[Clinical application of split liver transplantation: a single center report of 203 cases].

Objective: To investigate the safety and therapeutic effect of split liver transplantation (SLT) in clinical application. Methods: This is a retrospective case-series study. The clinical data of 203 consecutive SLT, 79 living donor liver transplantation (LDLT) and 1 298 whole liver transplantation (WLT) performed at the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to July 2023 were retrospectively analyzed. Two hundred and three SLT liver grafts were obtained from 109 donors. One hundred and twenty-seven grafts were generated by in vitro splitting and 76 grafts were generated by in vivo splitting. There were 90 adult recipients and 113 pediatric recipients. According to time, SLT patients were divided into two groups: the early SLT group (40 cases, from July 2014 to December 2017) and the mature SLT technology group (163 cases, from January 2018 to July 2023). The survival of each group was analyzed and the main factors affecting the survival rate of SLT were analyzed. The Kaplan-Meier method and Log-rank test were used for survival analysis. Results: The cumulative survival rates at 1-, 3-, and 5-year were 74.58%, 71.47%, and 71.47% in the early SLT group, and 88.03%, 87.23%, and 87.23% in the mature SLT group, respectively. Survival rates in the mature SLT group were significantly higher than those in the early SLT group (χ2=5.560,P=0.018). The cumulative survival rates at 1-, 3- and 5-year were 93.41%, 93.41%, 89.95% in the LDLT group and 87.38%, 81.98%, 77.04% in the WLT group, respectively. There was no significant difference among the mature SLT group, the LDLT group and the WLT group (χ2=4.016, P=0.134). Abdominal hemorrhage, infection, primary liver graft nonfunction,and portal vein thrombosis were the main causes of early postoperative death. Conclusion: SLT can achieve results comparable to those of WLT and LDLT in mature technology liver transplant centers, but it needs to go through a certain time learning curve.

Effects of a high-fat diet on the growth performance, lipid metabolism, and the fatty acids composition of liver and skin fat in Pekin ducks aged from 10 to 40 days.

This study aimed to investigate the effect of a high-fat diet on the growth performance, serum, liver, and skin lipid metabolism as well as the fatty acids composition of liver and skin fat in Pekin ducks from 10 to 40 d of age based on a pair-fed group. Two hundred forty healthy male ducks (10 d old, 470.53 ± 0.57 g) were randomly divided into 3 groups (8 replicates per cage of 10 ducks): a normal diet (ND, 3% fat), a high-fat diet (HFD, 9% fat), and a pair-fed diet (PFD, given the ND in an amount equal to that consumed of the HFD to eliminate the effects of feed intake). The results were as follows: compared to ND feeding, HFD feeding significantly decreased (P < 0.05) the feed intake and feed:gain ratio (F:G), along with serum triglyceride and nonesterified fatty acid contents. When compared with the ND and PFD, the HFD significantly decreased (P < 0.05) the liver weight and inhibited hepatic de novo lipogenesis (glucose-6-phosphate dehydrogenase and malate dehydrogenase activities), ß-oxidation (carnitine palmitoyltransferase-1 content), and decreased saturated fatty acids and monounsaturated fatty acids deposition. Moreover, the HFD significantly increased (P < 0.05) the total fat content, lipid droplet area, and polyunsaturated fatty acids (PUFAs) content in the liver, as well as the abdominal fat weight, subcutaneous fat weight, the total fat and PUFAs content in skin fat. These results suggested that the HFD improved feed efficiency, which was related to HFD feeding inhibiting hepatic de novo lipogenesis and ß-oxidation and promoting the deposition of fat in skin as well as altering the fatty acids composition of the liver and skin fat in Pekin ducks.

A 2-bp deletion in intron 1 of TMEM182 is associated with TMEM182 mRNA expression and chicken body weight.

1. Searching for molecular markers related to growth and carcase traits plays a critical role in improvement of the production performance of broilers. Previous studies found that transmembrane protein 182 (TMEM182) inhibits skeletal muscle development, growth, and regeneration, implying that the TMEM182 gene plays an important role during the development process of skeletal muscle.2. A novel 2-bp indel in intron 1 of TMEM182 was detected in a yellow chicken population derived from the cross of White Recessive Rock chickens with Xinghua chickens, and three genotypes II (inserted homozygote), ID (inserted and deleted heterozygote) and DD (deleted homozygote) were observed. Association analyses indicated that the indel was significantly associated with the body weight, muscle fibre area, breast muscle weight and wing weight in the F2 population.3. The expression of TMEM182 in leg muscle of chickens with II genotype was higher than that with DD genotype, with the 2-bp indel located in one of the putative PAX4 binding sites. Further research through luciferase assays revealed that the PAX4 could bind to the putative binding site and increase the TMEM182 transcription, with the 2-bp deletion disrupting the binding of PAX4.4. The present study provides evidence for the association of the novel 2-bp indel in intron 1 of TMEM182 with the growth and carcase traits of chickens. This 2-bp indel could be used as a genetic marker in broiler breeding.

[Clinical efficacy of split liver transplantation in the treatment of children with biliary atresia].

Objective: To compare the clinical efficacy of split liver transplantation (SLT) and living donor liver transplantation(LDLT) in the treatment of children with biliary atresia. Methods: The clinical data of 64 children with biliary atresia who underwent SLT and 44 children who underwent LDLT from June 2017 to May 2022 at Liver Surgery & Liver Transplantation Center,the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. Among the children who received SLT, there were 40 males and 24 females. The median age at transplantation was 8 months (range:4 to 168 months). Among the patients who received LDLT, there were 24 males and 20 females. The age at transplantation ranged from 4 to 24 months,with a median age of 7 months. Sixty-four children with biliary atresia were divided into two groups according to the SLT operation time: 32 cases in the early SLT group(June 2017 to January 2019) and 32 cases in the technically mature SLT group (February 2019 to May 2022). Rank sum test or t test was used to compare the recovery of liver function between the LDLT group and the SLT group,and between the early SLT group and the technically mature SLT group. The incidence of postoperative complications was compared by χ2 test or Fisher exact probability method. Kaplan-Meier method and Log-rank test were used for survival analysis. Results: The cold ischemia time(M (IQR)) (218 (65) minutes), intraoperative blood loss(175 (100) ml) and graft-to-recipient body weight ratio (3.0±0.7) in the LDLT group were lower than those in the SLT group(500 (130) minutes, 200 (250) ml, 3.4±0.8) (Z=-8.064,Z=-2.969, t=-2.048, all P<0.05). The cold ischemia time(457(158)minutes) and total hospital stay ((37.4±22.4)days) in the technically mature SLT group were lower than those in the early SLT group(510(60)minutes, (53.0±39.0)days).The differences were statistically significant (Z=-2.132, t=1.934, both P<0.05).The liver function indexes of LDLT group and SLT group showed unimodal changes within 1 week after operation. The peak values of ALT, AST, prothrombin time, activeated partial thromboplasting time, international normalized ratio, fibrinogen and creatinine all appeared at 1 day after operation, and the peak value of prothrombin activity appeared at 3 days after operation. All indicators returned to normal at 7 days after operation. The 1-,2-,and 3-year overall survival rates were 95.5% in LDLT group and 93.5% in the technically mature SLT group, and the difference was not statistically significant. The 1-,2-,and 3-year overall survival rates were 90.2% in the early SLT group and 93.5% in the technically mature SLT group, and there was no significant difference between the two groups(P>0.05). The main complications of the early SLT group were surgery-related complications(28.1%,9/32), and the main complications of the technically mature SLT group were non-surgery-related complications(21.9%,7/32). There were 5 deaths in the SLT group,including 4 in the early SLT group and 1 in the technically mature SLT group. Conclusion: The survival rate of SLT in the treatment of biliary atresia is comparable to that of LDLT.

[The expression level of secretory mature B cell surface antigen in primary diagnosed multiple myeloma and its clinical significance].

Objective: To explorer Secretory mature B cell surface antigen (sBCMA) expression level, changes during treatment and clinical significance in newly diagnosed MM patients. Methods: Clinical data of 158 MM patients admitted to the Department of Hematology, the First Affiliated Hospital of Soochow University from August 2018 to September 2020 were analyzed retrospectively. The concentration of sBCMA in the patients was determined by BCMA ELISA and compared with the normal range. The results were compared with clinical efficacy, age, type, R-ISS stage, renal impairment, and humoral immune function. Results: The median age of the patients was 57 (31-73 years old), 86 (54.5%) males and 72 (45.5%) females, mainly IgG type, 81 patients(51.2%). SBCMA value M(Q1,Q3) was 76.50 (55.50, 94.40) µg/L, 100% higher than the upper limit of normal value. According to the efficacy evaluation, the patients were divided into complete remission(CR) group, very good partial remission(VGPR) group, partial remission(PR) group and ineffiecacy group, the results showed the level of sBCMA in CR group[80.10 (58.05, 96.90) vs 15.70 (9.85, 28.65) µg/L] and VGPR group[74.60 (52.20, 93.00) vs 17.20 (13.30, 38.80) µg/L]was significantly higher than that before treatment(all P<0.001), and there was no significant difference in PR group and ineffective group before and after treatment (all P>0.05).The amount of serum intact protein M protein was positively correlated with the level of sBCMA expression in newly diagnosed patients (r=0.22, P=0.040), and there was no correlation between the proportion of bone marrow plasma cells and sBCMA expression (r=0.07, P=0.449).The correlation between sBCMA levels at initial diagnosis and MM type[IgG type, IgA type vs light chain type:(78.6±3.5), (72.4±5.4) vs (83.8±6.9)µg/L], age[≥65 vs<65 years: (73.6±5.5)vs (79.3±3.1)µg/L], R-ISS stage[stage Ⅰ, Ⅱ vs Ⅲ:(80.2±3.1) vs (69.4±6.1)µg/L], renal impairment [Creatinine clearance rate (Ccr) ≤30 vs>30 ml/min:(81.6±4.8) vs (76.5±3.4)µg/L], and high-risk karyotype[high-risk vs standard-risk:(73.6±5.7) vs (80.2±3.2)µg/L] were not associated (all P>0.05). Expression levels of sBCMA were negatively correlated with IgM levels in MM patients (r=-0.39, P=0.002) and after treatment (r=-0.25, P=0.015). Conclusions: The expression of sBCMA in MM patients is a reliable indicator of the clinical efficacy of MM and is related to the occurrence of MM immune deficiency and recovery after treatment. sBCMA can be used as a new independent marker for monitoring and predicting the efficacy of MM patients.

[The short-term and long-term prognostic analysis in patients with chronic total occlusion acute non-ST segment elevation myocardial infarction].

Objectives: To investigate the clinical impacts of chronic total occlusion (CTO) in acute non-ST segment elevation myocardial infarction (NSTEMI) patients underwent primary percutaneous coronary intervention (PCI). Methods: A total of 2 271 acute NSTEMI patients underwent primary PCI from China Acute Myocardial Infarction Registry were enrolled in this study and divided into the CTO group and the non-CTO group according to the angiography. The primary endpoint was in-hospital mortality and mortality during a 2-year follow-up. The secondary endpoint was major adverse cardiovascular events (MACE) including revascularization, death, re-myocardial infarction, heart failure readmission, stroke and major bleeding. Results: Thirteen-point four percent of the total acute NSTEMI patients had concurrent CTO. In-hospital mortality (3.6% vs. 1.4%, P<0.01) and 2-year mortality (9.0% vs. 5.1%, P<0.01) were significantly higher in the CTO group than those in the non-CTO group, respectively. Multiple regression analyses showed that chronic obstructive pulmonary disease (HR 7.28, 95%CI 1.50-35.35, P=0.01) was an independent risk factor of in-hospital mortality, and advanced age (HR 1.04, 95%CI 1.01-1.07, P<0.01), and low levels of ejection fraction (HR 0.95, 95%CI 0.93-0.98, P<0.01) were independent risk factors of 2-year mortality. CTO (HR1.67, 95%CI 1.10-2.54, P=0.02) was an independent risk factor of revascularization, but not a risk factor of mortality. Conclusions: Although acute NSTEMI patients concurrent with CTO had higher mortality, CTO was only an independent risk factor of revascularization, but not of mortality. Advanced age and low levels of ejection fraction were independent risk factors of long-term death among acute NSTEMI patients.

Development of a wide-range soft sensor for predicting wastewater BOD5 using an eXtreme gradient boosting (XGBoost) machine.

In wastewater monitoring, detecting extremely high pollutant concentrations is necessary to properly calibrate the treatment process. However, existing hardware sensors have a limited linear range which may fail to measure extremely high levels of pollutants; and likewise, the conventional "soft" model sensors are not suitable for the highly-skewed data distributions either. This study developed a new soft sensor by using eXtreme Gradient Boosting (XGBoost) machine learning to 'measure' the wastewater organics (in terms of 5-day biochemical oxygen demand (BOD5)). The soft sensor was tested on influent and effluent BOD5 of two different wastewater treatment plants to validate the results. The model results showed that XGBoost can detect these extreme values better than conventional soft sensors. This new soft sensor can function using a sparse input matrix via XGBoost's sparsity awareness algorithm - which can address the limitation of the conventional soft sensor with the fallibility of supporting hardware sensors even.

Intravitreal conbercept as an adjuvant in vitrectomy for proliferative diabetic retinopathy: a meta-analysis of randomised controlled trials.

PURPOSE: To evaluate the efficacy of intravitreal conbercept (IVC) in pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR). METHODS: A meta-analysis of randomized control trials (RCTs) using online databases was performed. The intraoperative outcome measures were the incidence of intraoperative bleeding and endodiathermy application, and the mean surgical time. The postoperative outcome measures were mean change in best-corrected visual acuity (BCVA) from baseline, postoperative vitreous clear-up time and incidence of recurrent vitreous hemorrhage (VH). RESULTS: Eight RCTs were selected for meta-analysis. They included 409 eyes (215 eyes in IVC group and 194 eyes in no conbercept group). Preoperative IVC application was associated with less intraoperative bleeding and endodiathermy applications (RR = 0.34, 95% CI, 0.23-0.50, P < 0.00001, and RR = 0.26, 95% CI, 0.12-0.56, P = 0.0005) compared to no conbercept. It also shortened surgical time (WMD = -15.87, 95% CI, -22.04 to -9.69, P < 0.00001). In addition, preoperative or intraoperative IVC achieved better BCVA outcome (WMD = -0.37, 95% CI, -0.62 to -0.13, P = 0.003), shorter vitreous clear-up time postoperatively (WMD = -5.44, 95% CI, -6.31 to -4.57, P < 0.00001) and a lower rate of VH recurrence (RR = 0.45, 95% CI, 0.22-0.91, P = 0.03). CONCLUSION: IVC is an effective adjuvant in PPV for PDR, with better intraoperative and postoperative outcomes.

Model-based analysis of sulfur-based denitrification in a moving bed biofilm reactor.

In this study, a biofilm model was developed for sulfur-based denitrification in a moving bed biofilm reactor (MBBR), including mass transport as well as the conversion kinetics of sulfur-oxidizing bacteria (SOB). The experimental reactor simulated received a synthetic wastewater containing nitrate, sulfide and thiosulfate. The substrate affinity of SOB for intermediary elemental sulfur (S0) was found the most sensitive parameter. After estimating this single parameter, the model could adequately describe the steady state performance of the experimental MBBR. The experimental and simulated mass balances indicated that a fraction of influent sulfur accumulated into intermediate S0. Furthermore, the simulations showed that SOB were active over the entire thickness of a 200 µm biofilm. The simulation results allowed to quantify the extent of diffusion and substrate limitation. Scenario analyses indicated that the specific nitrogen loading rate could be increased from 0.05 to 0.20 kg N.kg-1 VSS.day-1 (corresponding to 0.22-0.86 kg N.m-2.day-1 expressed per biofilm surface area) while maintaining nitrogen removal efficiencies above 70%. An increasing specific nitrogen loading rate in this range resulted in an almost linearly increasing specific nitrogen removal rate, independent from whether it was realized through a decreasing HRT, carrier filling ratio or biofilm thickness.

[A comparison of C+SCAV and SEAM conditioning regimens in efficacy and safety in autologous hematopoietic stem cell transplantation for non-Hodgkin's lymphoma patients].

Objective: This study aimed to compare the efficacy and safety of cladribine, smustine, etoposide, cyclophosphamide, and cytarabine (C+SCAV) and smustine, etoposide, cytarabine, and melphalan (SEAM) conditioning regimens in autologous stem cell transplantation (auto-HSCT) for non-Hodgkin's lymphoma (NHL) . Methods: A retrospective analysis was conducted on 61 NHL patients who received auto-HSCT in the Department of Hematology, the First Affiliated Hospital of Suzhou University, from March 2018 to May 2021. The C + SCAV group and SEAM group had 19 and 42 patients, respectively. Results: ① Among the 61 patients with NHL, 37 were male and 24 were female. The median age was 48 (21-66) years old. There were 19 cases in the C+SCAV group and 42 cases in the SEAM group. There was no significant difference in the baseline characteristics between the two groups (P>0.05) . ② The median time to neutrophil and platelet engraftment in the C+SCAV cohort were 10 (8-15) days and 13 (9-22) days, respectively, which does not differ from the SEAM group (P=0.103, P=0.403) . ③ No differences existed between the two groups in terms of survival. The 1-year progression-free survival (PFS) was (76.5±10.3) % for patients receiving C+SCAV and (78.4±6.8) % for those who received SEAM (P=0.841) . The 1-year overall survival was 100.0% for the C+SCAV group and 95.2±3.3% for the SEAM group (P=0.339) . ④The 1-year PFS of patients with complete remission in the C+SCAV group was similar to those who in the SEAM group [ (92.3±7.4) % vs (82.5±7.2) %, P=0.406]. ⑤ The incidence of non-hematological serious adverse events (≥ grade 3) in the C+SCAV group and SEAM group were 10.5% (2/19) and 40.5% (17/42) (P=0.013) , the incidence of severe mucositis was 5.3% (1/19) and 31.0% (13/42) (P=0.015) , and the incidence of severe infection (≥ grade 3) was 10.5% (2/19) and 19.0% (8/42) (P=0.389) , respectively. Conclusion: C + SCAV conditioning regimen appeared to be no different from the SEAM regimen in terms of survival. It can lower the incidence of SAE and does not increase the risk of severe infection. As a result, it can be used as an alternative conditioning regimen for lymphoma patients undergoing auto-HSCT.

[Analysis on human papillomavirus infection in 2 110 patients with cervical cancer in Henan province].

Objective: To explore human papillomavirus (HPV) infection status in 2 110 patients with cervical cancer in Henan province and analyze the main infection subtypes. Methods: A total of 2 110 patients with cervical cancer were detected for HPV subtypes by flow-through hybridization after PCR. The results were analyzed. Results: Among 2 110 patients with cervical cancer, 1 856 were detected to be HPV positive and the infection rate was 87.96%(95%CI: 86.57%-89.35%). The top six genotypes were HPV16, 58, 18, 52, 35 and 33. Single infection was the main type of infection in HPV positive cervical cancer patients (77.48%), and double infection was the second type infection(16.76%). The infection rate of HPV16 was 60.19%, occupying a predominant position in single or multiple infections. Among HPV positive cervical cancer patients, 1 599 cases were detected to be infected with high-risk subtypes and covered by nine-valence HPV vaccine, and the coverage rate reached 86.15% (1 599/1 856). Cervical cancer patients were mainly distributed in age group 40- years. The main HPV subtypes of cervical cancer patients were different among different age groups, but HPV16 subtype was in a predominant position in any age group. Conclusions: The main subtypes of HPV infection were HPV16, 58, 18, 52, 35 and 33 in cervical cancer patients in this study. The main infection type was single infection. There were more cervical cancer patients in age group 40- years.

Effect of active immunization with recombinant-derived goose INH-α, AMH, and PRL fusion protein on broodiness onset and egg production in geese (Anser cygnoides).

This study was conducted to investigate the potential effects of active immunization against recombinant-derived goose inhibin-α (INH-α), anti-Müllerian hormone (AMH), and prolactin (PRL) fusion protein on broodiness onset and egg production in geese. The purified fusion proteins (INH-α, AMH, and PRL) were prepared using a prokaryotic expression system. Female Zhedong geese (10 mo old) were randomly assigned to one of 4 treatments and raised in separate pens. The geese were actively immunized with the recombinant goose INH-α, AMH, or PRL, respectively, and phosphate-buffered saline as control. The results showed the corresponding antibodies were produced when the geese were immune INH-α, AMH-, and PRL-recombinant proteins. The significantly higher luteinizing hormone contents were observed in the INH-α, AMH, and PRL recombinant protein-immunized geese, while the lower AMH hormone content only in PRL-immunized birds. AMH recombinant protein immunized geese had more large yellow follicles of ovary, while the INHα-treated birds with more other follicles compared with control geese. In addition, the geese receiving INH-α recombinant protein, the broodiness onset was about 6 d, which significantly shorter than did PBS immunization (16 d). The INHα- and PRL-immunization also resulted in 12.5 and 8.5 d shorter broody duration intervals compared to the control birds. Moreover, the lower new broodiness rate was observed in three recombinant proteins treated birds. Finally, the PRL recombinant protein-immunization resulted in an average increase of 1.34 eggs during a 40-d observation. Collectively, the data demonstrated that active immunization against recombinant proteins INH-α or AMH could promote LH hormone secretion, regulate follicle development and decrease the broodiness rate. Also, active immunization with a recombinant-derived goose PRL protein might improve egg laying performance.

[Correlations of diurnal brain functional variations with serum biomarkers and objective sleep quality in patients with chronic insomnia disorder].

Objectives: To investigate the correlations of diurnal brain functional variations with serum biomarkers and objective sleep quality in patients with chronic insomnia disorder (CID). Methods: A total of 60 CID patients and 30 healthy sleep volunteers who visited Department of Sleep Disorders of Chaohu Hospital affiliated to Anhui Medical University from March 2018 to June 2019 were collected. Diurnal brain function state was evaluated by Quantitative Measurement System of Brain Functional Status, and serum concentrations of corticotropin-releasing hormone (CRH) and glial fibrous acidic protein (GFAP) were detected using enzyme-linked immunosorbent assay (ELISA). The sleep quality in the CID group was evaluated using ploysomnography (PSG) at the same time. The brain function status indicators with significant changes in CID group were acquired, and the consistency of these indicators with serum biological markers and objective sleep quality was analyzed. Results: There were 23 males and 37 females in chronic in somnia patients; 15 males and 15 females in the healthy control group. Compared with the healthy controls, four brain function indicators of CID patients increased (brain inertia (196.0(163.0, 258.0)vs 168.5(148.8,182.5)), brain chaos (5.0(1.0, 10.0)vs 0(0,2.0)), internal concentration (31.0(13.0, 45.0)vs 2.0(0,27.5)) and endogenous anxiety (12.0(4.0, 18.0)vs 0(0,6.5)), but one indicator decreased (brain inhibitory value (47.0(32.0, 58.0)vs 59.0(46.3,66.3))) (all P<0.05).The brain chaos value positively correlated with the serum GFAP level (r=0.374,P=0.006), and the brain inertia value positively correlated with the serum CRH level (r=0.299,P=0.031). The value of brain inhibition positively correlated with the sleep latency (r=0.284,P=0.042). However, the values of internal concentration negatively correlated with the sleep efficiency (r=-0.276,P=0.048) and the time in non-rapid eye movement sleep stage 1 (r=-0.341, P=0.024). Conclusion: The brain waves of CID patients show significant changes in their brain function indicators, which are related to serum biological markers and objective sleep quality.

[Clinical experience of laparoscopic pancreatoduodenectomy via orthotopic resection].

Objective: To examine the surgical approach, practical cognition as well as clinical effect of the orthotopic resection for laparoscopic pancreatoduodenectomy(OLPD). Methods: From March 2019 to December 2019, 32 cases were treated with laparoscopic pancreatoduodenectomy (LPD) in a novel approach without mobilization of pancreatoduodenum in Pancreas Center of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine.There were 16 male patients and 16 female patients.The mean age was (64.8±9.5) years old.Body mass index was 14.9 to 31.0 kg/m(2).All patients were diagnosed as ampullary or pancreatic head tumors and were not unresectable cases.In the surgical strategy, Kocher's dissociation, turning and pulling of the pancreaticoduodenal region, was not performed first.Anatomy in situ, separation of vessels which enter and exit from pancreas, separation of lymphatics and isolation of tumors were carried out in priority through the combined middle and left posterior approaches.Finally, the pancreatic head and duodenum region was mobilized and the entire resection of pancreas in situ was carried out.Digestive tract reconstruction was performed through Child method. Results: Postoperative pathology showed that 27 cases were pancreatic or ampullary malignant tumors and five cases were benign tumors among 32 patients.The operative time was (357.3±64.3) minutes.The diameter of pancreatic ducts was (3.0±1.0) mm. The pancreas of 20 cases (62.5%) were soft. Five patients suffered from pancreatic fistula (Grade B) and one patient suffered from intra-abdominal hemorrhage postoperatively.No other complications like pancreatic fistula (Grade C) or biliary fistula delayed gastric emptying or mortality were encountered.The postoperative hospital day was (13.7±3.6) days. Conclusions: Combining the multi-angle of the laparoscopic approaches and excising the pancreaticoduodenal specimen in situ, OLPD is a kind of surgical method which can realize the concept of no touch tumor surgery.Patients who undergo the OLPD can receive better treatments and results.

[Cardiopulmonary coupling analysis in diagnosis of sleep disorders].

Objectives: To compare diagnostic consistency for chronic insomnia (CI) and obstructive sleep apnea (OSA) between cardiopulmonary coupling (CPC) and polysomnographm (PSG). Methods: Two hundred and twenty-one patients were enrolled from the Department of Sleep Disorders, Chaohu Hospital affiliated to Anhui Medical University from July 2018 to December 2019, and monitored with overnight CPC and PSG simultaneously. According to clinical representations and PSG results, there were 88 males and 80 females with CI and OSA, including chronic insomnia (CI group, 93 cases), OSA (OSA group, 36 cases) and comorbid OSA with CI (COI group, 39 cases). The consistency of sleep and OSA parameters measured with CPC and PSG were analyzed. Results: (1)For all patients and CI group, the total sleep time (TST), sleep efficiency (SE) and rapid eye movement (REM) sleep time measured by CPC were significantly higher than those measured with PSG, and the wake time after sleep onset (WASO) was significantly lower than that measured with PSG (the specific median comparisons were as follows 420.0 min vs 395.5 min, 93.7% vs 81.8%, 90.0 min vs 37.5 min, 18.0 min vs 63.0 min in CI group, respectively; 414.0 min vs 392.5 min, 91.9% vs 81.9%, 72.0 min vs 34.8 min, 24.0 min vs 58.4 min in all patients, respectively (all P≤0.001). However, in the OSA patients, the TST, SE, WASO, REM sleep time and NREM sleep time measured using two methods were similar (all P>0.05). (2) According to OSA criteria, the consistency between CPC and PSG was fair (κ=0.255). Only CPC has a certain degree of value for OSA screening when the AHI ≥ 20/h (κ=0.580, sensitivity: 0.85, specificity: 0.82, positive predictive value: 0.59, negative predictive value: 0.95, positive likelihood ratio: 4.72). Conclusion: CPC technology may overestimate the sleep quality of CI patients, and its consistency is fair compared with that of PSG in the diagnosis of OSA.

Comparative transcriptome analysis reveals genes related to the yolk ratio of duck eggs.

Yolk ratio is an important production index in the salted duck egg industry. Yolk constituents are deposited during development of follicles. However, the molecular mechanism responsible for different yolk ratios in laying ducks remains elusive. In this study, Shaoxing ducks laying eggs with different yolk ratios were chosen for an analysis of liver and ovary transcriptome information. Twelve libraries were constructed and generated an average of 58.5 million clean reads per library, of which 69% of clean reads from liver and 65% of clean reads from ovary were mapped to a reference genome. Between cross-phenotype groups, a total of 250 and 230 differently expressed genes (DEGs) were identified in liver and ovary respectively, of which 101 and 50 DEGs respectively were characterized. Several DEGs were detected, among which HMGCS1, HMGCR, FDFT1, (DHCR7), (STARD4), CYP46A1 and LPIN3 are involved in cholesterol metabolism-related pathways; KIAA0319, STARD4, AP1S3, SH3GL2 and CAV2 are involved in vesicular transport in the liver; and ELOVL2 and PSD2 are involved in fatty acid elongation and endocytosis in the ovary. High yolk-ratio ducks had higher activity for cholesterol synthesis and molecular trafficking. The identification of candidate genes greatly advances the understanding of the genetic basis of the formation of different yolk ratios.

Comparison of the broody behavior characteristics of different breeds of geese.

A low laying performance in goose is one of the key factors preventing the industrial development, and the laying performance is related to broody behavior. However, the characteristics of broody behavior in geese remain unclear. In this study, the total 144 geese (300 day old), including Zhedong geese (Anser cygnoides), Sichuan geese (Anser cygnoides), and Carlos geese (Anser anser) were selected and assigned to 1 of 3 groups/breed (including 4♂+12♀). Laying and broody behaviors were recorded using the infrared video cameras from 2016 November 11 to 2017 June 15. The broody behavior was detected in 19.4% of Carlos geese, 33.3% of Sichuan geese, and 100% of Zhedong geese. Different goose breeds showed similar behavior characteristics. The low frequency of feeding, drinking, and low body weight were observed in the middle of broodiness. As the brooding progressed, the body temperature showed a downward trend and then recovered, whereas no difference was observed in Carlos goose. In addition, the plasma hormone concentration from different breeds and stages of broodiness were compared. The contents of FSH (follicle-stimulating hormone) and LH (luteinizing hormone) in geese were greater in the laying stage than that in the broody stage. Fewer FSH and LH were detected in Zhedong geese and Carlos geese, more in Sichuan geese. In broody goose, the PRL (prolactin) concentrations of the 3 goose breeds peaked in the middle of broodiness, and greater PRL was detected in Sichuan geese than those in Carlos geese and Zhedong geese. Finally, we compared egg production between the broody and non-broody geese in the observation period. The egg production of broody Carlos geese was 27, which was significantly higher than non-broody geese (14 eggs), while in Sichuan geese there was no significant difference between broody (24 eggs) and non-broody geese (26 eggs). Finally, the higher egg production was found with the more broody times in Zhedong geese. Taken together, although the different goose breeds showed similar broody behavior characteristics, the broody rate and hormone secretion were dissimilar, and the Zhedong geese exhibited strong broody feature.

Histological characteristics of follicles and reproductive hormone secretion during ovarian follicle development in laying geese.

Egg production in different goose breeds vary significantly, which is related with the physiology of reproduction. However, the knowledge of physiology of goose reproduction is not well documented. In the present study, the 3 breeds with significantly different egg production were selected to investigate the histological characteristics of follicles and reproductive hormone secretion during follicle development, which included Carlos geese (Anser anser), Zhejiang geese (Anser cygnoides), and Yangzhou geese (Anser cygnoides). The results indicated that there were significant differences in the morphology of ovary and follicles among different goose breeds. The mode of hierarchical follicles in Yangzhou geese was 5, and those were 3 and 4 in Zhejiang and Carlos geese, respectively. The numbers of prehierarchical follicles were 61 to 70, 69 to 75, and 28 to 39 in Yangzhou geese, Zhejiang geese, and Carlos geese, respectively. The thickness of granulosa layer of follicles was higher in the large yellow follicle than those in the other prehierarchical and hierarchical follicles, and Yangzhou geese were the highest among the 3 breeds. The concentration of follicle stimulating hormone (FSH) ranged from 12.17 to 28.06 U/L, and 17ß-Estradiol ranged from 27.01 to 49.39 pmol/L by the enzyme-linked immuno sorbent assay. The level of FSH of Yangzhou geese reached to the highest in the hierarchical follicle (F1), while the other 2 geese did not show the similar feature. In addition, the level of luteinizing hormone (LH) and progesterone (PROG) in the prehierarchical follicles of Yangzhou geese was higher than those in Carlos and Zhejiang geese. In summary, the difference of histological characteristics of follicles and reproductive hormone in different goose breeds was not only reflected in the number of follicles and the thickness of the granulose cell layer, but also embodied the secretion LH and PROG. The more thickness of the granulose cell layer and high secretions of LH and PROG contributed to the development of prehierarchical follicles to hierarchical follicles, which may be due to the fact that Yangzhou geese (Anser cygnoides) has more egg production.