[Long-term outcomes of laparoscopic gastrectomy for locally advanced gastric cancer with serosa-invasion].

Objective: To evaluate the long-term outcomes and prognostic factors of locally advanced gastric cancer with serosa-invasion. Methods: This study is a retrospective cohort study. The clinical and pathological data of 495 patients with locally advanced gastric cancer with serosa-invasion who underwent laparoscopic radical gastrectomy in Department of General Surgery, the First Hospital Affiliated to Army Medical University from October 2012 to October 2018 was analyzed retrospectively. There were 356 males and 139 females with an age (M(IQR)) of 59 (16) years (range: 18 to 75 years). Observation indicators included postoperative results and long-term prognosis. The survival curve was drawn by the Kaplan-Meier method. Univariate and multivariate prognostic analysis was performed using the Cox proportional hazards model. Results: Among the 495 patients, a total of 57 patients (11.5%) were lost to follow-up, with a follow-up time of 89 (40) months (range: 23 to 134 months). The 5-year disease-free survival rate (DFS) and the 5-year overall survival rate (OS) were 56.0% and 58.2%, respectively. The 5-year DFS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 60.5%, 51.6%, 33.3%, respectively. The 5-year OS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 62.2%, 54.1%, 39.3%, respectively. Multivariate analysis showed that age >65 years (DFS: HR=1.402, 95%CI: 1.022 to 1.922, P=0.036; OS: HR=1.461, 95%CI: 1.057 to 2.019, P=0.022), lymph node dissection number less than 25 (DFS: HR=1.348, 95%CI: 1.019 to 1.779, P=0.036; OS: HR=1.376, 95%CI: 1.035 to 1.825, P=0.028), pathological stage Ⅲ (DFS: HR=2.131, 95%CI: 1.444 to 3.144, P<0.01; OS: HR=2.079, 95%CI: 1.406 to 3.074, P<0.01), and no postoperative chemotherapy (DFS: HR=3.127, 95%CI: 2.377 to 4.113, P<0.01; OS: HR=3.768, 95%CI: 2.828 to 5.020, P<0.01) were independent prognostic factors for the decrease in DFS and OS rates. Conclusions: Laparoscopic radical gastrectomy for locally advanced gastric cancer with serosa-invasion could achieve satisfactory long-term oncological outcomes. More lymph node dissection and standardized postoperative adjuvant chemotherapy are expected to further improve the prognosis of patients with locally advanced gastric cancer with serous invasion after laparoscopic radical surgery.

[Therapeutic potential of EAE mice with sodium oligomannate and effects of intestinal flora and microglia polarization].

Objective: To investigate the therapeutic effect of sodium oligomannate on experimental autoimmune encephalomyelitis (EAE) mice and its effect on intestinal flora and microglia polarization. Methods: Fifty female C57BL/6 mice were randomly divided by the random number table method into the control group, EAE model group and low-dose, medium-dose and high-dose group of sodium oligomannate with 10 mice each. The EAE model group and each dose group of sodium oligomannate were induced by subcutaneous multi-point injection of MOG35-55 peptide for the EAE model. Mice in the low-dose, medium-dose and high-dose group of sodium oligomannate were gavaged sodium oligomannate 40, 80, and 160 mg/kg twice a day, respectively, starting from the day after modeling. The intervention continued until the mice were euthanized. Observe the incidence of disease, infiltration of inflammatory cells in spinal cord tissue, and demyelination in each group of mice.. The mice feces were collected and tested for intestinal flora by 16S rRNA sequencing. Immunofluorescence staining was used to observe the expression of Iba-1 protein, an activation indicator of microglia, in spinal cord tissue. The protein levels of M1 type markers iNOS, CD16, and M2 type markers Arg1 and CD206 were tsested in the spinal cord by Western blotting and immunofluorescence staining. Results: None of the mice in the control group developed any disease, while the mice in other groups showed varying degrees of disease, including tail sag, unstable walking, and hind limb weakness. Compared with the EAE model group, the incubation period was prolonged, the peak was delayed and the peak neurological dysfunction score was reduced (3.6±0.6 vs 3.0±0.6, 2.8±0.5, 1.8±0.6, P<0.05) in all sodium oligomannate groups, with milder symptoms at higher doses. The differences in pairwise comparisons between the groups were all statistically significant (all P<0.05). In the control group, no inflammatory cell infiltration or demyelinating changes were observed in spinal cord tissue. In the EAE model group, inflammatory cell infiltration and demyelination changes were evident in the spinal cord tissues at the onset peak. Compared with the EAE model group, inflammatory cell infiltration and demyelination were ameliorated in all sodium oligomannate groups. Compared with the control group, the relative abundance of Bacteroidota decreased and that of Firmicutes increased in the EAE model group. Compared with the EAE model group, the relative abundance of Bacteroidota increased and that of Firmicutes decreased, the ratio of Bacteroidetes to Firmicutes increased (0.20±0.05 vs 0.37±0.02,0.61±0.03,0.91±0.08,P<0.01) in the respective dose groups. The difference in pairwise comparison between groups was statistically significant (P<0.01), with greater changes at higher doses. Compared with the control group, the levels of Iba-1、CD16 and iNOS increased, while the levels of Arg-1 and CD206 decreased in the EAE model group. Compared with the EAE model group, the levels of Iba-1、CD16 and iNOS decreased, while the levels of Arg-1 and CD206 increased in all sodium oligomannate groups(P<0.01), with greater changes at higher doses. The difference between groups was statistically significant (P<0.01). Conclusions: Sodium oligomannate has a therapeutic effect on EAE and is dose-dependent. Its mechanism of action may be related toimproving intestinal microecology and the modulation of microglial polarization.

[Revelation of the list of occupational diseases and diagnostic criteria for occupational diseases].

The list of occupational diseases reflecting the latest advances in the identification and recognition of occupational diseases, and providing guidance on the protection of workers' health rights and interests and the prevention, recording, notification and compensation of related occupational diseases. Diagnostic criteria for occupational diseases are an important basis for making diagnoses attributable to occupational diseases, and provide a theoretical basis for health monitoring of occupational groups and occupational hygiene supervision. This thesis starts with the definition of the occupational disease elaborates in detail the development history of list of occupational diseases in International Labour Organization (ILO) , compares the list of occupational diseases in China (2013 version) with the list of occupational diseases in international (2010 version) , and then introduces in detail the latest diagnostic standards of the major occupational diseases. And finally, it puts forward relevant suggestions on the list and diagnostic level of China's occupational diseases, so as to provide certain insights for the further improvement of the list and diagnostic standards of occupational diseases.

Rectal microbiomes and serum metabolomics reveal the improved effect of Artemisia ordosica crude polysaccharides on the lactation performance, antioxidant status, and immune responses of lactating donkeys.

This study is aimed at investigating the effects of dietary supplementation with Artemisia ordosica crude polysaccharides (AOCP) on lactation performance, antioxidant status, and immune status of lactating donkeys and analyzing rectal microbiomes and serum metabolomes. Fourteen lactating Dezhou donkeys with similar age (6.16 ± 0.67 yr of BW ± SD), weight (250.06 ± 25.18 kg), DIM (39.11 ± 7.42 d), and average parity of 3 were randomly allocated into 2 treatments: a control group (CON, basal diet) and an AOCP group (AOCP, basal diet with 1.0 g/kg DM AOCP). Ten weeks were allotted for the experiment, 2 wk for adaptation, and 8 wk for collecting data and samples. The results showed that supplementation of donkey diets with AOCP increased lactation performance, including DMI, milking yield, estimated milk yield, solids-corrected milk, ECM, milk fat yield, milk protein yield, milk lactose yield, milk TS yield, and milk SNF yield. The digestibility of DM, CP, ADF, and NDF was increased in the AOCP group compared with the CON group. The AOCP group increased the concentrations of IgA, IgG, and IgM, the activities of the superoxide dismutase, catalase, and total antioxidant capacity in the serum. Artemisia ordosica crude polysaccharides decreased the concentrations of tumor necrosis factor-α, nitric oxide, reactive oxygen species, and malondialdehyde in the serum. Compared with the CON group, AOCP increased propionate, butyrate, isovalerate, and total VFA concentrations in rectal feces (P < 0.05). The addition of AOCP to increased diversity (Shannon index) and altered structure of the rectal microflora. As a result of AOCP supplementation, there has been a significant improvement in the colonization of beneficial bacteria, including Lactobacillus, Unclassified_f_Prevotellacea, Ruminococcus, and Fibrobacter genera. In contrast, a decrease in the colonization of the Clostridium_sensu_stricto_1 bacterial genus and other pathogenic bacteria was observed. Meanwhile, metabolomics analysis found that AOCP supplementation upregulated metabolites l-tyrosine content while downregulating 9(S)-HODE, choline, sucrose, lysophosphatidylcholine (LysoPC) (18:0), LysoPC (18:1(9Z)), and LysoPC (20:2(11Z,14Z)) concentrations. These altered metabolites were involved in the PPAR signaling pathway, prolactin signaling pathway, glycerophospholipid metabolism, carbohydrate digestion and absorption, and tyrosine metabolism pathways, which were mainly related to antioxidant capacity, immune responses, and protein metabolism in the lactating donkeys. As a consequence of feeding AOCP diets, beneficial bacteria were abundant, and antioxidant and protein metabolism-related pathways were enriched, which may enhance lactation performance in donkeys. Therefore, supplementing AOCP diets is a desirable dietary strategy to improve donkey health and lactation performance.

[Analysis of the awareness rate and correlates of core information on tuberculosis prevention and control in elderly in Chinese].

Objective: To understand the awareness and influencing factors of core information on tuberculosis prevention and control in the elderly population in China. Methods: The study included all participants aged ≥60 from the "13th Five-Year" National Tuberculosis Control Plan end-term assessment in 2020, with 13 706 valid questionnaires obtained. Multivariate logistic regression was used to analyze the influencing factors of the awareness rate of core information on tuberculosis prevention and control in the elderly. Results: The total awareness rate of core information on tuberculosis prevention and control in the elderly aged ≥60 was 78.4%, with the highest for "suspicious symptoms of pulmonary tuberculosis" (85.4%) and the lowest for "whether pulmonary tuberculosis can be cured" (65.3%). The complete awareness rate of core information on tuberculosis prevention and control in the elderly was 41.3%, and the proportion of those who received tuberculosis health education is 67.6%. Multivariate logistic regression analysis results showed that factors associated with low awareness of core information included females (OR=0.93, 95%CI: 0.86-1.00), ages 70- (OR=0.91, 95%CI: 0.84-0.98) and ≥80 (OR=0.77, 95%CI: 0.68-0.87) and minority ethnicity (OR=0.85, 95%CI: 0.74-0.99). Factors associated with high awareness of core information included educational levels of junior high school (OR=1.46, 95%CI: 1.34-1.58), high school (OR=1.62, 95%CI: 1.45-1.81), junior college (OR=1.37, 95%CI: 1.11-1.68), and an undergraduate degree or higher (OR=1.52, 95%CI: 1.09-2.11), and receiving tuberculosis health education (OR=2.13, 95%CI: 1.97-2.27). Conclusions: In 2020, the awareness rate of core information on tuberculosis prevention and control in Chinese older adults aged ≥60 was lower than the national planning target. Therefore, there should be an increased focus on health education about tuberculosis for elderly females, those aged ≥70, ethnic minorities, and those with lower education levels.

[Association between hair trace element and all-cause death in elderly people in Hainan].

Objective: To explore the association between hair trace element and all-cause death in the elderly in Hainan Province. Methods: The subjects of the study were elderly people from China Hainan Centenarian Cohort Study, a total of 163 elderly were included. The association between hair trace element level and all-cause death was analyzed by using Cox proportional risk regression model. Results: After fully adjusting the covariates, the multiple Cox proportional hazards regression analyses showed that selenium (Se), manganese (Mn), strontium (Sr) concentrations in hair were significantly associated with all-cause mortality, the hazard ratio (HR) were 0.72 (95%CI: 0.54-0.98, P=0.035), 1.50 (95%CI: 1.07-2.11, P=0.020) and 0.54 (95%CI: 0.37-0.79, P=0.001), respectively. Subgroup and cross analysis showed that hair copper (Cu) were significant association with death in the people with anemia, the HR were 1.81 (95%CI: 1.13-2.88, P=0.013). And, hair Mn interacted with anemia, the HR was 0.46 (95%CI: 0.22-0.94, P=0.033). Conclusions: Se, Mn and Sr concentrations in hair were associated with the elevated risk for all-cause death in the elderly in Hainan. Se, Mn and Sr concentrations in hair can be used as a reference index for the prediction of the death risk of long-lived elderly in community, suggesting that the daily diet of elderly people are rich and diverse, in order to maintain normal and balanced trace element content in the body.