Objective To assess the expression of thioredoxin reductase(TR)and thioredoxin (Trx)mRNA,TR activity in human placenta in women with preeclampsia,and to discuss the relationship between Trx system and the pathogenesis of preeclampsia.Methods Twenty-sixwomen with preeclampsia(10 mild and 16 severe)and 28 healthy gravidas (control) were included in this study.Semi-quantitative reverse transcription polymerase chain reaction(RT-PCR)were employed to demonstrate the expression of TR and Trx in placentas.TR activity was measured spectrophotometrically.Results The expression of TR mRNA(mild:0.865±0.018;severe:0.800±0.025,P＜0.05)and Trx mRNA(mild:0.873±0.008;severe:0.818±0.025,P＜0.05)were lower in placenta of preeclampsia than in the control group(TR mRNA:0.893±0.023;Trx mRNA:0.918±0.023.P＜0.05),and those levels in the severe preeclampsia group were lower than in the mild ones.Both the mild and severe preeclampsia groups showed lower TR activity than the control(mild:17.732±1.653;severe:15.626±1.543 vs 19.770±2.432,P＜0.05),and that of the severe preeclampsia group was lower than that of the mild ones.Positive correlation was found between the TR activity and TR mRNA expression in both groups(r=0.612,P＜0.001).Conclusions Abnormal decreased expression of TR mRNA and Trx mRNA and TR activity in human placenta of preeclampsia might participate and play an important role in the pathogenesis of preeclampsia.

Objective To report the clinical observation and nursing points for recurrent or refractory and aggressive non-Hodgkin's lymphoma treated with MINE regimen. Methods Patients (46 cases) with recurrent or refractory and aggressive non-Hodgkin's lymphoma were given mental nursing,preparation and evaluation of the condition of patients before chemotherapy. Complications especially extravasation of infusion fluid should be prevented during chemotherapy and myelosuppression and long-term complications should be prevented after treatment. Results No patient died after treatment but several complications such as infection(14 cases), nausea and vomiting (grade Ⅰ～Ⅱ, 22 cases, grade Ⅲ,2 cases), alopecia (grade Ⅰ～Ⅱ, 27 cases), mucositis (grade Ⅰ～Ⅱ, 4 cases), liver function lesion (grade Ⅱ, 1 case) were found and improved after proper treatment. No nephrotoxicity and hemorrhagic cystitis were found. Conclusions Selective mental nursing,proper chemotherapy preparation,evaluation of patients' condidtion and positively prevention of chemotherapy-related complications could increase the chemotherapy effect of patients with recurrent or refractory and aggressive non-Hodgkin's lymphoma.

Objective To investigate the accuracy and feasibility of brachial artery peak velocity variation (ΔVpeakbrach) and inferior vena cava variability (VIVC) as indicators of fluid responsiveness in critically ill patients. Methods A single-center prospective observation was conducted. The patients on mechanical ventilation with spontaneously breathing admitted to Department of Critical Care Medicine of the Second Affiliated Hospital of Kunming Medical University from June 2013 to August 2015 were enrolled. The patients were diagnosed as severe sepsis or sepsis shock. The peak velocity in brachial artery and diameter of the inferior vena cava at the end of inspiration and expiration was measured by bedside portable ultrasonic machine, and then ΔVpeakbrach and VIVC were calculated. The hemodynamic parameters were collected at baseline and after volume expansion (VE). The stroke volume (SV) was measured by pulse-indicated continuous cardiac output (PiCCO). Patients were classified as responders or non-responders according to the variation of SV (ΔSV) increased ≥ 15% or not after VE. Receiver operating characteristic curve (ROC) was plotted to evaluate the sensitivity and specificity of ΔVpeakbrach and VIVC in predicting volume responsiveness. Results Among 58 patients after VE, 32 patients were defined as responders and the rest 26 were defined as non-responders.There were no differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, dose of vasoactive agent, ventilator parameters and infection site. Compared with baseline hemodynamic parameters, heart rate (HR) was decreased (bpm: 95±18 vs. 103±21), and systolic blood pressure (SBP) was increased [mmHg (1 mmHg = 0.133 kPa): 92±8 vs. 80±7] after VE in responders; central venous pressure (CVP) was increased after VE in non-responders (mmHg: 11±4 vs. 8±3, all P < 0.05). The ΔVpeakbrach [(15.4±4.3)% vs. (11.2±3.5)%] and VIVC [(18.6±4.1)% vs. (14.3±3.6)%] in responders were significantly increased as compared with those of non-responders (both P < 0.05). The area under ROC curve (AUC) of ΔVpeakbrach for predicting volume responsiveness was 0.816. When the cut-off value of ΔVpeakbrach was ≥ 13.3%, the sensitivity was 71.9%, and the specificity was 80.8%. AUC of VIVC for predicting volume responsiveness was 0.733. When the cut-off value of VIVC was ≥ 19.25%, the sensitivity was 53.1%, and the specificity was 88.5%. Conclusion ΔVpeakbrach and VIVC are reliable indicators for predicting volume responsiveness in critical patients.

Halohydrin dehalogenase is of great significance for biodegradation of the chlorinated pollutants, and also serves as an important biocatalyst in the synthesis of chiral pharmaceutical intermediates. A putative halohydrin dehalogenase (HheTM) gene from Tistrella mobilis KA081020-065 was cloned and over-expressed in Escherichia coli BL21 (DE3). The recombinant enzyme was purified by Ni-NTA column and characterized. Gel filtration and SDS-PAGE analysis showed that the native form of HheTM was a tetramer. It exhibited the highest activity at 50 degrees C. The nature and pH of the buffer had a great effect on its activity. The enzyme maintained high stability under the alkaline conditions and below 30 degrees C. HheTM catalyzed the transformation of ethyl(S)-4-chloro-3-hydroxybutyrate in the presence of cyanide, to give ethyl (R)-4-cyano-3-hydroxybutyrate, a key intermediate for the synthesis of atorvastatin.
3-Hydroxybutyric Acid ; chemistry ; Bacterial Proteins ; genetics ; metabolism ; Cloning, Molecular ; Escherichia coli ; Hydrolases ; genetics ; metabolism ; Hydroxybutyrates ; chemistry ; Recombinant Proteins ; genetics ; metabolism ; Rhodospirillaceae ; enzymology ; genetics

Objective: To assess whether carbon monoxide (CO) poisoning increases the incidence of dementia. Methods: We searched the Cochrane Library, PubMed, and EMBASE from inception to 14 August 2022. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Only cohort study with an enough follow-up period was included for systematic reviews and meta-analysis. Results: Thirty-three full texts were initially searched, but only three studies met our inclusion criteria, and they were comprised of 134,563 participants who were initially free of dementia. The follow-up period ranged from 9 to 12 years. We found that CO poisoning increased the risk of dementia incidence (adjusted hazard ratio 2.61, 95% confidence interval 1.56 to 4.36, p=0.0003). Subgroup analysis showed that the increased dementia risk was significant in males but not in females, and the highest risk was in young age group, followed by in middle age group, but not in the old one. Conclusion Overall the evidence from prospective cohort studies supported a link between CO exposure and an increased dementia risk, although all the included studies were limited to Taiwanese population.

Objective: To investigate the safety and feasibility of caudal-medial approach combined with "page-turning" middle lymphadenectomy in the laparoscopic right hemicolectomy. Methods: A descriptive cohort study was conducted. Clinical data of 35 patients who underwent laparoscopic radical right hemicolectomy using caudal-medial approach combined with "page-turning" middle lymphadenectomy at Department of Gastrointestinal Surgery, Guangdong Hospital of Chinese Medicine from April 2018 to May 2020 were retrospectively analyzed. All operations were performed consecutively by the same surgeon. The caudal-medial approach was used to dissect the right Toldt's fascia and the anterior pancreaticoduodenal space in a caudal-to-cranial and medial-to-lateral manner guided by the duodenum. The "page-turning" middle lymphadenectomy was used to dissect the mesocolon along the superior mesenteric vein with ileocolic vein, Henle's trunk and pancreas exposed preferentially. Results: All the 35 patients completed the operation successfully, and there was no damage and bleeding of superior mesenteric vessels and their branches. The operative time was (186.9±46.2) minutes, and the blood loss was 50 (10-200) ml. The first time to flatus was (2.1±0.6) days, and the time to fluid intake was (2.5±0.8) days. The postoperative hospital stay was 6 (3-18) d. The overall morbidity of postoperative complication was 8.6% (3/35), including grade II in 1 cases (2.8%) and grade IIIa in 2 case (5.7%) according to the Clavien-Dindo grading standard. The total number of lymph node dissected was 30.2±5.6, and the positive lymph node was 0 (0-7). Tumor staging revealed 5 cases of stage I, 18 cases of stage II, 11 cases of stage III, and 1 case of stage IVA. In this study, the median follow-up time was 15 (4-29) months. One patient died due to cerebrovascular accident 12 months after surgery, and no tumor recurrence or metastasis was observed in all other patients. Conclusions: Laparoscopic radical right hemicolectomy using caudal-medial approach combined with "page-turning" middle lymphadenectomy is safe and feasible. The anterior pancreaticoduodenal space is preferentially mobilized, which reduces the difficulty of central vascular dissection.
Cohort Studies ; Colectomy ; Colonic Neoplasms/surgery* ; Humans ; Laparoscopy ; Lymph Node Excision ; Retrospective Studies