No abstract

Background: To identify and safeguard the ureters of patients with deep infiltrating endometriosis or complex pelvic adhesion (obliterated cul-de-sac) using indocyanine green (ICG) during laparoscopic surgery. Methods: Stepwise surgical demonstration using narrated video footage. The stepwise procedures were: (1) Explore the abdominal cavity, resect pelvic adhesions, remove the right ovarian endometrioma cysts, and open the peritoneum to locate the fluorescence. (2) Place bilateral 5-Fr ureteral catheters through the cystoscope, inject ICG retrogradely, and clip the catheter to retain the ICG. (3) Identify the course of ureters and perform ureterolysis with real-time visualization under Near-infrared fluorescence. Resect the para-ureteral endometriosis and other pelvic endometriosis. Results: The patient was discharged on the 4th postoperative day with satisfactory surgical effect and without any complications. Conclusions: For complex gynecologic surgeries whereby ureterolysis might be challenging, ICG fluorescence imaging could be used to quickly identify the course of the ureter, prevent ureteral injury and reduce the risks of perioperative and postoperative complications. This case demonstrates that intraureteral ICG provided quick visualization of the ureter and allowed surgeons to safely perform ureterolysis. The proposed technique could be considered in complex gynecological cancer, pelvic floor disorder or endometriosis surgery.

No abstract

As one form of stroke, intracerebral hemorrhage (ICH) is a fatal cerebrovascular disease, which has high morbidity and mortality, and lacks of effective medical treatment. An increased infiltration of inflammatory cytokines coupled with pyroptotic cell death is involved in the pathophysiological process of ICH. However, little is known about whether concomitant fracture patients have the same progression of inflammation and pyroptosis. Hence, we respectively established mouse ICH model and ICH with bilateral tibial fracture model (MI) to explore the potential cross-talk between the above two injuries. We found that MI obviously reversed the expressions of pyroptosis-associated proteins, which were remarkably up-regulated at the acute phase after ICH. Similar results were observed in neuronal expressions via double immunostaining. Furthermore, brain edema was also significantly alleviated in mice who suffered MI, when compared with ICH alone. To better clarify the potent mechanisms mediated this cross-talk, recombinant mouse interleukin-13 (IL-13) was used to investigate its effect on pyroptosis in the mouse MI model, in which lower level of IL-13 was observed. Remarkably, IL-13 administration re-awakened cell death, which was mirrored by the re-upregulation of pyroptosis-associated proteins and PI positive cell counts. The results of hemorrhage volume and behavioral tests further confirmed its critical role in regulating the neurological functions. Besides, IL-13-treated MI group showed poor outcomes of fracture healing. To sum up, our research indicates that controlling the IL-13 content in acute phase would be a promising target in influencing the outcomes of brain injury and fracture, and meanwhile, provides new evidence in repairing compound injuries in clinics.

As one form of stroke, intracerebral hemorrhage (ICH) is a fatal cerebrovascular disease, which has high morbidity and mortality, and lacks of effective medical treatment. An increased in ltration of in ammatory cytokines coupled with pyroptotic cell death is involved in the pathophysiological process of ICH. However, little is known about whether concomitant fracture patients have the same progression of in ammation and pyroptosis. Hence, we respectively established mouse ICH model and ICH with bilateral tibial fracture model (MI) to explore the potential cross-talk between the above two injuries. We found that MI obviously reversed the expressions of pyroptosis-associated proteins, which were remarkably up-regulated at the acute phase after ICH. Similar results were observed in neuronal expressions via double immunostaining. Furthermore, brain edema was also signi cantly alleviated in mice who suffered MI, when compared with ICH alone. To better clarify the potent mechanisms mediated this cross-talk, recombinant mouse interleukin-13 (IL-13) was used to investigate its effect on pyroptosis in the mouse MI model, in which lower level of IL-13 was observed. Remarkably, IL-13 administration reawakened cell death, which was mirrored by the re-upregulation of pyroptosis-associated proteins and PI positive cell counts. The results of hemorrhage volume and behavioral tests further con rmed its critical role in regulating the neurological functions. Besides, IL-13-treated MI group showed poor outcomes of fracture healing. To sum up, our research indicates that controlling the IL-13 content in acute phase would be a promising target in in uencing the outcomes of brain injury and fracture, and meanwhile, provides new evidence in repairing compound injuries in clinics.