Comparative genomic analysis of the genus Weissella and taxonomic study of Weissella fangxianensis sp. nov., isolated from Chinese rice wine starter.

In this study, three lactic acid bacteria, namely, HBUAS51963T, HBUAS51964 and HBUAS51965, were isolated from Chinese rice wine starter sampled in Fangxian County, PR China. All were non-motile, non-spore-forming and Gram-positive spherical cells. Their taxonomic status was characterized using a polyphasic approach. Genome-based analysis revealed that all three strains were phylogenomically related to Weissella thailandensis KCTC 3751T and Weissella paramesenteroides ATCC 33313T. The digital DNA-DNA hybridization (dDDH) and average nucleotide identity (ANI) values between the three strains and the phylogenetically related type strains were less than 54.8 and 93.8 %, respectively, and thus, they were below the thresholds of dDDH and ANI for species definition. The genomic DNA G+C content was 38.6 mol %. The predominant fatty acid methyl esters (>10 %) were C16 : 0, C19 : 0 cyc11 and summed feature 10 (C18 : 1 cyc11 and/or ECL 17.834). The polar lipids in the cells of strain HBUAS51963T were mainly phosphatidylglycerol, diphosphatidylglycerol, unidentified glycolipids, phospholipids and lipids. Finally, the three strains were capable of producing d-lactic acid (4.29 g l-1) and various organic acids such as tartaric, acetic, lactic and succinic acids. Overall, the results of genotypic, phenotypic and genomic analyses suggest that the three strains represent a new species of the genus Weissella, for which the name Weissella fangxianis sp. nov. is proposed. The type strain is HBUAS51963T (=GDMCC 1.3506T= JCM 35803T).

The effect of creative expression program in neurocognitive networks performance measured by task and resting-state functional MRI.

BACKGROUND: The current study examined the effects of a 16-week creative expression program on brain activity during a story creating task and resting-state functional network connectivity in mild cognitive impairment (MCI) adults. METHOD: Thirty-six MCI adults were allocated to either the creative expression program (CrExp, n = 18) or control group (CG,n = 18). Before and after intervention, all participants were scanned with functional magnetic resonance imaging (fMRI) during story creating task performance and a resting state. The two-group comparison was calculated between the blood oxygenation level-dependent (BOLD) signal changes for each cluster to investigate the differences in fMRI activation and functional connectivity (FC) between two groups. RESULTS: Task activation analyses showed an increase in the right anterior cingulate gyrus (ACG), right medial frontal gyrus (MFG), right lentiform nucleus (LN), left hippocampus (HIP), left middle occipital gyrus (MOG), and left cerebellum posterior lobe (CPL) (p < 0.05). Story creating performance improvements were associated with greater activation in the left HIP region. Resting-state functional connectivity (FC) between left HIP and certain other brain areas shown a significant interaction of creative expression group versus control group. Moreover, connectivity between the right angular gyrus (ANG), right inferior temporal gyrus (ITG), right superior occipital gyrus (SOG), left ANG, and left MFG were related to improved cognitive performance (p < 0.05). CONCLUSION: These data extend current knowledge by indicating that the creative expression program can improve cognitive activation in MCI, and these enhancements may be related to the neurocognitive network plasticity changes induced by creative expression training.

Low-temperature adaptation and preservation revealed by changes in physiological-biochemical characteristics and proteome expression patterns in post-harvest Hami melon during cold storage.

MAIN CONCLUSION: The proteome and its time-dependent effects reveal the importance of stress response (including expression regulation of heat-shock proteins) and fatty acid metabolism in cold adaptation and preservation of Hami melon. To better understand the molecular mechanism of how Hami melons respond to low-temperature stress, this study investigated the relevant physiological characteristics, catalytic antibody activity, and quantitative proteomics of Hami melon (Jiashi muskmelon) during low-temperature storage. Jiashi muskmelon was stored inside two refrigerators set at 21 °C (control group) and 3 °C, respectively, for 24 days. Low-temperature storage led to a significantly reduced decay rate, weight loss rate, and loss of relative conductivity. It also maintained fruit firmness, inhibited the production rate of malondialdehyde and H2O2, and induced over-expression of antioxidant enzyme and ATPase. A total of 1064 differentially expressed proteins (DEPs) were identified during low-temperature storage. Stimulation response was the main process in response to low-temperature. To further verify the proteome data, we selected four heat-shock proteins (HSP) displaying relatively high expression levels. Real-time fluorescence PCR results confirmed that HmHSP90 I, HmHSP90 II, HmHSP70, and HmsHSP were significantly up-regulated upon low-temperature induction. These proteins may protect the Hami melon from physiological and cellular damage due to the low-temperature stress by acting alone or synergistically. Additionally, the main enrichment term of the fatty acid metabolism-related DEPs was fatty acid beta oxidation at 21 °C in contrast to fatty acid biosynthesis processes at 3 °C. It is speculated that Hami melon enhances low-temperature adaptability by slowing down the oxidative degradation of fatty acids and synthesizing new fatty acids at low temperatures. This study provides new insights into the mechanism of low-temperature adaptation and preservation in post-harvest Hami melon during cold storage.

Analysis of bacterial diversity and genetic evolution of Lacticaseibacillus paracasei isolates in fermentation pit mud.

AIMS: Since little is known about the genetic diversity of lactic acid bacteria (LAB) isolates from the fermentation pit mud (FPM), we sought to evaluate the bacterial structure, identify the LAB isolates and investigate the genotype and genetic diversity of the LAB isolates. METHODS AND RESULTS: Using high-throughput MiSeq sequencing, we identified seven dominant bacterial genera in FPM. Lactobacillus had the highest abundance. We isolated 55 LAB strains. These isolates were all identified as Lacticaseibacillus paracasei. Using an extant multilocus sequence typing (MLST) scheme, isolates were assigned to 18 sequence types (STs) and three clonal complexes. ST1, the largest group, mainly comprised FPM isolates. Niche-specific ST2 to ST18 only contained FPM isolates. Isolates could be divided into four lineages, with most assigned to Lineage 1. Only one FPM isolate was classified as L. paracasei subsp. paracasei. Other isolates could not be classified at the subspecies level using the seven MLST loci. CONCLUSIONS: Lactobacilli account for a high proportion of bacteria in pit mud. Based on the traditional culture method, L. paracasei was the dominant species, and these isolates exhibit a high ethanol tolerance, high intraspecific diversity and specific genetic profiles. SIGNIFICANCE AND IMPACT OF THE STUDY: The study described the characterization of FPM bacterial diversity, giving an insight into the genetic diversity of L. paracasei strains present in FPM.

Effects of a staged integral art-based cognitive intervention (SIACI) program in older adults with cognitive impairments: protocol for a randomized controlled trial.

BACKGROUND: Given the aging population worldwide and the COVID-19 pandemic, which has been found to be associated with a deterioration in Alzheimer's disease (AD) symptoms, investigating methods to prevent or delay cognitive decline in preclinical AD and AD itself is important. The trial described in this protocol aims to evaluate the effects of a staged integral art-based cognitive intervention (SIACI) in older adults with CIs (preclinical AD [SCD or MCI] and mild AD), in order to gather evidence on the effects of SIACI on cognition and psychological/psychosocial health gains and determine the mechanisms. METHODS: The planned study is a single-center, parallel-arm, randomized controlled trial with allocation concealment and outcome assessor blinding. A total of 88 participants will be randomized to two groups: (i) an intervention group that receives the 16-week, 24-session SIACI program and (ii) a waitlist control group (which will receive the SIACI program after completing the follow-up assessment). Global cognitive function, specific domains of cognition (memory, language, executive function, and visuospatial skills), and other health-related outcomes (quality of life, anxiety, depression, sleep quality, and physical activity level) will be measured at baseline, immediately after the intervention, and at the 6-month follow-up. Blood biomarkers, event-related potential (ERP)-P300, and magnetic resonance imaging (MRI) data will be collected at baseline and immediately after the intervention to explore the mechanisms of SIACI. DISCUSSION: The trial will elucidate the immediate and long-term effects of SIACI based on neuropsychological testing and blood biomarkers, and neuroscience involving ERP-P300 and MRI parameters will make it possible to explore the mechanisms of SIACI in older adults with CIs. The results will provide evidence on the effectiveness of an AT-based cognitive intervention, which may delay or even halt cognitive decline in preclinical AD and AD itself. TRIAL REGISTRATION: ChiCTR, ChiCTR2100044959 . Registered 03 April 2021.

iTRAQ-based quantitative proteomics analysis of cantaloupe (Cucumis melo var. saccharinus) after cold storage.

BACKGROUND: Cantaloupe is susceptible to cold stress when it is stored at low temperatures, resulting in the loss of edible and commercial quality. To ascertain the molecular mechanisms of low temperatures resistance in cantaloupe, a cold-sensitive cultivar, Golden Empress-308 (GE) and a cold-tolerant cultivar, Jia Shi-310 (JS), were selected in parallel for iTRAQ quantitative proteomic analysis. RESULTS: The two kinds of commercial cultivars were exposed to a temperature of 0.5 °C for 0, 12 and 24 days. We found that the cold-sensitive cultivar (GE) suffered more severe damage as the length of the cold treatment increased. Proteomic analysis of both cultivars indicated that the number of differentially expressed proteins (DEPs) changed remarkably during the chilly treatment. JS expressed cold-responsive proteins more rapidly and mobilized more groups of proteins than GE. Furthermore, metabolic analysis revealed that more amino acids were up-regulated in JS during the early phases of low temperatures stress. The DEPs we found were mainly related to carbohydrate and energy metabolism, structural proteins, reactive oxygen species scavenging, amino acids metabolism and signal transduction. The consequences of phenotype assays, metabolic analysis and q-PCR validation confirm the findings of the iTRAQ analysis. CONCLUSION: We found that the prompt response and mobilization of proteins in JS allowed it to maintain a higher level of cold tolerance than GE, and that the slower cold responses in GE may be a vital reason for the severe chilling injury commonly found in this cultivar. The candidate proteins we identified will form the basis of future studies and may improve our understanding of the mechanisms of cold tolerance in cantaloupe.

High-throughput Sequencing-based Analysis of Microbial Diversity in Rice Wine Koji from Different Areas.

Rice wine, a traditional fermented alcoholic beverage in China, is produced with grains such as rice, which are fermented with saccharifying starter-koji. Its flavor quality is closely associated to the starter culture-koji, which is made by mixing botanical materials with high-class glutinous rice in certain ecological context. However, there are few reports on the microbial community structure of rice wine koji. In this paper, bacterial community structures of rice wine koji were analyzed using 16S rRNA gene sequencing based on Illumina MiSeq high-throughput technology in 20 samples collected from Xiaogan area, Hubei province and Dazhu area, Sichuan province (10 from each area). We found rice wine koji flora mainly consisted of Weissella, Lactobacillus, Lactococcus, Bacillus, Enterococcus, and Cronobacter, with relative abundances of 29.49%, 10.93%, 8.85%, 4.75%, 1.16% and 1.15%, respectively, as well as an accumulative average relative abundance of 58.71%. They all belonged to Firmicutes and Proteobacteria-the two known dominant genus. Genus-level PCA (Principal component analysis) and OTU-level PCoA (Principal coordinates analysis) based on unweighted UniFrac distances showed that the bacterial community structure differed significantly between the samples from the 2 areas. 7 OTUs were detected in all samples, accounting for 4.4% of the total qualified assembly. Among the 7 OTUs, 3 OTUs were identified as Enterococcus, 2 OTUs were identified as Cronobacter, 1 OTU was identified as Bacillus and 1 OTU was identified as Alkaliphilus. Fifty-eight lactic acid bacteria (LAB) strains were isolated from the 20 koji samples with traditional microbial methods. Among them, Enterococcus faecium and Pediococcus pentosaceus were the dominant LAB isolates, with relative abundances of 51.72% and 31.03%. Despite the differences, a large number of shared bacteria were detected in samples from the two areas.

A comparison of arterial spin labeling perfusion MRI and DCE-MRI in human prostate cancer.

Perfusion MRI has the potential to provide pathophysiological biomarkers for the evaluating, staging and therapy monitoring of prostate cancer. The objective of this study was to explore the feasibility of noninvasive arterial spin labeling (ASL) to detect prostate cancer in the peripheral zone and to investigate the correlation between the blood flow (BF) measured by ASL and the pharmacokinetic parameters K(trans) (forward volume transfer constant), kep (reverse reflux rate constant between extracellular space and plasma) and ve (the fractional volume of extracellular space per unit volume of tissue) measured by dynamic contrast-enhanced (DCE) MRI in patients with prostate cancer. Forty-three consecutive patients (ages ranging from 49 to 86 years, with a median age of 74 years) with pathologically confirmed prostate cancer were recruited. An ASL scan with four different inversion times (TI = 1000, 1200, 1400 and 1600 ms) and a DCE-MRI scan were performed on a clinical 3.0 T GE scanner. BF, K(trans), kep and ve maps were calculated. In order to determine whether the BF values in the cancerous area were statistically different from those in the noncancerous area, an independent t-test was performed. Spearman's bivariate correlation was used to assess the relationship between BF and the pharmacokinetic parameters K(trans), kep and ve. The mean BF values in the cancerous areas (97.1 ± 30.7, 114.7 ± 28.7, 102.3 ± 22.5, 91.2 ± 24.2 ml/100 g/min, respectively, for TI = 1000, 1200, 1400, 1600 ms) were significantly higher (p < 0.01 for all cases) than those in the noncancerous regions (35.8 ± 12.5, 42.2 ± 13.7, 53.5 ± 19.1, 48.5 ± 13.5 ml/100 g/min, respectively). Significant positive correlations (p < 0.01 for all cases) between BF and the pharmacokinetic parameters K(trans), kep and ve were also observed for all four TI values (r = 0.671, 0.407, 0.666 for TI = 1000 ms; 0.713, 0.424, 0.698 for TI = 1200 ms; 0.604, 0.402, 0.595 for TI = 1400 ms; 0.605, 0.422, 0.548 for TI = 1600 ms). It can be seen that the quantitative ASL measurements show significant differences between cancerous and benign tissues, and exhibit strong to moderate correlations with the parameters obtained using DCE-MRI. These results show the promise of ASL as a noninvasive alternative to DCE-MRI.

Comparative analysis of sensory features, microbial diversity, and their correlations in light-flavor Daqu from different regions.

This study performed a comparative analysis of the sensory and microbial profiles of light-flavor Bijou (LFD) from Taiyuan (Shanxi Province) and Suizhou (Hubei Province) in China. The results of the electronic nose showed that the aromatic substances of the LFD from Taiyuan (TLFD) were significantly higher (p < .05), while alcohol and aldehyde substances were significantly lower (p < .05) compared with the LFD from Suizhou (SLFD). The average response values of sensors W1C (sensitive to aromatic hydrocarbons), W3C (sensitive to amine and aromatic components), W5C (sensitive to olefins, aromatics, and polar molecules), and W2S (sensitive to alcohol and aldehyde compounds) to TLFD were 0.26, 0.33, 0.34, and 7.72, whereas the response values to SLFD were 0.25, 0.32, 0.33, and 8.04, respectively. The electronic tongue results showed that the aftertaste A (bitter aftertaste) and aftertaste B (astringent aftertaste) of the TLFD were significantly higher (p < .05) and umami was significantly lower (p < .05) as compared to the SLFD. The relative intensities of the aftertaste A, aftertaste B, and umami indicators of TLFD were 0.10, -0.008, and -0.22, respectively, while those of SLFD were -0.23, -0.36, and 0.835, respectively. MiSeq high-throughput sequencing results showed that TLFD exhibited lower fungal richness and diversity compared to SLFD. The dominant bacterial genera were mainly Bacillus (58.12%), Kroppenstedtia (10.11%), and Weissella (6.26%), and the dominant fungal genera were Saccharomycopsis (67.53%), Rasamsonia (9.90%), and Thermoascus (7.10%). Streptomyces and Staphylococcus were identified as the key characteristic microorganisms in TLFD, while Kroppenstedtia, Rasamsonia, and Thermoascus were the key characteristic microorganisms in SLFD. Correlation analysis indicated a stronger correlation between microorganisms and sensory characteristics in SLFD samples. This study provides valuable insights into the sensory and microbiological characteristics of LFD from different regions and offers a new perspective for understanding the production of differently flavored light-flavor Baijiu.

Predicting and assessing greenhouse gas emissions during the construction of monorail systems using artificial intelligence.

Based on partial data, this paper uses BP neural network optimised by particle swarm optimisation algorithm to predict the total greenhouse gas (GHG) emissions of the line in the construction phase. The GHG emission efficiency is analysed by SBM (Slacks-Based Measure) super efficiency method. Finally, the grey relational analysis (GRA) is applied to sort the GHG emission correlation factors. Based on the existing design and quota document data of 16 stations and 16 sections of the Wuhu Monorail Line 1, we have employed a neural network optimized by particle swarm optimization algorithm to predict the total emissions of greenhouse gases during the construction phase of the entire line consisting of 25 stations and 24 sections. The GHG emissions of all stations and sections are 29,300 tons and 21,000 tons. The technical efficiency, pure technical efficiency, and scale efficiency of the stations and sections were high. As for stations, the order of influence degree is metal material consumption (0.9731) > cost (0.9486) > electric energy consumption (0.9481) > station area (0.9109) > concrete and cement consumption (0.9032) > other material consumption (0.8831) > gasoline and diesel consumption (0.7258). For the section, the order of influence degree is cost (0.9766) > concrete (0.9581) > steel reinforcement (0.9483) > other steels (0.874) > section length (0.8337) > power energy consumption (0.7169) > wood consumption (0.6684).

Exploring jujube wine flavor and fermentation mechanisms by HS-SPME-GC-MS and UHPLC-MS metabolomics.

The fermentation metabolites significantly influence the quality of jujube wine. However, the dynamics of these metabolites during fermentation are not well understood. In this study, a total of 107 volatile and 1758 non-volatile compounds were identified using a flavor-directed research strategy and non-targeted metabolomics. The increase in esters and alcohols during fermentation shifted the aroma from grassy, mushroomy, and earthy to a floral and fruity flavor in the jujube wine. Leucine and phenylalanine were notably enriched during fermentation, potentially benefiting human health and enriching the flavor of fruit wines. Moreover, pathway analysis identified four key metabolic pathways and two crucial metabolic substrates, pyruvate and l-aspartate. This study provides a theoretical reference for optimizing the fermentation process and enhancing the quality of jujube wine.

An effective insulin infusion protocol for severe traumatic brain injury patients: A retrospective observational study.

PURPOSE: Severe traumatic brain injury (sTBI) patients often experience stress hyperglycaemia, which can lead to negative outcomes. This study aims to introduce an effective insulin infusion protocol specifically designed for sTBI patients. METHODS: Data was collected from all sTBI patients during two periods: 1 October 2019 to 30 April 2020, and 1 June 2020 to 31 December 2020. In May 2020, a new insulin infusion protocol was implemented. Blood glucose management, infection, coagulation, and prognosis were compared in these two periods. RESULT: 195 patients were included, with 106 using the new protocol. The proportion of hyperglycaemia decreased from 40.04% to 26.91% (P<0.05), and the proportion of on-target blood glucose levels increased from 35.69% to 38.98% (P<0.05). Average blood glucose levels decreased from 9.98±2.79mmol/L to 8.96±2.82mmol/L (P<0.05). There was no substantial increase in hypoglycaemia, which remained controlled below 1%. The new protocol positively influenced glucose concentration and dispersion trends. There were no significant differences in catheter-related infections, antibiotic use, mechanical ventilation (MV) duration, length of stay in ICU, Glasgow Outcome Scale (GOS), or mortality. However, the conventional protocol group had a higher coagulation tendency (R-value of thromboelastography 4.80±1.35min vs. 5.52±1.87min, P<0.05), with no difference in deep vein thrombosis (DVT) incidence. CONCLUSION: Our findings suggest that a customized insulin infusion process for sTBI patients can effectively manage blood glucose. While there is no significant improvement in infection control or prognosis, it may have a positive impact on coagulation without affecting the occurrence of DVT.

Comparative analysis of bacterial community structure and physicochemical quality in high-temperature Daqu of different colors in Qingzhou production area.

To compare the effects of differences in Daqu making technology and production regions on the bacterial composition and physicochemical properties of high-temperature Daqu (HTD), this study analyzed the bacterial community structure of three colors of HTD in the Qingzhou production area and measured their physicochemical quality. At the same time, a comparative analysis was conducted on the bacterial composition of Qingzhou and Xiangyang regions. The results revealed that the HTD in the Qingzhou area exhibited a diverse bacterial community dominated by Lentibacillus, Scopulibacillus, and Staphylococcus. The black HTD displayed the lowest bacterial richness (P < 0.05) and a relatively unique microbial structure. Significant variations were observed in the physicochemical qualities of the three colors of HTD. Notably, white HTD demonstrated higher moisture and ash content, saccharification and liquor-producing power. Yellow HTD exhibited higher amino nitrogen and protein content, and black HTD displayed higher water activity, acidity, and starch content. The variation in Bacillus, Limosilactobacillus, and Weissella distributions across different colors of HTD primarily contributed to these findings. From the HTD samples in the Qingzhou area, Bacillus (61.90 %) and lactic acid bacteria (17.46 %) being the predominant cultivable communities. Cluster analysis identified significant differences in bacterial communities among HTD samples from various production areas. It can enhance the understanding of HTD quality in the Qingzhou area and offer insights for optimizing HTD and Maotai-flavor Baijiu quality.

Modified versus three-level technique of retroperitoneal laparoscopic adrenalectomy for all patients with adrenal lesions ≤ 6cm: a retrospective, case-controlled study.

Objectives: The modified three-level technique for retroperitoneal laparoscopic adrenalectomy (RLA) has proven beneficial in the treatment of adrenal lesions in patients with BMI≥25 Kg/m2. This paper aims to summarize our institution's seven-year experience using this technique for all patients with Adrenal Lesions ≤ 6cm. Patients and methods: Between January 2016 and December 2022. The patients underwent laparoscopic adrenal surgery were categorized into Zhang's technique (ZT) (Three-level Technique) group and modified technique (MT) group. The fundamental characteristics and perioperative data were analyzed, with statistical significance set at p<0.05. Results: In total, 731 patients were stratified into two groups: ZT (n=448) and MT (n=283). Statistically significant distinctions were not detected between the two groups regarding sex, BMI, tumor location, tumor size, tumor type, or American Society of Anesthesiologists (ASA) score (p>0.05). The MT group demonstrated superior outcomes compared to the ZT group in terms of operative time, estimated blood loss, drainage volume, diet recovery time, complication rates, and postoperative hospitalization duration (p<0.05). 17 (4.34%) in the ZT group required unplanned adrenalectomy, while there was none in MT group (P<0.05). Conclusion: MT retroperitoneal laparoscopic adrenalectomy has demonstrated its benefits in the treatment of adrenal lesions across all patients with adrenal lesions ≤ 6cm, serving as a valuable point of reference for the surgical management of adrenal diseases. Patient summary: We have made modifications to the classic retroperitoneal laparoscopic adrenalectomy and achieved superior surgical outcomes, resulting in a procedure known as modified retroperitoneal laparoscopic adrenalectomy. This technique is suitable for both obese individuals and the general population with adrenal lesions ≤ 6cm.

Turbo fast three-dimensional carotid artery black-blood MRI by combining three-dimensional MERGE sequence with compressed sensing.

PURPOSE: In this study, we sought to investigate the feasibility of turbo fast three-dimensional (3D) black-blood imaging by combining a 3D motion-sensitizing driven equilibrium rapid gradient echo sequence with compressed sensing. METHODS: A pseudo-centric phase encoding order was developed for compressed sensing-3D motion-sensitizing driven equilibrium rapid gradient echo to suppress flow signal in undersampled 3D k-space. Nine healthy volunteers were recruited for this study. Signal-to-tissue ratio, contrast-to-tissue ratio (CTR) and CTR efficiency (CTReff ) between fully sampled and undersampled images were calculated and compared in seven subjects. Moreover, isotropic high resolution images using different compressed sensing acceleration factors were evaluated in two other subjects. RESULTS: Wall-lumen signal-to-tissue ratio or CTR were comparable between the undersampled and the fully sampled images, while significant improvement of CTReff was achieved in the undersampled images. At an isotropic high spatial resolution of 0.7 × 0.7 × 0.7 mm(3) , all undersampled images exhibited similar level of the flow suppression efficiency and the capability of delineating outer vessel wall boundary and lumen-wall interface, when compared with the fully sampled images. CONCLUSION: The proposed turbo fast compressed sensing 3D black-blood imaging technique improves scan efficiency without sacrificing flow suppression efficiency and vessel wall image quality. It could be a valuable tool for rapid 3D vessel wall imaging.

Comparison of MRS and DWI in the diagnosis of prostate cancer based on sextant analysis.

PURPOSE: To evaluate apparent diffusion coefficient (ADC) value, metabolic ratio ((Cho + Cr)/Cit) and the combination of the two in identifying prostate malignant regions. MATERIALS AND METHODS: Fifty-six consecutive patients with prostate biopsy results were retrospectively recruited in this study. Transrectal ultrasound-guided (TRUS) systemic prostate biopsies were used as a standard of reference. Mean ADC value and mean metabolic ratio (MMR) were calculated within each benign sextant region or malignant region. The efficiency of these two indices in prostate cancer (PCa) diagnosis is estimated in Fisher linear discriminant analysis (FLDA). The area under the receiver operating characteristic (ROC) curve was used to evaluate the distinguishing capacity of mean ADC, MMR, and the combination of the two in differentiating between noncancerous and cancerous cases. RESULTS: There were significant differences for mean ADC value and MMR between malignant and benign regions. Weights of mean ADC value obtained by FLDA were much higher than those of MMR. In differentiating malignant regions, both ADC alone and combined ADC and metabolic ratio performed significantly better than MMR alone. However, accuracy improvements were not significant by using combined ADC and MMR than ADC alone. CONCLUSION: DWI is more efficient than MR spectroscopic (MRS) in the detection of PCa in this study. Combined ADC and MMR performed significantly better than MMR alone in distinguishing malignant from benign region in prostate peripheral zone.

Application of the PDCA Cycle for Managing Hyperglycemia in Critically Ill Patients.

INTRODUCTION: Stress hyperglycemia is a common symptom in critically ill patients, and is not only a marker indicating the severity of illness but is also related to worsening outcomes. Managing stress hyperglycemia without increasing the likelihood of hypoglycemia is one of the most pressing challenges to be urgently addressed in clinics. The Plan-Do-Check-Act (PDCA) cycle management has been put forward in various surgical management scenarios, and has proven to be effective in the diagnosis and treatment of different diseases. It possesses dynamic characteristics and can be updated according to the results of glycemic control and feedback. This study focused on the use of PDCA to manage glucose levels in critically ill patients. METHODS: Based on the glucose level of 1003 critically ill patients admitted to the emergency intensive care unit (EICU) from 1 October 2019 to 31 December 2020, we collected and matched the prevalence of hyperglycemia, hypoglycemia, and glucose variability on a quarterly basis. According to the PDCA management method, we analyzed the possible causes, supervised the implementation of measures, summarized the feedback on improvements, and then proposed new improvement measures for implementation in the next quarter. RESULTS: Three measures were proposed and applied to enhance the management of hyperglycemia: (I) Updating and formulating three editions of the insulin infusion protocol and increasing the initial and maintenance doses of insulin on a case-by-case basis; (II) reducing the use of parenteral nutrition and ensuring that enteral nutrition is consumed at a uniform and slow rate; and (III) forming a training method during the COVID-19 pandemic and improving implementation of the insulin infusion protocol. Following PDCA management, the prevalence of hyperglycemia fell from 43.18% to 32.61%, the incidence of hypoglycemia was below 1.00%, and there was no significant fluctuation in blood glucose variability. CONCLUSION: The PDCA method is helpful in developing a superior insulin infusion protocol for critically ill patients and lowering the prevalence of hyperglycemia in critically ill patients.

Presence of lymph nodes and metastasis within prostatic anterior fat pad in radical prostatectomy patients: A single Chinese institution experience and literature review.

INTRODUCTION: Limited data from China, aim to investigate the incidence and the risk fctors of lymph node metastases in the prostatic anterior fat pad (PAFP). MATERIAL AND METHODS: Patients underwent radical prostatectomy (RP) were enrolled between March 2020 to December 2022 at a single institution. Separate pathological analysis of PAFP was performed within this area. Univariate analysis and Multivariate analysis were performed to determine the risk factor of PAFP metastasis. RESULT: A total of 255 patients were included. The study revealed an average age of 67.72 ± 7.07 years, with a mean total tumor volume of 41.54 ± 23.79 mL, and an average Pre-op PSA of 16.85 ng/mL. Clinical T stage was divided into T2, T3, and T4 (226, 25, 4 cases, respectively), while the Clinical M stage was categorized as M0 and M1 (248 and 7 cases, respectively). Out of the patients with PAFP, 19 (7.45 %) had lymph node in PAFP, and 3 (1.18 %) patients had metastases. In the univariate and multivariate analysis, Clinical M stage and anterior primary tumor were found to be a significant high-risk factor. Among the other 15 studies, six examined the risk factors associated with it, including anterior tumors, higher tumour volume, intermediate or high risk prostate cancer. CONCLUSION: Due to the low proportion of lymph node involvement (7.45 %) and rare tumor metastasis (1.18 %), routine separate pathological analysis of PAFP is not recommended in all RP patients unless there are anterior tumors, higher tumor volume, or intermediate/high risk prostate cancer.

Exploring metabolic dynamics during the fermentation of sea buckthorn beverage: comparative analysis of volatile aroma compounds and non-volatile metabolites using GC-MS and UHPLC-MS.

Sea buckthorn has a high nutritional value, but its sour taste and foul odor make it unpalatable for consumers. In this study, we analyzed the metabolite changes occurring during the yeast-assisted fermentation of sea buckthorn juice using the HeadSpace Solid-Phase Microextraction Gas Chromatography-Mass Spectrometry (HS-SPME-GC-MS) and Ultra-High Performance Liquid Chromatography-Mass Spectrometry (UHPLC-MS) techniques. A total of 86 volatile aroma compounds were identified during the fermentation process. The content of total volatiles in sea buckthorn juice increased by 3469.16 µg/L after 18 h of fermentation, with 22 compounds showing elevated levels. Notably, the total content of esters with fruity, floral, and sweet aromas increased by 1957.09 µg/L. We identified 379 non-volatile metabolites and observed significant increases in the relative abundance of key active ingredients during fermentation: glycerophosphorylcholine (increased by 1.54), glutathione (increased by 1.49), L-glutamic acid (increased by 2.46), and vanillin (increased by 0.19). KEGG pathway analysis revealed that amino acid metabolism and lipid metabolism were the primary metabolic pathways involved during fermentation by Saccharomyces cerevisiae. Fermentation has been shown to improve the flavor of sea buckthorn juice and increase the relative content of bioactive compounds. This study provides novel insights into the metabolic dynamics of sea buckthorn juice following yeast fermentation through metabolomics analysis. These findings could serve as a theoretical foundation for further studies on the factors influencing differences in yeast fermentation.