Stapled transperineal rectovaginal fistula repair for low- and mid-level rectovaginal fistulas: A comparison study with rectal mucosal advancement flap repair.

BACKGROUND: As an innovative treatment, stapled transperineal rectovaginal fistula repair (STR) for rectovaginal fistula (RVF) has demonstrated effectiveness in preliminary reports. This study aims to compare STR with rectal mucosal advancement flap repair (RAF), a widely utilized surgical procedure, for the surgical outcome of the low- and mid-level RVF. METHODS: In this retrospective cohort study, patients with low- and mid-level RVF who underwent STR or RAF were included from both the Sixth Affiliated Hospital of Sun Yat-sen University and Xi'an Daxing Hospital. Among the 99 total patients, 77 underwent STR and 22 underwent RAF. Patient demographics, operative data, and outcomes were collected and analyzed. Recurrence rate and associated risk factors were evaluated. RESULTS: There were no statistically significant differences among patients in terms of clinical characteristics like age, BMI, aetiology, and fistula features. During the follow-up period of 20 months (interquartile range 3.0-41.8 months), a total of 28 patients relapsed, with a significantly lower recurrence rate in the STR group (20.8 %) than in the RAF group (54.6 %) (P = 0.005). In the multivariate Cox analysis, STR was an independent protective factor against recurrence (HR: 0.37, 95%CI: 0.17-0.79, P = 0.01). Logistic regression indicated that there was no statistically significant difference between these two procedures in terms of surgical complications (OR: 0.53, 95%CI: 0.19-1.48, P = 0.23). CONCLUSION: For low- and mid-level RVF, STR may be an alternative option for treatment modality that offers a lower recurrence rate, without observed disadvantage in terms of surgical complication rates.

Minutes-duration optical flares with supernova luminosities.

In recent years, certain luminous extragalactic optical transients have been observed to last only a few days1. Their short observed duration implies a different powering mechanism from the most common luminous extragalactic transients (supernovae), whose timescale is weeks2. Some short-duration transients, most notably AT2018cow (ref. 3), show blue optical colours and bright radio and X-ray emission4. Several AT2018cow-like transients have shown hints of a long-lived embedded energy source5, such as X-ray variability6,7, prolonged ultraviolet emission8, a tentative X-ray quasiperiodic oscillation9,10 and large energies coupled to fast (but subrelativistic) radio-emitting ejecta11,12. Here we report observations of minutes-duration optical flares in the aftermath of an AT2018cow-like transient, AT2022tsd (the 'Tasmanian Devil'). The flares occur over a period of months, are highly energetic and are probably nonthermal, implying that they arise from a near-relativistic outflow or jet. Our observations confirm that, in some AT2018cow-like transients, the embedded energy source is a compact object, either a magnetar or an accreting black hole.

Synergistic Association between Plasma Aß1-42 and p-tau in Alzheimer's Disease but Not in Parkinson's Disease or Frontotemporal Dementia.

Beta-amyloid (Aß1-42) triggers the phosphorylation of tau protein in Alzheimer's disease (AD), but the relationship between phosphorylated tau (p-tau) and Aß1-42 in the blood is not elucidated. We investigated the association in individuals with AD (n = 62, including amnesic mild cognitive impairment and dementia), Parkinson's disease (n = 30), frontotemporal dementia (n = 25), and cognitively unimpaired controls (n = 41) using immunomagnetic reduction assays to measure plasma Aß1-42 and p-tau181 concentrations. Correlation and regression analyses were performed to examine the relation between plasma levels, demographic factors, and clinical severity. Both plasma Aß1-42 and p-tau concentrations were significantly higher in AD and frontotemporal dementia than in the controls and Parkinson's disease. A significant positive association was found between plasma p-tau and Aß1-42 in controls (r = 0.579, P < 0.001) and AD (r = 0.699, P < 0.001) but not in frontotemporal dementia or Parkinson's disease. Plasma p-tau was significantly associated with clinical severity in the AD in terms of scores of clinical dementia rating (r = 0.288, P = 0.025) and mini-mental state examination (r = -0.253, P = 0.049). Regression analysis showed that plasma Aß1-42 levels explain approximately 47.7% of the plasma p-tau levels in the AD after controlling age, gender, and clinical severity. While in non-AD participants, the clinical dementia rating explained about 47.5% of the plasma p-tau levels. The disease-specific association between plasma Aß1-42 and p-tau levels in AD implies a possible synergic effect in mechanisms involving these two pathological proteins' genesis.

Immunomagnetic Reduction Detects Plasma Aß1-42 Levels as a Potential Dominant Indicator Predicting Cognitive Decline.

Although the concentrations of Alzheimer's disease (AD) biomarkers Aß1-40, Aß1-42 and tau protein are very low in human plasma, ultrasensitive assays such as immunomagnetic reduction (IMR) are able to precisely quantify them. Review articles have described the detailed working mechanism of IMR and revealed the feasibility of detecting early-stage AD by assaying these plasma biomarkers with IMR. In this review, we aimed to compare the significance of these plasma biomarkers in predicting cognitive decline in patients with Down syndrome, stroke, or amnestic mild cognitive impairment based on findings in the literature. We found that plasma Aß1-42 might play the predominant role in predicting cognitive decline in these patients.

Effect of Times to Blood Processing on the Stability of Blood Proteins Associated with Dementia.

BACKGROUND: The stability of proteins in the collecting tubes after blood draw is critical to the measured concentrations of the proteins. Although the guidelines issued by the Clinical and Laboratory Standards Institute (CLSI) suggest centrifugation should take place within 2 h of drawing blood, it is very difficult to follow these guidelines in hospitals or clinics. It is necessary to study the effect of times to blood processing on the stability of the proteins of interest. METHODS: In this work, the plasma proteins of interest were those relevant to dementia, such as amyloid ß 1-40 (Aß1-40), Aß1-42, Tau protein (Tau), and α-synuclein. The times to blood processing after blood draw ranged from 0.5 to 8 h. The storage temperatures of blood were room temperature (approx. 25°C) and 30°C. After storage, blood samples were centrifuged at room temperature to obtain plasma samples. Ultrasensitive immunomagnetic reduction was applied to assay these proteins in the plasma. RESULTS: The levels of plasma Aß1-40, Tau, and α-synuclein did not significantly change until 8 h after blood draw when stored at room temperature. Plasma Aß1-42 levels did not change significantly after 8 h of storage at room temperature before blood processing. Higher storage temperatures, such as 30°C, for blood samples accelerated the significant variations in the measured concentrations of Aß1-40, Tau, and α-synuclein in plasma. CONCLUSION: According to these results, for clinical practice, it is suggested that blood samples be stored at room temperature for no longer than 4.5 h after blood draw until centrifugation for the assay of dementia biomarkers in plasma.

Aliskiren Improves Ischemia- and Oxygen Glucose Deprivation-Induced Cardiac Injury through Activation of Autophagy and AMP-Activated Protein Kinase.

Aliskiren is a direct renin inhibitor that has been effective in anti-hypertension. We investigated whether aliskiren could improve the ischemia-induced cardiac injury and whether the autophagy was involved in this effect. A myocardial infarction (MI) model was created by the ligation of the left anterior coronary artery in C57J/BL6 mice. They were treated for 1, 3, 7, and 14 days with vehicle or aliskiren (25 mg/kg/day via subcutaneous injection). In vivo, the MI mice exhibited worse cardiac function by echocardiographic assessment and showed larger myocardial scarring by light microscopy, whereas aliskiren treatment reversed these effects, which were also associated with the changes in caspase-3 and Bcl-2 expression as well as in the number of apoptotic cells. Aliskiren increased autophagy, as demonstrated by LC3B-II expression and transmission electron microscopy. Furthermore, H9c2 cardiomyocytes were employed as an in vitro model to examine the effects of aliskiren on apoptosis and autophagy under oxygen glucose deprivation (OGD)-induced injury. Aliskiren significantly increased cell viability in a dose-dependent manner. The beneficial effects of aliskiren were associated with decreased apoptosis and mitochondrial membrane potential as well as increased autophagy via increased autophagosome formation. We also found that aliskiren-induced cardiomyocyte survival occurred via AMP-activated protein kinase (AMPK)-dependent autophagy. Taken together, these results indicated that aliskiren increased cardiomyocyte survival through increased autophagosomal formation and decreased apoptosis and necrosis via modulating AMPK expression. AMPK-dependent autophagy may represent a novel mechanism for aliskiren in ischemic cardiac disease therapy.

Discovery of a very Lyman-α-luminous quasar at z = 6.62.

Distant luminous quasars provide important information on the growth of the first supermassive black holes, their host galaxies and the epoch of reionization. The identification of quasars is usually performed through detection of their Lyman-α line redshifted to 0.9 microns at z > 6.5. Here, we report the discovery of a very Lyman-α luminous quasar, PSO J006.1240 + 39.2219 at redshift z = 6.618, selected based on its red colour and multi-epoch detection of the Lyman-α emission in a single near-infrared band. The Lyman-α line luminosity of PSO J006.1240 + 39.2219 is unusually high and estimated to be 0.8 × 1012 Solar luminosities (about 3% of the total quasar luminosity). The Lyman-α emission of PSO J006.1240 + 39.2219 shows fast variability on timescales of days in the quasar rest frame, which has never been detected in any of the known high-redshift quasars. The high luminosity of the Lyman-α line, its narrow width and fast variability resemble properties of local Narrow-Line Seyfert 1 galaxies which suggests that the quasar is likely at the active phase of the black hole growth accreting close or even beyond the Eddington limit.

Analysis of nursing effect of different feeding ways in children with congenital cleft lip after surgery / 口腔疾病防治

Objective@# To investigate the influence of different feeding ways on the incidence rate of complication in patients with congenital cleft lip and their family satisfaction degree.@*Methods@# A retrospective analysis were conducted from 90 cases underwent surgery of congenital cleft lip with clinical data, were randomly assigned to the control group and the observation group, 45 cases in each. The control group routinely take spoon feeding way after surgery, whereas patients in the observation group does not change the feeding way in the past, continuely taking the nipple feeding or breastfeeding. Wound infection rate, wound rupture rate, crying in the process of feeding and parents' satisfaction were compared between the two groups.@*Results@#The wound infection rate and wound rate of the observation group were 2.2% and 0 respectively, the control group were 4.4% and 0 respectively. There was no significant difference between the 2 groups in the 2 index (P > 0.05). In the observation group, the crying children were less than the control group, In the observation group, the degree of coordination, parental satisfaction and acceptance of feeding were 84.4%, 88.9%, 93.3%, respectively, the control group were 55.6%, 60.0%, 66.7%. The observation group were better than the control group. The differences between groups was statistically significant (χ2coordination degree = 8.94, χ2satisfaction degree = 9.87, χ2recognition degree = 10.00, P < 0.05).@*Conclusion@# Children under the age of 1 with congenital grade Ⅰ and Ⅱ cleft lip do not change the way of feeding after surgery , who continue to take the bottle or breastfeeding can better meet the needs of children fed liquid diet, crying reduce, get parents' recogniton and reduce the burden on parents than the control group conventionally fed with a spoon.

Repetitive patterns in rapid optical variations in the nearby black-hole binary V404 Cygni.

How black holes accrete surrounding matter is a fundamental yet unsolved question in astrophysics. It is generally believed that matter is absorbed into black holes via accretion disks, the state of which depends primarily on the mass-accretion rate. When this rate approaches the critical rate (the Eddington limit), thermal instability is supposed to occur in the inner disk, causing repetitive patterns of large-amplitude X-ray variability (oscillations) on timescales of minutes to hours. In fact, such oscillations have been observed only in sources with a high mass-accretion rate, such as GRS 1915+105 (refs 2, 3). These large-amplitude, relatively slow timescale, phenomena are thought to have physical origins distinct from those of X-ray or optical variations with small amplitudes and fast timescales (less than about 10 seconds) often observed in other black-hole binaries-for example, XTE J1118+480 (ref. 4) and GX 339-4 (ref. 5). Here we report an extensive multi-colour optical photometric data set of V404 Cygni, an X-ray transient source containing a black hole of nine solar masses (and a companion star) at a distance of 2.4 kiloparsecs (ref. 8). Our data show that optical oscillations on timescales of 100 seconds to 2.5 hours can occur at mass-accretion rates more than ten times lower than previously thought. This suggests that the accretion rate is not the critical parameter for inducing inner-disk instabilities. Instead, we propose that a long orbital period is a key condition for these large-amplitude oscillations, because the outer part of the large disk in binaries with long orbital periods will have surface densities too low to maintain sustained mass accretion to the inner part of the disk. The lack of sustained accretion--not the actual rate--would then be the critical factor causing large-amplitude oscillations in long-period systems.

Proteome Scale-Protein Turnover Analysis Using High Resolution Mass Spectrometric Data from Stable-Isotope Labeled Plants.

Protein turnover is an important aspect of the regulation of cellular processes for organisms when responding to developmental or environmental cues. The measurement of protein turnover in plants, in contrast to that of rapidly growing unicellular organismal cultures, is made more complicated by the high degree of amino acid recycling, resulting in significant transient isotope incorporation distributions that must be dealt with computationally for high throughput analysis to be practical. An algorithm in R, ProteinTurnover, was developed to calculate protein turnover with transient stable isotope incorporation distributions in a high throughput automated manner using high resolution MS and MS/MS proteomic analysis of stable isotopically labeled plant material. ProteinTurnover extracts isotopic distribution information from raw MS data for peptides identified by MS/MS from data sets of either isotopic label dilution or incorporation experiments. Variable isotopic incorporation distributions were modeled using binomial and beta-binomial distributions to deconvolute the natural abundance, newly synthesized/partial-labeled, and fully labeled peptide distributions. Maximum likelihood estimation was performed to calculate the distribution abundance proportion of old and newly synthesized peptides. The half-life or turnover rate of each peptide was calculated from changes in the distribution abundance proportions using nonlinear regression. We applied ProteinTurnover to obtain half-lives of proteins from enriched soluble and membrane fractions from Arabidopsis roots.

Qualitative and quantitative screening of amino acids in plant tissues.

The comprehensive analysis of metabolites (metabolomics) and expressed proteins (proteomics) in any given biological system forms the center of modern efforts to define the critical functions of biological systems. Because amino acids play important roles in primary and secondary metabolic pathways as well as serving as the building blocks of proteins, they have been important targets for efforts at metabolic profiling. Amino acids have been analyzed using a number of procedures, including separation by high performance liquid chromatography (HPLC), gas chromatography (GC), liquid chromatography (LC), and capillary electrophoresis (CE). Mass spectrometry (MS) remains the primary analytical and detection system for metabolic profiling, including amino acid analysis, due to its accuracy and the information content obtained by such analyses, which facilitates the identification and measurement of large numbers of biomolecules. MS methods also add the capability of monitoring isotope distributions of molecules for metabolic flux analysis. Here we describe a GC-MS method that is suitable for analysis of amino acids in sub-milligram quantities of fresh plant material and that is easily adapted to high-throughput screening approaches.

An automated growth enclosure for metabolic labeling of Arabidopsis thaliana with 13C-carbon dioxide - an in vivo labeling system for proteomics and metabolomics research.

BACKGROUND: Labeling whole Arabidopsis (Arabidopsis thaliana) plants to high enrichment with 13C for proteomics and metabolomics applications would facilitate experimental approaches not possible by conventional methods. Such a system would use the plant's native capacity for carbon fixation to ubiquitously incorporate 13C from 13CO2 gas. Because of the high cost of 13CO2 it is critical that the design conserve the labeled gas. RESULTS: A fully enclosed automated plant growth enclosure has been designed and assembled where the system simultaneously monitors humidity, temperature, pressure and 13CO2 concentration with continuous adjustment of humidity, pressure and 13CO2 levels controlled by a computer running LabView software. The enclosure is mounted on a movable cart for mobility among growth environments. Arabidopsis was grown in the enclosure for up to 8 weeks and obtained on average >95 atom% enrichment for small metabolites, such as amino acids and >91 atom% for large metabolites, including proteins and peptides. CONCLUSION: The capability of this labeling system for isotope dilution experiments was demonstrated by evaluation of amino acid turnover using GC-MS as well as protein turnover using LC-MS/MS. Because this 'open source' Arabidopsis 13C-labeling growth environment was built using readily available materials and software, it can be adapted easily to accommodate many different experimental designs.

[Recent developments of drug eluting stent coatings].

Drug eluting stents (DESs) have revolutionized the interventional cardiology over the past decade since the first DES became commercially available in Europe in 2002. Compared to bare metal stents that are deployed to keep the vessel open by mechanical force, DESs have an additional function of reducing restenosis by the action of the drug on the target site. Coatings on the stent surface which ensure the maximum delivery of therapeutic agents to the target site with minimal systematic toxicity, also play an important role in adjusting the drug release profile. Coating material and technology not only affect the surface biocompatibility and the integrity maintenance during the implanting process, but also decide the way of drug delivering and transmitting from the coating. This paper reviews the basic principles of DES coating design, the categories of DES coatings, the commonly used clinical DES coatings and their efficiency in reducing restenosis, and finally provides the future perspectives for DES coatings.

Microscale analysis of amino acids using gas chromatography-mass spectrometry after methyl chloroformate derivatization.

To conduct studies of stable isotope incorporation and dilution in growing plants, a rapid microscale method for determination of amino acid profiles from minute amounts of plant samples was developed. The method involves solid-phase ion exchange followed by derivatization and analysis by gas chromatography-mass spectrometry (GC-MS). The procedure allowed the eluent to be derivatized directly with methyl chloroformate without sample lyophilization or other evaporation procedures. Sample extraction and derivatization required only ca. 30min and quantification of the 19 amino acids eluted from the cation exchange solid-phase extraction step from a single cotyledon (0.4mg fresh weight) or three etiolated 7-day-old Arabidopsis seedlings (0.1mg fresh weight) was easily accomplished in the selected ion monitoring mode. This method was especially useful for monitoring mass isotopic distribution of amino acids as illustrated by Arabidopsis seedlings that had been labeled with deuterium oxide and (15)N salts. Sample preparation was facile, rapid, economical, and the method is easily modified for integration into robotic systems for analysis with large numbers of samples.

Measuring the turnover rates of Arabidopsis proteins using deuterium oxide: an auxin signaling case study.

Rapid environmental responses in plants rely on endogenous signaling mechanisms, which in many cases are mediated by changes in protein turnover rates. It is therefore necessary to develop methods for measuring protein dynamics that monitor large sets of plant proteins to begin to apply a systems biology approach to the study of plant behavior. The use of stable isotope labeling strategies that are adaptable to proteomic methods is particularly attractive for this purpose. Here, we explore one example of such methods that is particularly suitable for plants at the seedling stage, where measurement of amino acid and protein turnover rates is accomplished using a heavy water labeling strategy. The method is backed by microarray evaluation to define its feasibility for specific experimental approaches, and the CULLIN-ASSOCIATED AND NEDDYLATION DISSOCIATED 1 (CAND1) and TRANSPORT INHIBITOR RESPONSE 1 (TIR1) proteins are used to illustrate the potential utility in understanding hormonal signaling regulation. These studies provide insight not only into the potential utility of the method, but also address possible areas of concern regarding the use of heavy water labeling during plant growth. These considerations suggest a prescription for specific experimental designs that minimize interference resulting from the induction of treatment-specific gene expression in the results obtained.

[Biomass- and energy allocation in Eucalyptus urophylla x Eucalyptus tereticornis plantations at different stand ages].

An investigation was made on the biomass- and energy allocation in 1-4-year-old Eucalyptus urophylla x Eucalyptus tereticornis plantations at Beipo Forest Farm of Suixi County in Guangdong Province. Stand age had significant effects on the retained biomass of the plantations (P < 0.01). The biomass was in the range of 10.61-147.28 t x hm(-2). Both the total biomass and the biomass of above- and belowground components increased with increasing stand age. The proportions of leaf-, branch- and bark biomass to total biomass decreased with year, while that of stem biomass was in reverse. The biomass allocation of the components in 1- and 2-year-old plantations decreased in order of stem > branch > bark > root > leaf, and that in 3- and 4 -year-old plantations was in order of stem > root > branch > bark > leaf. The mean ash content (AC) of the five components at different stand ages ranged from 0.47% to 5.91%, being the highest in bark and the lowest in stem. The mean gross caloric value (GCV) and ash free caloric value (AFCV) of different components ranged from 17.33 to 20. 60 kJ x g(-1) and from 18.42 to 21.59 kJ x g(-1) respectively. Of all the components, leaf had the highest GVC and AFCV, while bark had the lowest ones. Stand age had significant effects on the GVC of branch, stem, and bark, and on the AFCV of leaf, stem, and bark (P < 0.05), but the effects on the GVC of leaf and root, the AFCV of branch and root, and the GVC and AFCV of individual trees were not significant (P > 0.05). The retained energy of 1-4-year-old plantations ranged from 199.98 to 2837.20 GJ x hm(-2), with significant differences among the stand ages (P < 0.01). The retained energy of various components and plantations increased with stand age, and the energy allocation of various components had the same trend as biomass allocation.

The Arabidopsis P450 protein CYP82C2 modulates jasmonate-induced root growth inhibition, defense gene expression and indole glucosinolate biosynthesis.

Jasmonic acid (JA) is a fatty acid-derived signaling molecule that regulates a broad range of plant defense responses against herbivores and some microbial pathogens. Molecular genetic studies have established that JA also performs a critical role in several aspects of plant development. Here, we describe the characterization of the Arabidopsis mutant jasmonic acid-hypersensitive1-1 (jah1-1), which is defective in several aspects of JA responses. Although the mutant exhibits increased sensitivity to JA in root growth inhibition, it shows decreased expression of JA-inducible defense genes and reduced resistance to the necrotrophic fungus Botrytis cinerea . Gene cloning studies indicate that these defects are caused by a mutation in the cytochrome P450 protein CYP82C2. We provide evidence showing that the compromised resistance of the jah1-1 mutant to B . cinerea is accompanied by decreased expression of JA-induced defense genes and reduced accumulation of JA-induced indole glucosinolates (IGs). Conversely, the enhanced resistance to B. cinerea in CYP82C2-overexpressing plants is accompanied by increased expression of JA-induced defense genes and elevated levels of JA-induced IGs. We demonstrate that CYP82C2 affects JA-induced accumulation of the IG biosynthetic precursor tryptophan (Trp), but not the JA-induced IAA or pathogen-induced camalexin. Together, our results support a hypothesis that CYP82C2 may act in the metabolism of Trp-derived secondary metabolites under conditions in which JA levels are elevated. The jah1-1 mutant should thus be important in future studies toward understanding the mechanisms underlying the complexity of JA-mediated differential responses, which are important for plants to adapt their growth to the ever-changing environments.

[Growth effect of eucalyptus-acacia mixed plantation in South China].

Eucalyptus U6 and Acacia crassicarpa were mixed planted with different ratios and modes to investigate the growth parameters of the two tree species. In the 2-3 years old mixed plantation, the wind-throw of A. crassicarpa decreased markedly with increasing ratio of Eucalyptus U6, the decrement being 26.14% when the Eucalyptus U6/A. crassicarpa ratio was 3 : 1, but the survival rates of Eucalyptus U6 and A. crassicarpa had no significant difference under different planting modes. Mixed planting retarded the A. crassicarpa growth to some extent, with the DBH being 90% of that in pure A. crassicarpa stand. The mixed planting had little effects on the height growth of Eucalyptus U6, but promoted its DBH growth markedly, and the beneficial effect increased with increasing ratio of A. crassicarpa. In the 6 years old 1 : 1 Eucalyptus U6/A. crassicarpa plantation, the Eucalyptus U6 individuals with DBH > 15 cm occupied 32.1%; while in pure Eucalyptus U6 stand, they only accounted for 5.83%. Mixed planting with 2 : 1 Eucalyptus U6/A. crassicarpa could obtain a maximum total biomass of 198.8 m3 x hm(-2), which was 118.8% of the total biomass in pure Eucalyptus U6 stand, or 169.9% of that in pure A. crassicarpa stand. Mixture of Eucalyptus with Acacia would be a good choice to produce Eucalyptus trees with larger DBH.

[Laparoscopic operations for benign ovarian cysts: report of 50 cases].

OBJECTIVE: To investigate the surgical indications and techniques of laparoscopic operation for benign ovarian cysts. METHODS: Fifty patients with benign ovarian cysts underwent laparoscopic operations of cyst decollement, ovariotomy and adnexectomy. RESULTS: There were 46 cases (92%) of decollement, 2 cases (4%) of adnexectomy and 3 cases (6%) of ovariotomy. The operation time was 30-120 min, and the intraoperative blood loss 20 ml. CONCLUSION: Laparoscopic operation of benign ovarian cysts has advantages of minimal invasive surgery.