[Comparison of Two Methods With a Left-Sided Double-Lumen Tube for Endobronchial Intubation].

Objective To compare the success rates of two methods for endobronchial intubation:the left-sided double-lumen tube(DLT) rotated 90° counter-clockwise with the patient head at the mid positon and the tube rotated 180° counter-clockwise with the patient head turned to the right. Methods Six hundred and forty-eight patients were enrolled in this study,who were to undergo elective thoracic surgery by left-sided DLT intubation in the Peking Union Medical College Hospital from December 2021 to June 2022.They were randomized into a 90° group and a 180° group,with 324 patients in each group.In the 90° group,with the patient head kept at the mid position,the left-sided DLT was advanced until the bronchial cuff passed the vocal cords and then rotated 90° counter-clockwise.In the 180°group,with the left mandible angle of each patient in the straight line with the sternum,the tube was advanced until the bronchial cuff passed the vocal cords and then rotated 180° counter-clockwise.The intubation success rate and the intubation-related complications such as carina mucosal injuries were compared between the two groups. Results The 648 patients included 336 males and 312 females,with the age ranging from 39.0 to 75.0 years old and the average age of(54.6±9.0) years old.The success rate of first intubation was 80.3% in the 90° group and 75.0% in the 180° group,which showed no significant difference(P=0.109).The success rate of second intubation was higher in the 180° group than in the 90° group(P<0.001).The rate of carina mucosal injuries was 23.8% in the 90° group and 25.6% in the 180° group,which showed no significant difference(P=0.585). Conclusions Compared with the conventional method(90°),the intubation of the left-sided DLT rotated 180° counter-clockwise with the patient head turned to the right cannot improve the success rate of the first intubation.However,it could improve the success rate of reintubation as a remedy.

Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China.

AIM: To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis (EE) in a group of Chinese patients. METHODS: The medical records from 32 eyes of 29 patients diagnosed with EE in Peking Union Medical College Hospital from January 2009 to October 2019 were reviewed. RESULTS: The initial visual acuity (VA) of 30 eyes in this study was worse than 20/400. Twenty-three eyes were diagnosed with fungal endophthalmitis and nine with bacterial endophthalmitis. The most common fungal and bacterial isolates were Candida and Klebsiella pneumoniae, respectively. Several rare fungi and bacteria species were also isolated from our patients, including Cryptococcus, Paecilomyces, Brucella, and Bacillus licheniformis. The leading risk factor for EE was diabetes. The most common extraocular infection locus was genitourinary tract. Vitrectomy was performed on twenty-nine eyes. Eight eyes achieved final VA of 20/400 or better. EE caused by Candida had a better prognosis. CONCLUSION: The visual outcome of EE is based on pathogens and prompt intervention. Early vitrectomy and antimicrobial treatment are beneficial for EE.

The complete mitochondrial genome of Ophiocordyceps gracilis and its comparison with related species.

In this study, the complete mitochondrial genome of O. gracilis was sequenced and assembled before being compared with related species. As the second largest mitogenome reported in the family Ophiocordycipitaceae, the mitogenome of O. gracilis (voucher OG201301) is a circular DNA molecule of 134,288 bp that contains numerous introns and longer intergenomic regions. UCA was detected as anticodon in tRNA-Sec of O. gracilis, while comparative mitogenome analysis of nine Ophiocordycipitaceae fungi indicated that the order and contents of PCGs and rRNA genes were considerably conserved and could descend from a common ancestor in Ophiocordycipitaceae. In addition, the expansion of mitochondrial organization, introns, gene length, and order of O. gracilis were determined to be similar to those of O. sinensis, which indicated common mechanisms underlying adaptive evolution in O. gracilis and O. sinensis. Based on the mitochondrial gene dataset (15 PCGs and 2 RNA genes), a close genetic relationship between O. gracilis and O. sinensis was revealed through phylogenetic analysis. This study is the first to investigate the molecular evolution, phylogenetic pattern, and genetic structure characteristics of mitogenome in O. gracilis. Based on the obtained results, the mitogenome of O. gracilis can increase understanding of the genetic diversity and evolution of cordycipitoid fungi.

Betulinic acid attenuates lipopolysaccharide-induced vascular hyporeactivity in the rat aorta by modulating Nrf2 antioxidative function.

Betulinic acid (BA), a pentacyclic triterpenoid, has been reported to inhibit cardiovascular dysfunction under sepsis-induced oxidative stress. Nuclear factor erythroid-2 related factor-2 (Nrf2) is regarded as a key transcription factor regulating expression of endogenous antioxidative genes. To explore the preventive effects of BA against vascular hyporeactivity and the related antioxidative mechanism in sepsis, contraction and relaxation in aortas isolated from lipopolysaccharide (LPS)-challenged rats were performed. Male Sprague-Dawley rats were pretreated with brusatol (Bru, 0.4 mg/kg/2 days, i.p.), an inhibitor of Nrf2, and BA (10, 25, 50 mg/kg/day, i.g.) for 3 days and injected with LPS (10 mg/kg, i.p.) at the 4th day. Rats were anesthetized and killed by cervical dislocation after they were treated with LPS for 4 h. Thoracic aortas were immediately dissected out to determine contraction and relaxation using the organ bath system. Pro-inflammatory factors interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α) and oxidative stress were measured in aortic tissues and plasma. mRNA expression of Nrf2-regulated antioxidative enzymes, including superoxide dismutase (SOD), glutathione peroxidase (GPx), and heme oxygenase-1 (HO-1), in rat aortas was determined. Increases of IL-1ß, TNF-α, nitric oxide, and malondialdehyde and the decrease of glutathione induced by LPS were significantly attenuated by pretreatment with different doses of BA in plasma and aortas (p < 0.05 versus LPS), all of which were blocked by Bru (p < 0.01). Inhibition of phenylephrine (PE)- and KCl-induced contractions and acetylcholine (ACh)-induced vasodilatation in aortas from LPS-challenged rats was dose-dependently reduced by BA (p < 0.05; percentage improvements by BA in PE-induced contraction were 55.38%, 96.41%, and 104.33%; those in KCl-induced contraction were 15.11%, 23.96%, and 22.96%; and those in ACh-induced vasodilatation were 16.08%, 42.99%, and 47.97%), all of which were reversed by Bru (p < 0.01). Improvements of SOD, GPx, and HO-1 mRNA expression conferred by BA in LPS-challenged rat aortas were inhibited by Bru (p < 0.01; 145.45% versus 17.42%, 160.69% versus 22.76%, and 166.88% versus 23.57%). These findings suggest that BA attenuates impairments of aortic contraction and relaxation in LPS-challenged rats by activating Nrf2-regulated antioxidative pathways.

[Optical Coherence Tomography Angiography-based Follow-up Observation of Wet Age-related Macular Degeneration after Intravitreal Anti-Ranibizumab Therapy].

Objective To observe the imaging features of optical coherence tomography angiography(OCTA)in eyes with wet age-related macular degeneration(wAMD)after treatment with 3+pro re nata(3+PRN)of intravitreal anti-Ranibizumab.Methods This study included 8 treatment-naive eyes with wAMD diagnosed by fluorescein fundus angiography(FFA)and indocyanine green angiography(ICGA)from September 2016 to May 2017.All the patients were treated with 3+PRN of intravitreal anti-Ranibizumab(0.5 mg/0.05 ml).We performed OCTA with 6 mm×6 mm scans at baseline and 1,3,and 6 months after treatment.We analyzed best corrected visual acuity(BCVA)(logMAR),type of choroidal neovascular(CNV),and morphological features and changes of CNV,central retinal thickness(CRT),outer retina vessel density(ORVD),and choroidal capillary vessel density(CCVD).Results A total of 8 eyes were examined in 8 patients[4 males and 4 females with a mean age of(70.9±10.6)years of age].Three eyes had type Ⅰ CNV and 5 eyes had type Ⅱ CNV.At baseline,month 1,month 3,and month 6,BCVA was 0.55(0.33,0.87),0.35(0.24,0.84),0.35(0.22,0.58),and 0.26(0.10,0.58)logMAR,respectively(all P>0.05).CRT was(271.88±91.95),(204.00±45.78),(196.00±31.14),and(219.25±71.32)µm,respectively,and there was a statistical significance between CRT at baseline and CRT at month 3(t=2.211,P=0.044).ORVD was(41.38±2.77)%,(41.73±3.60)%,(42.53±1.95)%,and(41.40±2.33)%,respectively(all P>0.05).CCVD was(64.38±2.24)%,(64.96±1.39)%,(64.16±1.39)%,and(64.63±1.86)%,respectively(all P>0.05).Correlation analysis showed BCVA was significantly correlated with both CRT(P=0.009, RR=0.457)and CCVD(P=0.001,RR=0.574),but not with ORVD(P=0.093,RR=0.302).The morphological features at baseline showed that 2 eyes were lump-like,2 eyes were line-like,2 eyes were tangles,1 eye was elliptical ring-like,and 1 eye was fragment.At month 1,the morphologies were improved in 7 eyes,including the CNV showed decreased maximum diameter,rupture/fragment,loss of peripheral capillaries,decreased numbers and density,and reduced maximum cross-sectional area;the condition became worse in 1 eye,including the CNV showed ring formation,increased density,and increased maximum diameter.At month 3,the morphologied of 7 eyes were improved,while no obvious change was seen in 1 eye.At month 6,the CNV became normalized in 5 eyes but worsened in 3 eyes.No intraocular infection or other intravitreal injection-related complication was observed during the follow-up.Conclusion Observing CNV characteristics using OCTA technology can be used to evaluate the efficacy of Ranibizumab in patients with wAMD and guide the treatment and follow-up of wAMD patients.

Population genetic polymorphism and mutation analysis of 19 autosomal STR loci in Jiangsu Han individuals in Eastern China.

Aim: Genetic polymorphisms and the mutation ratio of 19 autosomal short tandem repeat (STR) loci were analysed in 10,000 individuals and 7755 families from Jiangsu Province in Eastern China.Subjects and methods: Nineteen STR loci were amplified by a multiplex amplification system and genotyped on the ABI 3130 Genetic Analyser. Allele frequencies, forensic parameters and mutations for the 19 autosomal STR loci were statistically analysed.Results: In total, 344 genotypes were discovered. No significant deviation from Hardy-Weinberg equilibrium was observed. The combined power of discrimination reached 0.9999999999999999984341, and the combined probability of paternity exclusion was 0.999999989. The pairwise genetic distance and p-values between the Jiangsu and 17 published populations depended on the FST value calculation and are shown by the neighbour-joining evolutionary tree. No statistically significant differences were found, except for the Xinjiang Altay Han (p = 0.01802) population. The average mutation rate of the Jiangsu population across all 19 loci was 1.4 × 10-3. The average mutation rate of the 13 core CODIS STR loci remained below 2 × 10-3 and there was no difference and relatively high consistency (p < 0.001) by correlation coefficient analysis among the six groups.Conclusions: Allelic genetic polymorphisms and mutation data were obtained from a large number of samples, which indicated that the amplification kit is suitable for forensic application and that the Jiangsu population has its own genetic characteristics that are different from those of other ethnic populations.

Comprehensive metabolomic, proteomic and physiological analyses of grain yield reduction in rice under abrupt drought-flood alternation stress.

Abrupt drought-flood alternation (T1) is a meteorological disaster that frequently occurs during summer in southern China and the Yangtze river basin, often causing a significant loss of rice production. In this study, the response mechanism of yield decline under abrupt drought-flood alternation stress at the panicle differentiation stage was analyzed by looking at the metabolome, proteome as well as yield and physiological and biochemical indexes. The results showed that drought and flood stress caused a decrease in the yield of rice at the panicle differentiation stage, and abrupt drought-flood alternation stress created a synergistic effect for the reduction of yield. The main reason for the decrease of yield per plant under abrupt drought-flood alternation was the decrease of seed setting rate. Compared with CK0 (no drought and no flood), the net photosynthetic rate and soluble sugar content of T1 decreased significantly and its hydrogen peroxidase, superoxide dismutase, peroxidase activity increased significantly. The identified differential metabolites and differentially expressed proteins indicated that photosynthesis metabolism, energy metabolism pathway and reactive oxygen species response have changed strongly under abrupt drought-flood alteration stress, which are factors that leads to the rice grain yield reduction.

[Effects of traditional tibetan medicine, Fructus Lonicerae microphyllae on phagecytosis and cytokines production of murine macrophages].

OBJECTIVE: To explore the effects of traditional Tibetan medicine, Fructus Lonicerae microphyllae (FLM) on phagecytosis and cytokines production of murine macrophages. METHOD: The phagecytosis of murine macrophages was analyzed by neutral red phagecytosis assay. The activities of IL-1 and TNF-alpha were measured by biological methods. The mRNA of TNF-alpha and INF-gamma expressed by macrophages was detected by RT-PCR. RESULT: The phagecytosis of murine macrophages was significantly enhanced by FLM at a concentration from 1 microg x mL(-1) to 100 microg x mL(-1) and the secretions of IL-1, and TNF-alpha from macrophages were markedly induced by FLM. Meanwhile, FLM also increased the expression of TNF-alpha mRNA and INF-gamma mRHA from macrophages in vitro. CONCLUSION: FLM could promote phagecytosis and cytokines production of murine macrophages.

[Immunosuppressive effect of Tibetan medicine, Artemisia vestita Wall Extract].

OBJECTIVE: To assess the immunosuppressive effect of Artemisia vestita Wall Extract (AV-ext) on mice. METHODS: The proliferative reaction of lymphocyte and the mixed lymphocytes reaction were used to determine the effects of AV-ext on the proliferation of mouse splenocyte in vitro and in vivo; Proliferative reaction of mouse splenocyte was used for detecting the effects of AV-ext on the level of IL-2 secreted by mouse activated splenocyte in vitro. Gelatin enzymogram method and adherence analytical method were employed to disclose the effects of AV-ext on mouse activated T-lymphocytes mobility and adherence. RESULTS: 1-100 microg/mL AV-ext exerted no obvious toxicity to mouse splenocyte, but it had obvious inhibitory effect on proliferative reaction of mouse splenocyte and mixed lymphocytes reaction induced by ConA. It also had obvious inhibitory effect on the level of IL-2 secreted by mouse activated splenocyte, on the production of MMP-9 by mouse activated T-lymphocytes, and on adherence. 150 mg/kg and 300 mg/kg of AV-ext, given to mouse per os for 7 days, could inhibit the proliferation of splenocyte and the secretion of MMP-9 by activated splenocyte of mouse. CONCLUSION: AV-ext can inhibit the cellular immune reaction of mouse obviously.