[Distal pancreatectomy with celiac axis resection for pancreatic body cancer: a single center review of 89 consecutive cases].

Objective: To investigate the clinical efficacy of distal pancreatectomy with celiac axis resection(DP-CAR). Methods: A total of 89 consecutive patients (50 males and 39 females) who were diagnosed with pancreatic body cancer and underwent DP-CAR in Pancreas Center,First Affiliated Hospital of Nanjing Medical University between September 2013 and June 2022 were retrospectively reviewed. There were 50 males and 39 females,with age(M(IQR)) of 63(12) years(range:43 to 81 years). Perioperative parameters,pathology results and follow-up data of these patients were analyzed,χ2 or Fisher's test for categorical data while the Wilcoxon test for quantitative data. Survival results were estimated by the Kaplan-Meier survival method. Results: Among 89 cases,cases combined with portal vein-superior mesenteric vein or organ resection accounted for 22.5% (20/89) and 42.7% (38/89),respectively. The operative time,blood loss and postoperative hospital stay were 270 (110) minutes,300 (300) ml and 13 (10) days,respectively. The overall morbidity rate was 67.4% (60/89) while the major morbidity was 11.2% (10/89). The increase rate in transient liver enzymes was 42.7% (38/89),3.4% (3/89) for liver failure,53.9% (48/89) for clinically relevant postoperative pancreatic fistula,1.1% (1/89) for bile leak,3.4% (3/89) for chylous leak of grade B and C,11.2% (10/89) for abdominal infection,9.0% (8/89) for postoperative hemorrhage of grade B and C,4.5% (4/89) for delayed gastric emptying,6.7% (6/89) for deep vein thrombosis,3.4% (3/89) for reoperation,4.5% (4/89)for hospital mortality,7.9% (7/89) for 90-day mortality. The pathological type was pancreatic cancer for all 89 cases and pancreatic ductal adenocarcinoma made up 92.1% (82/89). The tumor size was 4.8(2.0) cm, ranging from 1.5 to 12.0 cm. The number of lymph nodes harvested was 14 (13)(range:2 to 33),with a positive lymph node rate of 13.0% (24.0%). The resection R0 rate was 30.0% (24/80) and the R1 (<1 mm) rate was 58.8% (47/80). The median overall survival time was 21.3 months (95%CI: 15.6 to 24.3) and the median disease-free survival time was 19.1 months (95%CI: 11.7 to 25.1). The overall survival at 1-year and 2-year were 69.60% and 39.52%. The median survival time of 58 patients with adjuvant chemotherapy was 24.3 months (95%CI: 17.8 to 32.3) while that of 13 patients without any kind of adjuvant therapy was 8.4 months (95%CI: 7.3 to 22.3). Seven patients accepted neoadjuvant chemotherapy and there was no significant morbidity among them,with a resection rate of R0 of 5/7. Conclusion: DP-CAR is safe and feasible for selective cases,which could be more valuable in improving long-term survival when combined with (neo) adjuvant therapy.

[Comparison of radical antegrade modular pancreatosplenectomy with conventional distal pancreatectomy for pancreatic adenocarcinoma of the body and tail].

Objective: To compare the short-term outcomes and long-term survivals of radical antegrade modular pancreatosplenectomy(RAMPS) and conventional distal pancreatectomy(CDP). Methods: A total of consecutive 304 patients including 176 male patients and 128 female patients who underwent RAMPS or CDP at Pancreas Center, the First Affiliated Hospital with Nanjing Medical University from May 2013 to June 2019 were retrospectively analyzed. The median age was 64.1 years old (range:39 to 85 years old). There were 101 patients underwent RAMPS and 203 patients underwent CDP. Measurement data with skewed distribution were presented as (M(Q(R))) and comparison between groups was evaluated with the Wilcoxon rank sum test. Count data were analyzed using the χ(2) test or Fisher exact probability. Survival analyses were performed by the Kaplan-Meier method after a one to one propensity score matching(PSM) conducted to balance several variables. Results: An eighty-one to eighty-one patients were enrolled after PSM. The overall morbidity was 32.1%(26/81)and there were no in-hospital mortalities in RAMPS. The median operative time was 225(95)minutes in RAMPS, not significantly longer as compared with CDP(210(130)minutes, P=0.916). The median greatest tumor diameter in RAMPS was 4.0(2.3)cm, not significantly larger as compared with CDP(4.5(2.2)cm, P=0.520).There were 34.6%(28/81)patients who presented with T4 tumors by 8(th) AJCC TNM staging system in RAMPS, which was not significantly different as compared with CDP(39.5%, χ(2)=0.574, P=0.902). The median number of examined lymph nodes was 9(9), not significantly greater in RAMPS as compared with CDP(10(11), P=0.992). The rate of negative posterior margins using 1 mm rule in RAMPS was 70.3%(52/74), significantly higher as compared with CDP(53.6%(30/56), χ(2)=3.817, P=0.044). The overall R0 resection rate was 44.6% (33/74) in RAMPS and 37.5% (21/56) in CDP, which was not significantly different(χ(2)=0.663, P=0.474). The median overall survival was 16.5 months for RAMPS, 25.2 months for CDP, and there was no statistical difference between two groups(P=0.981). The median overall survival was 16.0 months for patients with preoperative CA19-9≥300 U/ml who underwent RAMPS, 10.1 months for patients who underwent CDP, without significant difference(P=0.082). Conclusions: RAMPS can improve the rate of negative posterior margins by 1 mm rule and probably increase R0 resection rate and the harvest of lymph nodes. RAMPS may be beneficial to some patients with preoperative CA19-9≥300 U/ml.

[Clinical observation on six children of left bundle branch area pacing].

Objective: To explore the safety and effectiveness of left bundle branch area pacing (LBBAP) in children. Methods: Clinical data, pacing electrocardiogram and parameters of 6 patients (5 females and 1 male) who underwent permanent pacemaker implantation and LBBAP from January to June 2019 in the Department of Pediatric Cardiology of Anzhen Hospital were retrospectively analyzed. Results: The weight of the 6 patients aged between 9 and 14 years ranged from 26 to 48 kg. Five patients were diagnosed with third degree atrioventricular block, and 1 patient was diagnosed with cardiac dysfunction after right ventricular apical pacing. Cardiac function decreased in one patient and remained normal in the other five patients. Left ventricular end diastolic diameter (LVEDD) Z score was 1.85±0.65. V(1) lead showed changes like right bundle branch block in pacing electrocardiogram. No significant difference was found regarding QRS wave duration ((95±13) ms vs. (111±20) ms, t=-1.610, P>0.05) between preoperation and postoperation. Pacing threshold was (0.85±0.26) V. The sensing threshold was (15.0±4.3) mV and the impedance was (717±72) Ω. P potential was recorded in 3 cases. The earliest left ventricular local activation time was (56±5) ms and remained stable at different output voltages. Postoperative echocardiography revealed that the electrodes were located near the endocardium of the left ventricular septum. No complications such as myocardial perforation and electrode dislocation occurred during follow-up. The pacing threshold, sensing threshold and impedance were (0.60±0.09)V, (16.1±3.9)mV, (662±78)Ω respectively at 3 months after operation. The patient with low left ventricular ejection fraction (LVEF) recovered to normal on the 3 rd day after LBBAP (45% vs. 57%). The LVEDD Z score decreased to (1.1±0.3) at 3 months after operation and was significantly lower than that before operation (t=2.38, P<0.05). Conclusions: LBBAP in children can achieve narrow QRS pacing andphysiological pacing with stablepacing parameters. It can improve left ventricular enlargement caused by long-term bradycardia, and cardiac dysfunction and cardiac enlargement caused by long-term right ventricular apical pacing quickly and effectively.LBBAP is safe and feasible for older children in the near future. However, the long term potential risks of LBBAP need further observation and study.

Symbiotic fungal endophyte Phomopsis liquidambari-rice system promotes nitrogen transformation by influencing below-ground straw decomposition in paddy soil.

AIMS: To explore if and how symbiotic Phomopsis liquidambari-rice system influences below-ground straw decomposition and then nitrogen(N) transformation in response to environmental N levels. METHODS AND RESULTS: Litter bag experiments were utilized to trace the decay process during rice growth phases (seedling (T1), tillering (T2), heading (T3) and maturing (T4) stage), with (E+) and without endophyte (E-), under low (LN), medium (MN) and high nitrogen (HN) supply. Litter, soil and plant samples were collected to evaluate the decay process, N transformations, plant quality and relative abundance of soil ammonia-oxidizing archaea (AOA), ammonia-oxidizing bacteria (AOB) and P. liquidambari. The results showed that straw decomposition increased by 19·76% (LN, T2 stage), 14·05% (MN, T3 stage) and 16·88% (MN, T4 stage) in E+ pots when compared with E- pots. Further analysis revealed that no significant endophyte × N interaction was found for straw decay rate and that the decay rate was reduced by a higher N supply (LN, 37·16 ± 0·65%; MN, 32·27 ± 1·72%; HN, 29·44 ± 1·22%) at the T1 stage, whereas straw decay rate and N release increased by 9·38 and 11·16%, respectively, mainly by endophyte colonization at the T4 stage. The abundance of AOA and AOB were altered, corresponding with the decay rate. Soil mineral N, straw mineral N and plant quality were shown to increase in E+ pots, depending on environmental N conditions and growth phase. The yield increased by 2·98% for E+ plants under MN level. CONCLUSIONS: Symbiotic P. liquidambari-rice system promoted below-ground straw decomposition and N transformation, depending on environmental N levels and plant growth phase. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides evidence that fungal endophyte-plant systems are able to promote N transformation by increasing straw decomposition. A reasonable combination of N inputs could enhance its advantage in agriculture ecosystems.

Enhanced heat stable antifungal factor production by Lysobacter enzymogenes OH11 with cheap feedstocks: medium optimization and quantitative determination.

Heat stable antifungal factor (HSAF) is considered to be a potential biological pesticide due to its broad antifungal activity and novel mode of action. However, few studies have reported on HSAF production during fermentation. Thus, this work was executed to optimize the medium composition to maximize HSAF production by Lysobacter enzymogenes OH11, with soybean flour, glucose and CaCl2 identified as suitable nutrients with concentrations of 8·00, 7·89 and 0·72 g l-1 respectively. Simultaneously, the quantitative analysis of HSAF production was established by eliminating the emulsification problem, and the highest HSAF production was determined to be 356·34 ± 13·86 mg l-1 using the optimized medium, 12-fold higher than when using the 10% TSB medium (29·34 ± 2·57 mg l-1 ). Furthermore, the cost of this medium was assessed and nearly 31-fold lower than that of 10% TSB. This study suggests that the optimized medium is not only effective but also economical for HSAF production. SIGNIFICANCE AND IMPACT OF THE STUDY: Significance and Impact of the Study: Heat stable antifungal factor (HSAF) exhibits a potent and broad antifungal activity with a novel mode of action. Increased production and reduced cost of raw materials are particularly important for the future production of HSAF, however, no report was involved in these studies. This study aimed to improve the production of HSAF with cheap raw materials through the medium optimization, which would lay the foundation for the application of HSAF in biological control.

Drought degree constrains the beneficial effects of a fungal endophyte on Atractylodes lancea.

AIMS: Plants, fungal endophytes (FEs) and the changing environment interact with each other forming an interlaced network. This study evaluates nonadditive and interactive effects of the FE Acremonium strictum and drought treatment on Atractylodes lancea plantlets. METHODS AND RESULTS: By applying FEs (meristem cultures of At. lancea, fungal inoculation of Ac. strictum and plantlet acclimatization) and drought treatment (regular watering, mild drought, severe drought), a research system of At. lancea ramets under different treatments was established. During 12 days of drought treatment, the plantlets' physiological responses and basic growth traits were measured and analysed. Although drought and FE presence affected plantlet traits to differing degrees, the interactive effects of the two were more pronounced. In particular under mild drought treatment, the FE conferred drought tolerance to plantlets by enhancing leaf soluble sugars, proteins, proline and antioxidant enzyme activity; decreasing the degree of plasmalemma oxidation; and increasing the host's abscisic acid level and root:shoot ratio. When exposed to regular watering or severe drought, these effects were not significant. CONCLUSIONS: Plant traits plasticity was conferred by dual effects of drought stress and FEs, and these factors are interactive. Although FEs can help plants cope with drought stress, the beneficial effects are strictly constrained by drought degree. SIGNIFICANCE AND IMPACT OF THE STUDY: During finite environmental stress, FEs can benefit plants, and for this reason, they may alleviate the effects of climate change on plants. However, because the benefits of FEs are highly context dependent, the role of FEs in a changing background should be re-assessed.

Antagonistic mechanisms of endophytic Pseudomonas fluorescens against Athelia rolfsii.

AIMS: To explore specific mechanisms of endophytic Pseudomonas fluorescens antagonizing Athelia rolfsii, causing southern blight of Atractylodes lancea and to evaluate the potential of this Ps. fluorescens strain to control southern blight. METHODS AND RESULTS: Endophytic Ps. fluorescens strain ALEB 7B isolated from A. lancea can significantly inhibit the growth of A. rolfsii strain SY4. Pre-inoculating A. lancea seedlings with Ps. fluorescens ALEB 7B reduces the southern blight morbidity rate significantly. In situ observation using scanning electron microscopy shows Ps. fluorescens ALEB 7B colonizing the plant cells. Volatile organic compounds (VOCs) from Ps. fluorescens ALEB 7B can kill A. rolfsii SY4 and dimethyl disulphide (DMDS) plays a major role. 2-Piperidinone is a unique substance having antifungal activity in dichloromethane extracts of bacterial cell-free culture filtrates. Other antagonistic mechanisms include ecological niche occupation, antibiotic production and lytic exoenzymes secretion. CONCLUSIONS: Specific antagonistic mechanisms of Ps. fluorescens ALEB 7B on A. rolfsii SY4 were detailed, including release of DMDS, production of 2-piperidone, secretion of antibiotics and lytic exoenzymes and competition for spaces and nutrients. SIGNIFICANCE AND IMPACT OF THE STUDY: This work firstly reports the significant inhibition of VOCs released by Ps. fluorescens on the growth of A. rolfsii. 2-Piperidinone is firstly found synthesized by Ps. fluorescens, having antifungal activity. This work provides an antagonistic bacterium with practical convenience and ecologically amity, which has potential for control to A. rolfsii in vitro.

Hydrogen peroxide regulated photosynthesis in C4-pepc transgenic rice.

In this study, we investigated the photosynthetic physiological basis in 'PC' transgenic rice (Oryza sativa L.), showing high-level expression of the gene encoding C4 phosphoenolpyruvate carboxylase (pepc), by hydrogen peroxide (H2O2). The C4-PEPC gene (pepc) from maize in the transgenic rice plants was checked by PCR. Comparison of yield components and photosynthetic indices between PC and untransformed wild-type (WT) plants indicated that increased yield in PC was associated with higher net photosynthetic rate and higher activities of phosphoenolpyruvate carboxylase (PEPC). Both PC and WT plants were treated with 1 mmol L(-1) abscisic acid (ABA), 0.04% 1-butanol (BA), 2 mmol L(-1) neomycin (NS), or 2 mmol L(-1) diphenyleneiodonium chloride (DPI) to investigate the relationship between photosynthesis and levels of H2O2 and phosphatidic acid. In both PC and WT, ABA induced H2O2 generation and simultaneous decrease in stomatal conductance (g(s)). PC plants treated with BA showed decreased H2O2 content and strongly increased g(s) within 2 h of treatment. Similar results were observed in response to DPI treatment in PC. However, WT did not observe the decrease of H2O2 during the treatments of BA and DPI. The reduced H2O2 content in PC caused by BA treatment differed to that induced by DPI because BA did not inhibit NADPH oxidase activities. While BA induced a larger PEPC activity in PC, and higher catalase activity as well. These results indicated that the regulation of endogenous H2O2 metabolism of PC could be helpful for enhancing photosynthetic capability.

[A comparative study on sterols of ethanol extract and water extract from Hericium erinaceus].

OBJECTIVE: To study the pharmaceutic chemical basis of the different medicinal effects, and to compare and analyze the sterols in Hericium erinaceus mycelia and its ethanol extract, water extract derived from solid fermented mycelia. METHOD: The components of Hericium erinaceus mycelia and two kinds of extract were compared with some biochemical methods such as GC, RP-HPLC, etc. Sterol composition in Hericium erinaceus mycelia was determined by using GC-mass spectrometry. RESULTS: The content of crude polysaccharide, water-soluble protein and fatty acid of ethanol extract showed no obvious advantage over its water extract. However, there was significant difference between two kinds of extract in the content of sterols. And ergostane derivatives, beta-sitosterol and C28 sterol with four bonds were detected as the major sterols in Hericium erinaceus mycelia, among which ergosterol was the principal sterol. CONCLUSION: Sterols in Hericium erinaceus exist mainly in ethanol extract. And three sterols are found for the first time from Hericium erinaceus, which are ergostane derivatives, beta-sitosterol and C28 sterol with four bonds.

[Comparative studies on the fatty acids contained in four species of medicinal plants from family Euphorbiaceae and their endophytic fungi].

OBJECTIVE: The relation of four species of medicinal plants from family Euphorbiaceae and their endophytic fungi was studied to find the source of active substances for developing new pharmaceutical resources. METHOD: The main fatty acids contained in Sapium sebiferum, Euphorbia pekinensis, Euphorbia helioscopia, Bischofia polycarpam and their 28 strains of endophytic fungi were compared and analysed by GC. RESULT: The main fatty acids of the plants are: alpha-linolenic acid, palmitic acid, linolenic acid and oleic acid. Linolenic acid, palmitic acid and oleic acid are the main fatty acids of the endophytic fungi. CONCLUSION: The fatty acids could be produced by the endophytic fungi, which could be used as a factor for identification. There are great differences at the contents of alpha-linolenic acid between the plants and their endophytic fungi, which were suggested to be related with the nutrition absorption and the relationship between the endophytes and the host plant.

Disposable, low cost, silver-coated, piezoelectric quartz crystal biosensor and electrode protection.

The use of a commercial, silver-coated, piezoelectric quartz crystal as a disposable, low cost and reliable immunosensor is presented. The protection of the silver electrode from undesirable oxidation was achieved by polystyrene or carboxy-poly(vinyl chloride) (PVC-COOH) modification. In addition to serving as protection for the electrode, polymer films provided a substrate for antibody immobilization by either physical adsorption or covalent linkage. Polystyrene modification showed an additional advantage of improvement of surface smoothness. The atomic force microscope (AFM) and scanning electron microscope (SEM) were used to evaluate the morphologies of polymer films obtained by dip or drop coating techniques. It was found that drop coating provided more significant improvement in surface smoothness than dip coating, and the resulting sensor surfaces were more suitable for in situ liquid phase assay. Although PVC-COOH-modified sensors were not suitable for liquid phase assay because of the high surface roughness, the covalent linkages (amide bonds) between antibodies and -COOH groups in the polymer film offered better sensor performance in ex situ assay in terms of a higher antibody binding capacity and better antigen detection sensitivity.