BACKGROUND:Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent metabolic disorder characterized by excessive lipid accumulation in the liver. The glycolytic enzyme enolase 3 (ENO3) is reported to be most significantly elevated in the analysis of MASLD-related sequencing results based on the GEO database. However, the specific mechanism by which ENO3 regulates MASLD is not fully understood. OBJECTIVE:To investigate the role and possible molecular mechanism of ENO3 in MASLD. METHODS:The expression of ENO3 and PKM2 in the liver tissues of control and MASLD rats was detected by immunohistochemistry and western blot. In vitro studies involved treating THLE-2 cells with free fatty acids (FFA) and Ferrostatin-1 (Fer-1), as well as manipulating ENO3 expression via small interfering RNA (siRNA) and overexpression plasmids, and manipulating PKM2 expression via siRNA. Fat accumulation was assessed using Oil Red O staining and measurements of intracellular total cholesterol (TC) and triglycerides (TG). Ferroptosis markers, including SLC7A11, GPX4, Fe2+, and malondialdehyde (MDA), were evaluated. Protein-protein interactions between ENO3 and PKM2 were examined using co-immunoprecipitation (Co-IP) and immunofluorescence. RESULTS:MASLD liver tissues exhibited significantly higher levels of ENO3 and PKM2. Silencing ENO3 in FFA-treated THLE-2 cells reduced fat accumulation, downregulated PKM2 expression, and decreased ferroptosis markers. Conversely, ENO3 overexpression promoted fat accumulation and ferroptosis, which were mitigated by Fer-1 or si-PKM2. Co-IP and immunofluorescence confirmed the physical interaction and co-localization of ENO3 and PKM2 in THLE-2 cells. CONCLUSIONS:ENO3 interacted with PKM2 to regulate ferroptosis and further promoted the progression of MASLD.

Multicomponent composites are considered conducive to electromagnetic wave (EMW) absorption, as multiple loss synergistic effect from each component, enhance the attenuation ability of EMW and optimize impedance matching. In this study, carbon material was modified by both semi-conductive and magnetic matters to improve their absorbing performance. The carbon-based fibrous composites of CeO2 and Co were prepared by electrospinning and subsequent carbonization. At a filling rate of 35 wt.%, the CeCoC nanocomposite fibers exhibit a minimum RL value of -61.4 dB at 2.2 mm, and an effective absorption bandwidth (EAB) of up to 7.6 GHz. The excellent absorbing performance is derived from the improved dielectric loss and optimized impedance matching. The introduction of rare earth oxide CeO2 not only helps to maintain the fibrous structure, but also promotes conduction loss. Especially, oxygen vacancy defects introduced by CeO2 greatly improved the dielectric loss capacity. The introduction of Co particles optimizes the impedance matching to reduce the matching thickness and strengthen magnetic loss. This study demonstrates the potential of rare earth oxides in improving EMW absorption performance, and opens up new opportunities for the development of advanced materials for high-performance EMW absorption applications.

At present, in order to overcome electromagnetic interference and prevent electromagnetic harm, the research of new and efficient electromagnetic wave absorbing materials has become the research focus in the field of materials science. The one-dimensional structure can promote the impedance matching and attenuation characteristics of the absorbing materials. Electrospinning, as an effective method to prepare nanofibers with high length-diameter ratio, has been widely concerned because it is suitable for structural design of various materials. In this paper, the research progress and absorption properties of nano-fiber materials prepared by electrospinning combined with different processes are introduced.

One-dimensional carbon-based nanofibers are considered as a group of the most promising candidates applied in electromagnetic wave absorption owing to their shape anisotropy, tractability, and stability. To further meet the requirements of lightweight, broadband and effective features, in this work, nickel/carbon nanofibers modified with molybdenum dioxide were resoundingly fabricated through electrospinning and subsequent carbonization. According to textural characteristic analyses, nickel nanoparticles with a diameter of approximately 30 nm were supported on the surface of the carbon nanofibers, while the smaller MoO2 grains were embedded inside. Under the premise of realizing an outstanding electromagnetic wave absorption intensity (-64.0 dB at 8.0 GHz), the ternary composites achieved a wide effective absorption bandwidth up to 6.9 GHz (9.5 GHz-16.4 GHz). Based on the investigations of electromagnetic parameters and field distribution simulation results, the interwoven network structure and the synergistic effect between each component not only endowed the materials with perfect impedance matching, but introduced manifold loss mechanisms including magnetic loss, conductivity loss and multiple polarization relaxation. Thus, this work provided theoretical guidance and enlightenment for the design of new generation fibrous electromagnetic wave absorbers.

AimsSplenectomy combined with pericardial devascularization is one of the important methods to treat hypersplenism, gastrointestinal bleeding, and other complications caused by liver cirrhosis; however, it is accompanied by a high risk of portal vein thrombosis (PVT). This study aimed to explore the preventive and therapeutic effects of proximal splenic vein ligation (PSVL) with postoperative transcatheter anticoagulant therapy (TCAT) on PVT. MethodsThis study retrospectively selected 143 patients with liver cirrhosis and portal hypertension, who received splenectomy combined with pericardial devascularization from June 30, 2018 to June 30, 2021. According to computed tomography photography, within 1 week before the operation, the patients were divided into a prevention group (without preoperative PVT, n = 112) and a treatment group (preoperative PVT, n = 31). Then, each group was subdivided based on the treatment and prevention measures into PSVL + TCAT (n = 70) and systemic anticoagulant therapy (SAT) subgroups (n = 73). The preventive and therapeutic effects of PSVL followed by TCAT on PVT were analyzed. ResultsThe operation time in the PSVL + TCAT subgroups was longer than that in the SAT subgroups (185 +/- 76 min vs. 161 +/- 55 min; p < 0.01). There was no difference between the two subgroups in terms of operative bleeding (345 +/- 82 mL vs. 336 +/- 65 mL; p > 0.50). There was no operative death, and all patients recovered uneventfully. In the prevention group, procedure-related complications occurred in two patients in the PSVL + TCAT subgroup (3.7% [2/54]), including one patient with slight pancreatitis and one patient with chylous leakage, owing to mobilization of the pancreas. The PVT incidence in the prevention group was significantly different between the two subgroups at postoperative 7th day, 3rd month, and 6th month (PSVL + TCAT: 0%, 11.1%, and 5.6% vs. SAT: 39.7%, 31.0%, and 20.7%, respectively; all p < 0.05). In the treatment group, the thrombus regression rate at postoperative 7th day and disappearance rates at the 3rd month and the 6th month of the PSVL + TCAT subgroup were significantly higher than those in the SAT subgroup after anticoagulant and thrombolysis therapy (PSVL + TCAT: 75.0%, 68.8%, and 87.5% vs. SAT: 20.0%, 26.7%, and 40.0%; all p < 0.05). ConclusionsPSVL + TCAT reduces the risk of PVT after splenectomy and is safe and effective in treating PVT during surgery for portal hypertension.

One-dimensional carbon-based materials have emerged as promising electromagnetic wave absorption agents due to their outstanding conductivity, high stability, low weight, and easy availability. Properly optimizing their electromagnetic parameters is expected to further enhance the electromagnetic wave attenuation capacity. In this work, efficient Cu9S5/C nanocomposite fibers are prepared by a combined approach of electrospinning and subsequent carbonization-sulfurization processes. The Cu9S5 nanoparti-cles with size of ca. 100-200 nm were homogeneously embedded in fibrous carbon matrix with diameter of 300 nm. For electromagnetic wave absorption, the optimized composited nanofibers (Cu9S5/C-3) exhibited an extremely superb reflection loss of -65.4 dB (9.5 GHz, 2.7 mm) at a lower mass fraction (20 wt%). And the effective absorption bandwidth could be up to 4.1 GHz (8.0-12.1 GHz) with a matching thickness of 2.9 mm, covering the whole X-band. Electromagnetic wave attenuation mechanism investi-gation revealed that the performance enhancement originated from the synergy of various loss pathways, including interfacial polarization, dipole polarization, and conductive loss. The unique hierarchical struc-ture from particle embedding, one-dimensional fiber, to three-dimensional network further amplified the performance advantages of each component. This work is anticipated to provide a feasible strategy to synthesize sulfide/carbon binary composite fibers for efficient electromagnetic wave absorption.(c) 2022 Elsevier Inc. All rights reserved.

本研究对28例脾切除联合断流术后患者测定门静脉压力梯度及其对普萘洛尔的反应性。结果表明，术后第3天患者门静脉压力梯度基线压力平均为（15.1±11.2）mmHg。对普萘洛尔有反应者15例，剂量增至100 mg/d仍无反应者13例。患者对普萘洛尔的降压反应存在个体差异并存在量效反应。

A type of hollow core-shell ZnO/Fe3O4@C fibers were fabricated by a facile combination of electrospinning, calcination, and pyrolytic pyrrole-derived carbon coating. The combination of ZnO/Fe(3)O(4 )fibers and carbon nanolayer improved the dielectric loss capability of the nanocomposites and obtained good impedance matching, leading to excellent electromagnetic wave (EMW) absorption performance. The minimum reflection loss of the ZnO/Fe3O4@C nanocomposites reached -74.2 dB at a thickness of merely 2.2 mm, and the effective absorption bandwidth reached 5.5 GHz at a matching thickness of 2.1 mm. Compared with the ZnO-or Fe3O4-based composites ever reported, our ZnO/Fe3O4@C nanocomposites exhibited superior EMW absorption characteristics due to the efficient design of multiple synergistical components and hollow fibrous structures. Combined with the facile, scalable preparation approach, the hollow core-shell ZnO/Fe3O4@C nanocomposite fibers with high EMW absorption performance show great potential for EMW absorption applications.

Objective:To study the clinical results of personalized surgical treatment for portal hypertension based on portal venous hemodynamics.Methods:A retrospective study was performed on patients with portal hypertension who underwent surgical treatment from January 2016 to December 2020 at the People’s Hospital of Ningxia Hui Autonomous Region and Wuhai People’s Hospital. Of 229 patients included into this study, there were 156 males and 73 females, with age of (4±11) years old. Portal vein CT and ultrasound doppler examination were performed preoperatively and portal vein manometry and ultrasound doppler examination were performed intraoperatively to evaluate portal venous hemodynamics. Based on the evaluation results, different surgical treatments were adopted. Postoperative complications and results of the operations were recorded. Long-term outcomes were evaluated by the rate of recurrence of gastroesophageal varices which was classified as disappearance, mild, moderate and severe according to endoscopic findings.Results:All the 229 patients completed the operations successfully. All together 13 operative treatments were used: (1) simple splenectomy ( n=11); (2) devascularization ( n=176), including 86 patients with splenectomy combined with extensive devascularization, 44 patients with splenectomy combined with selective devascularization and with preservation of paraesophageal veins, 39 patients with splenectomy combined with selective devascularization and reconstruction of spontaneous portosystemic shunt (34 patients with selective devascularization and reconstruction of spontaneous gastrorenal shunt and 5 patients with selective devascularization and reconstruction of spontaneous splenorenal shunt), 4 patients with secondary devascularization for variceal recurrence and 3 patients with devascularization and preservation of spleen; (3) shunt procedures were performed in 42 patients including 21 patients with splenectomy combined with coronary renal shunt, 11 patients with splenectomy combined with coronary-caval shunt, 6 patients with distal splenorenal shunt, 2 patients with proximal splenorenal shunt combined with devascularization, 1 patient with right gastroepiploic vein-inferior vena cava shunt and 1 patient with trans-inferior mesenteric vein coronary renal shunt. There were no operative deaths. The Clavien-Dindo grade 3 and above postoperative complication rate was 6.6% (15/229). Two hundred and eight patients were followed up for 6-60 months, with a median follow-up of 38 months. Severe recurrent varices were found in 21 patients (10.1%, 21/208), with 5 patients (2.4%, 5/208) presented with variceal bleeding. The rate of severe varices after selective shunting and selective devascularization by reconstructing the spontaneous portosystemic shunt (4.2%, 3/72) was significantly lower than that of the other devascularization procedures (13.7%, 17/124)(χ 2=4.53, P=0.033). Conclusion:Better clinical results were achieved by selecting the appropriate surgical procedures based on portal venous hemodynamic characteristics of patients. Selective shunting and selective devascularization by reconstructing the spontaneous portosystemic shunts significantly reduced the recurrence rate of severe varies.

Developing materials with a rational design of constituent and microstructure for excellent electromagnetic wave (EMW) absorption performance has been a puzzle for researchers. Herein, a type of zeolitic-imidazolate framework (ZIF-67) derivative embedded boron carbonitride (BCN) nanocomposites with a tubular micro-structure are prepared via a simple, facile, scalable pyrolysis approach. The presence of BCN nanotube not only optimizes the impedance matching, but also promotes the dispersion of the Co nanoparticles, contributing to a high-efficiency utilization of conductive and magnetic losses of the ZIF derivative. Furthermore, the nano-composites contain abundant heterogeneous interfaces, resulting in a high interfacial polarization capability, which is further confirmed by theoretical simulations. Consequently, BCN/C/Co composite nanotubes display superior EMW absorption properties. BCN/C/Co nanocomposites show a minimum reflection loss of -56.7 dB at 12.4 GHz and an effective absorption bandwidth of 5.5 GHz at a thickness of 2.6 mm. This work thus provides a reliable reference for preparing lightweight, high-performance EMW absorbers.

目的 探讨门静脉高压症术后门静脉系统血栓(portal venous system thrombosis,PVST)形成的原因及其防治措施.方法 对132例门静脉高压症患者行脾切除联合贲门周围血管离断术,术中均经胃网膜右静脉置入导管测压并留置导管,其中36例患者(设为试验组,其余设为对照组)术中增加脾静脉近端结扎.术后早期经导管滴注肝素盐水预防血栓,或发生血栓后滴注尿激酶溶栓,出院后口服华法林,使预防和治疗血栓的效果分别达到国际标准化比值(INR)维持于1.5～2.0和2.0～3.0,并直至血小板数量恢复正常.结果 术后2周内发生PVST共132例(100％),血栓分布:残余脾静脉血栓132例(100％),门静脉血栓(PVT)39例(29.5％).在39例PVT中,门静脉主干血栓33例,主干血栓均与残余脾静脉血栓相连,其中15例血栓最大横截面积<50％,14例血栓最大横截面积≥50％,4例为完全性血栓;肠系膜上静脉血栓6例,其中4例合并门静脉主干血栓并与肠系膜上静脉血栓相连,2例存在门静脉分支血栓且肠系膜上静脉血栓与脾静脉血栓相连.39例PVT中,门静脉左支血栓21例,门静脉右支血栓18例;PVT 2处及以上者25例.在试验组36例脾静脉近端结扎的患者中,发生门静脉主干血栓1例(2.8％);在对照组未采用脾静脉近端结扎的96例中发生PVT 38例(39.6％),两者对比差异有统计学意义(P<0.001).对39例PVT采用抗凝及溶栓治疗,其中33例在术后6个月获得随访并进行CT检查,发现血栓消失、机化再通和海绵样变各23例、7例和3例.结论 肝硬化门静脉高压症行脾切除联合贲门周围血管离断术后早期残余脾静脉内易形成血栓,残余脾静脉血栓向门静脉内蔓延是发生术后PVT的主要原因.脾静脉近端结扎的预防效果显著,经胃网膜右静脉留置导管,术后滴注肝素盐水和溶栓剂兼具预防和治疗双重作用,口服华法林效果确切但需检测凝血功能.

Objective:To evaluate the preventive effect of proximal splenic vein ligation after splenectomy on the splenic vein originated portal vein thrombosis (PVT) in portal hypertension.Methods:The clinical data of 94 patients of portal hypertension who had received splenectomy were retrospectively analysed. The proximal splenic vein was ligated in 36 cases during pericardial devascularization and coronary renal shunt with splenectomy. The other 58 cases who had received pericardial devascularization without proximal splenic vein ligation served as control. All of the patients in both groups were given heparin infusion postoperatively through the catheter which was placed in the right gastroepiploic vein during operation. CT portal veinography was performed at the 7th-14th postoperative day for detection of PVT.Results:None of the PVT occurred in the splenic vein ligation group. In the control group, PVT occurred in 22 cases(38%) and splenic vein thrombosis occurred in all the 58 cases (100%). PVT incidence between the two groups is significantly different (0 vs. 38%, χ 2=17.828, P<0.05). Conclusions:Ligation of the proximal splenic vein during splenectomy can effectively prevent the postoperative splenic vein originated PVT in portal hypertension.

目的:探讨经内镜逆行胰胆管造影(ERCP)术后应用自制C/S-J型胆道自行脱落支架行胆道引流的安全性与有效性.方法:将2015年10月-2018年10月期间收治的184例的胆管结石患者分为3组,分别行ERCP+十二指肠乳头切口(EST) +C/S-J型胆道自行脱落支架内引流术(C/S-J组,104例),ERCP+EST+经内镜鼻胆管引流术(ENBD)(ENBD组,40例),ERCP+EST+经内镜胆道支架引流术(ERBD)(ERBD组,40例).比较各组ERCP术后胰腺炎、胆管炎发生情况,并记录C/S-J组支架排出情况.结果:各组患者在性别、年龄、结石大小、结石数量、术前胆囊切除情况、术前胆管炎情况均无明显差异(均P＞0.05);C/S-J组、ENBD组、ERBD组ERCP术后急性胰腺炎发生率分别是6.73％(7/104)、7.50％(3/40)、10.00％(4/40),急性胆管炎的发生率分别是0.96％(1/104)、0.00％(0/40)、2.50％(1/40),组间无统计学差异(均P＞0.05).C/S-J组2例术后第1天支架从胆道排出,1例术后3个月支架未排出,后经十二指肠镜成功取出,其余患者支架在9～14d内脱落并经消化道自行排出体外,平均为10.2 d.无消化道梗阻、出血及穿孔等并发症发生.结论:采用自制C/S-J型胆道自行脱落支架行胆道引流安全、有效,能弥补ENBD与ERBD的不足之处.

BACKGROUND This study was conducted to compare the clinical effects of two techniques used for inflow occlusion during hepatectomy (selective hemihepatic vascular occlusion vs. Pringle maneuver) for the treatment of primary liver cancer. MATERIAL AND METHODS A total of 63 patients with primary hepatocellular carcinoma who underwent hepatectomy during June 2006 and June 2011 were included in this retrospective study. A total of 26 patients in group A accepted selective hemihepatic vascular occlusion, and 37 patients in group B underwent the Pringle maneuver during hepatectomy. The intraoperative conditions, postoperative liver function recovery, and complication rates were compared between these two groups. RESULTS There were no significant differences in intraoperative blood loss, blood transfusion, occlusion time, and postoperative complication rates between group A and group B (P>0.05). However, postoperative serum levels of alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), and albumin (ALB) in group A were significantly lower than those in group B (P<0.05). Moreover, there were noteworthy differences in peripheral artery pressure and sphygmus (P<0.05). CONCLUSIONS During hepatectomy, selective hemihepatic vascular occlusion benefits the patients with primary hepatocellular carcinoma by reducing the hepatic damage and improving postoperative hepatic function recovery, compared with the Pringle maneuver.

目的 总结胰腺实性假乳头状肿瘤(SPT)的诊治经验.方法 回顾性分析收治的17例SPT临床资料.结果 17例SPT患者出现腹痛腹胀12例(70.1％),查体发现5例(38.9％).肿瘤直径2.8～16.1 cm,中位数5.98 cm.8例实性(47.1％),9例囊实性(52.9％);3例周围血管神经侵犯(17.8％),CT诊断正确率52.9％(9/17).所有患者均行手术治疗,术后并发症率41.2％,围术期无再手术及死亡.术后平均随访35.8个月(1～82个月),无复发转移及死亡病例.结论 SPT属交界性肿瘤,早期无特异表现,瘤体巨大者可出现临床症状,术前主要依赖影像诊断,积极手术预后良好,复发转移者仍可积极治疗.

目的 比较两孔法与四孔法腹腔镜胆囊切除术的临床效果.方法 选取本科2015年7-10月间胆囊结石患者50例,随机采用两孔法(研究组)和四孔法(对照组)进行手术治疗,各25例,统计两组患者手术时间、术中失血量、术后24h疼痛、住院时间、切口疤痕满意度及并发症的发生率.计数资料采用x2检验,计量资料采用t检验,P＜0.05为差异有统计学意义.结果 研究组术后24h疼痛时间为(3.4±1.3)h,低于对照组的(4.4±1.0)h,对比差异有统计学意义(P＜0.05).术后腹壁美容满意度研究组为(84.6±6.8)分,高于对照组的(72.2±15.4)分,对比差异有统计学意义(P＜ 0.05).研究组住院时间为(3.6±0.7)d,短于对照组的(4.8±1.2)d,对比差异有统计学意义(P＜0.05).结论 两孔法治疗胆囊结石术后疼痛轻,术后切口满意度高,住院时间缩短,不增加手术并发症.

目的探讨一孔双视免气腹腔镜胆囊切除术(DPLC)的临床疗效。方法对行DPLC 120例患者的临床资料进行分析。结果除6例患者术中转开腹外,其余均顺利完成手术。结论 DPLC,具有创伤小、出血少、恢复快、适应证广、并发症少、易掌握等特点,最大限度地减轻了患者的病痛。

Objective To compare the efficiency of laparoscopic cholecystectomy (LC) and radical cholecystectomy (RC) in the patients with early gallbladder carcinoma. Methods From January 2001 to December 2008, 63 patients who had underwent LC(28 cases) or RC(35 cases) were analyzed retrospectively. The survival and recurrence rate after operation and complication were compared. Results After treatment, the complication in the LC group was less than that in the RC group (7. 1% vs. 48. 6%, χ2 = 12. 675 ,P ＜0.01). In the RC group,the 1,3,5 year overall cumulative survival rate of Nevein phase Ⅰ were all 100%, and 76. 2%, 42. 9%, and 23. 8% respectively in the phase Ⅱ. The overall cumulative survival rate of LC cases were 81.8%, 54. 5%,27.3% in phase Ⅰ and 17.6% ,5.9% ,0.0% in phase Ⅱ, respectively. The survival curves between the two groups were significantly diffierent(phase Ⅰ χ2 =20.74,P＜0.001; phase Ⅱ χ2 = 11.35,P＜0.001) and the survival rate in the RC group was higher than that in the LC group. The 1,3,5 year cumulative recurrence rates in the RC were 20.0%, 48. 6%, 68. 6%, respectively, which is significantly lower than those in the LC group (60.7%,85.7% and92.9%, respectively)(χ2 =10.30,P=0.0013).Conclusions RC is one of the first choices for early gallbladder carcinoma treatment, and will decrease the recurrence rate and improve the long-term life quality.

Objective To analyze the clinical characteristics of intracranial hemorrhage in children.Methods The data of children with intracranial hemorrhage from January,2004 to December,2006 were reviewed.Results Ninty-eight cases of intracranial hemorrhage were admitted.The leading causes of intracranial hemorrhage were neonates with hypoxic ischemic encephalopathy(HIE)and intracranial hemorrage(ICH)(32 cases),delayed Vitamin K deficiency(30 cases),cerebral trauma(12 cases),and arteriovenous malformation(12 cases).Other causes included thrombocytopenia(4 case),hemophilia(1 case),viral encephalitis(1 cases),acute leukaemia(2 cases),hemorrhage of cerebral tumour(1 case),and 2 cases were unknown.Treatment was given for 18 cases,and 15 patients died(15.3%).Conclusions The mortality and morbidity of intracranial hemorrhage are high and early intervention may improve the prognosis.

患者女,62岁.1年前因结石性胆囊炎于外院行胆囊切除、胆总管探查、T型管引流术,术后右上腹反复绞痛8月余,加重1周入院.体查:巩膜轻度黄染,右上腹可见经腹直肌切口疤痕.右上腹肌稍紧张,深压痛,肝未扪及,血红蛋120g/L,白细胞14×109/L,中性0.82,总胆红素84μmol/L,谷丙转氨酶180U/L,B超示胆囊已切除,