Introduction: HB presents with the highest frequency of CTNNB1 mutations, resulting in activation of Wnt signaling pathway. A number of studies have demonstrated CTNNB1 mutation contributed to the development of HB. However, limited research explored the function of lncRNAs in HB with CTNNB1 mutation. Methods: We screened lncRNA expression profiles in CTNNB1-mutated HB samples and identified lncRNAs associated with malignant phenotype in HB. The association between lncRNA and immune microenvironment was investigated. The biological function of lncRNA was further explored using in vitro experiments. Results: TUG1 was identified as onco-lncRNA in CTNNB1-mutated HB. TUG1 was shown to be associated with the infiltration of pro-tumor immunocytes via regulating the expression of CXCR4, a chemokine receptor playing a critical role in regulation of immune microenvironment. Inhibiting TUG1 could increase endogenous levels of miR-335-5p and consequently downregulating CXCR4, a direct target of miR-335-5p. Conclusion: Our findings provide evidence for TUG1 mediating infiltration of pro-tumor immunocytes in HB patients carrying CTNNB1 mutation. TUG1-miR-335-5p-CXCR4 axis might be a promising immunological target for the treatment of HB patients.

Background Although marginal donor livers expand the donor pool, an ideal method for quantitatively evaluating the quality of donor livers has not been developed. This study aimed to explore the feasibility of indocyanine green (ICG) fluorescence imaging for estimating liver function in an ischemia–reperfusion model. Methods Forty-eight rats were randomly and evenly divided into 8 groups: the control group and the experimental groups (I-VII). The portal vein blocking period was 0 min, 10 min, 20 min, 30 min, 40 min, 50 min and 60 min. After blood flow was reestablished and the hemodynamics stabilized, ICG was injected through the dorsal penile vein as a bolus, and the fluorescence signal was recorded for 30 min in real time. The fluorescence intensity (FI) curve of the liver was fitted with an asymptotic regression model. Fresh liver tissues and serum were obtained from the middle lobe of the liver on postoperative day (POD) 1 and POD 7 for histopathological evaluation and liver function tests. Results The growth rate of the FI curve, parameter b3, decreased from groups I to VII. According to the two sudden changes in b3 (20 min, 50 min), the experimental groups could be classified into 3 groups (A, B and C). Hepatocytes in groups I-II showed slight edema, group III began to show obvious hepatocyte edema and vacuolar degeneration, and in groups VI-VII, severe hepatocyte degeneration, necrosis and large inflammatory cell infiltration were observed. Suzuki’s scores in the 3 groups were also significantly different (P < 0.01). At the same time, the serum liver function in the experimental groups showed a significant increase on POD 1 and a decrease on POD 7. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TB) levels of groups A, B, and C were significantly different on POD 1 (P < 0.05), and the ALT and direct bilirubin (DB) levels were significantly different on POD 7 (P < 0.05); the lactic dehydrogenase (LDH) level of the group C was significantly higher than that of the groups A and B on POD 1 and POD 7. Meanwhile, the 7-day survival rate of the rats in group C was poor compared to that of the rats in groups A and B (58.3% vs. 100% vs. 100%). Conclusion ICG fluorescence imaging is effective for estimating the degree of liver damage and grading in an ischemia–reperfusion model. It probably has the potential for use in assessing the quality of the donor liver in liver transplantation.

High-powered lasers are commonly used for tissue resection in surgeries, including liver resection, medically known as hepatectomy; however, such lasers inevitably induce thermal damage that causes postoperative complications. This study aims to explore the effects of water cooling and different laser output modes on laser-induced thermal damage during hepatectomy. Methods: To avoid the influence of superposition, a 980-nm diode laser was used for a single-point hepatectomy. Eighteen Sprague-Dawley rats were used to explore the effects of water cooling and different laser output modes. A constant energy 10-J laser was used to cut the liver tissue with a power of 10 W and time of 1 second. The rats were randomly divided into six groups. The first three groups were assigned as test subjects for different laser output modes. Group 1 was operated with a continuous laser output for a duration of 1 second. Groups 2 and 3 were operated with a pulsed laser output for a duration of 1 second and a pulse width of 0.5 and 0.25 seconds, respectively. Groups 4, 5, and 6 were assigned for the water cooling test. Water cooling was performed based on the parameters of the first three groups. Medical saline (0.9% NaCl) was used for water cooling. The main observation indicators were resection efficiency and thermal damage, including the area of the thermal damage zone. Resection efficiency is calculated by dividing the resection area by the total thermal damage area. Results: In the three water cooling groups, the area of the resection, carbonized, sub-boiling coagulated, and total thermal damage zones were 0.0677, 0.00, 1.7293, and 2.2982 mm 2 in Group 4; 0.0465, 0.00, 1.3205, and 1.8414 mm 2 in Group 5; and 0.0565, 0.00, 1.4301, and 1.9650 mm 2 in Group 6, respectively. Compared with the first three groups, the water cooling groups exhibited significantly reduced thermal damage areas of in the carbonized, sub-boiling coagulated, and total thermal damage zones (p < 0.001 for all). In addition, there was no statistical difference in the resection area, vacuolated area, and resection efficiency. Furthermore, there was no statistical difference in the area of each thermal damage zone between the continuous and pulsed output groups. The resection efficiencies were 4.82%, 3.34%, 3.73%, 3.93%, 3.36%, and 3.01% in Groups 1 to 6, respectively. Moreover, there was no statistical difference (p > 0.05) in the resection efficiencies. Conclusion: Water cooling can reduce the total laser-induced thermal damage area and prevent tissue carbonization. Therefore, this cooling method can be used as a simple and safe strategy for controlling thermal damage during hepatectomy.

Background X-ray cholangiography is of great value in the imaging of biliary tract diseases; however, occupational radiation exposure is unavoidable. Moreover, clinicians must manually inject the contrast dye, which may result in a relatively high incidence of adverse reactions due to unstable injection pressure. Thus, there is a need to develop a novel remote-controlled cholangiography injection device. Methods Patients with external biliary drainage requiring cholangiography were included. A remote-controlled injection device was developed with three major components: an injection pump, a pressure sensor, and a wireless remote-control panel. Image quality, adverse reactions, and radiation dose were evaluated. Results Different kinds of X-ray cholangiography were successfully and smoothly performed using this remote-controlled injection device in all patients. The incidence of adverse reactions in the device group was significantly lower than that in the manual group (4.17% vs. 13.9%, P = 0.001), and increasing the injection pressure increased the incidence of adverse reactions. In addition, the device helped operators avoid ionizing radiation completely. Conclusions With good control of injection pressure (within 10 kPa), the remote-controlled cholangiography injection device could replace the need for the doctor to inject contrast agent with good security and effectivity. It is expected to be submitted for clinical application.

BACKGROUND: Endoscope can removes the button battery embedded in the esophagus，recommend emergency for symptomatic and asymptomatic children (< 2 hours) , For intragastric button batteries(BB), food debris may make positioning difficult. The smooth disc-shaped button battery allows foreign body forceps to grasp the battery Easy to slip off.Reasons for the delay include limited access to endoscopists, referral to tertiary care institutions, or delayed anesthesia due to gastric tamponade may all cause complications,In view of the extremely short effective treatment time window of the button battery in the upper gastrointestinal tract , this study designed a simple, fast and effective magnetic retrieval system for the button battery of the upper digestive tract. Method: A set of magnetic retrieval system(MRS) for removing the upper digestive tract button battery was designed, including the magnetic retrieval device and the external guide magnet. We verified its feasibility by finite element analysis (FEA) simulation and removed button batteries with MRS in Beagle model. Result: The button battery in the esophagus were all retrieved, No operation-related complications occurred. the retrieval time in the magnet group and endoscopic group was 92.91±82.47 s and 327.64±270.63 s respectively,P=0.012. 4 shifts happened in the endoscopic group during operation, 3 button batteries slipped off the forceps in the endoscopic group,resistance when retrieved was 2.1±1.02 N. The button battery in the stomach was all retrieved , the median time for magnetic aggregation using a guide magnet is 87s (70-135s), the median retrieved time was 21s (19-35s), and the resistance during the retrieved was 1.98N (1.67-2.4N). Conclusion: we designed a novel magnetic retrieval system in this study. The MRS has a short magnetic retrieval time, is safe,cheapness and easy to operate, We suggest that the MRS could be used for the retrieval of BB during children ingestion button batteries.