Eight previously undescribed aromatic abietane diterpenoids, clerochinoids A-H (1-8), including seven 17(15 → 16)-abeo-abietanes (1-7) and one 17(15 → 16),18(4 → 3)-diabeo-abietane (8), along with 12 known analogues (9-20) were isolated from the roots and stems of Clerodendrum chinense. Their structures were elucidated by extensive spectroscopic data analysis, X-ray crystallography, and ECD calculations. All the compounds were screened for their cytotoxic activity against two human non-small cell lung cancer cell lines, H1975 and HCC827. Compounds 3, 9, 10, 12-14, 16, 17, 18, and 20 exhibited enhanced activity compared to the positive control, gefitinib. The succinct structure-activity relationship of these abietane diterpenoids was also discussed.

Splenic hemangioma is the most common pathological classification of splenic tumors, and its surgical indication and treatment have been controversial. Before, open splenectomy was usually used to treat splenic hemangioma. Following the rapid development of laparoscopic techniques, people's requirements for minimally invasive treatment have gradually increased, and laparoscopic splenectomy has gradually become the main treatment method. However, through the deeper study of spleen function, it was found that partial splenectomy can cut down the incidence of postoperative thrombocythemia and decrease side effects on the physiological function of the body, so laparoscopic partial splenectomy came into being. However, due to the special anatomical structure, the incidence of hemorrhage during partial splenectomy is greater. Therefore, during the operation, we removed part of the splenic blood vessels, combined with microwave ablation, which perfectly solved the problem of intraoperative bleeding. Laparoscopic partial splenectomy combined with microwave ablation not only achieves the requirements of minimally invasive treatment but also reduces the risk of intraoperative bleeding, meriting clinical application and promotion.

Background:Globally, liver cancer as one of the most frequent fatal malignancies, hits hard and fast. And the lack of effective treatments for liver hepatocellular carcinoma (LIHC), activates the researchers to promote promising precision medicine. Interestingly, emerging evidence proves that cellular senescence is involved in the progression of cancers and is recognized for its hallmark-promoting capabilities. Hence, efforts have been made to construct and validate the senescence risk score signature (SRSS) model as a novel prognostic biomarker for LIHC. Methods:The existing databases were mined for the following bioinformatics analyses. GSE22405, GSE57957, and senescence-related genes (SRGs) from public databases were utilized as a training set and the validation set was constituted by LIHC and pancreatic adenocarcinoma (PAAD) from The Cancer Genome Atlas (TCGA). After overlapping differentially expressed genes (DEGs) with SRGs, differentially expressed SRGs were identified with the progression of liver cancer through univariate and multivariate Cox regression and enrichment analyses. The model that utilized three SRGs was constructed using the least absolute shrinkage and selection operator (LASSO) regression algorithm. Next, to evaluate the predictive performance of the SRSS model, the overall survival (OS) and survival rates were assessed through Kaplan-Meier (KM) and the receiver operating characteristic (ROC) curves. The predictive value for LIHC prognosis was further evaluated by capitalizing on risk score, nomograms, decision curve analysis (DCA) curves, and clinical information including tumor stages, gender, age, and race. Results:DEGs were revealed as enriching in multiple tumor-related biological processes (BPs) and pathways. IGFBP3, SOCS2, and RACGAP1 were identified as the three considerable SRGs for the model. The high-risk group had a worse prognosis [both hazard ratio (HR) >1, P<0.001] and ROC curves showed a reliable predictive model with area under the curve (AUC) predictive values ranging from 0.673-0.816 for different-year survival rates respectively. The univariate and multivariate Cox regression analyses exhibited that risk score was the only credible prognostic predictor (HR >1, P<0.001) among clinical features such as tumor stage, age, etc., in LIHC. The nomograms, and DCA curves, combined with multiple clinical information, proved that the predictive ability of SRSS was strongest, followed by nomogram and traditional tumor node metastasis (TNM) stage was the weakest. Conclusions:In summary, comprehensive analyses supported that the SRSS model can better predict survival and risk in LIHC patients. Promisingly, it may point out a brand-new direction for LIHC therapy.

Hypersplenism and esophageal variceal hemorrhage caused by portal hypertension are common and serious complications of decompensated cirrhosis. In recent years, with the widespread application of various therapeutic methods such as drugs, endoscopy, splenic artery embolization, transjugular intrahepatic portal shunt, and liver transplantation, the role of surgery in the treatment of portal hypertension has gradually diminished, and the indications for surgical treatment have become more strictly defined. However, according to the clinical practice in China, surgical treatment of portal hypertension still holds an important role that other treatments cannot fully replace. In fact, surgical treatment of portal hypertension is widely performed in hospitals at all levels in China, saving numerous lives. Splenectomy combined with pericardial devascularization (SPD) is the most common surgical method for treating hypersplenism and esophageal variceal hemorrhage caused by portal hypertension. Long-term clinical practice has proven that SPD is a safe and effective treatment for hypersplenism and esophageal variceal rupture and hemorrhage due to portal hypertension. With the rapid development of laparoscopic techniques, the minimally invasive advantages of laparoscopic splenectomy combined with pericardial devascularization (LSPD) have become increasingly evident. However, the successful performance of LSPD mainly depends on the skill and proficiency of the surgeon. In this context, this article presents detailed techniques for LSPD.

This study showcases a comprehensive treatment protocol for high-risk hepatocellular carcinoma (HCC) patients, focusing on the combined use of Y-90 transarterial radioembolization (TARE) and Programmed Cell Death-1 (PD-1) inhibitors as neoadjuvant therapy. Highlighted through a case report, it offers a step-by-step reference for similar therapeutic interventions. A retrospective analysis was conducted on a patient who underwent hepatectomy following Y-90 TARE and PD-1 inhibitor treatment. Key demographic and clinical details were recorded at admission to guide therapy selection. Y-90 TARE suitability and dosage calculation were based on Technetium-99m (Tc-99m) macroaggregated albumin (MAA) perfusion mapping tests. Lesion coverage by Y-90 microspheres was confirmed through single photon emission computed tomography/computed tomography (SPECT/CT) fusion imaging, and adverse reactions and follow-up outcomes were meticulously documented. The patient, with a 7.2 cm HCC in the right hepatic lobe (T1bN0M0, BCLC A, CNLC Ib) and an initial alpha-fetoprotein (AFP) level of 66,840 ng/mL, opted for Y-90 TARE due to high recurrence risk and initial surgery refusal. The therapy's parameters, including the lung shunting fraction (LSF) and non-tumor ratio (TNR), were within therapeutic limits. A total of 1.36 GBq Y-90 was administered. At 1 month post-therapy, the tumor shrank to 6 cm with partial necrosis, and AFP levels dropped to 21,155 ng/mL, remaining stable for 3 months. After 3 months, PD-1 inhibitor treatment led to further tumor reduction to 4 cm and AFP decrease to 1.84 ng/mL. The patient then underwent hepatectomy; histopathology confirmed complete tumor necrosis. At 12 months post-surgery, no tumor recurrence or metastasis was observed in follow-up sessions. This protocol demonstrates the effective combination of Y-90 TARE and PD-1 inhibitor as a bridging strategy to surgery for HCC patients at high recurrence risk, providing a practical guide for implementing this approach.

For recurrent choledocholithiasis, abdominal adhesions in previous surgeries lead to changes in anatomical structures, and a secondary injury occurs easily when performing another operation for laparoscopic common bile duct exploration (LCBDE), which was once considered a relative contraindication. In view of the limitations of the current surgical technique, this study summarized the surgical approaches and crucial anatomical landmarks for reoperation for LCBDE. Four general surgical approaches were proposed to expose the common bile duct, including the ligamentum teres hepatis approach, the anterior hepatic duodenal ligament approach, the right hepatic duodenal ligament approach, and the hybrid approach. Additionally, this study highlighted seven crucial anatomical landmarks: the parietal peritoneum, the gastrointestinal serosa, the ligamentum teres hepatis, the inferior margin of the liver, the gastric antrum, the duodenum, and the hepatic flexure of the colon, which were helpful to safely separate abdominal adhesions and expose the common bile duct. Moreover, to shorten the time of choledocholithotomy, a sequential method was innovatively applied for the removal of the stones in common bile duct. Mastering the above surgical approaches, including identifying crucial anatomical landmarks and adopting the sequential method will improve the safety of reoperation for LCBDE, shorten the operation time, promote the fast recovery of patients, reduce postoperative complications, and contribute to the popularization and application of this technique.

Plant essential oils, as biological pesticides, have been reviewed from several perspectives and play a key role in chemical ecology. However, plant essential oils show rapid degradation and vulnerability during actual usage. In this study, we conducted a detailed analysis of the compounds present in the essential oils of A. stechmanniana using gas chromatography–mass spectrometry (GC-MS). The results showed seventeen terpenoid compounds in the A. stechmanniana oil, with four major terpenoid compounds, i.e., eucalyptol (15.84%), (+)-2-Bornanone (16.92%), 1-(1,2,3-Trimethyl-cyclopent-2-enyl)-ethanone (25.63%), and (-)-Spathulenol (16.38%), in addition to an amount of the other terpenoid compounds (25.26%). Indoor toxicity assays were used to evaluate the insecticidal activity of Artemisia stechmanniana essential oil against Aphis gossypii, Frankliniella occidentalis, and Bactericera gobica in Lycium barbarum. The LC50/LD50 values of A. stechmanniana essential oils against A. gossypii, F. occidentalis, and B. gobica were 5.39 mg/mL, 0.34 mg/L, and 1.40 μg/insect, respectively, all of which were highly efficient compared with azadirachtin essential oil. Interestingly, A. stechmanniana essential oil embedded in β-cyclodextrin (microencapsule) remained for only 21 days, whereas pure essential oils remained for only 5 days. A field efficacy assay with the A. stechmanniana microencapsule (AM) and doses at three concentrations was conducted in Lycium barbarum, revealing that the insecticidal activities of AM showed high efficiency, maintained a significant control efficacy at all concentrations tested, and remained for 21 days. Our study identified terpenoid compounds from untapped Artemisia plants and designed a novel method against pests using a new biopesticide on L. barbarum.

Distal pancreatic carcinoma is a highly malignant tumor with strong invasiveness, often growing to the edge of the pancreas and penetrating the pancreatic capsule to infiltrate surrounding tissues. In conventional distal pancreatosplenectomy (DPS), tumor cells are prone to spread along the direction of blood and lymphatic reflux due to surgical compression. Additionally, inflammation makes it challenging to achieve R0 resection, leading to a lower patient survival rate. To address these limitations, radical antegrade modular pancreatosplenectomy (RAMPS) was developed, emphasizing deeper excision, including the left anterior renal fascia, the left anterior renal adipose sac, and even the left adrenal gland, to improve the R0 resection rate. With the advancement of minimally invasive surgical techniques, laparoscopic RAMPS (L-RAMPS) is being considered technically safe and feasible in oncology. However, due to technical difficulties and a lack of supporting evidence for clinical application, only a few institutions are currently conducting L-RAMPS. In this context, this article presents detailed techniques for laparoscopic posterior radical antegrade modular pancreatosplenectomy (L-pRAMPS), offering promise for future clinical applications.

Abstract The aim of this research was to evaluate insecticidal activities of the essential oil of Rhynchanthus beesianus rhizomes against adults of Liposcelis entomophila and Tribolium castaneum. Gas chromatography-mass spectrometry analyses revealed the presence of 44 compounds with β-eudesmol (19.1%), elemol (8.1%), α-terpineol (8.0%), methyl eugenol (6.5%), and caryophyllene (4.8%) being the major constituents. Bioactivity-directed chromatographic separation of the oil led to the isolation of four constituents, elemol, β-eudesmol, methyl eugenol, and α-terpineol. The essential oil exhibited fumigant toxicity against the adults of L. entomophila and T. castaneum with LC50 values of 0.57 and 4.96 mg/L air while the two isolates, methyl eugenol and α-terpineol possessed fumigant toxicity against the booklice (LC50 = 0.15 and 0.48 mg/L air, respectively) and the beetles (LC50 = 1.81 and 4.96 mg/L air, respectively). The oil also possessed contact toxicity against the booklice and the beetles with LD50 values of 121.56 μg/cm2 and 54.93 μg/adult, respectively, while the two isolates β-eudesmol and elemol showed contact toxicity against L. entomophila (LD50 = 99.21 and 35.19 μg/cm2, respectively) and T. castaneum (LD50 = 35.26 and 8.89 μg/adult, respectively). The results indicate that the oil of R. beesianus rhizomes and its isolates have potential as a source for natural insecticides.

Background Numerous cancer types present the aberrant TANK-binding kinase 1 (TBK1) expression, which plays an important role in driving inflammation and innate immunity. However, the prognostic role of TBK1 and its relationship with immune cell infiltration in hepatocellular carcinoma (HCC) remain unclear. Methods The expression and prognostic value of TBK1 was analyzed by Tumor Immune Estimation Resource (TIMER), Kaplan-Meier plotter and Gene Expression Profiling Interactive Analysis (GEPIA), Clinical Proteomic Tumor Analysis Consortium (CPTAC) and further confirmed in the present cohort of patients with HCC. The association between TBK1 and HCC immune infiltrates, and its potential mechanism were investigated via analyses of the Tumor Immune Estimation Resource, tumor-immune system interactions database (TISIDB), CIBERSORT, STRING, and Metascape. The effect of TBK1 on immune infiltrates and the therapeutic value of targeting TBK1 were further investigated in a HCC mouse model by treatment with a TBK1 antagonist. Results The level of TBK1 expression in HCC was higher than that measured in normal tissues, and associated with poorer overall survival (GEPIA: hazard ratio [HR]=1.80, P=0.038; Kaplan–Meier plotter: HR=1.87, P<0.001; CPTAC: HR=2.23, P=0.007; Our cohort: HR=2.92, P=0.002). In addition, high TBK1 expression was found in HCC with advanced TNM stage and identified as an independent poor prognostic factor for overall survival among patients with HCC. In terms of immune infiltration, tumor tissues from HCC patients with high TBK1 expression had a low proportion of CD8+ T cells, and TBK1 expression did not show prognostic value in HCC patients with enriched CD8+ T cells. Furthermore, TBK1 expression was positively correlated with the markers of T cell exhaustion and immunosuppressive cells in the HCC microenvironment. Mechanistically, the promotion of HCC immunosuppression by TBK1 was involved in the regulation of inflammatory cytokines. In vivo experiments revealed that treatment with a TBK1 antagonist delayed HCC growth by increasing the number of tumor-infiltrating CD8+ T cells. Conclusions The up-regulated expression of TBK1 may be useful in predicting poor prognosis of patients with HCC. In addition, TBK1, which promotes the HCC immunosuppressive microenvironment, may be a potential immunotherapeutic target for patients with HCC.

目的:探讨中药重楼(Paris polyphylla,PP)活性单体PP-11体外抑制人乳腺癌MDA-MB-231细胞增殖的作用及其机制.方法:采用不同浓度的PP-11作用于MDA-MB-231细胞,采用MTT法和集落形成实验检测细胞增殖情况;Hoechst 33258染色及Annexin V-FITC/PI双染流式细胞术检测细胞凋亡;JC-1染色检测线粒体膜电位改变;Western blot法检测细胞凋亡及自噬相关蛋白表达情况.再采用总caspase抑制剂Z-VAD-FMK、p38抑制剂SB203580和自噬抑制剂氯喹(chloroquine,CQ)进行阻断实验.结果:MTT测定结果显示,PP-11以剂量和时间依赖方式显著抑制MDA-MB-231细胞活力,其作用24、48和72 h后的IC50分别为5.64、4.58和3.06μmol/L.集落形成实验结果提示,PP-11显著抑制MDA-MB-231细胞集落形成.Hoechst 33258染色观察到PP-11组MDA-MB-231细胞出现典型的细胞凋亡形态.Annexin V-FITC/PI双染流式细胞术结果显示,随着PP-11浓度的增加,MDA-MB-231细胞凋亡率逐渐升高.JC-1染色结果显示,PP-11处理的MDA-MB-231细胞线粒体膜电位下降.Western blot检测结果显示,PP-11处理的MDA-MB-231细胞Bcl-2家族蛋白中抗凋亡蛋白Bcl-2和Bcl-xL的表达显著减少,促凋亡蛋白Bim和Bok表达增加,p-p38和p-p53蛋白水平升高,p-ERK蛋白水平降低,cleaved caspase-9、cleaved cas?pase-3及cleaved PARP的蛋白水平显著升高;PP-11降低MDA-MB-231细胞p-STAT3蛋白水平及其下游蛋白c-Myc、cyclin D和Mcl-1的表达.总caspase抑制剂Z-VAD-FMK和p38 MAPK抑制剂SB203580均可减弱PP-11诱导的细胞凋亡.随着PP-11作用浓度的增加,细胞自噬相关蛋白LC3-Ⅱ表达增加,p62/SQSTM1表达下降;采用PP-11联合自噬阻断剂CQ,可逆转PP-11诱导的cleaved PARP表达,并提高细胞活力(P<0.05).结论:重楼单体PP-11可显著抑制人乳腺癌MDA-MB-231细胞增殖.PP-11通过激活p38 MAPK信号通路、抑制ERK和JAK-Stat3信号通路诱导MDA-MB-231细胞发生线粒体相关的凋亡,并促进细胞自噬.

目的:通过检测ULK1和Beclin1在原发性肝细胞癌组织中的表达,结合数个临床病理因素,探讨ULK1和Beclin1在原发性肝细胞癌治疗中的临床意义.方法:手术取得80对肝癌和癌旁组织及20例正常肝脏组织,采用定量Real-time PCR(qPCR)及免疫组织化学技术检测各组织中ULK1和Beclin1的表达情况,联合临床病理因素进行统计分析.结果:ULK1和Beclin1在肝癌中蛋白表达及mRNA的表达,均低于在癌旁组织以及正常肝组织中的表达(P<0.05),而癌旁组织与正常肝组织中ULK1和Beclin1的表达的差异无统计学意义(P>0.05).ULK1和Beclin1在肝癌组织中的表达可能呈正相关关系(r=0.26,P=0.02).ULK1在肝癌中与性别、年龄、乙型肝炎表面抗原(HBsAg)、术前肝功能分级、甲胎蛋白(AFP)、嗜酒、肿瘤部位及分级无关,与肿瘤大小相关.Beclin1在肝癌中与性别、年龄、HBSAg、术前肝功能分级、嗜酒、肿瘤的部位及分级无关,但与肿瘤的大小及AFP表达相关.结论:ULK1和Beclin1可能通过影响自噬,进而肝癌的发生发展相关联.

Background Previous studies have indicated that harmine hydrochloride (HAR-HC) has anti-tumor characteristics. However, its potential impact on human leukemia cells is unknown. In this study, we explored the potential mechanism of HAR-HC effects on human leukemia cells in vitro. Methods MTT assay was used to detect cell viability; A flow cytometer was used to analyze the cell cycle; Anexinn V-FITC/PI was used to detect cell apoptosis; Western blotting assay was used to analyze the expression of related proteins. Results The result of flow cytometry suggested G2/M phage arrest in K562 cells induced by HAR-HC. The expression levels of Cyclin E2, Cyclin D1, Bcl-2, Bcl-xL, Mcl-1, pro-caspase-3, and PARP decreased and the expression levels of Cyclin A2, Cyclin B1, p21, Myt-1, p-cdc2 (Tyr15), cleaved -caspase-3 and cleaved-PARP increased. Moreover, the expression of p-JNK and p-ERK1/2 increased and autophagy was induced in the HAR-HC treatment group. Additionally, HAR-HC facilitated autophagy by activating the ERK1/2 pathway. Conclusion HAR-HC induced G2/M phase cell cycle arrest, autophagy and apoptosis by activating the JNK, and ERK1/2 pathways in the human leukemia K562 cells.

BACKGROUND:Norcantharidin (NCTD) is known to impact on cell progression in many cancers; however, its activity in non-small cell lung cancer (NSCLC) has not yet been characterized. In the present study, we set out to determine the cytotoxic effects of NCTD on the proliferation and apoptosis on A549 cells and their underlying mechanisms.METHODS:NSCLC cell line A549 cells were cultured. A549 cells were treated with different concentrations of NCTD. Cell proliferation was detected by MTT and cell clone formation assay. Cell cycle and apoptosis were detected by flow cytometry. After A549 cells were treated with NCTD for 24 hours, the mitochondrial membrane potential was measured. The protein expression of Bcl-2, Bax, light chain 3 (LC3), et al. was tested by western blot. The expression of LC3 and Tom20 protein was detected by immunofluorescence.RESULTS:NCTD suppressed the proliferation of NSCLC cells while decreasing mitochondrial membrane potential and inducing G2/M phase arrest. NCTD induced apoptosis, as demonstrated by increased B-cell lymphoma 2/Bcl-2-associated X protein and Bcl-2-associated X protein/myeloid cell leukemia 1 ratios. Aside from autophagy, NCTD induced mitophagy, with an increase in LC3 expression and a decrease in sequestosome 1 (p62) expression in the cytoplasm, accompanied by increased levels of Phospho-adenosine 5'-monophosphate -activated protein kinase (p-AMPK), Phospho-c-Jun NH2-Terminal Kinase (p-JNK), and Phospho-c-jun (p-c-jun) and a decreased level of Phospho-protein kinase B (p-AKT).CONCLUSIONS:This study has elucidated that NCTD restrains NSCLC cell progression via regulation of AMPK/mammalian target of rapamycin (mTOR)/uncoordinated 51-like kinase 1 (ULK1)/JNK pathways. This evidence provides insight into a novel treatment for NSCLC.

Two new decalin/tetramic acid hybrid metabolites, hyalodendrins A (1) and B (2) were isolated from plant endophytic fungus Hyalodendriella sp. Ponipodef12. The structures of the new compounds were elucidated by analysis of the spectroscopic data, including NMR, HRMS and ECD, and by chemical conversion. Compounds 1 and 2 were phomasetin analogues, and both showed potent larvicidal activity against the fourth-instar larvae of Aedes aegypti with the median lethal dose (LC50) values of 10.31 and 5.93 μg/mL, respectively.

Similar to other pear psylla species in Europe and America, Cacopsylla chinensis (Yang and Li) is one of the most important pests that causes yield loss in commercial pear orchards in China. To investigate effective essential oils as alternatives to conventional pesticides against C. chinensis, 26 essential oils derived from commonly used Chinese spices and medicinal herbs were screened for insecticidal activity. Among these, the essential oil from Perilla frutescens (L.) Britton leaves was the top performer; it exhibited strong and acute toxicity against pear psylla, with an LD50 value of 0.63 μg per adult. Then, we tested the constituents of the essential oil and its toxicity in the field. Field trials showed a 72% corrected reduction in the first-second-instar population 7 d after spraying P. frutescens leaf oil solution at a concentration of 1 mg/ml and a 47% corrected reduction at days 3 and 14. This report is the first to document the application of essential oil from P. frutescens leaves to control C. chinensis under field conditions. Our results suggest that P. frutescens oil can be considered a novel potential pesticide for C. chinensis control in pear orchards.

Objective To explore the application value of scar hidden laparoscopic appendectomy (SHLA). Methods A retrospectively analysis was made on clinical data of 107 patients underwent SHLA and 134 patients underwent conventional laparoscopic appendectomy (CLA) from July 2011 to June 2016. The operative time, operative blood loss, postoperative exhaust time, pain score, postoperative complications, postoperative hospital stay and cosmetic score were compared between the two groups. Results All the operations of both groups were successful without conversion to open surgery. There were 1 case of wound infection in the SHLA group and 1 case of wound infection and 1 case of incision fat necrosis in the CLA group. There were no significant differences in operative time [(48. 0 ± 15. 9) min vs. (45. 2 ± 11. 5) min, t=1. 585, P=0. 114], operative blood loss [(12. 9 ± 8. 4) ml vs. (14. 0 ± 10. 7) ml, t= -0. 870, P=0. 385], postoperative exhaust time [(1. 3 ± 0. 7) d vs. (1. 3 ± 0. 5) d, t=0. 000, P=1. 000], pain score [(4. 9 ± 1. 2) points vs. (5. 2 ± 1. 5) points, t= -1. 683, P=0. 094], postoperative complications [0. 9% vs. 1. 5%, χ2=0. 000, P=1. 000], and postoperative hospital stay [(3. 2 ± 1. 1) d vs. (3. 5 ± 1. 4) d, t= -1. 814, P=0. 071] between SHLA and CLA. The cosmetic score in the SHLA group was higher than that in the CLA group [(4. 4 ± 0. 6) points vs. (4. 0 ± 0. 9) points, t=3. 949, P=0. 000]. Conclusion SHLA is safe and feasible for acute appendicitis with favourable cosmetic results.

患者男,68岁.因"腹胀、腹痛伴排便不畅20 d",于2011年11月30日入院.既往有"高血压病"2年余.查体:心肺无特殊,腹平坦,腹肌无强直,全腹未触及肿块;上腹有压痛,无反跳痛;肝脾肋下未触及;肝肾区无叩击痛;肠鸣音消失.入院胸、腹部平片示:心肺未见异常.腹部未见急腹症X线征象,结肠较多内容物.腹部超声示:肝实质回声增粗,肝左外叶胆管局部扩张,腹膜后实性占位,性质待定.上腹部CT示:肝脏Ⅱ段病灶,性质待定;腹腔干右侧及腹主动脉旁多发肿大淋巴结.磁共振胰胆管成像(MRCP)示:腹膜后(腹腔干右旁)肿大淋巴结,考虑转移瘤.胃镜、肠镜、胶囊内镜检查皆未见明显异常.糖类抗原CA19-9 1 047.49 U/ml.术前初步诊断为腹腔转移瘤:胆管癌并腹腔转移?15 d后行剖腹探查手术,术中可见肝左外叶约1.5 cm直径大小结节,质地韧,边界清,胆囊稍肿胀及肝十二指肠韧带中下方肿物,约3 cm×4 cm,质硬,不规则,下方与胰体部边界不清,粘连明显,胰头未见肿块.术中冰冻提示肝十二指肠韧带淋巴结见低分化癌转移,遂行"肝十二指肠韧带淋巴结微波消融+肝十二指肠韧带淋巴结活检+胆囊切除术".术后病理报告示:1. 肝十二指肠韧带淋巴结见低分化癌转移,伴显著的纤维组织增生;2. 左肝肿物见肝内胆管明显扩张,小胆管增生,纤维组织增生,少量慢性炎症细胞浸润;3. 慢性胆囊炎,胆囊泥沙样结石.术后1个月开始先后进行4次化疗,方案为:奥沙利铂150 mg+氟尿嘧啶3.25 g+亚叶酸钙0.6 g+吉西他滨1.2 g.

The essential oil of Stachys riederi var. japonica (Family: Lamiaceae) was extracted by hydrodistillation and determined by GC and GC-MS. A total of 40 components were identified, representing 96.01% of the total oil composition. The major compounds in the essential oil were acetanisole (15.43%), anisole (9.43%), 1,8-cineole (8.07%), geraniol (7.89%), eugenol (4.54%), caryophyllene oxide (4.47%), caryophyllene (4.21%) and linalool (4.07%). Five active constituents (acetanisole, anisole, 1,8-cineole, eugenol and geraniol) were identified by bioactivity-directed fractionation. The essential oil possessed fumigant toxicity against maize weevils (Sitophilus zeamais) and booklice (Liposcelis bostrychophila), with LC50 values of 15.0 mg/L and 0.7 mg/L, respectively. Eugenol and anisole exhibited stronger fumigant toxicity than the oil against booklice. 1,8-Cineole showed stronger toxicity, and anisole as well as eugenol exhibited the same level of fumigant toxicity as the essential oil against maize weevils. The essential oil also exhibited contact toxicity against S. zeamais adults and L. bostrychophila, with LC50 values of 21.8 µg/adult and 287.0 µg/cm2, respectively. The results indicated that the essential oil of S. riederi var. japonica and its isolates show potential as fumigants, and for their contact toxicity against grain storage insects.