Yeast strains with improved ethanol yield are important for efficient bioconversion of lignocellulosic biomass for fuel ethanol.Candida shehatae CICC1766 was adapted to 4%(v/v)ethanol,and then subjected to UV mutagenesis.One respiration deficient mutant Rd-5 with improved xylose fermentation capability was selected.Protoplasts of Rd-5 were inactivated by UV treatment,followed by the PEG-mediated protoplast fusion with a Saccharomyces cerevisiae strain with good ethanol-fermenting capability.The xylose fermenting capability of the fusants was investigated,and the fusant F6 demonstrated good ethanol fermentation performance,producing 18.75g/L ethanol from 50g/L xylose with an ethanol yield of 0.375 or 73.4% of its theoretical value of 0.511.Comparing with its parent Candida shehatae strain,the ethanol yield of F6 was increased by 28%.

OBJECTIVETo analyze the efficiency of cervical lymph node metastasis dissection and postoperative morbidity after selective three-field lymph node dissection (3FLND) for thoracic esophageal squamous cell carcinoma, and explore the proper selection conditions.

METHODSAccording to the conditions as follows: systemic evaluation, tumor T staging, tumor location, cervical CT and ultrasonography and the number of lymph nodes metastases, 85 patients with thoracic esophageal squamous cell carcinoma were selected and received 3FLND.

RESULTSIn the same period 45.5% (85/187) of the patients received 3FLND selectively based on the conditions. The rate of the cervical lymph nodes metastasis was 40.0% (34/85). The rate of the cervical positive lymph nodes of the upper, middle and lower thoracic esophageal carcinomas with enlarged lymph nodes suggested by cervical CT and ultrasonography was 68.4% (13/19), 41.7% (20/48) and 16.7% (1/6), respectively. Twelve patients with upper thoracic esophageal carcinoma with enlarged lymph nodes unrevealed by cervical CT and ultrasonography showed no histopathological lymph node metastasis. In the same period 17.1% (32/187) of the patients were selectively not undergone three-field lymph node dissection. The cervical lymph node metastasis rates in patients with upper and middle mediastinal lymph node metastasis were 79.3% (23/29) and 58.6% (17/29), significantly higher than 8.9% (5/56) and 7.1% (4/56) in the patients without upper and middle mediastinal lymph node metastasis (P<0.05). There was no in-hospital mortality in the group. The incidence of pulmonary complications and over-all postoperative morbidity was 24.7% and 42.4%, respectively.

CONCLUSIONSSelective 3FLND based on certain conditions can reduce the risk of postoperative morbidity and improve the efficiency of metastatic cervical lymph node dissection in thoracic esophageal squamous cell carcinoma. The thoracic tracheoesophageal groove positve lymph node indicated by CT scans should be one of selective conditions for 3FLND. The upper thoracic esophageal carcinoma should selectively receive 3FLND. The selection standards should be more strict for the lower thoracic esophageal carcinoma.

Carcinoma, Squamous Cell ; pathology ; surgery ; Esophageal Neoplasms ; pathology ; surgery ; Female ; Humans ; Lymph Node Excision ; methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Survival Rate ; Treatment Outcome

OBJECTIVEPeriventricular leukomalacia (PVL), the principal form of brain injury in the premature infant, is characterized by overt focal necrotic lesions in periventricular white matter and diffuse cerebral white matter injury. The early detection of the disease is not consistently possible with cranial ultrasonography or conventional magnetic resonance imaging (MRI). Recently, diffusion-weighted imaging (DWI) has been shown to be highly sensitive in detecting acute ischemic cerebral injury. This study aimed to evaluate possible role of DWI in early diagnosis of PVL.

METHODSImages and clinical data from 12 preterm infants with PVL diagnosed in our NICU from August, 2005 to April, 2007 were reviewed. MRI using conventional and diffusion-weighted imaging, as well as the assays of blood routine test, serum bilirubin, C-reactive protein (CRP), blood culture, blood gas analysis, blood sugar and serum ions were performed in these preterm infants. All examinations were performed on a 3.0-T MRI system (Philips Intera Acheva Magnetom Vision) with echo-planar imaging capability with the use of a standard protocol. The imaging protocol for all the patients contained diffuse weighted images (EPI-SE, TR = 2144 ms, TE = 56 ms), T1-weighted images (TR = 389 ms; TE = 15 ms; slice thickness = 4 mm) as well as T2-weighted images (TR = 3035 ms; TE = 100 ms; slice thickness = 4 mm). The first MR examinations were performed in all these twelve preterm infants (mean age 4.5 days, range 2 - 7 days). Conventional MRI and DWI sequences obtained in the acute phase were compared. All the neonates underwent another two MRI examinations up to 2 and 4 weeks after delivery; five subjects also underwent MRI follow-up for up to 4 - 8 months (in 3 for 4 months, in 1 for 7 months, and in another for 8 months). Qualitative evaluations were performed to assess the presence of DWI changes compatible with PVL.

RESULTSThe gestational ages of these twelve patients were from 31 to 35 weeks. None of them had intrauterine distress or birth asphyxia. None of the patients had localized neurological signs in the early course except for abnormal muscular tone of some extent, but seizure and apnea were their major symptoms. No other positive signs of nervous system was found in these preterm infants with PVL. First DWI detection (on the average of 4.5 days) in all these infants showed bilateral, symmetric, diffuse high signal intensity (including genu and plenum of corpus callosum), while conventional MRI showed normal images on both T1- and T2-weighted imaging; two weeks later, DWI showed irregularly high, low mixed signals while conventional MRI showed punctate high signal intensity on T1-weighted imaging and slightly lower signal on T2-weighted imaging. Four weeks later, DWI showed cystic low signal intensity where conventional MRI showed low signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging (cystic PVL). Four months later, DWI showed that the cystic cava became diminished and disappeared, while conventional MRI showed reduced cerebral white matter and dilation of ventricle.

CONCLUSIONBilateral, symmetric, diffuse high signal intensity on DWI seems to be the earliest evidence of PVL; diffusion-weighted imaging performed in the acute phase of the disease may have a higher correlation with later evidence of PVL than does conventional MR imaging. DWI is likely to be a considerable technique in the early assessment of white matter injury and later PVL in preterm infants.

Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular ; diagnosis ; pathology ; Male ; Prognosis ; Retrospective Studies

OBJECTIVETo retrospectively analyze the patients of vertically unstable pelvic fractures treated with percutaneous iliosacral screws fixation and to explore the operative techniques and its therapeutic efficacy.

METHODSFrom June 2002 to August 2009, 54 patients with vertical unstable pelvic fracture were fixed with percutaneous iliosacral screws. After operation, 46 patients were followed up more than 18 months. Among them, 32 patients were male and 14 patients were female, the average age was 36.4 years old (ranged from 19 to 64 years). The average time from injury to operation was 8.5 days (ranged from 7 to 11 days). All pelvic fractures had vertical dislocation ranging from 8 to 40 mm (averaged 28.5 mm). After admitted, all patients were applied bone traction. After recuction, the fractures were fixed with percutaneous iliosacral 7.3 mm cannulated screws, which crossed the iliac and sacral-iliac joint and sacral promontory to S(1)vertebrae. After operation, all patients took X-ray examination. The reduction and the fracture reduction were judged according to Matta criterion and clinical function was judged according to Majeed functional scoring.

RESULTSForty-six patients were followed up from 1.5 to 3 years with an average of 29 months. Fracture uninon was achieved in all patients. All patients got clinical recovery at mean time of 5.2 months and returned to normal daily life. According to Matta criterion for fracture reduction, the results were excellent in 40 cases and good in 6 cases. According to Majeed functional scoring, 32 patients were excellent, 12 good and 2 normal. There were no serious complications of vascular damage.

CONCLUSIONPercutaneous iliosacral screw fixation is an effective technique with advantages of minimal invasive and faster recovery in the management of vertically unstable pelvic fractures.

Adult ; Bone Screws ; Female ; Fracture Fixation ; instrumentation ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Retrospective Studies ; Skin ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVESTo evaluate the characteristic morphology of heel spur, and to investigate the relationship of heel spur and plantar heel pain.

METHODSFrom June 2005 to April 2009, 210 cases (254 feet) with heel spur (according to Denis Pain Scale) were divided into cases group 1 (P2, n = 46), 2 (P3, n = 44), 3 (P4, n = 42), 4 (P5, n = 36) and controls group (P1, n = 42). Three-dimensional reconstruction of heel spur was performed in all groups using volume rendering based on multi-slice CT data by Super Image orthopedics edition 1.0. The characteristic morphology of heel spur was observed and the data were measured and analyzed, involving the width of basilar part, the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur.

RESULTSParts of cases groups displayed coarse arcuate edge and undersurface with one or more little heel spurs adhere to heel spur, of which the numbers were greater than controls group, especially in cases group 4. No significant difference of the width of basilar part of heel spur was found among 5 groups (F = 2.32, P > 0.05). However, obvious difference was found in the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur (F = 8.23, 6.82, 5.87, P < 0.05). Compared with the controls group, the angle between heel spur and planta pedis of cases groups had higher degrees, but the difference of the other data presented irregular.

CONCLUSIONSThe characteristic morphology of heel spur varies in patients associated with plantar heel pain. No correlation is found between the severity and the morphological data, including the width of basilar part, the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur.

Aged ; Calcaneus ; diagnostic imaging ; pathology ; Case-Control Studies ; Female ; Heel Spur ; complications ; diagnostic imaging ; pathology ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, X-Ray Computed

AIMTo establish an HPLC-fluorescence method for determination of loratadine in human plasma and evaluate its relative bioavailability.

METHODSAn Alltech-C18 column and a mobile phase of acetonitrile-water-glacial acetic acid-triethylamine (90:100:6:0.15) were used. The fluorescence detector was set at Ex 274 nm, Em 450 nm. The flow rate was 1 mL.min-1.

RESULTSThe calibration curve was linear over a concentration range of 0.2-30 micrograms.L-1. The limit of quantification was 0.2 microgram.L-1. The average method recoveries varied from 96% to 98%. The results showed AUC, Tmax, Cmax and T1/2 beta between the testing tablets, testing capsules and reference tablets had no significant difference (P > 0.05). Relative bioavailabilities were 107% +/- 17% and 100% +/- 14% respectively.

CONCLUSIONThe three formulations were bioequivalent.

Area Under Curve ; Biological Availability ; Chromatography, High Pressure Liquid ; methods ; Fluorescence ; Histamine H1 Antagonists, Non-Sedating ; blood ; pharmacokinetics ; Humans ; Loratadine ; blood ; pharmacokinetics ; Male

BACKGROUNDDisability and death following hip fracture is becoming more common as the population ages. Previous reports have focused on the selection of internal fixation methods and the analysis of the perioperative therapeutic results in the Chinese population. Few studies have focused on factors influencing medium and long term survival after surgery for hip fracture. We conducted a retrospective study on the factors influencing survival one year after hip fracture surgery in our elderly Chinese population to provide a reference for improved treatment and to enhance efficacy.

METHODSRecords from patients undergoing treatment for hip fracture at our hospital from October 2009 through June 2011 were retrospectively reviewed. Through telephone follow-up, the health condition of each patient was surveyed, and the 1-year postoperative mortality was analyzed. The patients' age, gender, fracture type, pre-injury health condition, mobility, complications, surgical timing, surgical types, methods of anesthesia, and postoperative complications were analyzed. Univariate and multivariate regression analysis was performed on relevant influencing factors.

RESULTSA total of 184 patients had complete data and were followed-up for 12-23 months (average, 16.5 months). There were 30 deaths (16.3%) at one-year. Univariate analysis revealed that factors such as age, gender, fracture-type, number of co-existing diseases, complications such as chronic obstructive pulmonary disease or sequelae of stroke, American society of Anesthesiology (ASA) scores, anesthesia methods, pre-injury activity, and post-operative complications were significantly different between survival versus mortality groups (P < 0.05). Multivariate regression analysis revealed that age, ASA score, pre-injury mobility and combined chronic obstructive pulmonary disease were independent risk factors for death.

CONCLUSIONFull consideration of medium-/long-term risk factors in the treatment of hip fracture in the elderly, selection of appropriate anesthesia and treatment methods, and improved pre-surgical health conditions would reduce postoperative mortality and enhance surgical efficacy.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Hip Fractures ; mortality ; surgery ; Humans ; Male ; Middle Aged ; Regression Analysis ; Retrospective Studies

OBJECTIVETo distinguish lingual thyroglossal duct cyst (LTDC) from laryngomalacia in newborn infants.

METHODSData of 10 newborn infants with laryngeal stridor and dyspnea, admitted to the department of neonatology in our hospital during December, 2004 to August, 2007, who were finally diagnosed with LTDC though previously diagnosed as congenital laryngeal stridor in other hospitals, were summarized and analyzed.

RESULTSInspiratory stridor with chest wall retractions was cardinal symptom of newborn with LTDC. A slightly gray and round cyst with smooth surface at the base of the tongue was found with laryngoscopy. On computed tomography examination of larynx, a well-circumscribed lesion with low intensity was detected at the base of the tongue protruding into the air passage. Pathological examination demonstrated that the cyst wall was composed of tabular and columnar epithelium.

CONCLUSIONSLTDC is a common disease in newborns, which is similar to laryngomalacia. For neonates suspected of LTDC, laryngoscopic examination should be performed first, while laryngeal CT scan is an important diagnostic basis. Cyst puncture can ameliorate the symptoms of the patients, while surgical removal is the method of radical cure.

Early Diagnosis ; Female ; Humans ; Infant, Newborn ; Male ; Respiratory Sounds ; Retrospective Studies ; Thyroglossal Cyst ; diagnosis

AIM: To investigate the curative effect of phacoemulsification and intraocular lens ( IOL ) implantation combined with goniosynechialysis in the treatment of age-related cataract merging with primary angle-closure glaucoma ( PACG) . · METHODS: Totally 80 patients with age-related cataract merging with PACG were in our hospital from January 2014 to January 2016. The preoperative average intraocular pressure ( IOP) was 33. 22 ± 3. 17mmHg; the average depth of anterior chamber was 2. 07 ± 0. 15mm;the dynamic situation of primary angle closure ≤1/2 cycle by gonioscope. They were randomly divided into Group A and B for doing a study. All the two groups were treated with phacoemulsification and intraocular lens implantation. And the Group A was with goniosynechialysis. The following up period was 2mo, and we observed the IOP, chamber depth and the anterior chamber angle. · RESULTS: The change of chamber depth and intraocular pressure about the two groups: the average intraocular pressure of the Group A was 15. 11 ± 3. 67mmHg,the chamber depth was 3. 11±0. 08mm;those of the Group B were 17. 24 ± 1. 67mmHg, 2. 76 ± 0. 15mm respectively; the differences had statistical significance (P<0. 05). Postoperatively, there were 28 eyes (70%) in Group A with fully open anterior chamber angle, and 18 eyes (45%) in Group B (P<0. 05). · CONCLUSION: The phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of age-related cataract merging with primary angle-dosure glaucoma is safe and reliable. It's simple to operate, and do not increase the risk of surgery.

Abstract: Objective To explore the threshold of ALT for initiating antiviral therapy in HBV infected patients, and to provide a basis for initiating antiviral therapy in chronic HBV-infected patients. Methods This retrospective cohort study recruited 707 consecutive treatment-naïve chronic hepatitis B (CHB) patients undergoing diagnostic liver biopsy in the department of infectious diseases of the Affiliated Hospital of Yan′an University from October 2013 to August 2018. Liver biopsy specimens were obtained under ultrasound guidance using Menghini 16G disposable needles. The METAVIR scoring system, which is commonly used internationally, was used to divide the patients into the group with mild liver tissue injury and the group with significant liver tissue injury, and the alanine aminotransferase (ALT) levels were measured separately. Receiver operating characteristic (ROC) curve and Mann-Whitney U test were used to evaluate the diagnostic value of ALT for significant liver tissue injury under different demographic characteristics. Results Of 707 patients, 292 (41.30%) had significant liver tissue injury confirmed by liver biopsy (METAVIR ≥A2 and/or F2). When the ULN of ALT was set to NICE criteria (30 U/L for males, 19 U/L for females), AASLD criteria (35 U/L for males, 25 U/L for females) and EASL or APASL criteria (40 U/L for males and females), CHB patients with 30 years olds, 22 U/L for HBeAg negative and 31 U/L for HBeAg positive patients. Conclusions The threshold of ALT for initiating antiviral therapy in chronic HBV patients should be individualized, especially should be down-regulated for the females, olders and HBeAg-negative patients.