Identification of hub genes significantly linked to tuberous sclerosis related-epilepsy and lipid metabolism via bioinformatics analysis.

Background: Tuberous sclerosis complex (TSC) is one of the most common genetic causes of epilepsy. Identifying differentially expressed lipid metabolism related genes (DELMRGs) is crucial for guiding treatment decisions. Methods: We acquired tuberous sclerosis related epilepsy (TSE) datasets, GSE16969 and GSE62019. Differential expression analysis identified 1,421 differentially expressed genes (DEGs). Intersecting these with lipid metabolism related genes (LMRGs) yielded 103 DELMRGs. DELMRGs underwent enrichment analyses, biomarker selection, disease classification modeling, immune infiltration analysis, weighted gene co-expression network analysis (WGCNA) and AUCell analysis. Results: In TSE datasets, 103 DELMRGs were identified. Four diagnostic biomarkers (ALOX12B, CBS, CPT1C, and DAGLB) showed high accuracy for epilepsy diagnosis, with an AUC value of 0.9592. Significant differences (p < 0.05) in Plasma cells, T cells regulatory (Tregs), and Macrophages M2 were observed between diagnostic groups. Microglia cells were highly correlated with lipid metabolism functions. Conclusions: Our research unveiled potential DELMRGs (ALOX12B, CBS, CPT1C and DAGLB) in TSE, which may provide new ideas for studying the psathogenesis of epilepsy.

Functional Study of SAMD9L in Familial Gastric Cancer.

BACKGROUND: Familial aggregation occurs in approximately 10% of cases of gastric cancer. The genetic predisposition or cause of the disease in only about 40% of hereditary gastric cancer cases is known, while the genetic factors of the remaining cases remain to be studied. METHODS: Samples were collected from a family with gastric cancer, including 3 gastric cancer and 17 healthy samples. Whole-exome sequencing was performed on samples from 3 patients with gastric cancer and 1 sample from healthy peripheral blood. SAMD9L was knocked down using small interfering RNAs and short hairpin RNA. The expression of SAMD9L was detected by quantitative real-time polymerase chain reaction and Western blot in SGC-7901 cells. CCK-8 assay was used to detect the proliferation of gastric cancer cells. The migration and invasion of gastric cancer cells were detected by Transwell assay and scratch assay. The cell apoptosis was detected by flow cytometry. RESULTS: Twelve single-nucleotide variants and 9 insertions/deletions mutation sites were identified as candidate genes. Among them, SAMD9L regulates cell proliferation as a tumor suppressor gene. The experiments of knocking down SAMD9L in SGC-7901 cells revealed that reduced expression of SAMD9L significantly enhanced the proliferation, migration, and invasion of SGC-7901 cells. CONCLUSIONS: These results suggest that SAMD9L inhibits the proliferation of gastric cancer cells, thereby increasing the risk of gastric cancer in people with SAMD9L downregulation. Therefore, SAMD9L may represent a susceptibility gene of this gastric cancer family.

Rab25 gene down-regulates snail expression and inhibits epithelial mesenchymal transformation of human breast cancer MDA-MB-231 cells / 中华内分泌外科杂志

Objective:To probe into Rab25 Gene’s Effect on TGF-β inhibition of proliferation, invasion and epithelial mesenchymal transformation (EMT) of breast cancer MDA-MB-231 cells and explore its molecular mechanism.Methods:The experiment was divided into three groups: control group,TGF-β Group and si-Rab25 group. TGF-β induced MDA-MB-231 cell model of EMT was built. CCK-8 assay was used to detect cell proliferation. Transwell assay was used to detect the ability of cell invasion and migration.Western blot was used to detect the changes of related proteins in each group.Results:After stimulating MDA-MB-231 cells with TGF-β, Rab25 gene was highly expressed. Compared with TGF-β group (57.48±%3.62%), the migration ability and invasion ability of cells in si-Rab25 group (33.49%±2.93%) decreased by 41.7%, with a significant difference ( P<0.05). Compared with TGF-β group (153.21%±4.17%), the proliferation ability of cells in si-Rab25 group (115.32%±5.69%) decreased by 24.73%, with a significant difference ( P<0.05). The expression of MDA-MB-231 fine EMT related protein in si-Rab25 group was significantly different from that in TGF-β group ( P<0.05). The expression of p-AKT and Snail protein in si-Rab25 group was significantly lower than that in TGF-β group ( P<0.05) . Conclusions:Rab25 gene is highly expressed in MDA-MB-231 cells. Silencing Rab25 gene can activate AKT signal pathway, inhibit Snail protein expression, regulate EMT related protein expression, and inhibit EMT transformation.

Correlation between early T lymphocyte subsets and natural killer cell levels and intestinal injury and prognosis in patients with sepsis / 中华急诊医学杂志

Objective:To explore the correlation between the levels of peripheral blood T lymphocyte subsets (CD3 +, CD4 +, CD8 +) and natural killer cells (NK cells) in the early stage of sepsis and intestinal injury and prognosis of patients, so as to provide the basis of immunotherapy for clinical treatment of sepsis. Methods:A prospective case-control study was conducted. Sixty-one patients with sepsis admitted to Department of Critical Care Unit (ICU) of Ningxia Medical University from September 2018 to May 2019 were selected as subjects (sepsis group). Seventeen patients with common postoperative non-sepsis were used as controls (non-sepsis group). Venous blood samples were collected from all subjects within 24 h of ICU admission, and the levels of T lymphocyte subsets and NK cells were measured. At the same time, 35 sepsis patients without chronic gastrointestinal tract and chronic renal insufficiency were selected from the sepsis group, and their serum levels of intestinal fatty acid binding protein (I-FABP) and D-lactic acid were measured. Age, sex, and underlying disease were recorded for all subjects. The acute physiology and chronic health evaluationⅡ(APACHEⅡscore) within 24 h of ICU in the sepsis group were evaluated, and the patients were followed up for 28 days. T lymphocyte subsets and NK cells, I-FABP, D-lactic acid levels were compared between the sepsis group and non-sepsis group. T lymphocyte subsets and NK cell levels were compared between the survival and death groups. Spearman correlation method was used to analyze the correlation between serum I-FABP and D-lactic acid in the early stage of sepsis and levels of CD3 +, CD4 +, CD8 + and NK cells, and multivariate logistic regression analysis was used to assess the risk factors of death in sepsis patients. Results:Compared with the non-sepsis group, serum I-FABP and D-lactic acid levels were increased in the sepsis group [I-FABP (μg/L): 18.36 (14.75, 28.34) vs 16.17 (12.12, 18.40), D- Lactic acid (mg/L): 18.70 (10.10, 40.60) vs 8.85 (7.10, 15.76), all P < 0.05]. Peripheral blood CD3 +, CD4 +, NK cells in the sepsis group were decreased [CD3 +(%): 54.30 (37.48 , 61.65) vs 60.75 (48.88, 69.95), CD4 +(%): 24.60 (17.65, 32.15) vs 31.90 (24.95, 37.10), NK cells (%): 18.20 (11.95, 31.10) vs 24.70 (19.30, 32.65), P<0.05], but there was no significant difference in peripheral blood CD8 + levels between the two groups ( P>0.05). There were no significant differences in CD3 +, CD4 +, CD8 + and NK cell levels between the survival group and death group (all P>0.05).Correlation analysis of T lymphocyte subsets, NK cells and intestinal injury markers ( n=35) showed that I-FABP was negatively correlated with CD3 + and CD8 + ( r=-0.478 and r=-0.415, respectively, both P<0.05), but not correlated with CD4 + and NK cells (both P>0.05). D-lactic acid was negatively correlated with CD3 + and CD4 + ( r=-0.344 and r=-0.423, respectively, P<0.05), and positively correlated with NK cells ( r=0.393, P<0.05), but there was no correlation between D-lactic acid and CD8 + (both P>0.05). Multivariate logistic regression analysis showed that only the APACHEⅡ score was an independent risk factor for 28-day mortality in patients with sepsis ( OR=1.222, 95% CI:1.084-1.378, P<0.01), but the early CD3 +, CD4 +, CD8 +, NK cell levels were not associated with 28-day prognosis in patients with sepsis ( P>0.05). Conclusions:Immunosuppression can occur in the early stage of sepsis, which is related to intestinal damage, but is not associated with patient prognosis.

Clinical efficacy and safety analysis of retrograde intrarenal stone surgery for treatment of upper urinary calculi / 中华泌尿外科杂志

Objective To evaluate efficacy and safety of retrograde intrarenal stone surgery for treatment of upper urinary calculi.Methods The clinical data of 640 patients with upper urinary tract calculi treated by retrograde intrarenal stone surgery (RIRS) in Renmin Hospital of Wuhan University from April 2016 to January 2019 were retrospectively analyzed.There were 424 males and 216 females.The awerage age was (46.2 ± 12.8) years old,ranging 18 to 76 years old.The maximum diameter of the stone is (1.4 ±0.7) cm,ranging 0.6-3.2 cm.There were 126 cases with inferior calculi and 514 cases with non-lurgical calculi.There were 196 cases with unilateral ureteral calculi,118 unilateral ureteral calculi cases with renal calculi,236 cases with unilateral renal stones,and 90 cases with double kidney stones.104 cases were placed with double J tube before operation and 496 cases were not placed before operation.There were 8 cases of horseshoe kidney,30 cases of isolated kidney with renal insufficiency,4 cases of pelvic ectopic kidney with dysplasia,6 cases of congenital ureteral malformation and 2 cases of sponge kidney.Preoperative average hemoglobin was (133.2 + 5.6) g/L,ranging 126-188 g/L.And average serum creatinine was (84.4 + 12.2) μmol/L,ranging 74-242μmol/L before operation.All patients were treated with general anesthesia under the lithotomy position.The ureteroscopy combined with holmium laser lithotripsy was performed.The 200tμm fiber was used,which the parameters were set as 12-45 W(0.5-1.5 J/10-30 Hz).The stone baskets were used to take stones according to actual conditions.The operation was performed by doctors of the same qualifications.Results All patients underwent successful operation.The mean operation time was (45.6 + 14.6) min.The average postoperative hospitalization was (4.8 ± 1.5) d.The postoperative serious complication rate was 0.9％,including(2 cases of sepsis and 1 case of subcapsular hematoma.Of the 640 patients,596 were admitted to the hospital for a double J tube and 44 were lost of follow-up.552 patients met the stone removal criteria,44 patients did not meet the stone removal criteria for other treatments,such as extracorporeal shock wave lithotripsy,ureteroscopy or observed regularly.The stone-free rate (SFR) was 92.6％ (552/596) after 1-3 months.On the first postoperative day,serum creatinine was (76.0 ±10.6) (58-156) μmol/L,and postoperative hemoglobin was (126.4 ±9.6) (120-176) g/L.There was no significant difference in preoperative and postoperative hemoglobin (t =2.02,P =0.064).Preoperative and postoperative creatinine (t =64.76,P ＜ 0.05) was statistically significant.Meanwhile,the stone size (x2 =29.569,P ＜ 0.05) and position (x2 =44.949,P ＜ 0.05) versus SFR the impact was statistically significant.Multivariate regression analysis showed that stone size was not an independent risk factor for stone clearance (P =0.639).The stone position was an independent risk factor for stone clearance (P =0.013).Conclusions RIRS is a reliable treatment for small and medium calculi patients of the upper urinary tract.The curative effect of stone removal is clear,the complications are few,the safety is high.However,there are certain limitations to the efficacy in the treatment of large stones and lower calculi.Lower calculi is the independent risk factor for the treatment of efficacy.

Annual data report on surgical treatment of esophageal cancer in Shanghai Chest Hospital in 2015 / 中国胸心血管外科临床杂志

@#Objective    To give an annual data report of surgical treatment of esophageal cancer in Shanghai Chest Hospital to provide reference for treatment and research on esophageal cancer. Methods    The clinical data of 414 patients with esophageal cancer who underwent endoscopy (9 patients) and esophagectomy (405 patients) in Shanghai Chest Hospital in 2015 were reviewed, including 334 males and 80 females. Their tumor biological characteristics and short-term and long-term treatment results were analyzed. Results    Patients in this group were predominantly aged 60 to 69 years (46.9%), and the tumor was mainly located in the middle thorax (50.7%). About 79.9% of the patients received trans-right thoracic esophagectomy, 44.4% received minimally invasive surgery; 388 (93.7%) patients accepted upfront esophagectomy without induction therapy, and 179 (43.2%) patients received postoperative adjuvant therapy. The R0 resection rate was 90.6%, and the 30- and 90-day mortality rates were 1.4% and 2.4%, respectively. The 4-year overall survival rate of the R0 resection patients was 65.7%. Conclusion    Satisfactory long-term survival results can be obtained for thoracic esophageal cancer if R0 resection can be achieved by trans-right thoracic esophagectomy and extended lymphadenectomy combined with appropriate postoperative adjuvant treatment.

Application and funding status of otorhinolaryngology head and neck surgery research projects funded by National Natural Science Foundation of China from 2009 to 2019 / 中华耳鼻咽喉头颈外科杂志

Objective@#Based on the application and funding of Otorhinolaryngology Head and Neck Surgery (H13) funded by the Nature Science Foundation of China (NSFC), we analyzed the basic research status of the field of Otorhinolaryngology Head and Neck Surgery, and provided the references for developing the discipline development plan, optimizing the discipline strategic layout and promoting the discipline progress.@*Method@#The data of both applied and funded grants of Otorhinolaryngology Head and Neck Surgery in NSFC from 2009 to 2019 were collected for further analysis.@*Results@#From 2009 to 2019, H13 received 5 103 applications, accounting for 1.00% of the total number of applications in the department of health science, and 922 applications were funded (mainly from the General Projects and the Youth Science Fund Projects), with a funding rate of 18.07% and a funding amount of 445.509 million yuan, accounting for 1.02% of the total funding amount of the department of health science. Among the seven sub-categories of H13, H1304 (Hearing abnormal and balance disorders) received 1 845 applications, and 352 were funded. H1301 (Disease of smell, nose and anterior skull base) received 1 217 applications, and 248 were founded, H1303 (Ear and lateral skull base disease) and H1305 (Otorhinolaryngology and developmental related diseases) received 498 and 488 applications,and 83 and 112 were founded respectively. The National Science Fund for Distinguished Young Scholars received 33 applications, and 5 were founded, with a funding rate of 15.15%. Clinicians accounted for 81% of the General Projects principals, and researchers and technicians accounted for 19%. Clinicians accounted for 72% of the Youth Science Fund Projects principals, and researchers and technicians accounted for 24%.@*Conclusion@#The basic research of Otorhinolaryngology Head and Neck Surgery in China has some shortcomings, such as small volume, uneven development of various disciplines, less leading academic leaders, less training of young leading talents, less major projects, more clinicians instead of researchers engaged in the basic scientific research.

Clinical efficacy and safety analysis of retrograde intrarenal stone surgery for treatment of upper urinary calculi / 中华泌尿外科杂志

Objective@#To evaluate efficacy and safety of retrograde intrarenal stone surgery for treatment of upper urinary calculi.@*Methods@#The clinical data of 640 patients with upper urinary tract calculi treated by retrograde intrarenal stone surgery (RIRS) in Renmin Hospital of Wuhan University from April 2016 to January 2019 were retrospectively analyzed. There were 424 males and 216 females. The awerage age was (46.2±12.8) years old, ranging 18 to 76 years old. The maximum diameter of the stone is (1.4±0.7) cm, ranging 0.6-3.2 cm. There were 126 cases with inferior calculi and 514 cases with non-lurgical calculi. There were 196 cases with unilateral ureteral calculi, 118 unilateral ureteral calculi cases with renal calculi, 236 cases with unilateral renal stones, and 90 cases with double kidney stones. 104 cases were placed with double J tube before operation and 496 cases were not placed before operation. There were 8 cases of horseshoe kidney, 30 cases of isolated kidney with renal insufficiency, 4 cases of pelvic ectopic kidney with dysplasia, 6 cases of congenital ureteral malformation and 2 cases of sponge kidney. Preoperative average hemoglobin was (133.2±5.6)g/L, ranging 126-188 g/L.And average serum creatinine was (84.4±12.2)μmol/L, ranging 74-242μmol/L before operation. All patients were treated with general anesthesia under the lithotomy position. The ureteroscopy combined with holmium laser lithotripsy was performed.The 200μm fiber was used, which the parameters were set as 12-45 W(0.5-1.5 J/10-30 Hz). The stone baskets were used to take stones according to actual conditions. The operation was performed by doctors of the same qualifications.@*Results@#All patients underwent successful operation. The mean operation time was (45.6±14.6)min. The average postoperative hospitalization was (4.8±1.5)d. The postoperative serious complication rate was 0.9%, including(2 cases of sepsis and 1 case of subcapsular hematoma. Of the 640 patients, 596 were admitted to the hospital for a double J tube and 44 were lost of follow-up. 552 patients met the stone removal criteria, 44 patients did not meet the stone removal criteria for other treatments, such as extracorporeal shock wave lithotripsy, ureteroscopy or observed regularly. The stone-free rate (SFR) was 92.6% (552/596) after 1-3 months. On the first postoperative day, serum creatinine was (76.0±10.6)(58-156) μmol/L, and postoperative hemoglobin was (126.4±9. 6)(120-176) g/L. There was no significant difference in preoperative and postoperative hemoglobin (t=2.02, P=0.064). Preoperative and postoperative creatinine (t=64.76, P<0.05) was statistically significant. Meanwhile, the stone size (χ2=29.569, P<0.05) and position (χ2=44.949, P<0.05) versus SFR the impact was statistically significant. Multivariate regression analysis showed that stone size was not an independent risk factor for stone clearance (P=0.639). The stone position was an independent risk factor for stone clearance (P=0.013).@*Conclusions@#RIRS is a reliable treatment for small and medium calculi patients of the upper urinary tract. The curative effect of stone removal is clear, the complications are few, the safety is high. However, there are certain limitations to the efficacy in the treatment of large stones and lower calculi. Lower calculi is the independent risk factor for the treatment of efficacy.

Expression and function of lncRNA BDNF-AS in breast cancer / 中国肿瘤临床

Objective: To determine expression of brain-derived neurotrophic factor antisense (BDNF-AS) long non-coding RNA (ln-cRNA) in breast cancer, and to investigate its effects on proliferation, apoptosis, migration and invasion. Methods: Between 2016 and 2018, samples from 88 cases of breast cancer were collected at the First Hospital of Lanzhou University. RT-qPCR was used to deter-mine expression of lncRNA BDNF-AS in breast cancer tissue and cells. A pcDNA3.1 plasmid was used to overexpress BDNF-AS in MDA-MB-231 cells. Cell viability was quantified using an MTT assay, proliferative capacity was determined using an EdU assay and a colori-metric assay was used to measure the Caspase-3 activity. Moreover, the protein levels of Bax, Bcl-2, MMP-9, E-cadherin, and BDNF were quantified by Western blot. Scratch and transwell assays were used to determine cell migration and invasion. Results: Lower ln-cRNA BDNF-AS expression was observed in breast cancer tissue and cells compared with normal paracancerous tissues (P<0.05), and with normal, HBL-100 breast cells (P<0.01). BDNF-AS expression negatively correlated with tumor-node-metastasis (TNM) stage (P<0.05) and lymphatic metastasis (P<0.05) of breast cancer. Overexpression of BDNF-AS with the pcDNA3.1 plasmid decreased viability of MDA-MB-231 cells (P<0.01), EdU-positive cells (P<0.01), and Caspase-3 activity (P<0.01). Additionally, Bcl-2, MMP-9, and BDNF ex-pression was downregulated (P<0.01), while Bax and E-cadherin expression was upregulated (P<0.01). Overexpression of BDNF-AS al-so inhibited cell healing and invasion which were determined by scratch assays (P<0.01). Conclusions: LncRNA BDNF-AS expression is downregulated in breast cancer, which inhibits breast cancer cell proliferation, migration, invasion, and promotes apoptosis.

Analysis of intestinal patients' flora changes with severe pneumonia based on 16SrDNA sequencing technology / 中华危重病急救医学

Objective To investigate the characteristics of gut microbiota dysbosis in patients with severe pneumonia using 16SrDNA sequencing. Methods A prospective observational research was conducted. The stool samples retained by natural defecation or enema within 2 days after hospital were collected from 16 patients with severe pneumonia admitted to department of intensive care unit (ICU) of General Hospital of Ningxia Medical University from June to December in 2018 and 10 persons for physical exam were enrolled as the healthy control group. The 16SrDNA sequencing technology was used to detect fecal flora and analyze biological information. Results ① 1015475 effective sequences were obtained from the stool samples from the severe pneumonia group and the healthy control group. Using 16SrDNA method, it was found that the average effective length of the sample sequence was 458.35 bp and the average sequence number of the total samples was 39056.73. ② Analysis of α diversity of gut microbiota showed that, compared with the healthy control group, the Ace index, Chao index and the Shannon index of gut microbiota diversity in the severe pneumonia group were significantly decreased [Ace index: 167.23 (143.14, 211.26) vs. 227.71 (214.53, 247.05), Chao index: 152.38 (138.09, 182.54) vs. 228.25 (215.49, 248.95), Shannon index:2.37 (1.68, 2.89) vs. 3.39 (3.03, 3.63), all P < 0.01], and the Simpson index was significantly increased [0.21 (0.11, 0.33) vs. 0.07 (0.06, 0.12), P < 0.01], which indicated the gut microbiota diversity of the severe pneumonia group was decreased. ③ Analysis of β diversity of gut microbiota, principal coordinate analysis (PCoA) showed that gut microbiota structural with the healthy control group was similar, while that in the severe pneumonia group was different. Adonis analysis showed that the structural of the gut microflora revealing significant differences between the severe pneumonia group and the healthy control group (R2 = 0.061, P = 0.05). ④ Analysis of phylum difference gut microflora showed that, compared with the healthy control group, the proportion of Firmicutes in severe pneumonia group was decreased [27.36 (18.12, 39.28)％ vs. 52.25 (38.36, 63.82)％, P = 0.02], the proportions of Actinobacterias, Synergistetes and Fusobacterias were increased [2.30 (0.30, 4.80)％ vs. 0.02 (0.00, 0.06)％, 0.36 (< 0.01, 0.57)％ vs. < 0.01 (< 0.01, < 0.01)％, 0.01 (< 0.01, 0.08)％ vs. < 0.01 (< 0.01, < 0.01)％, all P < 0.05]. ⑤ Analysis of genus difference gut microflora showed that, the proportions of Bifidobacterium, Ruminococcus, Pseudobutyrivibrio, Coprococcus, Lachnospira and Prevotella in the severe pneumonia group were significantly lower than those in healthy control group [0.18 (0.01, 0.25)％ vs. 3.40 (0.46, 5.78)％, 0.01 (< 0.01, 0.29)％ vs. 2.26 (0.84, 4.86)％, 0.01 (< 0.01, 0.02)％ vs. 2.73 (1.87, 5.74)％, 0.02 (< 0.01, 0.07)％vs. 0.80 (0.50, 2.32)％, < 0.01 (< 0.01, < 0.01)％ vs. 0.88 (0.33, 2.08)％, 0.02 (< 0.01, 0.31)％ vs. 7.74 (0.07, 36.27)％, all P < 0.05]; the proportions of Escherichia and Enterococcus in the severe pneumonia group were higher than those in healthy control group, but there was no difference between the two groups [2.00 (0.57, 10.23)％ vs. 1.16 (0.23, 2.68)％, 0.02 (< 0.01, 0.42)％ vs. < 0.01 (< 0.01, 0.04)％, both P > 0.05]; the proportions of Fusobacterium and Staphylococcus in severe pneumonia group were significantly higher than those in healthy control group [0.01 (< 0.01, 0.08)％ vs. < 0.01 (< 0.01, < 0.01)％, 0.01 (< 0.01, 0.02)％ vs. < 0.01 (< 0.01, < 0.01)％, both P < 0.05]. Conclusion Gut microbiota dysbiosis in patients with severe pneumonia shows that the abundance and diversity decrease, structure of intestinal flora changes, and beneficial symbiotic bacteria decrease and pathogenic bacteria increase, which may be associated with the occurrence and development of severe pneumonia.

Rapamycin reduces mortality in acute-stage paraquat-induced toxicity in zebrafish

INTRODUCTION@#Paraquat (PQ) intoxication is frequently associated with a high mortality rate. No specific treatment has been shown to reduce mortality in victims within the first 72 hours. We investigated the protective effects of rapamycin (Rapa) against PQ-induced toxicity in a zebrafish model.@*METHODS@#To determine the maximum nonlethal concentration (MNLC) and lethal concentration 50 (LC50) of Rapa, zebrafish were treated at 2-5 days post fertilisation (dpf) and their mortality was recorded every 24 hours. At 5 dpf, the zebrafish were treated with PQ 100 µg/mL or PQ+Rapa (MNLC, 1/3 MNLC or 1/9 MNLC) for 72 hours, and the rate of survival was recorded every 24 hours. Reverse transcription-polymerase chain reaction was used to test the signalling pathway of mTOR (mammalian target of rapamycin).@*RESULTS@#MNLC and LC50 of Rapa were determined to be 6.7 µg/mL and 28.9 µg/mL, respectively. At 48 hours, the PQ+Rapa groups had much lower mortality than the PQ group. The rates of survival of the PQ+Rapa groups were 43.33% (MNLC), 53.89% (1/3 MNLC) and 44.45% (1/9 MLNC), as compared to 19.45% in the PQ group, with the 1/3 MNLC group showing the highest rate of survival (p < 0.001). atg1 was slightly activated in the PQ group. In the PQ+Rapa groups, the expression of atg1 was markedly increased, suggesting strengthening of the autophagy process.@*CONCLUSION@#Rapa can increase the rate of survival of PQ-intoxicated zebrafish by inhibiting mTOR complex 1 and activating autophagy. Rapa could be an alternative first-line drug in the treatment of PQ poisoning.

Safety and efficacy of flexible ureteroscopy lithotripsy for the treatment of renal stone in solitary kidney patients / 中华泌尿外科杂志

Objective To evaluate the safety and efficacy of flexible ureteroscopy lithotripsy (FURL) for the treatment of renal stone in solitary kidney patients.Methods The clinical data of 46 patients of solitary kidney,who were treated with FURL from March 2015 to May 2018 in our hospital,were analyzed retrospectively.There were 34 males and 12 females,aged (48.6 ± 9.6) years.Maximum diameter of stone was (15.3 ±4.8) mm,and 29 cases in left kidney and 17 cases in right.34 cases were non-renal calcaneal calculi,12 cases were subrenal calyceal stones.There were 3 cases of congenital solitary kidney,31 cases of functional solitary kidney (contralateral kidney GFR ＜ 10 ml/min) and 12 cases of acquired solitary kidney (7 cases of renal calculi,4 cases of tumor,1 case of tuberculosis).The mean reoperative serum creatinine was (116.38 ± 25.77)μmol/L.All patients were treated with general anesthesia,lithotomy,soft ureteroscopy combined with holmium laser lithotripsy,and assisted lithotripsy.All operations were performed by the same surgeon.The data of operation time,hospital stay,blood loss,renal function before and after operation,postoperative complications and stone clearance rate were recorded.Results In this study,46 cases of the operation were successfully completed.The mean operation time was (58.6 ±16.4) min,the average hospitalization time was (5.6 ± 1.4) days.The mean hemoglobin was decreased (1.4 ± 0.9) g/L.The mean operative time was (58.6 ± 16.4) min.The average postoperative hospitalization time was (5.6 ± 1.4) days.The Postoperative hematuria occurred in 32 cases,low back pain in 3 cases and fever in I case.Stone-free reached in 39 of 46 patients,the stone-free rate(SFR)of primary operation was 84.8％ (39/46).There were 7 cases of residual calculi,five patients were treated with secondary FURL,2 patients were required conservative treatment.The SFR was 95.7％ (44/46) after the second stage operation.The mean serum creatinine was (112.29 ± 20.62) μ mol/L on the first day after operation,which was not different statistically with that before operation (P =0.177).The mean serum creatinine was (81.54 ± 10.75) μmol/L one month after operation,which was significantly lower than preoperative and 1 day postoperative (P ＜ 0.05).Conclusions FURL could be a safe and effective treatment for renal stone in solitary kidney patients.It has a definite stone-free effect,low incidence of complications.

Clinical significance on serum intestinal fatty acid binding protein and D-lactic acid levels in early intestinal injury of patients with sepsis / 中华危重病急救医学

Objective To investigate the changes and clinical significances of intestinal fatty acid binding protein (I-FABP) and D-lactic acid levels in early intestinal injury of patients with sepsis and septic shock. Methods A prospective observational study was conducted. Thirty septic patients (septic group) and 30 septic shock patients (septic shock group) were admitted to the intensive care unit (ICU) of General Hospital of Ningxia Medical University from August 2018 to December 2018, and 20 healthy adults were served as healthy control group. Serum samples were collected within 24 hours after ICU admission in septic shock and septic groups, and in healthy control group during physical examination. The serum I-FABP, D-lactic acid, endotoxin, hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and lactic acid (Lac) were determined. Gender and age of all subjects, and basic diseases, the main area of infection and acute physiology and chronic health evaluationⅡ(APACHEⅡ) scores within 24 hours after ICU admission of all patients were recorded. At the same time, the survival of the patients was followed up for 28 days. Spearman correlation analysis was used to analyze the correlation between serum I-FABP, D-lactic acid and other parameters. Risk factors of death in patients with sepsis and septic shock were screened by multivariate Logistic regression analysis of bicategorized variables. Results There was no significant difference in gender or age among the groups, as well as in the proportion of basic diseases, celiac infection or non-celiac infection between the sepsis group and the septic shock group, indicating that the general clinical baseline data among the groups were comparable. Serum levels of I-FABP and D-lactic acid in the sepsis group and the septic shock group were significantly higher than those in the healthy control group [I-FABP (μg/L): 27.46 (22.52, 34.39), 36.95 (29.82, 44.24) vs. 17.93 (14.65, 22.11), D-lactic acid (mg/L): 15.32 (9.84, 38.62), 27.95 (10.01, 47.69) vs. 9.38 (8.81, 14.48), all P < 0.01]. The serum level of I-FABP in the septic shock group was significantly higher than that in the sepsis group (P < 0.05), but the difference in serum D-lactic acid level between the two groups was not statistically significant (P > 0.05). Serum I-FABP level in the celiac infection group (n = 40) was significantly higher than that in the non-celiac infection group [n = 20; μg/L: 34.76 (27.46, 43.90) vs. 25.71 (20.55, 37.77), P < 0.01], but the difference in serum D-lactic acid level was not statistically significant [mg/L: 25.13 (9.83, 40.55) vs. 30.36 (10.17, 50.00), P > 0.05]. There was no significant difference in serum I-FABP or D-lactic acid levels between the survival group (n = 34) and the death group [n = 26; I-FABP (μg/L): 33.39 (25.20, 39.50) vs. 29.26 (22.50, 43.81), D-lactic acid (mg/L): 14.83 (9.71, 38.45) vs. 33.90 (11.93, 45.34), both P > 0.05]. Correlation analysis between serum I-FABP, D-lactic acid level and endotoxin, inflammatory factors, Lac and APACHEⅡ score in septic and septic shock patients showed that only D-lactic acid was significantly positively correlated with TNF-α and Lac (r values were 0.455 and 0.406, respectively, both P < 0.01), while I-FABP was not correlated with endotoxin, inflammatory factors, Lac or APACHEⅡscore. Multivariable Logistic regression analysis showed the APACHEⅡ score was an independent risk factor to affect the prognosis (death for 28 days) of septic and septic shock patients [odds ratio (OR) = 1.248, 95% confidence interval (95%CI) = 1.091-1.427, P = 0.001], while I-FABP, D-lactic acid, endotoxin, hs-CRP, TNF-α, IL-6, and Lac had no impact on 28-day prognosis of patients. Conclusion Serum I-FABP and D-lactic acid levels can evaluate early intestinal injury in patients with sepsis and septic shock, but neither of them is related to the prognosis of patients.

Clinical investigation of gut microbiota dysbiosis in septic patients / 中华急诊医学杂志

Objective To investigate the characteristics of gut microbiota dysbosis in septic and non-septic patients in ICU.Methods A prospective observational research was conducted.Ten septic patients(septic group),ten patients without sepsis(non-septic group) were admitted to Department of Critical Care Medicine of General Hospital of Ningxia Medical University from February 2017 to June 2017 were enrolled.And ten healthy persons was enrolled as control group.Stool samples were collected from septic and non-septic patients within two days following admission to the intensive care unit (ICU);healthy persons' was random.High throughput 16S rRNA gene sequencing technology was used to detect fecal bacterium of three groups.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score,Sequential Organ Failure Assessment (SOFA) score of patients were recorded on the first day after admission to ICU.Results Compared with the control group,the α diversity of gut microbiota in non-septic and septic groups showed a downward trend,the [3 diversity showed that the structure of gut microbiota in non-septic and the septic groups was significant different,and the individual differences were more obvious.At the level of phylum,compared with the control group,the proportion of Firmicutes+Bacteroidetes in non-septic and septic groups decreased significantly(P=0.013,0.028),and the proportion of Proteobacteria increased(P=0.017,0.026),while the proportion of Fusobacteria just increased in the non-septic group(P ＜ 0.01).At the level of genus,compared with the control group,the proportion of beneficial symbiotic genus in non-septic and septic groups can be seen decreased,such as Ruminococcus(P=0.045,0.026),Pseudobutyrivibrio(P=0.009,＜ 0.01),Anaerostipes(P=0.011,0.003),Coprococcus(P=0.045,0.011),Phascolarctobacterium(P=0.008,0.022),Subdoligranulum(P=0.006,0.026).The proportion of Lactobacillus,Dorea,Faecalibacterium,Roseburia and Blautia showed downward trend in non-septic and septic groups,but only the decline of Lactobacillus in non-septic group had statistical difference(P=0.005),and the decline of Dorea,Faecalibacterium,Roseburia and Blautia in septic group had statistical differences(P=0.037,0.038,0.002 and 0.017,respectively).The proportion of conditional pathogenic Fusobacterium,Actinomyces,Peptstreptococcus,Streptococcus increased in non-septic group(P=0.001,0.019,0.011 and 0.014,respectively),the proportion of pathogenic Staphylococcus(P=0.035,0.006),Enterococcus(P=0.001,0.001),Anaerococcus(P=0.006,0.006) and Bacillus(both P ＜ 0.01) increased in non-septic and septic groups.Conclusions Gut microbiota dysbiosis occured in septic and non-septic patients in the ICU,and showed that diversity decreased,structure of intestinal flora changed,obligate anaerobic bacteria decreased,facultative anaerobic bacteria increased,benefical symbiotic bacteria decreased,pathogenic bacteria increased and can be the dominate genus.

Analysis of intestinal patients' flora changes with severe pneumonia based on 16SrDNA sequencing technology / 中华危重病急救医学

Objective@#To investigate the characteristics of gut microbiota dysbosis in patients with severe pneumonia using 16SrDNA sequencing.@*Methods@#A prospective observational research was conducted. The stool samples retained by natural defecation or enema within 2 days after hospital were collected from 16 patients with severe pneumonia admitted to department of intensive care unit (ICU) of General Hospital of Ningxia Medical University from June to December in 2018 and 10 persons for physical exam were enrolled as the healthy control group. The 16SrDNA sequencing technology was used to detect fecal flora and analyze biological information.@*Results@#① 1 015 475 effective sequences were obtained from the stool samples from the severe pneumonia group and the healthy control group. Using 16SrDNA method, it was found that the average effective length of the sample sequence was 458.35 bp and the average sequence number of the total samples was 39 056.73. ② Analysis of α diversity of gut microbiota showed that, compared with the healthy control group, the Ace index, Chao index and the Shannon index of gut microbiota diversity in the severe pneumonia group were significantly decreased [Ace index: 167.23 (143.14, 211.26) vs. 227.71 (214.53, 247.05), Chao index: 152.38 (138.09, 182.54) vs. 228.25 (215.49, 248.95), Shannon index: 2.37 (1.68, 2.89) vs. 3.39 (3.03, 3.63), all P < 0.01], and the Simpson index was significantly increased [0.21 (0.11, 0.33) vs. 0.07 (0.06, 0.12), P < 0.01], which indicated the gut microbiota diversity of the severe pneumonia group was decreased. ③ Analysis of β diversity of gut microbiota, principal coordinate analysis (PCoA) showed that gut microbiota structural with the healthy control group was similar, while that in the severe pneumonia group was different. Adonis analysis showed that the structural of the gut microflora revealing significant differences between the severe pneumonia group and the healthy control group (R2 = 0.061, P = 0.05). ④ Analysis of phylum difference gut microflora showed that, compared with the healthy control group, the proportion of Firmicutes in severe pneumonia group was decreased [27.36 (18.12, 39.28)% vs. 52.25 (38.36, 63.82)%, P = 0.02], the proportions of Actinobacterias, Synergistetes and Fusobacterias were increased [2.30 (0.30, 4.80)% vs. 0.02 (0.00, 0.06)%, 0.36 (< 0.01, 0.57)% vs. < 0.01 (< 0.01, < 0.01)%, 0.01 (< 0.01, 0.08)% vs. < 0.01 (< 0.01, < 0.01)%, all P < 0.05]. ⑤ Analysis of genus difference gut microflora showed that, the proportions of Bifidobacterium, Ruminococcus, Pseudobutyrivibrio, Coprococcus, Lachnospira and Prevotella in the severe pneumonia group were significantly lower than those in healthy control group [0.18 (0.01, 0.25)% vs. 3.40 (0.46, 5.78)%, 0.01 (< 0.01, 0.29)% vs. 2.26 (0.84, 4.86)%, 0.01 (< 0.01, 0.02)% vs. 2.73 (1.87, 5.74)%, 0.02 (< 0.01, 0.07)% vs. 0.80 (0.50, 2.32)%, < 0.01 (< 0.01, < 0.01)% vs. 0.88 (0.33, 2.08)%, 0.02 (< 0.01, 0.31)% vs. 7.74 (0.07, 36.27)%, all P < 0.05]; the proportions of Escherichia and Enterococcus in the severe pneumonia group were higher than those in healthy control group, but there was no difference between the two groups [2.00 (0.57, 10.23)% vs. 1.16 (0.23, 2.68)%, 0.02 (< 0.01, 0.42)% vs. < 0.01 (< 0.01, 0.04)%, both P > 0.05]; the proportions of Fusobacterium and Staphylococcus in severe pneumonia group were significantly higher than those in healthy control group [0.01 (< 0.01, 0.08)% vs. < 0.01 (< 0.01, < 0.01)%, 0.01 (< 0.01, 0.02)% vs. < 0.01 (< 0.01, < 0.01)%, both P < 0.05].@*Conclusion@#Gut microbiota dysbiosis in patients with severe pneumonia shows that the abundance and diversity decrease, structure of intestinal flora changes, and beneficial symbiotic bacteria decrease and pathogenic bacteria increase, which may be associated with the occurrence and development of severe pneumonia.

Salvage esophagectomy after definitive chemoradiotherapy: analysis of eighteen cases of a single operation group / 中华胸心血管外科杂志

Objective To investigate the safety and efficacy of definitive chemoradiotherapy(dCRT) in esophageal cancer.Methods A retrospective analysis of 18 consecutive cases ofsalvage esophagectomy after dCRT by the single operation groupin department of Thoracic surgery,Shanghai chest hospital affiliated to Shanghai Jiaotong University from December 2014 to March 2017.Results 16 males and 2 females.There were 6 cases and 12 cases of recurrent and persistent tumor after dCRT respectively.All the patients were treated with McKeown operation stytle combing thoracic and abdominal lymph nodes dissection.Esophagus was replaced by stomach of 15 cases and colon of 3 cases respectively.Radical resection (R0) was performed in 12 cases,palliative resection (R2) in 6 cases.There were 4 cases of pathological complete response (pCR).The incidence of postoperative complications was 11 cases,including 6 cases of pulmonary infection,4 cases of anastomotic leak,2 cases of incision infection,one case of respiratory insufficiency,one case of recurrent laryngeal nerve paralysis,one case of chylothorax,one case of aortic bleeding caused by empyema.One patient died in perioperative period because of aortic bleeding due to empyema.The follow-up period was from 2 to 26 months,and the median follow-up time was 9 months.There were 13 patients survived and 5 patients died at the last follow-up date including one death in perioperative period,2 cases died of local-regional recurrence and metastasis respectively.Conclusion Salvage esophagectomy is a treatment option for the recurrent or persistent disease after dCRT,but the incidence of postoperative complications is high.Accurate clinical staging is especially important after dCRT and ycT4,ycN + patientsshould be avoided.R0 resection and recurrence after long disease free period are favorable prognostic factors.

Study on correlation between adropin protein and homocysteine level in patients with coronary artery disease / 国际检验医学杂志

Objective To investigate the correlation between serum adropin protein and homocysteine (Hcy) level in the patients with coronary artery disease (CAD) ,and to study their relationship with CAD se-verity .Methods One hundred and seventy cases of CAD in this hospital from August 2015 to October 2016 were selected as the research subjects .Peripheral blood was collected for measuring serum adropin protein , Hcy and other conventional biochemical indicators ,and the coronary artery lesion was detected by coronary an-giography ,the severity of coronary artery lesion was assessed by SYNTAX score .Results In 170 cases of CAD ,mean serum Hcy level was (15 .92 ± 8 .31)μmol/L ,the adropin protein level in the hyperhomocysteine-mia group was lower than that in the non-hyperhomocysteinemia group ,the difference was statistically signifi-cant(P<0 .05) .Mean SYNTAX score in all cases was (21 .51 ± 11 .20) points ,and serum adropin protein was negatively correlated with Hcy level (r= -0 .169 ,P= 0 .028) ,serum Hcy level had no obvious correlation with SYNTAX score (r= 0 .124 ,P=0 .108) ,the adropin protein level was negatively correlated with SYN-TAX score (r= -0 .181 ,P=0 .018) .Generalized structural equation model showed that with the decrease of adropin protein level ,the SYNTAX score was increased (P=0 .019) ,compared with the patients without com-plicating hyperhomocysteinemia ,the SYNTAX score in the patients with hyperhomocysteinemia was much higher(P=0 .005) .Conclusion The lower the adropin protein level ,the higher the Hcy level and the severe the coronary artery lesion .

Study on relationship between imageology and pathology of 624 patients with T1 stage lung cancer / 中华胸心血管外科杂志

Objective To study the relativity between imageology and pathology during lung cancer,and estimate whether the lung cancer is preinvasive lesions,which can support evidences for the operation methods.Methods Clinical data of 624 patients who were diagnosed as lung adenocarcinoma and had solitary pulmonary nodule(diameter≤3 cm) were collected,all of them were scanned by thin layer CT scan(1 mm).The correlation between imageology and pathology data were analyzed.Results In 125 cases of GGO,the ratio of invasive lesions were 0 (0/72),6.1％ (3/49) and 100％ (4/4) in stage T1a,T1b and T1c respectively.In 285 cases of mGGO,if solid component was less than 0.5 cm,the ratio of invasive lesions were 1.7％ (1/58),6.9％ (2/29) and 50.0％ (2/4) in stage T~,T1b and Tic;but the ratio of invasive lesions were 81.3％ (13/16),94.1％ (96/102) and 97.4％ (74/76) respectively when the solid component was more than 0.5 cm.In 214 cases with solid nodules,the ratio of invasive lesions were 87.1％ (27/31),98.8％ (84/85) and 99.0％ (97/98) in stage T1 a,T1b and T1c.Conclusion The ratio of invasive lesions and solid component increased gradually along with the growing of tumor diameter in stage T1 lung cancer.CT imaging was highly correlated with the pathology diagnosis of preinvasive lesions and invasive lesions,which can be used as the guidance for operation methods.

Compatibility of Radix astragali and Radix salviae miltiorrhiae for the treatment of cardio-cerebrovascular system diseases:research advances / 国际药学研究杂志

Because of the high morbidity and mortality rate,cardio-cerebrovascular diseases,including cerebral embolism, cerebral hemorrhage,cerebral vasospasm and myocardial infarction,have become main diseases threatening human health. Tradition-al chinese medicine(TCM)holds that the basic pathogenesis is Qi imbalances,which could be improved by benefiting Qi and promot-ing blood circulation. The compatibility of Radix astragali and Radix salviae miltiorrhiae are particularly suitable for treating the car-dio-cerebrovascular system diseases by improving Qi deficiency and blood stasis. This paper focuses on the application of Radix astrag-ali,Radix s. miltiorrhiae and their compatibility for treating the cardio-cerebrovascular system diseases. Moreover,our research would offer valuable references for the development of new drugs related to the treatment of cardio-cerebrovascular system diseases.

Safety of peroral endoscopic cardial constriction for gastro-esophageal reflux / 中华消化内镜杂志

Objective To explore the clinical safety of peroral endoscopic cardial constriction for gastro-esophageal reflux.Methods Clinical data of 47 patients with gastro-esophageal reflux who underwent peroral endoscopic cardial constriction in Chinese PLA General Hospital were retrospectively studied from August 2013 to August 2016.Results A total of 47 patients underwent peroral endoscopic cardial constriction successfully with no perforation or fever.Retrostemal vague pain and discomfort occurred in 7 cases,mild dysphagia occurred in 2 cases,and mild hemoptysis occurred in one patient the day after the operation.No special measures were taken and all 10 patients showed symptom remission in less than two days.As for the postoperative treatment,22 (46.8％) patients were given a liquid diet on the day of operation,39(82.9％) patients were given semi-or liquid diet on the first day after the operation,and two days later,43 (91.5％) resumed semi-or liquid diet.Only 9 cases were given antibiotics for prophylaxis for infection.Conclusion Peroral endoscopic cardial constriction is safe and effective for gastro-esophageal reflux.The hospitalizing time is short and postoperative recovery is quick.