Objective To investigate the adhesion mechanism of Lactobacillus acidophilus FN001外to Peyer's patches. Methods Adhesion of L. acidophilus FN001 to mice Peyer's patches was studied in vitro using a fluorescent quantization method. The nature of adhesion mediator was studied by the effects of physical, chemical and enzymatic pre-treatments of the bacteria on their adhesion and effect of sugars on in- hibition of adhesion. The presence of lectin-like proteins in the cell surface was determined by hemagglutina- tion. Effect of L. acidophilus FN001 on inhibition of adhesion of pathogens to Peyer's patches was also stud- ied. Results The adhesion of L. acidophilus FN001 was strongly inhibited in the presence of D-mannose and methyl-ct-D-mannoside. Pretreatment of L. acidophilus FN001 with pepsin and trypsin decreased the ad- hesive capacity indicating that cell surface proteins are involved in adhesion to Peyer's patches. L. acidophi- lus FN001 could agglutinate rabbit red cell in mannose specific manner and protease pretreatment could de-crease hemagglutinin, suggesting that L. acidophilus FN001 has mannose specific lectin (s). In adherence inhibition assay, L. acidophilus NF001 could significantly inhibit adhesion of E. coli ATCC25922 to Peyer's patches when L. acidophilus NF001 were applied to Peyer's patches first or at the same time with pathogen. Conclusion It was concluded that a mannose-specific protein mediated adhesion of L. acidophilus FN001 to the Peyer's patches, and L. acidophilus FN001 could inhibit adhesion of pathogen with similar lectins speci- ficity to Peyer's patches.

Objective To investigate the clinical values of Dynamic changes of evaluation of central venous pressure (△CVP) combining with the pulse Doppler records of early mitral dilatation of blood flow velocity and peak atrial systolic blood flow velocity ratio (E/A) in the diagnosis and prognosis assessment of septic patients.Methods The study totally enrolled patients who were admitted to Intensive Care Unit of the Central Hospital of Puyang during January 2013 to June 2016.By the standard of 28 days,all the cases were divided into the survival group and the dead group.All patients admitted in the intensive treatment unit (ICU) in the same period were recorded of the acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score and sequential organ failure score (SOFA).Observe the dynamic changes of the two groups of patients on central venous pressure (△CVP) and E/A changes record into the family,after 6 hours and 24 of the related E/A value on each node,at the same time record the related CVP values,calculated the absolute value of the dynamic change of each node in the comparison after 6 h and 24 hours,the records of the node values mapped the receiver-operating characteristic curve (ROC) to evaluate the value of each index for prognosis.Results A total of 233 cases of sepsis patients enrolled,28 d survival of 122 cases,survival rate was 52.4％;111 cases died,mortality was 47.6％.The ICU blood lactate,APACHE Ⅱf,SOFA score of the dead group was significantly higher than the survival group,and their stay in ICU was significantly shorter than the survival group (P＜0.05),other clinical features of the difference was not statistically significant(P＞0.05).The E/A value differences between the dead group and survival group into the ICU 0h and 6h were 0.54±0.17,0.69±0.24;0.57±0.28,0.85±0.25 (P＜0.05),the ROC curve analysis is 0.792,0.818,and there are different CVP change value △h2 CVP change value △h1,24 hours and after 6 hours of the patient,namely:5.67 ± 4.16,7.82 ±4.81;6.58±3.89,8.82±2.40 (P＜0.05) the area under the ROC curve it was,0.778,0.705,wherein when the 6h,the cutoff value E/A 0.75 area taken under the ROC curve (AUC) was 0.818 for the highest single index,the sensitivity and specificity were forecast 74.16％,95.45％,which the ICU 6 when E/A area under the ROC curve of dynamic changes in the value of a ACVP with CVP (AUC) of up to 0.844;0.471 to take their cut-off point,the sensitivity of the prognosis was 88.32％,specificity degree of 90.71％,better predictive strength thanthe other indicators,as well as sensitivity and specificity.Conclusion Early E/A can be used as prognostic evaluation of sepsis as new and important indicator,combining with dynamic changes of the early CVP as an early assessment of the clinical condition of patients with sepsis,and can be prediction of the prognosis of patients,as well as reference for the therapeutic intervention on high-risk patients.

Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.

Objective:To compare the histopathological features and treatment efficacy of different methods for metachronous early gastric cancer (MEGC) in the remnant stomach.Methods:A total of 66 patients [38 endoscopic submucosal dissection (ESD) and 28 gastrectomy] with MEGC in the remnant stomach from January 2014 to December 2020 in Drum Tower Hospital were divided into the ESD group and the gastrectomy group. The baseline characteristics, histopathological features, treatment efficacy, and cost differences of the two groups were analyzed.Results:The MEGC in the remnant stomach mostly occurred in elderly male patients, with the mean age of 69.7±8.5 years. The mean interval of the occurrence of MEGC in the remnant stomach was 6 years. As for the tumor location, the gastric body (31.6%) was the main location in the ESD group and gastric cardia (53.6%) in the gastrectomy group with significant difference ( χ2=11.07, P=0.026). The mean operation time, hospital stay, postoperative fasting time, and total treatment cost were 80.0 min, 6.0 d, 1.5 d, ￥19 436 in the ESD group and 215.0 min, 19.0 d, 6.5 d, and ￥68 665 in the gastrectomy group, respectively, with significant differences between the two groups ( P<0.05). The overall survival rate during follow-up was 76.3% in the ESD group and 71.4% in the gastrectomy group with no significant difference between the two groups ( χ2=0.736, P=0.778). In terms of postoperative complications, the incidences of bleeding and infection were 7.9% and 5.3% in the ESD group, and those of obstruction and infection were both 14.3% in the gastrectomy group. There was significant difference in the incidences of postoperative obstruction between the two groups ( P<0.05). Conclusion:ESD is safe and effective for MEGC in the remnant stomach and is better than gastrectomy in terms of the treatment cost and operation time, but the long-term efficacy still needs to be validated by large-scale prospective studies.