[The efficacy and safety analysis of cervical and abdominal double single-port minimally invasive esophagectomy].

Objective: To summarize the efficacy and safety of minimally invasive esophagectomy through cervical and abdominal double single-port. Methods: A total of 28 patients who underwent cervical and abdominal double single-port minimally invasive radical resection of esophageal cancer from January 2021 to October 2022 in the First Affiliated Hospital of Fujian Medical University were retrospectively collected, including 18 males and 10 females, aged 58-80 (72±4) years. All patients were placed in the supine position, the single port was operated through the cervical mediastinum first, then the single port was operated through the abdominal cavity, and finally the neck was anastomosed. The operative time, intraoperative blood loss, postoperative ambulation time, postoperative drainage tube removal time, postoperative complications, postoperative pathological examination results, postoperative discharge time of patients were recorded and followed. Results: In the included 28 patients, there were twenty-six patients successfully completed the cervical and abdominal double single-port minimally invasive radical resection of esophageal cancer, and two patients were transferred to the right thoracoscopic surgery due to oozing of blood and unclear visual field, without conversion to laparotomy or enlargement of the incision occurred. The operation time was 125 to 215 (152±32) minutes, including 43 to 100 (56±15) minutes in the mediastinum and 35 to 63 (40±5) minutes in the abdominal cavity. Intra-operative blood loss was 55-100 (45±20) ml. There were 8 to 14 (11±3) lymph nodes dissected in the mediastinum and 7 to 15 (9±3) lymph nodes dissected in the abdominal cavity. Twenty-eight patients were active in bed 1 to 2 days after surgery. The left cervical drainage tube was removed 2 days after surgery. There was no anastomotic fistula, anastomotic stenosis, pulmonary infection, chylothorax and stomach emptying disorder in the whole group. Pleural effusion occurred in 4 cases, all of them had pleural damage during the operation, and were cured after postoperative puncture and drainage; two cases had hoarseness and one case had cough after eating, all patients were discharged from hospital after eating liquid. Postoperative hospital median stay was [ M(Q1, Q3)] 7(6, 9) d. The postoperative pathological examination results of all patients were squamous cell carcinoma, and the postoperative pathological stage was pT1-3N0-1M0. The median postoperative follow-up was 25 (5, 35) months, and no patients had complications, recurrence, metastasis or death during the follow-up period. Conclusion: The cervical and abdominal double single-hole minimally invasive radical resection of esophageal cancer is safe and feasible, with good short-term efficacy, which provide an opportunity for radical surgery for patients with advanced age, poor cardiopulmonary function or insufficient thoracic conditions.

[Effects of expanded anterolateral approach for tibial plateau fractures involved the posterolateral column].

Objective: To explore the short-term effects of expanded anterolateral approach in treating fracture involved the posterolateral tibial plateau. Methods: A retrospective analysis of the clinical data from 16 patients undergoing extended anterolateral approach for fracture involved the posterolateral tibial plateau in the First Affiliated Hospital of Wannan Medical College between January 2013 and July 2016 was done. The patients were treated with 3.5 mm proximal "L" type proximal tibial locking compression plate with four locking screws through the nail row technique. The X-rays examinations were carried out immediately after the operation and at 1.5, 3, 6, and 12 months later, to continuously measure the tibial plateau angle (TPA) and posterior slope angle (PA). The Rasmussen radiology score was used to assess the reduction. One year later, the modified Rasmussen knee score was used to assess the recovery of knee function, the Lysholm score was applied to evaluate the cartilage injury, softening and degeneration, and lateral stress test and dial test were carried out to evaluate the stability of the knee. Results: The group consisted of 11 males and 5 females; aged 25 to 71 years, mean (47±12) years; schatzker type Ⅱ 9 cases, type Ⅴ 6 cases and type Ⅵ 1 case. There were 9 cases of type B in Orthopedic Trauma Association (OTA) classification, and 7 cases of type C. X-ray was immediately performed after operation and it showed that 14 cases got anatomic reduction, 2 cases left<2 mm of steps. Rasmussen radiology score was 14 to 18 points, mean (17.0±1.5) points. X-ray examination showed no significant difference in TPA immediately after operation and 1.5, 3, 6, 12 months later (F=0.05, P=0.99), and there was no significant difference in PA among the time points (F=0.02, P=1.00). At one-year of follow-up, the modified Rasmussen knee score ranged from 18 to 29 with an average of (25.0±3.3) points, of which 7 were excellent, 8 were good and 1 was fair. The excellent and good rate was 93.75%. Knee range of motion was 110°-135° with a mean of (122±8)°. Lysholm score was 93±4. Evaluation of lateral stress test and dial test were both negative. Conclusions: The short-term curative effect of expanded anterolateral approach in treating fracture involved the posterolateral tibial plateau with the 3.5 mm proximal "L" type proximal tibial locking compression plate proximal to the locking screw is satisfactory, it provides sufficient exposure and effective fixation, the joint function and stability are satisfying.

Effects of increasing root carbon investment on the mortality and resprouting of Haloxylon ammodendron seedlings under drought.

Tree mortality induced by drought is one of the most complex processes in ecology. Although two mechanisms associated with water and carbon balance are proposed to explain tree mortality, outstanding problems still exist. Here, in order to test how the root system benefits survival and resprouting of Haloxylon ammodendron seedlings, we examined the various water- and carbon-related physiological indicators (shoot water potential, photosynthesis, dark respiration, hydraulic conductance and non-structural carbohydrates [NSC]) of H. ammodendron seedlings, which were grown in drought and control conditions throughout a grow season in greenhouse. The survival time of the seedling root system (died 70 days after drought) doubled the survival time of the shoot (died at 35 days). Difference in survival time between shoot and root resulted from sustained root respiration supported by increased NSC in roots under drought. Furthermore, investment into the root contributed to resprouting following drought. Based on these results, a death criterion is proposed for this species. The time sequence of major events indicated that drought shifted carbon allocation between shoot and root and altered the flux among different sinks (growth, respiration or storage). The interaction of water and carbon processes determined death or survival of droughted H. ammodendron seedlings. These findings revealed that the 'root protection' strategy is critical in determining survival and resprouting of this species, and provided insights into the effects of carbon and water dynamics on tree mortality.

Phylogeny of 16S rRNA and nifH genes and regulation of nitrogenase activity by oxygen and ammonium in the genus Paenibacillus.

All Paenibacillus 16S rDNA sequences, except for that of Paenibacillus massiliensis T7, formed a coherent cluster, distinct from Gram-positive nitrogen-fixing Clostridium pasteurianum and Heliobacterium chlorum. All Paenibacillus NifH sequences formed two main clusters. Cluster I encompassing the NifH sequences from most of members of Paenibacillus spp., such as Paenibacillus azotofixans NifH1 and NifH2, Paenibacillus polymyxa and Paenibacillus macerans. Cluster II including only P. azotofixans NifH3. Curiously, three copies of nifH genes of Paenibacillus sabine T27 clustered within P. azotofixans cluster I (NifH1 and NifH2). The effect of O2 and ammonium on nitrogenase activity was studied with 14 different nitrogen-fixing Paenibacillus strains. The optimal oxygen concentration level for all Paenibacillus strains is in the 0 to 0.05% range, similar to that for Klebsiella pneumoniae. In all Paenibacillus strains, the highest nitrogenase activity is obtained in the condition of 0-0.1 mM NH4Cl and the increase of NH4CI from 0.1 to 5 mM caused a rapid inhibition of nitrogenase activity. However, the inhibition was reversible in the presence of 200 mM NH4Cl in some Paenibacillus strains. It is the first time to use almost all of the recognized nitrogen-fixing Paenibacilus spp. to investigate the phylogeny of 16S rRNA and nifH genes. The data that the inhibition of O2 and ammonium on nitrogenase acitivity will provide a base for studying the molecular regulatory mechanism of nitrogen fixation in the genus Paenibacillus.