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1341
Review Article Open Access
Al Mughirah Salahaldin Ebrahim, Mena Mekhael Fahem
Published online April 24, 2022
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2022.00005
Abstract
Three-dimensional (3D) printing has provided individuals in various industries with a tool to bring their creations to life. The medical field is no stranger to 3D printing, which [...] Read more.

Three-dimensional (3D) printing has provided individuals in various industries with a tool to bring their creations to life. The medical field is no stranger to 3D printing, which has been utilized in various applications since its inception. The various additive technologies currently available to elucidate the differences between them will be discussed briefly. The current applications of 3D printing in medicine could be divided into applications in medical education, patient care, equipment modification or fabrication, and research. The various applications in these categories are described with examples of upcoming research and technology that may be available in the near future. Despite the benefits of 3D printing, challenges remain, and technology improvements are required before there will be more adoption in the medical field. The technology is growing rapidly and evolving, and more 3D printing applications will be seen in the future.

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1342
Original Article Open Access
Fan Gao, Yukun Lin, Mengdi Zhang, Yuju Niu, Luyao Sun, Wenwen Li, Haojie Xia, Haihong Lin, Zhenzhen Guo, Gangjun Du
Published online April 21, 2022
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2022.00014
Abstract
Lasting LPS stimulation changes macrophages toward the M2 phenotype therefore resulting in immunodepression. Melatonin can improve sleep, adjust the time difference, regulate immunity, [...] Read more.

Lasting LPS stimulation changes macrophages toward the M2 phenotype therefore resulting in immunodepression. Melatonin can improve sleep, adjust the time difference, regulate immunity, and anti-tumor. This study is to observe whether melatonin can induce M2 macrophage apoptosis to reverse lasting LPS-induced immunodepression for lung cancer prevention and explore the possible mechanism.

The effects of LPS alone or in combination with melatonin on macrophage phenotypes were assessed by surface markers, morphological changes, cytokines, autophagy, and autophagic efflux. The anti-cancer effect was evaluated in the lung carcinogenic model and lung cancer allograft model. Melatonin-related targets and pathways were predicted by network pharmacology.

Single LPS stimulation polarized macrophages to M1 phenotype, whereas LPS stimulation lasting for 7d polarized macrophages to M2 phenotype. However, combination treatment of lasting LPS and 10 µM melatonin inhibited the polarization of macrophages towards an M2-like phenotype and exerted a continuous antitumor effect. In the urethane-induced lung carcinoma model, long-lasting LPS administration (>4 times) facilitated macrophage polarization toward the M2 phenotype and promoted lung carcinogenesis, which was abrogated by macrophage depletion, while melatonin alone or in combination with lasting LPS could decrease M2-like macrophages and prevented carcinogenesis. In the Lewis lung cancer allograft model, melatonin decreased M2 macrophages and promoted the tumor-suppressing effect of short-term LPS administration (<4 times). Network pharmacology indicated that melatonin regulates macrophages by targeting the multi-protein network.

Melatonin as a key maintainer of macrophage phenotype can induce LPS-stimulated M2 macrophage apoptosis to reverse system immunodepression for lung cancer prevention.

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1343
Original Article Open Access
Lihong Mao, Chaoqun Li, Xiaoyu Wang, Mingyu Sun, Yifan Li, Zihan Yu, Binxin Cui, Gaoyue Guo, Wanting Yang, Yangyang Hui, Xiaofei Fan, Jie Zhang, Kui Jiang, Chao Sun
Published online April 20, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2022.00027
Abstract
Emerging evidence has demonstrated that abnormal body composition may potentiate the development of frailty, whereas little work focuses on the role of divergent adipose tissue. [...] Read more.

Emerging evidence has demonstrated that abnormal body composition may potentiate the development of frailty, whereas little work focuses on the role of divergent adipose tissue. Therefore, we aimed to determine the potential contribution of adipose tissue distribution to multidimensional frailty in decompensated cirrhosis.

We conducted a retrospective cohort study. Divergent adipose tissues were assessed by computed tomography-derived subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI) and total adipose tissue index (TATI), respectively. Frailty was identified by our validated self-reported Frailty Index. Multiple binary logistic models incorporating different covariates were established to assess the relationship between adipose tissue distribution and frailty.

The study cohort comprised 245 cirrhotic patients with 45.3% being male. The median Frailty Index, body mass index (BMI) and model for end-stage liver disease (MELD) score were 0.11, 24.3 kg/m2 and 8.9 points, respectively. In both men and women, patients who were frail exhibited lower levels of SATI in comparison with nonfrail patients. SATI inversely correlated with Frailty Index in the entire cohort (rs=−0.1361, p=0.0332). Furthermore, SATI or TATI was independently associated with frail phenotype in several multiple logistic regression models adjusting for age, BMI, presence of ascites, sodium, Child-Pugh class or MELD score in isolation.

In the context of decompensated cirrhosis, low SATI and concomitant TATI were associated with higher risk of being frail. These findings highlight the importance to further apply tissue-specific tools of body composition in place of crude metric like BMI.

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1344
Editorial Open Access
Derrick Michael Van Rooyen, Oyekoya Taiwo Ayonrinde
Published online April 19, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2022.00103
1345
Original Article Open Access
Li Chen, Xintong Kang, Xiujuan Meng, Liang Huang, Yiting Du, Yilan Zeng, Chunfeng Liao
Published online April 15, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2021.00391
Abstract
The goal of this study was to investigate the mechanism by which the long noncoding RNA MALAT1 inhibited hepatocyte proliferation in acute liver injury (ALI). Lipopolysaccharide [...] Read more.

The goal of this study was to investigate the mechanism by which the long noncoding RNA MALAT1 inhibited hepatocyte proliferation in acute liver injury (ALI).

Lipopolysaccharide (LPS) was used to induce an ALI cellular model in HL7702 cells, in which lentivirus vectors containing MALAT1/EZH2/GFER overexpression or knockdown were introduced. A series of experiments were performed to determine their roles in liver injury, oxidative stress injury, and cell biological processes. The interaction of MALAT1 with EZH2 and enrichment of EZH2 and H3K27me3 in the GFER promoter region were identified. Rats were treated with MALAT1 knockdown or GFER overexpression before LPS induction to verify the results derived from the in vitro assay.

MALAT1 levels were elevated and GFER levels were reduced in ALI patients and the LPS-induced cell model. MALAT1 knockdown or GFER overexpression suppressed cell apoptosis and oxidative stress injury induced cell proliferation, and reduced ALI. Functionally, MALAT1 interacted directly with EZH2 and increased the enrichment of EZH2 and H3K27me3 in the GFER promoter region to reduce GFER expression. Moreover, MALAT1/EZH2/GFER was activated the AMPK/mTOR signaling pathway.

Our study highlighted the inhibitory role of reduced MALAT1 in ALI through the modulation of EZH2-mediated GFER.

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1346
Original Article Open Access
Deli Kafache, Markusse Deli, Borris Rosnay Tietcheu Galani, Aurelie Ntso Agume, Armand Abdou Bouba, Nicolas Yanou Njintang
Published online April 14, 2022
Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2022.00004
Abstract
Carissa edulis (Apocynaceae) is a wild fruit species highly consumed by Cameroonian populations because of its many biological effects. However, few studies so far have addressed [...] Read more.

Carissa edulis (Apocynaceae) is a wild fruit species highly consumed by Cameroonian populations because of its many biological effects. However, few studies so far have addressed the nutritional, antioxidant, and physicochemical properties of this plant.

Juice and cake powders obtained from C. edulis fruits were examined for their contents in macronutrients, micronutrients, and phenolic compounds through conventional methods. Then, the in vitro antioxidant properties were assessed using the 1,1-diphenyl-2-picrylhydrazyl radical scavenging, total reducing power, and the total antioxidant capacity assays.

The results showed that cakes displayed significantly higher fat (22.68 ± 2.16 vs 5.06 ± 0.43 g/100 g dry weight (DW)), carbohydrates (39.25 ± 1.16 vs 19.29 ± 0.55 g/100 g DW), protein (1.32 ± 0.56 vs 0.23 ± 0.13 g/100 g DW), zinc, copper, and calcium levels compared to juice. However, their ash (0.28 ± 0.02 vs 0.31 ± 0.02 g/100 g DW), moisture (5.67 ± 0.53 vs 14.40 ± 1.36 g/100 g), carotenoids, and Vitamin C levels were significantly lower. The phenolic content in the juice was generally lower (p < 0.05) than in the cake. Polyphenols, flavonoids tannins, and anthocyanins were respectively the most quantitatively important compounds. On the other hand, the study of the antioxidant activity revealed that the cake had higher antioxidant activities.

Taken all together, the results showed that the cake of the C. edulis fruits has higher nutritional value, bioactive compound levels, and antioxidant potentials than juice which merits further consideration as food supplements.

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1347
Opinion Open Access
Yang Hou, Li Xiao, Sinan Cheng, Wei Duan, Yingchun Hou
Published online April 14, 2022
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2022.00021
Abstract
In this century, viral infections are still a serious threat to the safety of human life and health. Millions of people were infected by viruses every year worldwide, and many of [...] Read more.

In this century, viral infections are still a serious threat to the safety of human life and health. Millions of people were infected by viruses every year worldwide, and many of them died from the infections. In recent decades, outbreak pandemics of SARS, influenza, and especially SARS-Cov-2 (nCov-2019) have been witnessed. To protect people from viral infections, vaccine is one of the most important approaches. But to develop a vaccine against a viral infection, the status and its regulation of the human immunity against a viral infection must be explored and known well. As a reference for the protection approach or strategy to control viral infections, based on the reports or publications in recent years, we present our new perspectives about human immunity statuses against viral infection, and conclude the statuses as three basic types: efficient immunity status, non-efficient immunity status and separated immunity status.

Full article
1348
Original Article Open Access
Yeon Ji Chae, Hwon Heo, Chul-Woong Woo, Sang-Tae Kim, Jae-Im Kwon, Monica Young Choi, Yu Sub Sung, Kyung Won Kim, Jeong Kon Kim, Yoonseok Choi, Dong-Cheol Woo
Published online April 13, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2021.00499
Abstract
Efficacy evaluations with preclinical magnetic resonance imaging (MRI) are uncommon, but MRI in the preclinical phase of drug development provides information that is useful for [...] Read more.

Efficacy evaluations with preclinical magnetic resonance imaging (MRI) are uncommon, but MRI in the preclinical phase of drug development provides information that is useful for longitudinal monitoring. The study aim was to monitor the protective effectiveness of silymarin with multiparameter MRI and biomarkers in a thioacetamide (TAA)-induced model of liver injury in rats. Correlation analysis was conducted to assess compare the monitoring of liver function by MRI and biomarkers.

TAA was injected three times a week for 8 weeks to generate a disease model (TAA group). In the TAA and silymarin-treated (TAA-SY) groups, silymarin was administered three times weekly from week 4. MR images were acquired at 0, 2, 4, 6, and 8 weeks in the control, TAA, and TAA-SY groups.

The area under the curve to maximum time (AUCtmax) and T2* values of the TAA group decreased over the study period, but the serological markers of liver abnormality increased significantly more than those in the control group. In the TAA-SY group, MRI and serological biomarkers indicated attenuation of liver function as in the TAA group. However, pattern changes were observed from week 6 to comparable levels in the control group with silymarin treatment. Negative correlations between either AUCtmax or T2* values and the serological biomarkers were observed.

Silymarin had hepatoprotective effects on TAA-induced liver injury and demonstrated the usefulness of multiparametric MRI to evaluate efficacy in preclinical studies of liver drug development.

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1349
Original Article Open Access
Yan-Zhu Lin, You Wu, De-Hai Cao, Yong-Jian Peng, Jun Deng, Wen-Jie Lin, Min-Yi Si-Tu, Ling Zhuo, Jie-Min Chen, Man-Xia Lei, Rong-Bin Liu, Wei-Guang Zhang, Jian-Jun Li, Xiao-Chun Yang, Guo-Kai Feng
Published online April 12, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2021.00414
Abstract
Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death and ranks sixth in terms of incident cases worldwide. The purpose of this study was to develop [...] Read more.

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death and ranks sixth in terms of incident cases worldwide. The purpose of this study was to develop an effective and sensitive method to distinguish liver cancer tissues from normal tissues in HCC patients. Integrin α6 is a promising cell surface target for molecular imaging of HCC, where it is overexpressed and is a prognostic biomarker. We previously identified an integrin α6-targeted peptide CRWYDENAC (RWY) that has been used for positron emission tomography (PET) imaging of HCC in mouse models.

We labeled the integrin α6-targeted RWY peptide with cyanine 7 (Cy7) to form an optical probe (Cy7-RWY) for near infrared fluorescent (NIRF) and photoacoustic (PA) imaging in HCC. Mice transplanted with subcutaneous HCC-LM3 or orthotopic HCC-H22 cells that overexpressed integrin α6 were intravenously injected with Cy7-RWY and its corresponding Cy7-control. NIRF and PA images of mice were collected from 0 to 48 h after injection.

Both NIRF and PA signals started to accumulate in the tumor 2 h after injection of Cy7-RWY and peaked at 24 h.

Cy7-RWY is a promising optical probe for NIRF and PA imaging of HCC in mice, and has potential clinical application for HCC detection.

Full article
1350
Original Article Open Access
Long Chen, Chaoqun Zhao, Weili Yao, Wei Liu, Hua Zhang, Yongping Mu, Hong Cai, Dongying Xue, Chengbao Wang, Wan’e Wang, Yuehong Lin, Jiamei Chen, Ping Liu
Published online April 8, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2021.00451
Abstract
The aim was to evaluate the efficacy and safety of Yanggan Jian (YGJ) in HBV-infected patients with decompensated cirrhosis. This randomized, double-blind controlled trial [...] Read more.

The aim was to evaluate the efficacy and safety of Yanggan Jian (YGJ) in HBV-infected patients with decompensated cirrhosis.

This randomized, double-blind controlled trial enrolled 160 patients with HBV-related decompensated cirrhosis who were already receiving or about to start antiviral therapy. Patients were randomly assigned to receive YGJ or placebo for 24 weeks, and were followed-up to 36 weeks. The primary outcome was the proportion of patients with a ≥2 point reduction in Child-Turcotte-Pugh (CTP) score from baseline at week 24. Secondary outcomes were CTP class and score, serum liver function indices, mortality, incidence of hepatocellular carcinoma and variceal bleeding.

The proportion of patients with a CTP score reduction ≥2 was significantly greater in the YGJ than in the placebo group (p=0.009); the percentage of patients with CTP class C was significantly less than that in the placebo group (p<0.05), and the YGJ group had a significantly greater mean change from baseline in CTP score at week 24 (p=0.034). The improvement in measured values and change from baseline of prothrombin time, serum albumin, platelets, cholinesterase, international normalized ratio, and activated partial thromboplastin time were significantly better with YGJ than with placebo. Between-group differences in cumulative rates of variceal bleeding, hepatocellular carcinoma, death, or the frequency of any adverse event (AE), AEs related to treatment, or discontinuation because of AEs were not significant.

YGJ significantly improved CTP scores and hepatic synthetic and reserve function in patients with HBV-related decompensated cirrhosis, and was safe and well tolerated.

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1351
Opinion Open Access
Yang Hou, Sinan Cheng, Li Xiao, Wei Duan, Yingchun Hou
Published online April 7, 2022
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2022.00020
Abstract
After a period of more than 50 years, numerous evidences have led to the exploration of the cyclic control core of cells, which sequentially comprise of genomes (G), transcriptomes [...] Read more.

After a period of more than 50 years, numerous evidences have led to the exploration of the cyclic control core of cells, which sequentially comprise of genomes (G), transcriptomes (T) and proteomes (P). In the previous reports of the investigators on spatiotemporal cell biology, a novel theory system was introduced and reported, and the cyclic control core was named, the “GTP core”. Indeed, the GTP core controls all events in cells based on the spatiotemporal cell biology. In the present study, the schematic regulation of the GTP core based on the spatiotemporal cell biology was further discussed and summarized, in order to improve and perfect this novel theory system. It is hoped that these perspectives would lead to the further discussion and exploration of this area by other researchers worldwide.

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1352
Original Article Open Access
Saleh A. Alqahtani, Ahmet Gurakar, Hani Tamim, Thomas D. Schiano, Alan Bonder, Zachary Fricker, Marwan Kazimi, Devin E. Eckhoff, Michael P. Curry, Behnam Saberi
Published online April 6, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2021.00538
Abstract
Liver organ shortage remains a major health burden in the US, with more patients being waitlisted than the number of liver transplants (LTs) performed. This study investigated US [...] Read more.

Liver organ shortage remains a major health burden in the US, with more patients being waitlisted than the number of liver transplants (LTs) performed. This study investigated US national and regional trends in living donor LT (LDLT) and identified factors associated with recipient survival.

We retrospectively analyzed LDLT recipients and donors from the United Network Organ Sharing/Organ Procurement Transplant Network database from 1998 until 2019 for clinical characteristics, demographic differences, and survival rate. National and regional trends in LDLT, recipient outcomes, and predictors of survival were analyzed.

Of the 223,571 candidates listed for an LT, 57.5% received an organ, of which only 4.2% were LDLTs. Annual adult LDLTs first peaked at 412 in 2001 but experienced a significant decline to 168 by 2009. LDLTs then gradually increased to 445 in 2019. Region 2 had the highest LDLT numbers (n=919), while region 1 had the highest proportion (11.1%). Overall, post-LT mortality was 21.4% among LDLT recipients. Post-LDLT survival rates after 1-, 5-, and 10-years were 92%, 87%, and 70%, respectively. Interval analysis (2004–2019) showed that patients undergoing LDLT in recent years had lower mortality than in earlier years (hazard ratio=0.81, 95% confidence interval=0.75–0.88).

Following a substantial decline after a peak in 2001, the number of adult LDLTs steadily increased from 2011 to 2019. However, LDLTs still constitute the minority of the transplant pool in the US. Life-saving policies to increase the use of LDLTs, particularly in regions of high organ demand, should be implemented.

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1353
Review Article Open Access
Joshua Crane, Qiuying Shi, Yibo Xi, Jinping Lai, Kien Pham, He Wang
Published online April 1, 2022
Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2022.00004
Abstract
Oropharyngeal squamous cell carcinomas (OPSCCs) have shown an alarming rate of increase in incidence over the past several decades, markedly in men. In the United States, transcriptionally-active [...] Read more.

Oropharyngeal squamous cell carcinomas (OPSCCs) have shown an alarming rate of increase in incidence over the past several decades, markedly in men. In the United States, transcriptionally-active human papillomavirus (HPV), particularly HPV 16, has become the highest contributive agent of OPSCCs, affecting approximately 16,000 people a year. Compared to patients with HPV-negative OPSCCs, patients with HPV-positive OPSCCs exhibit better health responses to chemoradiotherapy and an overall increase in long-term survival. Despite promising treatment options, many OPSCCs are discovered at an advanced stage, and ∼20% of cases will recur after definitive treatment. Therefore, extensive research is ongoing to identify new targets for precision treatment and to stratify tumor prognosis. The aim of this review is to capture the most updated research on HPV-positive OPSCCs, emphasizing their relevance as potential new targets for precision medicine and survival prognosis.

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1354
Original Article Open Access
Huancai Fan, Ruojia Zhang, Shufeng Li, Haojun Shi, Yi Li, Yun Geng, Yuang Zhang, Dandan Shi, Ting Wang, Xifeng Li, Tingting Zhang, Jihong Pan, Luna Ge, Guanhua Song
Published online April 1, 2022
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2021.00076
Abstract
Euphorbiasteroid (EUP) is one of the ingredients of traditional Chinese medicinal plants with anti-inflammatory activity. This study aimed to evaluate the effect of EUP on rheumatoid [...] Read more.

Euphorbiasteroid (EUP) is one of the ingredients of traditional Chinese medicinal plants with anti-inflammatory activity. This study aimed to evaluate the effect of EUP on rheumatoid arthritis (RA).

Cell Counting Kit-8 (CCK8) and 5-Ethynyl-2′-deoxyuridine (EdU) were performed to detect the proliferation of fibroblast-like synoviocytes (FLSs). The expression of cytokines was detected by quantitative real-time polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA). The Transwell system without the gel was utilized to detect the cell migration. The pro-angiogenesis ability of HUVECs was detected by tube formation assay. EUP was introduced into the collagen-induced arthritis (CIA) model to determine its therapeutic effect, as measured by microcomputed tomography (micro-ct) and hematoxylin-eosin (H&E) staining. AKT1 was enriched by network pharmacology and molecular docking techniques. Western blot, immunofluorescence (IF) and RT-qPCR were conducted to detect the effects of EUP on AKT1.

When RA FLSs were treated with EUP, the proliferation of RA FLSs decreased in a dose- and time-dependent manner. Furthermore, the production of inflammatory cytokines, cell migration and proangiogenic ability of RA FLSs were suppressed by the EUP treatment. The in vivo experiments revealed that EUP can significantly reduce the severity of the CIA model by decreasing the paw thickness, arthritis score, cartilage degeneration, joint destruction, and serum inflammatory cytokine level. The network pharmacology and molecular docking predicted AKT1 as the target, in which EUP exerts its effects. The western blot, IF and RT-qPCR identified the toll-like receptor signaling pathway and its key component, AKT1, as potential targets, in which EUP exerts its anti-arthritic effects in RA.

EUP ameliorates the deterioration of RA by inactivating the toll-like receptor signaling pathway via AKT1. Therefore, EUP might hold potential as a treatment medicine for RA.

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1355
Case Series Open Access
Noman Niazi, Maria Nowicka, Munir Khan, Ahmed Aljawadi, Anand Pillai
Published online March 31, 2022
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2021.00075
Abstract
Diabetic foot ulcers (DFUs) are a significant source of morbidity, and pose great financial burden to the health service. Conventional treatments with dressings are often ineffective. [...] Read more.

Diabetic foot ulcers (DFUs) are a significant source of morbidity, and pose great financial burden to the health service. Conventional treatments with dressings are often ineffective. Platelet-rich products have been used in recent years for the treatment of DFUs, with promising results. The present study aims to evaluate the efficacy of plasma rich in growth factors (PRGF) membrane therapy in the treatment of chronic non-healing DFUs, in order to improve wound healing and accelerate the epithelisation of chronic wounds.

A total of six diabetic patients with chronic non-healing foot ulcers were included in the present study. The Endoret procedure was used to isolate the PRGF from blood samples, resulting in the formation of a membrane clot, which was placed over the bed of the ulcer. A portion of the PRGF was also allowed to infiltrate around the ulcer edge. Patients were followed up in clinic at two weekly intervals, until full healing was achieved.

All six patients (mean age: 60 years old) underwent successful treatment with the PGRF membrane. Full epithelisation of the ulcers was achieved for all patients, with a mean duration of eight weeks. No complications were noted throughout the treatment period.

The use of an autologous PRGF membrane is a secure and efficacious surgical treatment for chronic non-healing DFUs. The present study demonstrates that the PRGF fibrin membrane can be used to optimize surface regeneration in DFUs. Additional data and randomized studies are required to establish the effectiveness of this method in treating DFUs.

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1356
Original Article Open Access
Sheng-Liang Xin, Xiao-Li Pan, Xiao-Yuan Xu, Yan-Yan Yu
Published online March 31, 2022
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2022.00060
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease caused by over-nutrition. Impaired autophagy is closely related to NAFLD progression. Recently, ubiquitin-specific [...] Read more.

Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease caused by over-nutrition. Impaired autophagy is closely related to NAFLD progression. Recently, ubiquitin-specific peptidase-10 (USP10) was reported to ameliorate hepatic steatosis, but the underlying mechanism is still unclear. In view of the potential effects of USP10 on autophagy, we investigated whether USP10 alleviated steatosis through autophagy.

HepG2 cells were treated with palmitic acid (PA) to model NAFLD in vitro. Lentivirus was used to regulate USP10 level in cells. Autophagic regulators were used to autophagic progression in cells. Western blotting, real-time fluorescence quantitative polymerase chain reaction, lipid drop staining and immunofluorescent staining were performed to determine the effect of USP10 on lipid autophagy. Student’s t-test and Tukey’s post hoc test were used to compare the means among groups.

PA induced cellular steatosis with dependance on autophagy. USP10 overexpression alleviated PA-induced steatosis, restored autophagic activity, promoted autophagic flux, including synthesis and degradation of autophagosomes, and lipid-targeted autophagy. In the presence of autophagy inhibitors, the protective effectiveness of USP10 on steatosis decreased. Furthermore, the specific inhibitor to C-jun N-terminal protein kinase-1 (JNK1), DB07268, abolished USP10-induced autophagy. However, during early stage inhibition of JNK1, compensatory expression of tuberous sclerosis complex-2 (TSC2) maintained autophagy. The degree of TSC2-to-JNK1 compensation was positively associated with USP10 level. Functionally, JNK1 and TSC2 were involved in the lipid-lowering effect of USP10.

USP10 alleviated hepatocellular steatosis in autophagy-dependent manner. JNK1/TSC2 signaling pathways were required for USP10-induced autophagy.

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1357
Review Open Access
Dan Mu, Lei Mao, Wen-Jing Luo, Fang Wang, Guan Wang
Published online March 30, 2022
Gastroenterology & Hepatology Research. doi:10.53388/ghr2022-03-043
Abstract
CTLA-4 and PD-1/PD-L1 are common immune checkpoints targeted in clinical. Immunotherapy has made a breakthrough in the treatment of gastrointestinal tumors. However, some patients [...] Read more.

CTLA-4 and PD-1/PD-L1 are common immune checkpoints targeted in clinical. Immunotherapy has made a breakthrough in the treatment of gastrointestinal tumors. However, some patients may experience hyperprogression (HPD) during immunotherapy, which is characterized by abnormally accelerated tumor growth. Previous studies have shown that the incidence of HPD in gastrointestinal tumor immunotherapy is about 4%-29.4%, but the overall survival of patients with HPD is only a few months. HPD is a difficulty in immunotherapy. This review summarizes the definition, identification, incidence, mechanism and related predictors of hyperprogression in gastrointestinal tumor immunotherapy.

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1358
Article Open Access
Heng Xu, Yaqi Zhang, Huan Chen, Tengfei Bai
Published online March 30, 2022
Gastroenterology & Hepatology Research. doi:10.53388/ghr2022-03-045
Abstract
To analyze and explore the key targets and molecular mechanisms of action of Radix Paeoniae Alba against Toosendan Fructus-induced hepatotoxicity and the relationship between corresponding [...] Read more.

To analyze and explore the key targets and molecular mechanisms of action of Radix Paeoniae Alba against Toosendan Fructus-induced hepatotoxicity and the relationship between corresponding compounds based on network pharmacology.

Using network pharmacology, a "traditional Chinese medicine–chemical composition–key target–pathway" analysis was conducted on Radix Paeoniae Alba for the treatment of Toosendan Fructus-induced hepatotoxicity. The possible mechanism of action was analyzed in terms of function.

The core targets, such as interleukin (IL)-6, tumor necrosis factor (TNF), heat shock protein 90 alpha family class A member 1 (HSP90AA1), peroxisome proliferator-activated receptor gamma (PPARG), prostaglandin-endoperoxide synthase 2 (PTGS2), heme oxygenase 1 (HMOX1), Jun proto-oncogene (JUN), caspase-3, estrogen receptor 1 (ESR1), and aryl hydrocarbon receptor (AHR) were screened from the targets of Radix Paeoniae Alba against Toosendan Fructus-induced hepatotoxicity. Biological process (BP) of toxic targets (BP terms) involved "response to drug; activation of cysteine-type endopeptidase activity involved in apoptotic process," positive regulation of transcription. Cellular components (CC terms) mainly involved cytosol and membrane rafts. Molecular function (MF) terms included "protein homodimerization activity," RNA polymerase II transcription factor activity and enzyme binding, etc." The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway included the TNF signaling pathway, cancer pathways, and apoptosis.

Radix Paeoniae Alba might alleviate Toosendan Fructus-induced hepatotoxicity through IL6, TNF, HSP90AA1, PPARG, PTGS2, HMOX1, and other targets, possibly via the activation of cysteine-type endopeptidase activity involved in these pathways.

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1359
Article Open Access
Xue Feng, Yue Wang, Li Xu
Published online March 30, 2022
Gastroenterology & Hepatology Research. doi:10.53388/ghr2022-03-044
Abstract
To use network pharmacology and molecular docking technology to explore material basis and molecular mechanism of Coix lacryma-jobi, Hedyotis diffusa, Curcuma zedoaria, and Salvia [...] Read more.

To use network pharmacology and molecular docking technology to explore material basis and molecular mechanism of Coix lacryma-jobi, Hedyotis diffusa, Curcuma zedoaria, and Salvia chinensis on the treatment of pre-cancerous stomach diseases. Our findings provide a theoretical foundation for further clinical research.

We searched and screened the targets of four pharmaceutical components for activity against precancerous lesions of gastric cancer (PLGC) using the GeneCards and OMIM network databases. The Chinese medicine composition-target network was constructed using Cytoscape3.7.2 software, and the protein interoperability network of the four drugs for PLGC treatment was constructed using the string data platform. The core target was found by topological analysis. Finally, biopathic and enrichment analyses were carried out on the drug-disease intersection target.

A total of 19 active ingredients and 123 component targets were collected for four enterolytic drugs. For PLGC, 1487 targets were identified, and 64 targets were collected for pharmaceutical components and diseases. A topological analysis was performed with a value greater than the mean degree (29.0), and 64 key core targets were obtained (including TP53, EGFR, TNF, and VEGFA), and the key targets were screened for TP53, EGFR, TNF, and VEGFA, among others, through network topology and protein interoperability network analyses. GO functional enrichment analysis resulted in 1337 bio-process entries, 46 cell composition entries, and 74 molecular function entries. KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analysis and screening resulted in 254 signaling pathways, including stomach cancer, breast cancer, prostate cancer, non-small cell lung cancer, and colon cancer.

The four enterolysis drugs may be used to prevent and control PLGC by acting on TP53, EGFR, TNF, and VEGFA targets and relevant gastric cancer, inflammatory, and immune pathways.

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1360
Article Open Access
Kai Xiong, Ting-hui Yue, Tao Yang, Wen-ting Hu, Jia Deng, Tian-bao Xiao
Published online March 30, 2022
Gastroenterology & Hepatology Research. doi:10.53388/ghr2022-03-048
Abstract
To evaluate the benefits of traditional Chinese herbal medicine (TCHM) plus triple therapy (TT) in the management of Helicobacter pylori (H. pylori)-induced chronic atrophic gastritis [...] Read more.

To evaluate the benefits of traditional Chinese herbal medicine (TCHM) plus triple therapy (TT) in the management of Helicobacter pylori (H. pylori)-induced chronic atrophic gastritis (CAG).

A comprehensive access and electronic database search were carried out from inception to June 2020. Prospective randomized trials (TCHM plus TT vs. TT) were selected to assess the eradication rate of H. pylori (ER of H. pylori), clinical symptom relief rate (SRR), treatment-related adverse reactions (TRAR) and 95% confidence intervals (CI) in the meta-analysis and cumulative meta-analysis (CMA). Meta-regression analysis was used to analyze heterogeneity between studies and publication bias.

33 studies contained 3,226 participants were included. Compared with the TT group, TCHM plus TT group showed a significantly higher ER of H. pylori (OR=4.14, 95% CI: 3.21-5.35; P=0.000) and SRR (OR=4.50, 95% CI: 3.59-5.64). Meanwhile, the TRAR of TCHM plus TT remedy was significantly lower than TT monopoly (RR=0.43, 95% CI: 0.29-0.64; P=0.000). The results of the CMA, sorted by publication year, duration of treatment, and sample size, confirmed that combined treatment remedy was superior to TT monopoly in respect of ER of H. pylori and SRR.

The present study obtained reliable and convincing evidence suggesting that TCHM plus TT remedy was efficacious and safe in treating H. pylori-induced CAG.

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