1,3-propanediol is an important chemical used as building block for the synthesis of highly promising polyesters such as polytrimethylene terephthalate. A genetically modified Klebsiella pneumoniae LDH526 can use glycerol as sole carbon source and produce 1,3-propanediol with the titer above 90 g/L. A key factor affecting the production of 1,3-propanediol by the mutant K. pneumoniae is the accurate control of the feeding of glycerol. To generate a robust and reproducible fermentation process of 1,3-propanediol, we designed and optimized an automatically feeding strategy of glycerol based on fermentation kinetics. By coupling the substrate feeding rate with easily observed variables -pH and fermentation time, we have achieved self-starting glycerol feeding and dynamic control of the glycerol concentration during the fermentation process. This automated system allowed us to generate a reproducible, consistent and operator-independent process from lab-scale to production scale. The final concentration of 1,3-propanediol was above 95 g/L after 72 h.
Culture Media ; Fermentation ; Glycerol ; Industrial Microbiology ; methods ; Klebsiella pneumoniae ; growth & development ; Propylene Glycol ; Propylene Glycols ; metabolism

Objectives To explore the relationship between the extension force deficiency of the lower extremity and fall risks among the senior female,so as to reveal the potential factors contributing to fall.Methods Forty community-dwelling senior females aged 65 and older were assigned to the group of fallers or non-fallers according to their reported fall history and measured fall risk index (FRI).Extension force of the lower extremity was measured through 3-consecutive fast squats on a force platform.The time for 3m-time up and going (TUG),as well as static and dynamic balance were also measured.Results Compared to the non-fallers,the fallers showed lower peak extension force per body weight (PEF/BW) of the left leg and larger asymmetry of the peak extension force per body weight between the two legs in squats.Correlation analysis showed that FRI had a strong negative relation with PEF/BW of the left leg and a strong positive relation with extension force asymmetry/body weight.Also time for 3m-TUG was positively related to all the force variables standardized by the body weight,especially for the left leg.However,the analysis failed to find a relationship between the velocity of the center of pressure (COP) sway on static balance and any force variables.In addition,PEF/BW of the left leg decreased and force asymmetry/body weight between the two legs increased with aging.Conclusion Extension force measurement in squat is an effective way to assess the muscle strength deficiency related to the increased fall risk.The extension force of the lower extremity to support the body weight in squat had a strong relation to the function decline in the dynamic balance,which contributes greatly to fall risk.The extensive force asymmetry in squat between the two legs is another important fall risk factor for the senior females.

It is an important part of curriculum resources for network curriculum. An excellent network curriculum can enhance the quality of curriculum resources. In our teaching practice of health management,we designed and constructed network curriculum according to the characteristics of subjects and demand of our students based on the public net platform of health management.

Objective:To investigate the early diagnosis value of neutrophilic CD 64 index(nCD64 ID),neutrophilic CD32 index( nCD32 ID) in ascites and CRP in blood of liver cirrhosis patients combined with spontaneous bacterial peritonitis. Methods:The data of 156 cases with liver cirrhosis was analyzed retrospectively, which CD32 index, CD64 index and CRP were detected respectively and ROC curve analysis were performed. Results:The nCD64 ID,nCD32 ID and CRP in bacterial infection group were all significantly higher than that in no infection group(P<0. 001). The sensitivity and specificity of nCD32 ID,nCD64 ID and CRP were 82. 8%,96. 2%,72. 5% and 81. 0%, 95. 8%, 73. 1% respectively. Conclusion: The sensitivity and specificity of nCD64 ID were higher than nCD32 ID and CRP. The nCD64 ID can be used as an effective index for early diagnosis and differential diagnosis of liver cirrhosis combined with spontaneous bacterial peritonitis.

Objective:To investigate the therapeutic effect of different prone position ventilation (PPV) on patients with severe acute respiratory distress syndrome (ARDS) at high altitude.Methods:The severe ARDS patients who met the Berlin standard admitted to the department of intensive care unit (ICU) of Qinghai Provincial People's Hospital from January 2017 to January 2020 were enrolled. The patients with classic PPV treatment (i.e. alternate prone supine position, about 16 hours per day) were included in the discontinuous PPV group; the patients with modified PPV treatment (i.e. alternate left and right prone positions 20°-30°, every 4 hours and continuous treatment for 24 hours per day) were included in the continuous PPV group. The oxygenation index (PaO 2/FiO 2), mechanics of breathing, ventilator parameters before treatment and 72 hours after treatment, and mechanical ventilation time, the length of ICU stay, and related complications between the two groups were analyzed. Results:Eighteen cases were treated with continuous PPV and 20 cases were treated with discontinuous PPV. There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), PaO 2/FiO 2, lung compliance, driving pressure (ΔP) and positive end expiratory pressure (PEEP) before treatment between the two groups. Compared with before treatment, PaO 2/FiO 2 in discontinuous PPV group and continuous PPV group was increased significantly after 72-hour treatment [mmHg (1 mmHg = 0.133 kPa): 99.7±15.4 vs. 55.5±6.3, 121.8±25.3 vs. 55.1±7.1, both P < 0.05], lung compliance was improved significantly (mL/cmH 2O: 36.8±2.4 vs. 28.0±2.0, 43.4±6.7 vs. 27.7±2.1, both P < 0.05), and ΔP was decreased significantly [cmH 2O (1 cmH 2O = 0.098 kPa): 10.5 (10.0, 12.0) vs. 13.0 (12.3, 14.0), 10.0 (8.0, 12.0) vs. 13.0 (12.0, 14.0), both P < 0.05], PEEP was also decreased [cmH 2O: 12 (12, 14) vs. 14 (13, 14), 10 (8, 10) vs. 14 (12, 15), both P < 0.05], and the indexes in continuous PPV group were improved more significantly than those in discontinuous PPV group [PaO 2/FiO 2 (mmHg): 121.8±25.3 vs. 99.7±15.4, lung compliance (mL/cmH 2O): 43.4±6.7 vs. 36.8±2.4, ΔP (cmH 2O): 10.0 (8.0, 12.0) vs. 10.5 (10.0, 12.0), PEEP (cmH 2O): 10 (8, 10) vs. 12 (12, 14), all P < 0.05]. The duration of mechanical ventilation and the length of ICU stay in the continuous PPV group were significantly shorter than those in the intermittent PPV group [days: 6.0 (5.0, 7.3) vs. 8.0 (7.0, 9.0), 9.7±1.5 vs. 12.1±2.2, both P < 0.01]. During the PPV treatment, there were 3 cases of cheek skin damage and 2 cases of ear skin damage in the continuous PPV group, and 3 cases of facial skin damage in the intermittent PPV group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.321, P = 0.571). All patients were repaired normally after PPV, without adverse consequences. Conclusion:Continuous PPV is more effective than discontinuous PPV in the treatment of severe ARDS patients at high altitude, and the related complications are did not increased in prolonged time of PPV.

OBJECTIVETo observe the clinical effect of chronic fatigue syndrome (CFS) treated with moxibustion at Gaohuang (BL 43).

METHODSWith stratified block randomization, 72 patients accorded with inclusive criteria were divided into a moxibustion at Gaohuang (BL 43) group (moxibustion group) and an acupuncture group, 36 cases in each one. In the moxibustion group, Gaohuang (BL 43) was treated with big moxa cones as the main acupoint, 10 cones a time; Qihai (CV 6) and Zusanli (ST 36) were added with big moxa cones, 7 cones a time. In the acupuncture group, acupoints were the same as those in the moxibustion group, and twirling reinforcing method was used after qi arriving, 60 times one minute and 360° with range. In the two groups, 10-day treatment was made into one course and there were two days between courses. The treatment was given once a day for 3 courses. Changes of fatigue assessment index (FAI) before and after treatment and clinical effects were observed.

RESULTSThe total effective rate was 88.9% (32/36) in the moxibustion group, which was better than 72.2% (26/36) in the acupuncture group apparently (P < 0.05). After treatment in the two groups, FAI scores were obviously declined compared with those before treatment (both P < 0.01) and FAI score in the moxibustion group was apparently lower than that in the acupuncture group (P < 0.05).

CONCLUSIONMoxibustion at Gaohuang (BL 43) can improve the FAI score of patients with CFS and the clinical efficacy is definite.

Acupuncture Points ; Adult ; Fatigue Syndrome, Chronic ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

This article focused on basic clinical skill training of Changhai Hospital,in such aspects as courses,teaching infrastructure,faculty competence,teaching pattern,evaluation system and incentives mechanism.These efforts aim at exploring the establishment of a new clinical skills teaching model,which prove satisfactory and improving the standardized residents basic clinical skill training system.

Laparoscopic curative gastrectomy has been widely adopted because it is minimal invasiveness.The efficacy of laparoscopic gastrectomy is comparable to that of open gastrectomy for patients with early or advanced gastric cancer,but few studies of laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy for patients with advanced gastric cancer have been reported.Seven patients with advanced gastric cancer received laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy at the First Hospital of Jilin University from September 2010 to September 2011.The mean operation time,blood loss,postoperative hospital stay and the nunber of lymph nodes resected were (218 ± 24) minutes,(366 ± 174) ml,( 14.6 ± 2.8 ) days and 32 ± 15,respectively.Two patients were complicated by pancreatic juice leakage and were cured with drainage. No anastomotic leakage,abdominal bleeding or mortality was observed. With the development of techniques and equipments,laparoscopic total gastrectony combined with distal pancreatectomy and splenectomy is safe and feasible in selected patients.

This paper introduces such instrumental induced abortions without vacuum aspiration in China as rotary instrument-induced abortion, ultrasound termination pregnancy, acupuncture antiearly pregnancy and microwave radiation induced abortion. This paper can be referred to when new abortion method and apparatus developed.

Objective To detect the level of CD64 and serum procalcitonin (PCT ) and investigate the diagnosis value of CD64 and serum PCT in cirrhosis patients with spontaneous bacterial peritonitis (SBP) .Methods Participants were categorized in‐to three groups including liver cirrhosis with SBP(45 patients) ,liver cirrhosis without SBP(93 patients) and health personnel(50 persons) .CD64 was detected by flow cytometry and serum PCT was measured by electroc hemiluminescence immunoassay .The li‐mosis vein blood samples were obtained from the patients with SBP at the time of 24 h after admission ,before antibacterial drugs use and 7 days after the effective treatment of antibacterial drugs .The CD64 and serum PCT were detected with the limosis vein blood samples .At the same time ,the complete blood count ,liver ,kidney and blood coagulate functions were tested .The participants in other two groups were detected the CD64 ,serum PCT ,complete blood count ,liver ,kidney and blood coagulate functions at the same time .Results The level of CD64 and serum PCT in cirrhosis patients with SBP were significantly higher than those in liver cirrhosis without SBP and normal controls (P< 0 .01) .ROC curve analysis showed that the sensitivity and specificity of CD64 and serum PCT were 95 .5% ,93 .8% and 96 .1% ,85 .2% respectively .Conclusion CD64 and serum PCT can be determined as the im‐portant indicator in early diagnosis and efficacy criterion .