Application of the Ethyl Acetate Extract of Cichorium as a Potential Photosensitizer in Photodynamic Therapy Induces Apoptosis and Autophagy in Colorectal Cancer Cell Lines via the Protein Kinase R-Like Endoplasmic Reticulum Kinase Pathway

The present study aims to evaluate the effect of the ethyl acetate extract of Cichorium (EAEC) as a novel photosensitizer in photodynamic therapy (PDT) of colorectal carcinoma (CRC) HCT116 and SW620 cells. The absorption and fluorescence spectra of EAEC were measured using a UV-vis spectrophotometer and fluorescence spectrophotometer, respectively. EAEC-induced reactive oxygen species (ROS) production in HCT116 and SW620 cells was detected using 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) and glutathione/glutathione disulfide (GSH/GSSG). The photo- and dark toxicities of EAEC were estimated using the Cell Counting Kit-8 (CCK-8) assay. Cellular uptake and localization of EAEC were detected by confocal laser fluorescence microscopy. Annexin V-FITC/PI staining, Western blotting and immunofluorescence staining were used to assess apoptosis and autophagy. The antitumor activity of EAEC was confirmed in a xenograft model. Finally, effects on the PERK pathway were verified using qRT-PCR and Western blotting. EAEC displayed absorption and fluorescence emission peaks at 660 nm and 678 nm, respectively. EAEC induced ROS production in CRC cells. Assessment of dark toxicity showed that treatment with EAEC alone induced little cytotoxicity in CRC or normal cells but that EAEC-PDT induced significant photocytotoxicity in CRC cells in a time- and dose-dependent manner. After cellular uptake, EAEC was located in the mitochondria. Treatment with EAEC-PDT reduced xenograft tumor size. Further evaluation suggested that activation of the PERK pathway mediates these effects, as the apoptotic rate and autophagy flux increased markedly after EAEC-PDT. EAEC, a natural photosensitizer extracted from Cichorium, displays potential utility in PDT of CRC by targeting the PERK pathway.

[Nanobacteria in serum, bile and gallbladder mucosa of cholecystolithiasis patients]

OBJECTIVE

To find the distribution of nanobacteria in the serum, bile and gallbladder mucosa of cholecystolithiasis patients.

METHODS

The infection rate of nanobacteria was identified by ELISA in the serum samples from 338 healthy people and 76 patients with cholecystolithiasis (chi(2) = 0.89, P > 0.05). Nanobacteria were cultured from the bile samples in 57 patients with cholecystolithiasis and 18 non-cholelithiasis patients and identified by immunohistochemical staining and TEM (chi(2) = 29.80, P < 0.05). Forty samples of gallbladder mucosa randomly selected from the 57 cholecystolithiasis patients were identified by immunohistochemical staining and compared with the corresponding bile samples.

RESULTS

The infection rate of nanobacteria was 8.0% and 31.6% for the serum samples of the healthy people and cholecystolithiasis patients, respectively. The positive rate of nanobacteria in the bile samples was 61.3% and there was no significant difference in the bile of the cholecystolithiasis patients and the control group (61.4% vs. 61.1%). Fourteen positive patients had infection of nanobacteria in the gallbladder mucosa, submucosa, and calcific field.

CONCLUSIONS

The infection rate of nanobacteria was 8% in the serum samples from the healthy people. There are nanobacteria in the serum, bile, and gallbladder mucosa. The infection of the nanobacteria may result in calcification and fibrosis of the gallbladder.

[Analysis of learning curve of laparoscopic splenectomy]

OBJECTIVE

To evaluate the surgical outcomes of laparoscopic splenectomy and to investigate the learning curve of laparoscopic splenectomy.

METHODS

Forty cases of laparoscopic splenectomy (performed by W.Y. between September 2008 and August 2010) in our general surgery department were reviewed, and the cases were divided equally into 4 groups (group I, II, III, IV) according the time sequence of the operations. The operating time, blood loss, conversion to open surgery, conversion to hand-assisted laparoscopic splenectomy, postoperative hospital stay, postoperative liquid diet recovery time, intra- and postoperative complications and the operative frequency were compared.

RESULTS

There were no statistical differences among the groups in age and gender (P>0.05). The operating time, blood loss and postoperative hospital stay of groups III and IV were significantly less than those of groups I and II (P<0 .05). Postoperative liquid diet recovery time appear to show a gradual shortening trend from Group I to Group IV, but the differences were not at standard statistical thresholds (P>0.05). Frequency of conversion to open surgery, of conversion to hand-assisted laparoscopic splenectomy, of complications among the four groups were also not statistically different (P>0.05). The operative frequency of group I-IV increased from 1.25/month to 2.5/month.

CONCLUSION

The learning curve of laparoscopic splenectomy for surgeon who was experienced in open splenectomy and laparoscope cholecystectomy is approximately 20 cases, and the operative frequency is about 1.33/month.

Global, regional, and national pancreatitis burden and health inequality of pancreatitis from 1990 to 2019 with a prediction from 2020 to 2034

BACKGROUND

Pancreatitis is a digestive system disease that imposes a significant burden on society. However, there is a lack of comprehensive research on the incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of pancreatitis, as well as on health inequalities and future trends.

METHODS

Pancreatitis burden data, including the number and age-standardized rates (ASR) of incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), were collected from the Global Burden of Diseases 2019 (GBD 2019). SDI and HDI were used to analyze the influence of societal development on the burden of pancreatitis in the population. Additionally, the Gini coefficient and the Concentration index were used to assess health inequalities in the burden of pancreatitis. Global population data from 1990 to 2034 was obtained from WHO. Based on the population data and pancreatitis burden data, a prediction model of the burden was constructed to calculate the number and ASR of incidence, prevalence, deaths, YLLs, YLDs, and DALYs from 2019 to 2034 using the BAPC package and the Nordpred package.

RESULTS

From 1990 to 2019, there has been a decreasing trend in the ASR of incidence, prevalence, deaths, YLLs, YLDs, and DALYs in pancreatitis. However, despite this decline, the number of cases has been on the rise. Furthermore, pancreatitis imposes a higher burden on males in comparison to females, and there exists a negative correlation between pancreatitis burden and both the Social Development Index (SDI) and the Human Development Index (HDI). Additionally, health inequalities have progressively worsened globally between 1990 and 2019, particularly concerning the burden of pancreatitis in countries with low Social Development Index (SDI). Looking to the future, it is projected that the number of deaths and new cases will continue to increase from 2020 to 2034.

CONCLUSIONS

Pancreatitis remains a mounting worldwide burden. In order to alleviate this challenge, preventive strategies should focus on males and middle-aged or older individuals, specifically in countries with a low SDI. Pancreatitis is expected to predominantly impact Eastern Europe, characterized by a high ASR of incidence, and Asia, boasting a substantial population.

Application of irregular mesohepatectomy with alternating regional blood occlusion for central liver tumors

BACKGROUND/AIMS

Mesohepatectomy is rarely used to treat central liver tumors because of its technical complexity. This retrospective study aimed to evaluate the application of irregular mesohepatectomy with alternating regional blood occlusion for central liver tumors.

METHODOLOGY

From 2003 to 2008, 128 patients with central liver tumors were treated by irregular mesohepatectomy (Group I, n=85) and anatomic mesohepatectomy (Group II, n=43) respectively. The clinical profiles and follow-up data, including the operation time, bleeding volume, blood transfusion volume, postoperative recovery of liver function and postoperative complications, were compared among the two groups. Kaplan-Meier analysis was made for survival rates comparison.

RESULTS

The average operative durations were 195.1 +/- 52.4 min and 264.3 +/- 57.3 min in Group I and Group II, respectively. There was significant difference between the two groups in incidence of postoperative biliary fistula (18.8% vs 9.3%, p<0.05), but not in bleeding volume, blood transfusion volume, post-operative LFT changes and 1, 3 and 5-year survival rates. Kaplan-Meier survival analysis showed no significant difference between the two groups on survival rate.

CONCLUSION

Irregular mesohepatectomy with alternating regional blood occlusion can achieve an efficacy comparable to anatomic mesohepatectomy.