[Differences in Soil Fertility and Bacterial Community Structure Between Carbon Inputs such as Biochar and Organic Fertilizer and Their Relationship].

The potato planting area of Guizhou Province ranks second in China. However, due to factors such as climatic conditions and unbalanced fertilization, soil organic matter in potato fields is consumed rapidly and has a large deficit, which affects soil biological function and soil fertility. Biochar and organic fertilizer are effective ways to supplement foreign aid organic matter to improve soil quality. However, the differences in soil fertility and microbial community structure and their relationships under the conditions of organic fertilizer or biochar combined with chemical fertilizer are not clear. In this study, three treatments of conventional fertilization （NPK）, increased application of biochar （NPKB）, and increased application of organic fertilizer （NPKO） were set up to investigate the characteristics of potato rhizosphere soil, bacterial community composition, and diversity； to analyze the effects of these factors on the soil integrated fertility index； and to explore the direct and indirect effects of IFI on soil fertility and bacterial community structure differences between treatments and their driving factors. The results showed that soil pH, available phosphorus （AP）, available potassium （AK）, total nitrogen （TN）, organic carbon （SOC）, and C/N ratio were significantly higher in the NPKB and NPKO treatments than in the NPK treatment （P<0.05）. Soil IFI was greatest for NPKO, followed by NPKB and least for the NPK treatment. A total of 8 214 ASVs were obtained from all the soil samples, belonging to 26 phyla, 75 classes, 165 orders, 176 families, and 251 genera （excluding unidentified fungi）. Proteobacteria, Actinobacteria, and Chloroflexi were the dominant phyla, accounting for 54.85% of all ASVs. Compared to that in the NPK and NPKB treatments, the NPKO treatment had the highest bacterial diversity and number of significantly different taxa, and soil AN, AP, AK, SOC, TN, and IFI were significant correlates of bacterial diversity index （P<0.05）. Additionally, pH, TN, and SOC were significant influencers of bacterial taxa differences （P<0.05）, with importance ranked as TN （70.59%） > SOC （49.42%） > pH （27.08%）. Structural equations suggested that pH-related soil properties and bacterial community diversity were the direct pathways influencing IFI, and soil pH-related soil characteristics could also indirectly affect IFI by affecting bacterial Shannon diversity. These results indicate that soil fertility and bacterial community structure were significantly different and correlated between the biochar and organic fertilizer addition treatments and that pH and bacterial community diversity were the key factors influencing IFI, with the NPKO treatment in particular having the best effect on improving IFI. Considering the effect of soil fertilization and the functional group of bacteria, NPKO is the recommended combination for the best synergistic effect of soil fertilization, that is, N 150 kg·hm-2+P2O5 135 kg·hm-2+K2O 135 kg·hm-2+organic fertilizer 6.6 t·hm-2.

Carbon Nanoparticles in Mongolian Medicine Alleviate Acute Gastric Ulcer Induced by Ethanol by Regulating Fas/FasL Pathway.

INTRODUCTION: The consumption of large amounts of ethanol can directly lead to acute gastric mucosal bleeding, edema, and erosion, while long-term drinking has been associated with gastric ulcers. Previous research has demonstrated that Har Gabur, a traditional Mongolian medicine, alleviates gastric ulcers through the physical adsorption of its carbon components. It is well known that the immune response has an important role in gastric ulceration. METHODS: In the present study, we used an ethanol-induced injury cell and mice model to investigate whether Har Gabur can inhibit the immune response stimulated by ethanol and identify the active constituents of Har Gabur involved in this process. RESULTS: We found that Har Gabur significantly repressed the activated Fas/FasL signal pathway and endogenous Bax/Bcl-2 apoptosis pathway. The molecular mechanism of the protective effect most likely involved the transcription or mRNA stability, as Har Gabur remarkably reversed the change in mRNA level of apoptosis-related genes induced by ethanol. CONCLUSION: Har Gabur operated in a cell-state-specific manner in vivo without inducing adverse effects in normal mice. Importantly, GO was identified as the main active ingredient of Har Gabur for gastric ulcers.

Diagnostic value of endoscopic ultrasonography in pancreatic duct stones / 中华肝胆外科杂志

Objective:To investigate the diagnostic value of endoscopic ultrasonography (EUS) in pancreatic duct stones.Methods:The clinicopathologic data of 204 patients undergoing EUS for symptoms such as abdominal pain, abdominal distension and jaundice suspected of pancreatic duct stones, who were admitted to the General Hospital of Western Theater Command from January 2019 to April 2023 were retrospectively analyzed. Of 159 patients were finally enrolled, including 47 females and 112 males, aged (51.8±13.9) years. Surgery or endoscopic retrograde cholangiopancreatography (ERCP) is considered the " gold standard" for the diagnosis of pancreatic duct stones. Of 38 patients (23.9%) had abdominal ultrasound, 143 (89.9%) had CT scan and 93 (58.5%) had magnetic resonance cholangiopancreatography (MRCP) at the same time. The diagnostic accuracy of imaging examinations in pancreatic duct stones was compared.Results:In 159 patients, 61 (38.4%) were diagnosed of pancreatic duct stones. In the 159 patients, 61 (38.4%) were diagnosed of pancreatic duct stones by EUS. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, Youden index and accuracy of EUS for pancreatic duct stones were 98.4%, 99.0%, 98.4%, 99.0%, 97.3% and 98.7%, respectively. The accuracy of EUS in diagnosing pancreatic duct stones was higher than that of percutaneous ultrasound, CT and MRCP (χ 2=7.71, 13.76, and 5.70, P=0.012, <0.001, 0.033). The diagnostic accuracy of EUS is comparable with operation and ERCP (Kappa=0.854, P<0.001). Conclusion:EUS could be a superior imaging approach to diagnose the pancreatic duct stone.

Practical Optimization and Application of Time-delay Exposure System for Mobile Digital Radiography Equipment / 中国医疗器械杂志

This study introduced a time-delay exposure system independent of the mobile digital radiography equipment. The system consisted of lithium battery, delay control circuit, micro electric motor and related auxiliary facilities. When the starting time was reached through the delay circuit, the motor pushed out the rod to squeeze the exposure button and completed the exposure. The accessories used in this system were easy to purchase and cheap. At the same time, the technology was mature and had good compatibility. The exposure success rate was high and the exposure effect was satisfactory. This time-delay exposure system had good practicability and popularization value.

Research progress on the effect of iron oxide nanoparticles in macrophage polarization / 生物医学工程学杂志

Macrophages are important immune effector cells with significant plasticity and heterogeneity in the body immune system, and play an important role in normal physiological conditions and in the process of inflammation. It has been found that macrophage polarization involves a variety of cytokines and is a key link in immune regulation. Targeting macrophages by nanoparticles has a certain impact on the occurrence and development of a variety of diseases. Due to its characteristics, iron oxide nanoparticles have been used as the medium and carrier for cancer diagnosis and treatment, making full use of the special microenvironment of tumors to actively or passively aggregate drugs in tumor tissues, which has a good application prospect. However, the specific regulatory mechanism of reprogramming macrophages using iron oxide nanoparticles remains to be further explored. In this paper, the classification, polarization effect and metabolic mechanism of macrophages were firstly described. Secondly, the application of iron oxide nanoparticles and the induction of macrophage reprogramming were reviewed. Finally, the research prospect and difficulties and challenges of iron oxide nanoparticles were discussed to provide basic data and theoretical support for further research on the mechanism of the polarization effect of nanoparticles on macrophages.

Early management after left ventricular assist device implantation in 22 patients: a single center experience / 中华胸心血管外科杂志

Objective:To investigate and summarize the early management experience of 22 patients with end-stage heart failure(ESHF) who underwent left ventricular assist device(LVAD) implantation in an intensive care unit(ICU) in a single center.Methods:Data of 22 patients with ESHF treated with LVAD in the ICU of TEDA International Cardiovascular Hospital from September 2020 to August 2022 were retrospectively analyzed. There were 16 males and 6 females, aged from 20 to 67 years old, with a mean age of(51.0±13.3)years old. There were 21 cases with dilated cardiomyopathy, 1 case with ischemic cardiomyopathy, 6 cases with tricuspid regurgitation, 1 case with intra-aortic balloon pump for cardiogenic shock, and 5 cases with cardiac resynchronization therapy for arrhythmia. After the operation, all patients received restricted fluid therapy, a " stepwise" anticoagulation strategy, and strict blood pressure management. The postoperative complications and treatment process were reviewed, the treatment and management experience were summarized, and the prognosis of the patients was statistically analyzed.Results:All 22 patients survived within 90 days after surgery, and 21 patients(95.5%) recovered well, the pump works fine and there was no hemolysis and thrombosis of LVAD. Major complications included: 1 case of severe pneumonia(4.5%), 2 cases of pericardial tamponade(9.1%), 1 case of intracerebral hemorrhage(4.5%), 1 case of mediastinal infection(4.5%), 5 cases of positive occult blood in gastric juice(22.7%), no cases of right ventricular failure、aortic insufficiency and cerebral infarction. The duration of postoperative mechanical ventilation was 17(8.5, 51.5) h, and the ICU stay was 14(10, 27) days.Conclusion:LVAD is another effective treatment for patients with ESHF in addition to heart transplantation. Good postoperative blood pressure control, " stepwise" anticoagulation strategy and " restrictive" fluid management can reduce postoperative complications in the early phase of post-operation, which is crucial for the prognosis of patients with LVAD.

Content Determination of Related Substances in Belinostat by HPLC / 中国药房

OBJECTIVE：To establish the method for the con tent determination of related substances in belinstat. METHODS ： HPLC method was adopted and the principal component self-control comparison method with correction factor was used to calculate the contents of related substances. The determination was performed on ODS-AM column with 1.02％ potassium dihydrogen phosphate buffer （pH value adjusted to 3.5 with phosphoric acid ）-acetonitrile（85∶15，V/V）as mobile phase A ，1.02％ potassium dihydrogen phosphate buffer （pH value adjusted to 3.5 with phosphoric acid ）-acetonitrile（30 ∶ 70，V/V）as mobile phase B （gradient elution ），at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃，and the detection wavelength was 220 nm. The sample size was 10 μL. RESULTS：The linear ranges of belinstat and impurities A ，D，F，G，H were 0.113-1.693， 0.050-1.496，0.117-1.750，0.098-1.471，0.120-1.799，0.100-1.506 μ g/mL（r≥0.999 7）. The correction factors of the last 5 impurities were 1.0，1.0，1.2，1.5，1.0；the detection limits were 0.250，0.590，0.490，0.600，0.500 ng，respectively. The quantification limits were 0.500，1.170，0.980，1.200，1.000 ng，respectively. The recoveries were 90.18％-111.48％（RSD＝ 1.52％-4.78％，n＝9）. RSDs of stability （100 h）and precision tests were no more than 16％，and the durability was good. Impurities A ，D and H were detected in 3 batches of belinlestat ，the contents were 0.030％-0.038％，0.019％-0.022％ and 0.012％-0.013％，respectively. The contents of other maximum monomer impurities were 0.012％-0.013％ and the total impurities were 0.075％-0.084％. Impurities B ，C，F，G were not detected. CONCLUSIONS ：The method for the content determination of related substances in belinstat has been successfully established ，and the method is accurate and specific.

Expression and characterization of β-N-acetylglucosaminidases from Bacillus coagulans DSM1 for N-acetyl-β-D glucosamine production / 生物工程学报

β-N-acetylglucosaminidases (NAGases) can convert natural substrates such as chitin or chitosan to N-acetyl-β-D glucosamine (GlcNAc) monomer that is wildly used in medicine and agriculture. In this study, the BcNagZ gene from Bacillus coagulans DMS1 was cloned and expressed in Escherichia coli. The recombinant protein was secreted into the fermentation supernatant and the expression amount reached 0.76 mg/mL. The molecular mass of purified enzyme was 61.3 kDa, and the specific activity was 5.918 U/mg. The optimal temperature and pH of the BcNagZ were 75 °C and 5.5, respectively, and remained more than 85% residual activity after 30 min at 65 °C. The Mie constant Km was 0.23 mmol/L and the Vmax was 0.043 1 mmol/(L·min). The recombinant BcNagZ could hydrolyze colloidal chitin to obtain trace amounts of GlcNAc, and hydrolyze disaccharides to monosaccharide. Combining with the reported exochitinase AMcase, BcNagZ could produce GlcNAc from hydrolysis of colloidal chitin with a yield over 86.93%.

Research Progress of Nano-drug Delivery System Targeting Tumor-associated Macrophage in Cancer Treatment / 肿瘤防治研究

Tumor-associated macrophages(TAMs), abundantly infiltrated in the tumor microenvironment, have a significant influence on tumor metastasis, angiogenesis and immune escape. Therefore, TAMs-targeted immunotherapy has become a hot point in the field of cancer treatment. However, most of the conventional TAMs-targeted agents may cause serious adverse effects, such as short retention time, poor drug enrichment and drug-resistance. In order to overcome these shortcomings, nanobiotechnology has attracted considerable attention. More recently, a series of important progress for nanomedicine has been achieved in the area of drug delivery and diagnostic imaging, because of their special physical and chemical properties. Hence, the TAMs-targeted nanomedicine delivery system provides new ideas for tumor immunotherapy. This paper reviews the role of TAMs in tumor microenvironment, the tumor-promoting mechanism, and introduces the research progress of nanomedicine in TAMs polarization, nanodrug delivery, TAMs-targeted imaging and preventing the TAMs recruitment, so as to provide reference for the application of nanotechnology in tumor immunotherapy.

A case report of spermatic neuroblastoma / 中华泌尿外科杂志

The purpose of this study is to study the clinical characteristics of spermatic cord tumor.The clinical data of a case of varicocele in our hospital were analyzed retrospectively.In this case,the patients with varicocele had a good recovery after operation.Varicocele is a rare case.The best mode of treatment is surgical resection and follow-up after operation.

A calcium-sensing receptor polymorphism at E942K promotes the proliferation of gastric cancer cells via Ca and ERK1/2 pathways / 生理学报

The study was designed to investigate the effects and mechanism of a calcium-sensing receptor (CaSR) polymorphism at E942K on the proliferation of gastric cancer cells. Single nucleotide polymorphisms (SNPs) were detected between gastric cancers group and normal controls group by DNA sequence analysis. The cell model was constructed by transfection of E942K mutant plasmid and wild-type (WT) plasmid into SGC-7901 and HEK-293 cells. The effect of E942K mutation on cell proliferation ability was detected by CCK8 and cell clone formation experiments. The effect of E942K mutation on calcium signaling was detected by calcium imaging. Western blot experiments were used to detect changes in phosphorylation levels of key proteins ERK1/2 and β-catenin in downstream signaling pathways after E942K mutation. The results showed that the mutation rate of E942K in gastric cancer group was significantly higher than that in normal control group (P < 0.05). CCK8 and cell clone formation experiments showed that E942K mutation significantly improved the proliferation ability of SGC-7901 gastric cancer cells and HEK-293 cells. E942K mutation enhanced calcium signaling in SGC-7901 and HEK-293 cells. E942K mutation enhanced ERK1/2 phosphorylation without affecting β-catenin phosphorylation. The results suggest that E942K mutation in CaSR may ultimately promote the proliferation of gastric cancer cells by enhancing intracellular calcium signaling and ERK1/2 phosphorylation. These results have potential clinical implications for the diagnosis and targeted therapy of gastric cancer.

Predictive Value of Pancreatic Steatosis for Severity of Coronary Atherosclerosis in Patients with Type 2 Diabetes Mellitus / 中国医学科学院学报

To investigate the association of pancreatic steatosis with coronary atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who underwent coronary computed tomography angiography(CCTA)in our center due to chest pain were enrolled from January 2016 to February 2019. According to the CCTA findings,patients were divided into normal group,mild-to-moderate coronary atherosclerosis group and severe coronary atherosclerosis group. CT attenuation of pancreas and spleen was measured on abdominal non-enhanced CT,and the CT attenuation indexes including the difference between pancreatic and splenic attenuation (P-S) and the ratio of pancreas-to-spleen attenuation (P/S) were calculated. Analysis of variance or Kruskal-Wallis rank test were used to assess differences among each group. Logistic regression analysis was used to analyze the risk factors of severe coronary stenosis. The accuracy of P/S in predicting severe coronary artery stenosis was assessed by receiver operator characteristic (ROC) curve analysis. A total of 173 consecutive T2DM patients were enrolled. These patients included 27 patients with normal coronary artery (15.6%),124 patients with mild to moderate stenosis (71.7%),and 22 patients with severe stenosis (12.7%). There were significant differences in CT attenuation of pancreas (=11.543,=0.003),P-S (=11.152,=0.004) and P/S (=11.327,=0.004) among normal coronary artery group,mild and moderate stenosis group,and severe stenosis group. The CT attenuation of pancreatic head,body,and tail significantly differed in patients with coronary artery stenosis (=14.737,=0.001). After adjusting for confounding factors,multiple Logistic regression showed that P/S (=0.062,95%=0.008-0.487,=0.008) was still significantly associated with the severe coronary artery stenosis. The area under the ROC curve of P/S for the diagnosis of severe coronary artery stenosis was 0.701,and the optimal cutoff point was 0.660. CT attenuation of pancreas and CT attenuation indexes are associated with the severity of coronary stenosis in T2DM patients,suggesting that pancreatic steatosis may be used as one of the indicators for predicting severe coronary artery stenosis.

Amelioration of hypoxia and LPS-induced intestinal epithelial barrier dysfunction by emodin through the suppression of the NF-κB and HIF-1α signaling pathways.

Intestinal barrier dysfunction occurs in critical illnesses and involves the inflammatory and hypoxic injury of intestinal epithelial cells. Researchers are still defining the underlying mechanisms and evaluating therapeutic strategies for restoring intestinal barrier function. The anti-inflammatory drug, emodin, has been shown to exert a protective effect on intestinal barrier function; however, its mechanisms of action remain unknown. In this study, we investigated the protective effects of emodin on intestinal barrier function and the underlying mechanisms in intestinal epithelial cells challenged with lipopolysaccharide (LPS) and hypoxia/reoxygenation (HR). To induce barrier dysfunction, Caco-2 monolayers were subjected to HR with or without LPS treatment. Transepithelial electrical resistance and paracellular permeability were measured to evaluate barrier function. The expression of the tight junction (TJ) proteins, zonula occludens (ZO)-1, occludin, and claudin-1, as well as that of hypoxia-inducible factor (HIF)-1α, phosphor-IκB-α, phosphor-nuclear factor (NF)-κB p65 and cyclooxygenase (COX)-2 was determined by western blot analysis. The results revealed that emodin markedly attenuated the decrease in transepithelial electrical resistance and the increase in paracellular permeability in the Caco-2 monolayers treated with LPS and subjected to HR. Emodin also markedly alleviated the damage caused by LPS and HR (manifested by a decrease in the expression of the TJ protein, ZO-1), and inhibited the expression of HIF-1α, IκB-α, NF-κB and COX-2 in a dose-dependent manner. In conclusion, our data suggest that emodin attenuates LPS- and HR-induced intestinal epithelial barrier dysfunction by inhibiting the HIF-1α and NF-κB signaling pathways and preventing the damage caused to the TJ barrier (shown by the decrease in the expression of ZO-1).

Comparison of Prenatal Diagnostic Value between Fast Imaging Employing Steady State Acquisition and Single Shot Fast Spin Echo Sequence in Diagnosis of Placental Invasion / 中国医学科学院学报

Objective To compare the prenatal diagnostic value and image quality of magnetic resonance imaging(MRI)with fast imaging employing steady state acquisition(FIESTA)or single shot fast spin echo(SSFSE)sequence,in order to provide references for sequence selection of prenatal diagnosis.Methods The MRI data of 121 patients with suspected placental invasion were retrospectively analyzed. The ability of FIESTA in displaying MRI signs associated with placental invasion and its image quality were assessed and compared with SSFSE. Based on the records of cesarean section and pathological finding,the sensitivity,specificity,positive predictive values,and negative predictive values of these two sequences were calculated.Results The image quality was significantly higher in FIESTA than in SSFSE(χ =29.74,P=0.000). FIESTA had significantly higher ability to display focal interruptions in the myometrial wall than SSFSE(χ =6.750,P=0.006);in addition,the ability to display abnormal vessel in the placenta(χ =8.471,P=0.020),placental heterogeneity(χ =13.885,P=0.000),hypointense intraplacental bands(χ =4.267,P=0.035)were also significantly higher in SSFSE than in FIESTA,while the efficiency for displaying uterine bulging(χ =0.250,P=0.625),uterine recess(χ =0.167,P=0.687),uterine penetration and parametrium implantation(χ =0.800,P=0.375),and protrusion of the placenta into the cervix(χ =0.081,P=0.776)were not significantly different between these two sequences. Both sequences had a specificity of 100% in displaying uterine penetration and parametrium implantation,uterine recess,and protrusion of the placenta into the cervix. Conclusions FIESTA has better ability in displaying the contour and demarcation of placenta and uterine,whereas SSFSE is more efficient in displaying the changes of intraplacental signals. FIESTA can be used to observe the relationship between the placenta and the surrounding structures and whether the surrounding tissue is implanted,and the changes of placental signals can be observed in SSFSE. The combination of these two sequences can improve the prenatal diagnosis of placenta invasion.

Effect of alveolar macrophages phagocytosis on prognosis in patients with acute respiratory distress syndrome caused by abdominal infection: a multicenter study / 中华危重病急救医学

Objective To investigate the effects of alveolar macrophage phagocytosis on prognosis in patients with acute respiratory distress syndrome (ARDS) caused by abdominal infection. Methods ARDS patients caused by severe intra-abdominal infection admitted to intensive care unit (ICU) of Tianjin Fourth Central Hospital, Tianjin Nankai Hospital, Tianjin First Central Hospital and Tianjin Fifth Central Hospital from June 2016 to March 2018 were enrolled. The gender, age, acute physiology and chronic health evaluationⅡ(APACHEⅡ) within 24 hours of admission, neutral red phagocytosis and alkaline phosphatase activity of macrophages in bronchoalveolar lavage fluid, the length of ICU stay, total hospitalization time, hospitalization expenses, and prognosis were recorded. According to the prognosis, the patients were divided into death group and survival group, and the parameters were compared between the two groups. Pearson test was used to analyze the correlation between neutral red phagocytosis function of macrophages and alkaline phosphatase activity and other indicators. The prognosis was analyzed by binary Logistic regression combined with neutral red phagocytosis and alkaline phosphatase activity in patients, and the predictive value of both subjects on prognosis was analyzed by the receiver operating characteristic (ROC) curve. Results Twenty patients were enrolled in the study, with 8 in the death group and 12 in the survival group. Compared with the survival group, the death group was older (years old: 58.50±14.86 vs. 46.67±13.40), APACHEⅡ score was higher (21.50±3.93 vs. 13.58±4.12), neutral red phagocytosis ability and alkaline phosphatase activity of alveolar macrophages were significantly decreased (A value:0.265±0.050 vs. 0.338±0.016; μmol/L: 12.06±1.24 vs. 17.96±3.90), and the length of ICU stay was significantly longer (days: 22.00±14.59 vs. 11.50±3.17), hospitalization cost was significantly increased (10 thousand Yuan:24.17±11.02 vs. 13.44±3.53), the total hospitalization time was shorter (days: 25.25±15.01 vs. 35.67±8.58), and the difference was statistically significant (all P < 0.05). There was no significant difference in gender between the survival group and the death group [male (case): 8 vs. 6, P > 0.05]. The neutral red phagocytosis ability of alveolar macrophages in ARDS patients caused by abdominal infection was negatively correlated with age, APACHEⅡ score and the length of ICU stay (r value was -0.328, -0.572, -0.809, respectively, all P < 0.05); alkaline phosphatase activity was negatively correlated with age, APACHEⅡ score, the length of ICU stay and hospitalization expenses (r value was -0.334, -0.583,-0.470, -0.517, respectively, all P < 0.05). Binary Logistic regression analysis showed that neutral red phagocytosis [odds ratio (OR) = 0.596, 95% confidence interval (95%CI) = 0.212-0.997] and alkaline phosphatase activity (OR = 0.573, 95%CI = 0.339-0.968) were the influencing factors of prognosis (both P < 0.05). ROC curve analysis showed that the AUC of neutral red phagocytosis ability for prognosis of ARDS patients caused by abdominal infection was 0.948, and the sensitivity and specificity were 91.7% and 87.5% when the off-cut value was 0.317. The AUC of alkaline phosphatase for the prognosis of ARDS patients caused by abdominal infection was 0.813; when the cut-off value was 19.72 μmol/L, the sensitivity was 75.0%, and the specificity was 87.5%. Conclusion The alveolar macrophage phagocytosis dysfunction in ARDS patients caused by severe abdominal infection was not only related to the severity of the disease, but also increased the medical burden of patients, and significantly affected the mortality of such patients.

Application value of enhanced recovery after surgery in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis / 中华消化外科杂志

Objective@#To explore the clinical application value of enhanced recovery after surgery (ERAS) in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis.@*Methods@#The prospective study was conducted. The clinicopathological data of 52 patients with cholecystolithiasis comorbid with choledocholithiasis who were admitted to the Third Affiliated Hospital of Zunyi Medical University from September 2016 to September 2018 were collected. Patients were divided into 2 groups by random number table: patients in observation group received laparoscopic cholecystectomy + choledocholithotomy + choledochoscopic exploration + T-tube drainage (or primary suture of common bile duct) and perioperative management guided by the concept of enhanced recovery after surgery (ERAS), and patients in control group received traditional perioperative management. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) postoperative complications; (4) postoperative pain scores; (5) changes in hepatic function and blood routine during perioperative period. Follow-up using outpatient examination and telephone interview was performed to detect complications during the postoperative 6 months up to March 2019. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the paired t test or repeated ANOVA. Count data were described as absolute numbers and percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability.@*Results@#Fifty-two patients were screened for eligibility, including 20 males and 32 females, aged 25-68 years, with an average age of 53 years. There were 30 patients in the observation group and 22 in the control group. (1) Surgical situations: the operation time and volume of intraoperative blood loss were (133±19)minutes and (47±21)mL in the observation group, and (136±22)minutes and (49±23)mL in the control group, respectively, showing no significant difference between the two groups (t=-0.386, -0.211, P>0.05). (2) Postoperative situations: time to out-of-bed activity, time to initial food intake, time to first anal flatus, duration of postoperative hospital stay, and hospital expenses were (18±4)hours, (19±5)hours, (28±2)hours, (4.0±1.0)days, and (1.82±0.22)×104 yuan in the observation group, and (29±7)hours, (46±9)hours, (37±4)hours, (6.6±1.6)days, and (2.25±0.29)×104 yuan in the control group, respectively, showing significant differences between the two groups (t=-7.054, -14.169, -9.426, -6.582, -5.809, P<0.05). (3) Postoperative complications: 1 of 30 patients in the observation group had postoperative biliary leakage, with a postoperative complication rate of 3.3%, and was cured after symptomatic support treatment. Six of 22 patients in the control group had postoperative complication, with a postoperative complication rate of 27.3%, including 2 of biliary leakage, 1 of hemorrhage, 1 of abdominal infection, 1 of pulmonary infection, 1 of urinary infection, and they were cured after symptomatic support treatment. There was a significant difference between the two groups (χ2=4.358, P<0.05). (4) Postoperative pain scores: from postoperative 6 hours to 48 hours, the postoperative pain score changed from 2.4±0.7 to 1.9±0.9 in the observation group, and from 4.1±0.7 to 2.9±0.9 in the control group, respectively, showing a significant difference in the changing trend between the two groups (F=78.053, P<0.05). (5) Changes in hepatic function and blood routine during perioperative period: from preoperation to postoperative 3 days, levels of alamine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT), total bilirubin (TBil), and count of white blood cells in the observation group changed from (77±20)U/L to (53±12)U/L, from (85±22)U/L to (61±17)U/L, from (166±39)U/L to (55±24)U/L, from (40±13)μmol/L to (29±12)μmol/L, from (7.0±2.0)×109/L to (6.8±1.9)×109/L, and changed from (79±23)U/L to (62±14)U/L, from (88±24)U/L to (64±17)U/L, from (179±34)U/L to (74±29)U/L, from (45±13)μmol/L to (35±12)μmol/L, from (7.9±2.4)×109/L to (7.5±1.9)×109/L in the control group, respectively. The levels of ALT, AST, GGT, TBiL, and count of WBC showed increasing at postoperative 1 day, and decreasing at postoperative 3 days. There was no significant difference in the changing trend between the two groups (F=0.058, 0.471, 3.021, 1.593, 2.172, P>0.05).@*Conclusion@#ERAS is safe and effective in the laparoscopic surgery for choledocholithiasis comorbid with cholecystolithiasis.

Application value of enhanced recovery after surgery in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis / 中华消化外科杂志

Objective To explore the clinical application value of enhanced recovery after surgery (ERAS) in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis.Methods The prospective study was conducted.The clinicopathological data of 52 patients with cholecystolithiasis comorbid with choledocholithiasis who were admitted to the Third Affiliated Hospital of Zunyi Medical University from September 2016 to September 2018 were collected.Patients were divided into 2 groups by random number table:patients in observation group received laparoscopic cholecystectomy + choledocholithotomy + choledochoscopic exploration +T-tube drainage (or primary suture of common bile duct) and perioperative management guided by the concept of enhanced recovery after surgery (ERAS),and patients in control group received traditional perioperative management.Observation indicators:(1) surgical situations;(2) postoperative situations;(3) postoperative complications;(4) postoperative pain scores;(5) changes in hepatic function and blood routine during perioperative period.Follow-up using outpatient examination and telephone interview was performed to detect complications during the postoperative 6 months up to March 2019.Measurement data with normal distribution were represented as Mean ± SD,and comparison between groups was analyzed using the paired t test or repeated ANOVA.Count data were described as absolute numbers and percentages,and comparison between groups was analyzed using the chi-square test or Fisher exact probability.Results Fifty-two patients were screened for eligibility,including 20 males and 32 females,aged 25-68 years,with an average age of 53 years.There were 30 patients in the observation group and 22 in the control group.(1) Surgical situations:the operation time and volume of intraoperative blood loss were (133± 19) minutes and (47 ± 21) mL in the observation group,and (136±22) minutes and (49±23)mL in the control group,respectively,showing no significant difference between the two groups (t=-0.386,-0.211,P＞0.05).(2) Postoperative situations:time to out-of-bed activity,time to initial food intake,time to first anal flatus,duration of postoperative hospital stay,and hospital expenses were (18±4) hours,(19±5) hours,(28±2)hours,(4.0± 1.0)days,and (1.82±0.22) × 104 yuan in the observation group,and (29±7)hours,(46±9)hours,(37±4)hours,(6.6±1.6)days,and (2.25±0.29) ×104 yuan in the control group,respectively,showing significant differences between the two groups (t =-7.054,-14.169,-9.426,-6.582,-5.809,P＜0.05).(3) Postoperative complications:1 of 30 patients in the observation group had postoperative biliary leakage,with a postoperative complication rate of 3.3％,and was cured after symptomatic support treatment.Six of 22 patients in the control group had postoperative complication,with a postoperative complication rate of 27.3％,including 2 of biliary leakage,1 of hemorrhage,1 of abdominal infection,1 of pulmonary infection,1 of urinary infection,and they were cured after symptomatic support treatment.There was a significant difference between the two groups (x2 =4.358,P ＜ 0.05).(4) Postoperative pain scores:from postoperative 6 hours to 48 hours,the postoperative pain score changed from 2.4 ± 0.7 to 1.9± 0.9 in the observation group,and from 4.1 ± 0.7 to 2.9 ± 0.9 in the control group,respectively,showing a significant difference in the changing trend between the two groups (F=78.053,P＜0.05).(5) Changes in hepatic function and blood routine during perioperative period:from preoperation to postoperative 3 days,levels of alamine aminotransferase (ALT),aspartate transaminase (AST),gamma-glutamyltransferase (GGT),total bilirubin (TBil),and count of white blood cells in the observation group changed from (77±20)U/L to (53± 12)U/L,from (85±22)U/L to (61± 17) U/L,from (166±39) U/L to (55±24) U/L,from (40± 13) μmol/L to (29±12) μmol/L,from (7.0±2.0) × 109/L to (6.8± 1.9) × 109/L,and changed from (79±23) U/L to (62± 14) U/L,from (88±24)U/L to (64± 17) U/L,from (179±34) U/L to (74±29) U/L,from (45± 13) μmol/L to (35±12) μmol/L,from (7.9±2.4)× 109/L to (7.5± 1.9)× 109/L in the control group,respectively.The levels of ALT,AST,GGT,TBiL,and count of WBC showed increasing at postoperative 1 day,and decreasing at postoperative 3 days.There was no significant difference in the changing trend between the two groups (F=0.058,0.471,3.021,1.593,2.172,P＞0.05).Conclusion ERAS is safe and effective in the laparoscopic surgery for choledocholithiasis comorbid with cholecystolithiasis.

Expression and Clinical Significance of Peripheral Blood T cell JAK2/STAT3 mRNA in Chronic Idiopathic Thrombocytopenic Purpura / 中国实验血液学杂志

OBJECTIVE@#To detect the expression of JAK2/STAT3 mRNA in peripheral blood T cells from the patients with chronic idiopathic thrombocytopenic purpura（CITP）, and to explore the relationship between JAK2/STAT3 mRNA and CITP.@*METHODS@#CITP group and healthy control group were set in this study, The JAK2/STAT3 mRNA expression level in peropheral blood T cells of 2 groups was detected with the RT-PCR and agarose gel electrophoresis.@*RESULTS@#JAK2 mRNA expression level in CITP group was significantly higher than that in control group（P<0.01）, the STAT3 mRNA expression level in CITP group was also higher than control group（P<0.01）, The JAK2/STAT3 mRNA expression level of CITP patiants increased obviously compared with control group.@*CONCLUSION@#The expression level of JAK2/STAT3 mRNA increases signficanlty in chronic ITP patients, which involves in pathogenesis of CITP.

Mechanical Properties and Biological Characteristics of the Porous 3D-Printed β-TCP Composite Scaffolds / 医用生物力学

Objective To study the mechanical properties and biological characteristics of 3D-printed porous β-tricalcium phosphate ［β-Ca3(PO4)2, β-TCP］ scaffolds, so as to provide guidance for the design of composite scaffolds in animal experimentation. Methods Poly 1,8-octanediol citrate (POC), a kind of novel biodegradable materials, was used as the adhesive. The 3D-printed porous β-TCP scaffolds were fabricated by fused deposition modeling (FDM) technology, and Gly-Arg-Gly-Asp-Ser (GRGDS), a kind of polypeptides, was added into the scaffolds to improve the adhesive property of cells. The optical microscope and scanning electron microscope (SEM) were used to observe the micro-pore architectures of those scaffolds. The material testing machine was used to conduct compressive test on the scaffolds, and the water contact angles of the scaffolds were measured. The cell adhesion rate and proliferation rate of the scaffolds were also tested by in vitro cell experiment. The model of SD rat skull defects was repaired by the scaffolds, and the osteogenic ability in vivo was further studied. Results The GRGDS, remaining active, was evenly distributed in the composite scaffolds. The micro-pore architectures of the polypeptide modified scaffolds changed, with improvement in cell adhesion rate, while the compressive modulus, water contact angle and osteogenic ability in vivo of the scaffolds were not obviously affected. Conclusions The cell adhesion capacity of β-TCP composite scaffolds modified by polypeptide improved significantly, while the mechanical properties and hydrophilicity, osteogenic ability in vivo of the scaffolds were not affected very much. These research results provide new ideas for reconstruction of scaffolds for repairing bone defects in clinic, and a laboratory basis for further clinical application of this scaffold.

Risk factors for cervical cancer in rural areas of Wuhan China: a matched case-control study.

Cervical cancer is a serious public health problem in developing countries. We investigated possible risk factors for cervical cancer in rural areas of Wuhan China using a matched case-control study with 33 women diagnosed with cervical cancer and 132 healthy women selected from the same area as matched controls. A questionnaire, which included questions about general demography conditions, environmental and genetic factors, the first sexual intercourse, first marriage age, age at first pregnancy, pregnancy first child's age, female personal health history, social psychological factors, dietary habits, smoking and alcohol status and other living habits was presented to all participants. At the same time, HPV infection of every participant was examined in laboratory testing. Results showed HPV infection (P<0.000, OR=23.4) and pregnancy first child's age (P<0.000, OR=13.1) to be risk factors for cervical cancer. Menopause (P=0.003, OR=0.073) was a protective factor against cervical cancer. However, there was no indication of associations of environmental (drinking water, insecticide, disinfectant) genetic (cancer family history), or life-style factors (smoking status, alcohol status, physical training, sleep quality), including dietary habits (intake of fruit and vegetable, meat, fried food, bean products and pickled food) or social psychological factors with cervical cancer. The results suggest that the risk of cervical cancer in Chinese rural women may be associated with HPV infection, menopause and the pregnancy first child's age.