[Comparative analysis of intestinal microbiota distribution characteristics based on metagenomics in patients with hepatitis B cirrhosis with or without ascites].

Objective: To use metagenomic sequencing to compare the differences in intestinal microbiota species and metabolic pathways in patients with hepatitis B cirrhosis with or without ascites and further explore the correlation between the differential microbiota and clinical indicators and metabolic pathways. Methods: 20 hepatitis B cirrhosis cases [10 without ascites (HBLC-WOA), 10 with ascites (HBLC-WA), and 5 healthy controls (HC)] were selected from the previously studied 16S rRNA samples. Metagenome sequencing was performed on the intestinal microbiota samples. The Kruskal-Wallis rank sum test and Spearman test were used to identify and analyse differential intestinal microbiota populations, metabolic pathways, and their correlations. Results: (1) The overall structure of the intestinal microbiota differed significantly among the three groups (R = 0.19, P = 0.018). The HC group had the largest abundance of Firmicutes and the lowest abundance of Proteobacteria at the genus level. Firmicutes abundance was significantly decreased (P(fdr) < 0.01), while Proteobacteria abundance was significantly increased (P(fdr) < 0.01) in patients with cirrhosis accompanied by ascites; (2) LEfSe analysis revealed that 29 intestinal microbiota (18 in the HBLC-WA group and 11 in the HBLC-WOA group) played a significant role in the disease group. The unclassified Enterobacteriaceae and Klebsiella species in the HBLC-WA group and Enterobacteriaceae in the HBLC-WOA group were positively correlated with the Child-Turcotte-Pugh (CTP) score, prothrombin time, and international normalized ratio score and negatively correlated with albumin and hemoglobin levels (P < 0.05). Escherichia and Shigella in the HBLC-WA group were positively correlated with CTP scores (P < 0.05); (3) The correlation analysis results between the KEGG pathway and 29 specific intestinal microbiota revealed that Enterobacteriaceae and arachidonic acid, α-linolenic acid, glycerolipid metabolism, and fatty acid degradation were positively correlated in the lipid metabolism pathway, while most Enterobacteriaceae were positively correlated with branched-chain amino acid degradation and negatively correlated with aromatic amino acid biosynthesis in the amino acid metabolic pathway. Conclusion: A significant increment of Enterobacteriaceae in the intestines of HBLC-WA patients influenced hepatic reserve function and was associated with amino acid and lipid metabolic pathways. Therefore, attention should be paid to controlling the intestinal microbiota to prevent complications and improve the prognosis in patients with hepatitis B cirrhosis, especially in those with ascites.

A proof-of-concept study of an automated solution for clinical metagenomic next-generation sequencing.

AIMS: Metagenomic next-generation sequencing (mNGS) has been utilized for diagnosing infectious diseases. It is a culture-free and hypothesis-free nucleic acid test for diagnosing all pathogens with known genomic sequences, including bacteria, fungi, viruses and parasites. While this technique greatly expands the clinical capacity of pathogen detection, it is a second-line choice due to lengthy procedures and microbial contaminations introduced from wet-lab processes. As a result, we aimed to reduce the hands-on time and exogenous contaminations in mNGS. METHODS AND RESULTS: We developed a device (NGSmaster) that automates the wet-lab workflow, including nucleic acid extraction, PCR-free library preparation and purification. It shortens the sample-to-results time to 16 and 18·5 h for DNA and RNA sequencing respectively. We used it to test cultured bacteria for validation of the workflow and bioinformatic pipeline. We also compared PCR-free with PCR-based library prep and discovered no differences in microbial reads. Moreover we analysed results by automation and manual testing and found that automation can significantly reduce microbial contaminations. Finally, we tested artificial and clinical samples and showed mNGS results were concordant with traditional culture. CONCLUSION: NGSmaster can fulfil the microbiological diagnostic needs in a variety of sample types. SIGNIFICANCE AND IMPACT OF THE STUDY: This study opens up an opportunity of performing in-house mNGS to reduce turnaround time and workload, instead of transferring potentially contagious specimen to a third-party laboratory.

Gene mapping reveals the association between tyrosine protein kinase Abl1 and the silk yield of Bombyx mori.

The Z chromosome of the silkworm contains a major gene that influences silk yield. This major locus on chromosome Z accounts for 35.10% of the phenotypic variance. The location and identification of the gene have been a focus of silkworm genetics research. Unfortunately, identification of this gene has been difficult. We used extreme phenotype subpopulations and selected from a backcross population, BC1 M, which was obtained using the high-yield strain 872B and the low-yield strain IS-Dazao as parents, for mapping the gene on the chromosome Z. The candidate region was narrowed down to 134 kb at the tip of the chromosome. BmAbl1 in this region correlated with silk gland development by spatiotemporal expression analysis. This gene was differentially expressed in the posterior silk glands of the high- and low-yield strains. In BmAbl1, an insertion-deletion (indel) within the 10th exonic region and an SNP within the 6th intronic region were detected and shown to be associated with cocoon shell weight in 84 Bombyx mori strains with different yields. Nucleotide diversity analysis of BmAbl1 and its 50 kb flanking regions indicated that BmAbl1 has experienced strong artificial selection during silkworm domestication. This study is the first to identify the genes controlling silk yield in the major QTL of the Z chromosome using forward genetics.

[Evaluation of kurtosis on hearing loss caused by non-steady state noise in general equipment manufacturing industry].

Objective: To study the effect of occupational exposure to non-steady state noise on hearing loss in the general equipment manufacturing industry, and to explore the feasibility of applying kurtosis index to evaluate hearing loss caused by non-steady state noise. Methods: A total of 233 workers exposed to non-steady state noise in 6 general equipment manufacturing enterprises were selected as the observation group, and 237 workers exposed to steady noise in 4 textile enterprises were selected as the control group between 2012 and 2018. Personal normalized continuous A-weighted sound pressure level equivalent to an 8 h-working-day (L(Aeq, 8 h)) was determined by a noise dosimeter. Cumulation noise exposure (CNE) was calculated from L(Aeq, 8 h) and related working age, and the CNE was adjusted by using noise kurtosis (CNE' after adjustment) . Meanwhile, questionnaires and hearing loss tests were performed for all subjects. The changes in the threshold of high-frequency hearing and the incidence of high-frequency hearing loss caused by noise in the two groups were compared before and after the adjustment of the kurtosis of CNE. The correlation between CNE and the incidence of high-frequency hearing loss before and after kurtosis adjustment was analyzed. Results: There was an difference between the 3000-8000 Hz hearing threshold of workers in different CNE groups (P<0.05) . logistic regression analysis showed that CNE was a risk factor of high-frequency hearing loss for workers in the observation group (OR=1.189, P<0.05) , and trend Chi-square test showed that the incidence of high-frequency hearing loss increased with CNE levels (χ(2)(trend)=34.415, P<0.05) .Before the kurtosis adjustment, in the CNE 95~<110 dB (A) ·year level group, the incidence of high-frequency hearing loss and the high-frequency hearing threshold in the observation group were significantly higher than those in the control group (P<0.05) . After kurtosis adjustment, there was no significant difference in the incidence of high-frequency hearing loss between the observation group and the control group in each level group (P>0.05) . The correlation between CNE after kurtosis adjustment and the incidence of high-frequency hearing loss was better than that before adjustment (after R(2) adjustment >before R(2) adjustment) . Conclusion: The effect of non-steady state noise on high-frequency hearing loss of workers in general equipment industry increases with the increase of CNE, and the effect of non-steady state noise on high-frequency hearing loss of workers is greater than that of steady noise. CNE' can be used to evaluate the hearing loss caused by non-steady state noise.

[Dose-response relationship between noise kurtosis and noise-induced hearing loss].

Objective: To analyse the dose-response relationships between the kurtosis metric of noise and noise-induced hearing loss (NIHL) and study the role of kurtosis in the evaluation of NIHL associated with non-Gaussian noise. Methods: From January 2012 to December 2017, a total of 1869 workers in seven manufacturing industries were selected as the study subjects. The basic data of the workers were investigated by questionnaire, personal noise waveform was collected for a long time, and pure tone hearing threshold was tested. The 8-hour continuous equivalent A sound level (L(Aeq, 8 h)) , cumulative noise exposure (CNE) and kurtosis structure indexes were calculated. The dose-response relationships between kurtosis and NIHL were analyzed by stratification analysis method, which controlled the influence of CNE, L(Aeq, 8 h), exposure duration, age and sex on hearing loss using high-frequency noise-induced permanent threshold shift (NIPTS(346)) and high-frequency noise-induced hearing loss (HFNIHL) as outcome indicators. Results: When CNE was <90 dB (A) ·year and ≥100 dB (A) ·year, NIPTS(346) in the extremely high kurtosis group was significantly greater than that in the Gaussian kurtosis, low kurtosis and medium kurtosis group (P<0.05) . In the workers exposed to L(Aeq, 8 h)<85 dB (A) and ≥94 dB (A) , NIPTS(346) in the extremely high kurtosis group was significantly greater than that in the Gaussian kurtosis group (P<0.05) . Among workers under the age of 50 or male workers, NIPTS(346) in the extremely high kurtosis group was significantly greater than that in the Gaussian kurtosis, low kurtosis and medium kurtosis group (P<0.05) . Kurtosis was positively correlated with NIPTS(346) (r=0.121, P<0.05) . When CNE was <100 dB (A) ·year, the detection rate of HFNIHL increased with the increase of kurtosis level (P<0.01) . Logistic regression analysis showed that kurtosis was an important influencing factor for HFNIHL (OR=1.321) . Conclusion: Kurtosis has a dose-response relationship with the detection rate of HFNIHL in noise exposed workers, and noise kurtosis is an influencing factor of NIHL.

Tailored Plasmons in Pentacene/Graphene Heterostructures with Interlayer Electron Transfer.

van der Waals (vdW) heterostructures, which are produced by the precise assemblies of varieties of two-dimensional (2D) materials, have demonstrated many novel properties and functionalities. Here we report a nanoplasmonic study of vdW heterostructures that were produced by depositing ordered molecular layers of pentacene on top of graphene. We find through nanoinfrared (IR) imaging that surface plasmons formed due to the collective oscillations of Dirac Fermions in graphene are highly sensitive to the adjacent pentacene layers. In particular, the plasmon wavelength declines systematically but nonlinearly with increasing pentacene thickness. Further analysis and density functional theory (DFT) calculations indicate that the observed peculiar thickness dependence is mainly due to the tunneling-type electron transfer from pentacene to graphene. Our work unveils a new method for tailoring graphene plasmons and deepens our understanding of the intriguing nano-optical phenomena due to interlayer couplings in novel vdW heterostructures.

[Correlation analysis between prostate imaging report and data system score and pathological results of prostate cancer].

Objective: To explore the correlation between prostate imaging report and data system (PI-RADS) score and international society of uological pathology (ISUP) grade of prostate cancer (PCa) and the role of PI-RADS score in predicting the pathological features of clinically significant PCa (csPCa), positive surgical margin and pathological upgrade. Methods: The pathologically positive patients with multi-parameter magnetic resonance image (mpMRI) were included in this study. The patients with prostate specific antigen (PSA)<100 µg/L were divided into two groups: biopsy group (n=523) and RP group (n=215). The correlation between PI-RADS score and ISUP grade and the accuracy of predicting csPCa in the two groups were evaluated. In the RP group, the correlation between PI-RADS score and postoperative pathological grade or degradation and positive incisal margin was further discussed. The patients with PSA≥100 µg/L (171cases in biopsy group and 6 cases in RP group) were not included in the statistical analysis, and the results were simply described. Results: The age, prostate volume, and PSA level of biopsy group and RP group was (72±8) years vs (68±7) years, 48.3 (32-57) cm(3) vs 47.2 (32-54) cm(3), and 26.3(10.2-34.2)µg/L vs 21.7 (9.24-23.95)µg/L, respectively. The PI-RADS scores ≤ 3,4, and 5 in the biopsy group were 109,97, and 317 respectively, and those in the RP group were 61,55, and 99 respectively. There were significant differences in the composition of ISUP grades of different PI-RADS scores between the two groups (P<0.001), and there was a positive correlation between the two groups (r=0.493 in the biopsy group, r=0.671 in the RP group, both P<0.001). Using PI-RADS score to predict csPCa, biopsy group (AUC=0.764, P<0.001, 95%CI:0.710-0.819) and RP group (AUC=0.807, P<0.001, 95%CI:0.735-0.879) had certain accuracy. The PI-RADS score combined with PSA could improve the accuracy of csPCa prediction in the biopsy group (AUC=0.795,P<0.001, 95% CI:0.746-0.843) and the RP group (AUC=0.852, P<0.001, 95%CI:0.789-0.915). Compared with the pathological results of biopsy in the RP group, 52.6% of the patients showed upgrade and degrade of ISUP, and there was insignificant difference in the composition of PI-RADS scores between upgraded and degraded patients (P>0.05). However, 41.7%(27/65) of the patients with ISUP grade 1 biopsies had pathological upgrades that the patients with PI-RADS ≤ 3 accounted for 33.3%, while the patients with PI-RADS>3 accounted for 66.7%, and there was significant difference between the two groups (P<0.05). After RP, 43.3% of the patients had positive surgical margins, and the patients with PI-RADS score ≤ 3, 4 and 5 were 13 (14%), 24 (25.8%) and 56 (60.2%), respectively, while the PI-RADS scores of patients with negative surgical margin were 48 (39.3%), 31(25.4%) and 43(35.2%), respectively. There was significant difference between the two groups (P<0.001). The higher the PI-RADS score, the greater the possibility of the positive surgical margin. For the patients with PSA ≥ 100 µg/L, 98.8% (169/171) patients in the biopsy group had a PI-RADS score 5. The pathological results of all patients were csPCa, of which 85.4% (146/171) had ISUP grade ≥ 4. Among them, 6 cases underwent RP, 5 cases had ISUP grade ≥ 4, all surgical margin were positive, 5 cases had seminal vesicle invasion, 3 cases had capsule invasion and 3 cases had positive pelvic lymph nodes. Conclusion: ThePI-RADS score is correlated with the ISUP grade of PCa. Combined with PSA can accurately predict csPCa. At the same time, the higher PI-RADS score, the more likely the patients with positive incisal margin after RP and Gleason score of 3+3=6 at the time of puncture will be upgraded pathologically.

Developmental expression and evolution of hexamerin and haemocyanin from Folsomia candida (Collembola).

Haemocyanins constitute a group of copper-containing respiratory proteins, and hexamerins were derived from hexapod haemocyanin but lost the ability to transport oxygen and serve as storage proteins. Although hexamerins have been reported in most insect species, none of them has been identified in Collembola, one of the most primitive hexapod lineages, thereby preventing us from exploring relevant evolutionary scenarios regarding the origin and evolution of hexamerins in hexapods. Here we report on collembolan hexamerins for the first time, and investigated the temporal expression profiles of hexamerin and haemocyanin in the collembolan Folsomia candida. Haemocyanin was expressed over the entire life cycle, with higher expression at the embryonic stage than at other stages, whereas hexamerin expression was restricted to embryos, unlike insect hexamerins, which are generally expressed from larval to adult stages. A phylogenetic analysis and molecular clock estimation suggested that all investigated hexapod hexamerins have a single and ancient origin (~423 Ma), coincident with the rise of atmospheric oxygen levels in the Silurian-Devonian period, indicating a physiological link between molecular evolution and Palaeozoic oxygen changes.

[Complications of transperineal template-guided prostate mapping biopsy].

Objective: To assess the complications of transperineal template-guided prostate mapping biopsy (TTMB). Methods: Between May 2017 and March 2018, 142 consecutive patients with prior negative transrectal biopsy results and persistently elevated prostate-specific antigen (PSA) were divided into the observation group and the control group randomly. The observation group underwent TTMB and the control group underwent transperineal template-guided prostate saturation biopsy (TTSB). Bleeding, infection, urinary function were recorded after prostate biopsy. Erectile function (ED) was measured at baseline, 1 month, 3 months and 6 months after prostate biopsy using the International Index of Erectile Function (IIEF-5). Results: A mean of 59 cores (from 33 to 116 cores) were obtained in TTMB, and a mean of 23 cores (from 11 to 44 cores) were obtained in TTSB. The positive rate was 50.0% (30/60) in TTMB, and 32.9% (27/82) in TTSB, and there were significant differences between two groups (P<0.05). The incidence of severe hematuria and urinary retention was 8.3% (5/60) and 11.7% (7/60) respectively in TTMB, while 1.2% (1/60) and 11.7% (7/60) respectively in TTSB. There were significant differences between two groups (P<0.05). But there were no significant differences between two groups in the incidence of mild, moderate and total hematuria, hematospermia, perineal hematoma, infection (P>0.05). Rectal bleeding was not observed. In TTMB group, the IIEF-5 scores at baseline, 1 month, 3 months and 6 months were (19.1±4.5), (17.4±4.8), (18.6±4.5), (19.0±4.0), respectively. In TTSB group, the IIEF-5 scores at baseline, 1 month, 3 months and 6 months were (19.7±4.3), (18.2±4.5), (19.1±4.1), (19.6±4.2), respectively. There were significant differences between baseline and 1 month after prostate biopsy in two groups (P<0.05), but there were no significant differences of IIEF-5 score between the two groups (P>0.05). Conclusions: TTMB can improve the positive rate for patients with prior negative transrectal biopsy results and persistently elevated PSA. TTMB has low complication rates, and most side-effects are self-limited. Compared with TTSB, the incidence of urinary retention and severe hematuria increases, but they can be recovered after clinical intervention. ED is transient, and affected for 1 month after the biopsy, but it will be recovered to the baseline after 3 to 6 months. Therefore, TTMB is a safe and reliable procedure.

[Effect of multimodal analgesia using periprostatic nerve block anesthesia combined with flurbiprofen in transperineal template-guided prostate biopsy].

Objective: To evaluate the effect of multimodal analgesia using periprostatic nerve block anesthesia (PNB) combined with flurbiprofen in patients undergoing transperineal template-guided prostate biopsy (TTPB). Methods: Totally 166 patients (aged (68.2±9.1) years, range: 47 to 81 years) who received TTPB from October 2017 to June 2018 at Department of Urology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University were enrolled prospectively. All the patients were randomly divided into 2 groups. The observation group (n=79) was given flurbiprofen axetil 1 mg/kg intravenously for half an hour before operation and lidocaine was used for PNB before the biopsy. The control group (n=87) was given normal saline combined with PNB. A visual analog scale (VAS) and visual numeric scale (VNS) were used to assess the patients' pain and quantify their satisfaction at two time points: VAS-1 and VNS-1: during biopsy procedure, VAS-2 and VNS-2: 30 min after the procedure. The date were compared by t test, χ(2) test, Fisher exact test and two-way repeated measures anova analysis between the 2 groups. Results: The age, total prostate volume, serum prostate-specific antigen and the number of cores were comparable among the 2 groups (P>0.05). The VAS-1 scores of the control group and the observation group were 2.8±1.7, 1.9±1.2, respectively, and the VNS-1 were 3.1±0.7, 3.4±0.3, respectively. The VAS-1 were significantly lower in observation group than in control group (F=3.904, P=0.000). Conversely, the VNS-1 were higher in observation group (F=3.526, P=0.000). At 30-minute postoperative, the VAS-2 and VNS-2 were 0.7±0.4 and 3.7±0.2 in the control group, respectively. The VAS-2 and VNS-2 were 0.6±0.5 and 3.8±0.1 in the observation group, respectively. There were no significant differences in the pain scores or the satisfaction scores between the 2 groups (F=1.429, 2.825; P=0.136, 0.083). The incidence of overall complications was 26.4% (23/87) in the control group and 25.3% (20/79) in the observation group, with no statistical difference between the 2 groups (χ(2)=0.027, P=0.869). And the complications had no statistically significant difference among the 2 groups including hematuria, urinary retention, infection, hematospermia, vascular and neurological reactions, nausea, vomiting, dizziness, headache, and respiratory depression (P>0.05). Conclusion: The multimodal analgesia induced by PNB and flurbiprofen could effectively relieve the pain for patients who received TTPB.

Imaging the Localized Plasmon Resonance Modes in Graphene Nanoribbons.

We report a nanoinfrared (IR) imaging study of the localized plasmon resonance modes of graphene nanoribbons (GNRs) using a scattering-type scanning near-field optical microscope (s-SNOM). By comparing the imaging data of GNRs that are aligned parallel and perpendicular to the in-plane component of the excitation laser field, we observed symmetric and asymmetric plasmonic interference fringes, respectively. Theoretical analysis indicates that the asymmetric fringes are formed due to the interplay between the localized surface plasmon resonance (SPR) mode excited by the GNRs and the propagative surface plasmon polariton (SPP) mode launched by the s-SNOM tip. With rigorous simulations, we reproduce the observed fringe patterns and address quantitatively the role of the s-SNOM tip on both the SPR and SPP modes. Furthermore, we have seen real-space signatures of both the dipole and higher-order SPR modes by varying the ribbon width.

Real-Space Imaging of the Tailored Plasmons in Twisted Bilayer Graphene.

We report a systematic plasmonic study of twisted bilayer graphene (TBLG)-two graphene layers stacked with a twist angle. Through real-space nanoimaging of TBLG single crystals with a wide distribution of twist angles, we find that TBLG supports confined infrared plasmons that are sensitively dependent on the twist angle. At small twist angles, TBLG has a plasmon wavelength comparable to that of single-layer graphene. At larger twist angles, the plasmon wavelength of TBLG increases significantly with apparently lower damping. Further analysis and modeling indicate that the observed twist-angle dependence of TBLG plasmons in the Dirac linear regime is mainly due to the Fermi-velocity renormalization, a direct consequence of interlayer electronic coupling. Our work unveils the tailored plasmonic characteristics of TBLG and deepens our understanding of the intriguing nano-optical physics in novel van der Waals coupled two-dimensional materials.

Direct molecular typing of Bordetella pertussis from nasopharyngeal specimens in China in 2012-2013.

Data on the molecular epidemiology of Bordetella pertussis are limited in developing countries where whole-cell pertussis vaccines (WCVs) have been used. The aim of this study was to determine the genotypes of circulating B. pertussis in China by direct molecular typing of clinical specimens. DNA extracts of 122 nasopharyngeal swabs (NPs) positive for B. pertussis by polymerase chain reaction (PCR) (targeting IS481 and ptx-Pr) from 2012 to 2013 were used for typing using the multiple-locus variable number tandem repeat analysis (MLVA) and also by PCR-based multilocus sequence typing (MLST) of B. pertussis virulence genes (ptxP, prn, and fim3). One hundred and eight DNA extracts (89 %) generated a complete MLVA type (MT). Among the 18 MTs obtained, MT55 (52 %) and MT104 (13 %) were the most common. MT27, which is linked to the ptxP3 allele and is prevalent in many developed countries using acellular pertussis vaccines (ACVs), was only found in 7 (6 %) DNA extracts. Eighty-seven DNA extracts (71 %) produced a complete multiantigen sequence typing (MAST) type. Of them, 77 (89 %) had the ptxP1/prn1/fim3-1 allele profile. Four DNA extracts (5 %) had the ptxP3/prn2/fim3-2 profile and 3 (4 %) had the ptxP3/prn1/fim3-2 allele profile. These seven DNA extracts also harbored MT27. Our result shows that B. pertussis circulating in China was different from those found in countries where ACVs have been in use, supporting the notion that selection pressure induced by WCVs and ACVs on the bacterial population differs.

Isolation, identification and fibrolytic characteristics of rumen fungi grown with indigenous methanogen from yaks (Bos grunniens) grazing on the Qinghai-Tibetan Plateau.

AIM: To obtain co-cultures of anaerobic fungi and their indigenously associated methanogens from the rumen of yaks grazing on the Qinghai-Tibetan Plateau and investigate their morphology features and ability to degrade lignocellulose. METHODS AND RESULTS: Twenty fungus-methanogen co-cultures were obtained by Hungate roll-tube technique. The fungi were identified as Orpinomyces, Neocallimastix and Piromyces genera based on the morphological characteristics and internal transcribed spacer 1 sequences analysis. All methanogens were identified as Methanobrevibacter sp. by 16S rRNA gene sequencing. There were four types of co-cultures: Neocallimastix with Methanobrevibacter ruminantium, Orpinomyces with M. ruminantium, Orpinomyces with Methanobrevibacter millerae and Piromyces with M. ruminantium among 20 co-cultures. In vitro studies with wheat straw as substrate showed that the Neocallimastix with M. ruminantium co-cultures and Piromyces with M. ruminantium co-cultures exhibited higher xylanase, filter paper cellulase (FPase), ferulic acid esterase, acetyl esterase activities, in vitro dry matter digestibility, gas, CH4 , acetate production, ferulic acid and p-coumaric acid releases. The Neocallimastix frontalis Yak16 with M. ruminantium co-culture presented the strongest lignocellulose degradation ability among 20 co-cultures. CONCLUSIONS: Twenty fungus-methanogen co-cultures were obtained from the rumen of grazing yaks. The N. frontalis with M. ruminantium co-cultures were highly effective combination for developing a fermentative system that bioconverts lignocellulose to high activity fibre-degrading enzyme, CH4 and acetate. SIGNIFICANCE AND IMPACT OF THE STUDY: The N. frontalis with M. ruminantium co-cultures from yaks grazing on the Qinghai-Tibetan Plateau present great potential in lignocellulose biodegradation industry.

[Management of early bronchopleural fistula after pneumonectomy].

OBJECTIVE: To investigate the management of early bronchopleural fistula(BPF) within one month after pneumonectomy. METHODS: A total of 30 cases developed BPF within one month after pneumonectomy in recent 30 years were reviewed from First Hospital of Jilin University. All patients were treated by reoperation, closed drainage with or without open thoracic window, or endobronchial glue. RESULTS: Seventeen patients were returned to the operating room for reclosure of BPF, one patients died of BPF and 16 reoperations were successful.Twelve cases were treated by closed drainage with or without followed open thoracic window. In 6 patients who were managed by closed drainage alone, 2 cases died of BPF and 4 bronchopleural fistulas closed spontaneously. In 6 patients treated with closed drainage and later with open thoracic window, one case died of BPF. One patient successfully underwent endoscopic glue to close BPF with injection three times. CONCLUSION: Within one month postoperatively, BPF without established empyema with pus should be reoperated if the patient had enough cardiopulmonary reserve and could there fore tolerate reoperation. Contamination of pleural space is not the contraindication to reoperation. Reclosure via original thoracotomy and repair the fistula with pedicled intercostal muscle flap are convenient and efficient. Drainage with or without followed open thoracic window is appropriate for the patients with limited cardiopulmonary reserve, impaired general condition, secondary to empyema with pus, early recurred cancer, or some small fistulas.

[Effect of prostate volume on the peripheral nerve block anesthesia in prostate biopsy].

OBJECTIVE: To evaluate the anesthetic efficacy of periprostatic nerve block in transrectal ultrasound(TRUS) guided biopsy on different prostate volume. METHODS: A total of 568 patients received prostate biopsy in Department of Urology, Subei People's Hospital from May 2013 to September 2015 were retrospectively studied. All patients were divided into local anesthesia group and nerve block group according to different way of anesthesia. Then each group was divided into four subgroups(20-40 ml, >40-60 ml, >60-100 ml and >100 ml subgroups) according to different prostate volume range. After being anaesthetized successfully, patients in two groups underwent prostate biopsy, visual analogue scale(VAS) scores, visual numeric scale(VNS)scores and complications were recorded and analyzed. At inter-group and intra-group in local anesthesia group and nerve block group, Mann-Whitney U test of non-parametric analysis and single factor variance analysis were used to compare the VAS scores and the VNS scores respectively, and chi-square test was used to compare the rates of complication. RESULTS: The VAS scores of four subgroups: local anesthesia group: 1.9±0.9, 2.8±1.5, 3.8±2.3 and 5.3±2.5; nerve block group: 1.5±0.7, 2.0±0.8, 2.9±1.7 and 4.2±2.0. The VNS scores: local anesthesia group: 3.4±0.6, 2.9±0.6, 2.7±0.5 and 1.6±0.7; nerve block group: 3.7±0.5, 3.3±0.4, 3.0±0.8 and 2.0±0.7. The VAS scores and the VNS scores had significant differences (Z=-3.637-98.253, all P<0.05) at inter-group or intra-group level. For the complication rates of operation, hematuria, blood, urinary retention were significant differences (F=1.347-15.402, all P<0.05) at intra-group level. But there were no significant differences at inter-group level(P>0.05). CONCLUSION: Compared with local anesthesia, ultrasound guided prostate peripheral nerve block anesthesia has great analgesic effect and high safety, but for patients with a large prostate volumethe analgesic effect is inefficiency.

Novel NPHS1 splice site mutations in a Chinese child with congenital nephrotic syndrome.

Congenital nephrotic syndrome (CNS) is defined as heavy proteinuria or nephrotic syndrome occurring before 3 months of age. It is characterized by early onset and progresses to end-stage renal disease. Recently, several genes associated with CNS have been identified, including NPHS1 and NPHS2. Mutations in the NPHS1 gene have been identified in patients with CNS in Finland with relatively high frequency. Thus far, only a few case reports about CNS have described an NPHS1 mutation in China. In this study, mutational analyses of NPHS1 and NPHS2 were performed in a Chinese child with CNS. Mutations were analyzed in all exons and exon/intron boundaries of NPHS1 and NPHS2 in the patient and his parents as well as in 50 unrelated controls using polymerase chain reaction and direct sequencing techniques. No mutations were detected in NPHS2. A novel splice site mutation (IVS11+1G>A) within intron 11 and a missense mutation within exon 8 (c.928G>A) in the NPHS1 gene were detected in the child. The child's mother had normal urinalysis and a c.928G>A (D310N) heterozygous mutation, and his father had normal urinalysis and IVS11+1G>A. These were not identified in the 50 unrelated controls. The novel splice site mutation of IVS11+1G>A and a missense mutation at c.928G>A in NPHS1 were found to cause CNS in this Chinese child.

Monocytic myeloid-derived suppressor cells accumulate in renal transplant patients and mediate CD4(+) Foxp3(+) Treg expansion.

Myeloid-derived suppressor cells (MDSC) are negative regulators of the immune response and are in part responsible for the inhibition of the T cell-mediated immune responses. While MDSC have been demonstrated to participate in the induction of prolonged allograft survival in animal models of transplantation, little is known about their immune regulatory function in human transplant recipients. Here, we report that two subsets of human MDSC expressing CD11b(+), CD33(+) and HLA-DR(-) develop in renal patients posttransplantation. We found that CD14(+) expressing monocytic MDSC isolated from transplant recipients were highly efficient in suppressing the proliferation of CD4(+) T cells in mixed leukocyte reactions. In addition, we observed that CD11b(+) CD33(+) HLA-DR(-) MDSC are capable of expanding Treg in vitro, and their accumulation overtime after transplantation linearly correlated with an increase in Treg in vivo. This is the first study to link the presence of MDSC with the emergence of Treg in vivo in transplant recipients, and to define the subpopulation of MDSC derived from transplant recipients responsible for generation of Treg. Further studies are necessary to determine the alloimmune regulatory function of MDSC in human transplant recipients.

The tumor necrosis factor-alpha-induced protein 8 family in immune homeostasis and inflammatory cancer diseases.

Within the immune system homeostasis is maintained by a myriad of mechanisms that include the regulation of immune cell activation and programmed cell death. The breakdown of immune homeostasis may lead to fatal inflammatory diseases. We set out to identify genes of tumor necrosis factor-alpha-induced protein 8 (TNFAIP8) family that has a functional role in the process of immune homeostasis. Tumor necrosis factor-alpha-induced protein 8 (TNFAIP8), which functions as an oncogenic molecule, is also associated with enhanced cell survival and inhibition of apoptosis. Tumor necrosis factor-alpha-induced protein 8-like 2 (TIPE2) governs immune homeostasis in both the innate and adaptive immune system and prevents hyper-responsiveness by negatively regulating signaling via T cell receptors and Toll-like receptors (TLRs). There also exist two highly homologous but uncharacterized proteins, TIPE1 and TIPE3. This review is an attempt to provide a summary of TNFAIP8 family associated with immune homeostasis and inflammatory cancer diseases.

[Preliminary report on the use of total lumpectomyconical remnant gastric - esophagus side overlap anastomosis in radical resection of Siewert type II proximal gastric cancer].

Objective: There is no standard method for esophageal remnant gastric reconstruction for proximal gastrectomy. Reflux esophagitis caused by esophagogastrostomy remains a difficult surgical problem. To report the preliminary surgical results of novel esophagus-conical remnant gastric side overlap anastomosis (CGEO) , with particular emphasis on postoperative esophageal reflux. Methods: In June 2022, we developed a novel CGEO for laparoscopic proximal gastrectomy on two patients with Siewert type II esophagogastric junction adenocarcinoma. Surgical procedures for CGEO: (1) Laparoscopic proximal gastrectomy and preparation of conically shaped gastric remnant; (2) Determining anastomotic site of residual stomach and esophagus; (3) Side-to-side anastomosis of right esophageal wall to anterior of conical gastric remnant; (4) Valvuloplasty of esophageal stump. Results: Case 1 was a 71-year-old man with an operation time of 305 minutes and was successfully discharged from the hospital on the 9th day after surgery, and the postoperative pathology was T3N0M0. Case 2 was an 82-year-old man with an operation time of 325 minutes. He was discharged on the 10th day after surgery. In both cases, only mild esophageal mucosal changes were seen in gastroscopy, there were no obvious symptoms of esophageal reflux. There was also no significant weight change at half a year after operation. Conclusion: CGEO is moderately safe in radical surgery for proximal gastric cancer, and may have a preventive effect on the occurrence of postoperative esophageal reflux, but long-term results need to be confirmed by further studies with follow-up.