| 1 | Anatomical variation of infra-pyloric artery origination: A prospective multicenter observational study (IPA-Origin)显示文摘Objective: Infra-pyloric artery(IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, its anatomical variation is not thoroughly understood. Our study aimed to clarify the origination of the IPA.Methods: We did this prospective, multicenter, open-label, observational study at gastric surgery departments of34 hospitals in China. Gastric cancer patients aged 18 years or older and scheduled to undergo elective total or distal gastrectomy were assigned. During the surgery, IPA dissecting and exposing the origination point with photographs or video clips were required. The primary outcome was the origination of the IPA. Analysis of variance, χ~2 tests and Fisher's tests were used to analyze the differences between groups. The study is registered at Clinicaltrials.gov(No. NCT03071237).Results: Between May 8 and July 31, 2017, 429 patients were assigned for the study, and 419(97.7%) patients had the IPA dissected and recorded through photograph or video and were included in the primary outcome analysis. The median age was 62 years old, and 73.7% were male. Among the patients, 78.5% received laparoscopic surgery. Single IPA origination was identified in 398(95.0%) patients, including gastroduodenal artery(GDA) in154(36.8%) patients, anterior superior pancreaticoduodenal artery(ASPDA) in 130(31.0%) patients, and right gastroepiploic artery(RGEA) in 114(27.2%) patients. Fifteen(3.6%) patients were identified with multiple IPA and 6(1.4%) patients were identified as IPA absence. The differences in the distribution of surgical approach(P=0.003) and geographic area(P=0.030) were statistically significant. No difference was shown in sex, age,gastrectomy type, tumor location, and clinical T, N and M stage.Conclusions: Our study found that the IPA originates from GDA, ASPDA and RGEA in similar proportions.Laparoscopic surgery may be more helpful in dissection of the IPA than open surgery. | Rulin Miao Jianjun Qu Zhengrong Li Daguang Wang Jiang Yu Weidong Zang Yong Li Fenglin Liu Jian Zhang Wu Song Kai Ye Su Yan Wei Wang Shuangyi Ren Lu Zang Changqing Jing Li Zhang Kuan Wang Weihua Fu Lin Fan Bin Liang Gang Zhao Jun Cai Li Yang Jiaming Zhu Jun You Kun Yang Qingxing Huang Zhaojian Niu Ning Ning Xingfeng Qiu Gang Ji Feng Liang Hua Huang Chao Gao Fei Shan Shuangxi Li Yongning Jia Lianhai Zhang Xiangji Ying Yan Zhang Zhaode Bu Xiangqian Su Gang Zhao Ziyu Li Jiafu Ji | 2018 | Chinese Journal of Cancer Research2018，30，5： | 5 |
| 2 | Melatonin decreases GSDME mediated mesothelial cell pyroptosis and prevents peritoneal fibrosis and ultrafiltration failure显示文摘Peritoneal fibrosis together with increased capillaries is the primary cause of peritoneal dialysis failure.Mesothelial cell loss is an initiating event for peritoneal fibrosis.We find that the elevated glucose concentrations in peritoneal dialysate drive mesothelial cell pyroptosis in a manner dependent on caspase-3 and Gasdermin E,driving downstream inflammatory responses,including the activation of macrophages.Moreover,pyroptosis is associated with elevated vascular endothelial growth factor A and C,two key factors in vascular angiogenesis and lymphatic vessel formation.GSDME deficiency mice are protected from high glucose induced peritoneal fibrosis and ultrafiltration failure.Application of melatonin abrogates mesothelial cell pyroptosis through a MT1R-mediated action,and successfully reduces peritoneal fibrosis and angiogenesis in an animal model while preserving dialysis efficacy.Mechanistically,melatonin treatment maintains mitochondrial integrity in mesothelial cells,meanwhile activating m TOR signaling through an increase in the glycolysis product dihydroxyacetone phosphate.These effects together with quenching free radicals by melatonin help mesothelial cells maintain a relatively stable internal environment in the face of high-glucose stress.Thus,Melatonin treatment holds some promise in preserving mesothelium integrity and in decreasing angiogenesis to protect peritoneum function in patients undergoing peritoneal dialysis. | Hongxia Ruan Xuejuan Li Lina Zhou Zihan Zheng Rulin Hua Xu Wang Yuan Wang Yujie Fan Shuwen Guo Lihua Wang Shafiq ur Rahman Ziwei Wang Yuyuan Wei Shuangyan Yu Rongzhi Zhang Qian Cheng Jie Sheng Xue Li Xiaoyan Liu Ruqiang Yuan Xiaoyan Zhang Lihong Chen Guowang Xu Youfei Guan Jing Nie Hongqiang Qin Feng Zheng | 2024 | Science China(Life Sciences)2024，67，2： | 0 |
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