supramolecular nanoparticles

Biocompatible and enzyme-responsive supramolecular assemblies have attracted more and more interest in biomaterial fields, and find many feasible applications especially in the controlled drug release at specific sites where the target enzyme is located. In this work, novel supramolecular nanoparticles were successfully constructed from two biocompatible materials, i.e. a cyclic polysaccharide named sulfato-β-cyclodextrin (SCD) and a protein named protamine, through non-covalent association, and fully characterized by means of atomic force microscopy (AFM) and high-resolution transmission electron microscopy (TEM). Significantly, the disassembly of the resulting nanoparticles can respond especially to trypsin over other enzymes. Owing to their trypsin-triggered disassembly behaviors, these nanoparticles can efficiently release the encapsulated model substrate in a controlled manner. That is, the model substrate can be encapsulated inside the nanoparticles with a high stability and released when treated with trypsin.

Applications of HPLC/MS in the analysis of traditional Chinese medicines

In China, traditional Chinese medicines (TCMs) have been used in clinical applications for thousands of years. The successful hyphenation of high-Performance liquid chromatography (HPLC) and mass spectrometry (MS) has been applied widely in TCMs and biological samples analysis. Undoubtedly, HPLC/MS technique has facilitated the understanding of the treatment mechanism of TCMs. We reviewed more than 350 published papers within the last 5 years on HPLC/MS in the analysis of TCMs. The present review focused on the applications of HPLC/MS in the component analysis, metabolites analysis, and pharmacokinetics of TCMs etc. 50% of the literature is related to the component analysis of TCMs, which show that this field is the most populär type of research. In the metabolites analysis, HPLC coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry has been demonstrated to be the powerful tool for the characterization of structural features and fragmentation behavior patterns. This paper presented a brief overview of the applications of HPLC/MS in the analysis of TCMs. HPLC/MS in the fingerprint analysis is reviewed elsewhere.

Progress in cell membrane chromatography

Cell membrane chromatography (CMC) was first established by He et al. in 1996. A bioaffinity chromatography technique, CMC has since proven to be an important method for studying drug-receptor interactions and screening active compounds from medicinal herbs. This paper briefly reviews the characteristics of the cell membrane stationary phase (CMSP), the CMC analytical system, and its applications.