Objective To establish the resist-fatigue animal test through using Maca, in order to provide reference for the relevant departments to exploit new sports nutrition . Methods Thirty male KM mice were randomly divided into Quiet control group (A),Exhaustive group (B,high altitude),Maca exhaustive group (C), there were 10 mice in each group. Drinking water containing Maca (Maca =500 mg/L) was supplied in group C. Additional exhaustive group (D,low altitude) was set.Thirty days later, all mice were killed after one exhaustive test, then we tested the exhaustive time, the level of T-SOD and liver glycogen. Results The exhaustive time of group C was significantly longer than group B (P<0.05), the T-SOD level of group C was significantly higher than group A and group B (P<0.05), and the liver glycogen content of group C was significantly higher than group B (P<0.05) . Conclusion Maca can raise T-SOD and liver glycogen level of the mice after exhaustive swimming, and has function of resist-fatigue.

Objective To evaluate the safety,feasibility and results of the hand-assisted retroperitoneal laparoscopic living donor nephrectomy ( HRPLDN ) with a modified technique. Methods Living donors (n =32) were divided into HRPLDN group (n =16) and open group (n =16) according to surgical technique.Operative data and postoperative outcomes including operative time,estimated blood loss,warm ischemia time,length of hospital stay and complication rate,were collected. Results All procedures were completed successfully.In HRPLDN group,the mean operative time was 101.3 ± 21.2 min (range from 70 to 150 min),with an estimated blood loss of 53.8 ±25.5 ml (range from 20 to 100 ml) and warm ischemia time of 2.4 ± 0.6 min ( range from 1.5 to 3.5 min).No living donor needed conversion to open surgery and the urine volume of transplanted kidney after first 24 hours was 5036 ml (range from 3500 -6500 ml).The mean postoperative on bed time were (2.8 ± 0.7 ) d (ranging from 2 -4 d).All parameters of HRPLDN were significantly better than that of open groups. Conclusion Living donor nephrectomy with HRPLDN is a safe and reliable surgical technique.

OBJECTIVE To study the phenotypic existence,genetic type and gene transfer of extended spectrum beta-lactamases(ESBLs) and AmpC beta-lactamase from Klebsiella pneumoniae and K.oxytoca. METHODS Disk confirmation test and 3-aminophenylboronic acid(APB) disk potentiation test were used to detect ESBLs and AmpC beta-lactamase.The genetic types of these two kinds of beta-lactamases were examined by gene chip technology and sequence analysis.The transfer of resistance genes was conducted by conjugation. RESULTS From 72 strains of K.pneumoniae and 20 strains of K.oxytoca which were not susceptible to cefoxitin,coexistence of AmpC(beta-lactamase) with ESBLs together was very common,accounted for 54.2% and 75.0%,single ESBLs accounted for 22.2% and 25.0%,respectively.There were 12.5% single AmpC in(K.pneumoniae).DHA type ampC gene and SHV type ESBLs gene were the main molecular types.These genes could be transferred from clinical isolates to recipient E.coli J53. CONCLUSIONS ESBLs as well as AmpC(beta-lactamase) are the most important resistance mechanism in K.pneumoniae and K.oxytoca.The resistance could be transferred through the bacterial conjugation.

Objective To construct double expression retroviral vectors targeting chronic myeloid leukemia (CML) b3a2-type mRNA and investigate its effect on the phenotype of K562 cells. Methods The eGFP coding sequence was inserted into the retroviral vector pMSCV-neo to construct pMSCV/GFP, then H1-RNA pol III-based transcription cassettes was subcloned into it to form pMSCV/GFP-H1-BCR/ABL40AS. Two control vectors pMSCV/GFP-H1-BCR/ABL40S & pMSCV/GFP-H1-BCR/ABL80AS were constructed in addition. All these constructions were identified by restriction enzyme analysis and DNA sequencing. After that, the recombinant vectors were transferred into retrovirus packaging cell line PT67 by using lipofectamine2000, and G418 were used to select stable virus-producing cell lines. Viral titer was determined by infection of NIH3T3 cells sequentially. The cell-growth curve was assayed, cell apoptosis was checked with Annexin V-PE/7AAD double staining and flow cytometry analysis after 24-hour infection, the PKR phosphorylation was assayed by Western blotting. Results The plasmids were successfully constructed. Four cell lines, named as PT67-MSCV/GFP, PT67-40as, PT67-40s and PT67-80as were gained by G418 selection, and virus titers were 6.2?10~ 5 , 5.6?10~ 5 , 4.6?10~ 5 and 6.0?10~ 5 CFU/ml respectively. PT67-40as suspensions could induce K562 cell apoptosis by (22.54?3.19)%, significantly different from PT67-MSCV/GFP or PT67-40s (P

Objective To investigate the effect of subanesthetic dose of esketamine on remifentanil-in-duced hyperalgesia after cesarean section under general anesthesia,and its effect on serum homocysteine(Hcy)level and postpartum depression.Methods A total of fifty patients undergoing cesarean section under general anesthesia were randomly divided into the esketamine group and the control group(25 cases in each group).The two groups were given esketamine 0.2 mg/kg and the same amount of normal saline by slow in-jection 10 min after fetal delivery.Then,the extubation time,visual analogue scale(VAS)score within two hours after operation,and consumption of morphine while in the post-anaesthesia care unit(PACU)were compared between the two groups.The Edinburgh Postnatal Depression Scale(EPDS)scores were compared at one day before surgery,one day,four days,and one month after surgery.Serum Hcy levels were measured at one day before surgery,one day and four days after surgery.Results There was no significant difference in extubation time between the two groups(P>0.05).Compared with the control group,it took a longer time for patients in the esketamine group to have a VAS score≥4 for the first time,but the time from morphine injection to a VAS score<4 was shortened(P<0.05).The amount of morphine used in the esketamine group was lower than that in the control group in PACU(P<0.05).Compared with the control group,the VAS scores of the esketamine group decreased at 15 min,30 min,45 min,one hour,and 90 min after surgery(P<0.05),while there was no statistical significance difference in VAS scores at two hours after surgery(P<0.05).EPDS scores in the esketamine group were lower than those in the control group at one day and four days after surgery(P>0.05),but there was no statistically significant between the two groups at one month after surgery(P>0.05).Serum Hcy level in the esketamine group was lower than that in the control group at one day and four days after surgery(P<0.05).Conclusion The subanesthetic dose of esketamine during caesarean section under general anesthesia can effectively relieve remifentanil-induced postoperative hy-peralgesia and prevent the occurrence of postpartum depression.

Objective ToexplorethediagnosticvalueofenhancedCTandGd-EOB-DTPA-enhanced MRIinthedetectionofhepatocellular carcinoma (HCC).Methods 41patientswith52HCCsunderwentenhancedCTandGd-EOB-DTPA-enhancedMRIrespectively.The imagingmanifestationswereanalyzed,andthelesionsweregrouped.Theimagingdiagnositicresultswerecomparedwiththepathologicalresults, andtheefficacyofthetwomodalitieswasevaluatedusingtheaccuracyindex.Results Ofthetotal52HCCs,42lesionswereidentifiedexactlyby enhancedCT,and51byGd-EOB-DTPA-enhancedMRI.Foralllesions,includingsmalllesions(≤2cm),theaccuracyratioofGd-EOB-DTPA-enhancedMRIwashigherthanthatofenhancedCT withastatisticallysignificantdifference(P<0.05),however,therewasnosignificant differenceforthelesionsbiggerthan2cm (P>0.05).Conclusion EnhancedCTislimitedindiagnosisoftheHCCssmallerthanor equalto2cm.ThediagnosticefficacyofGd-EOB-DTPA-enhanced MRIishigherthanthatofenhancedCT,anditcansignificantly improvethediagnosisofsmallHCC.

Objective To provide theoretical basis for researchers and institutions to conduct research in stroke according the multiple dimension analysis of stroke research paper cooperation nationally.Methods Using the scientometrics and social network analysis for data mining of 95883 stroke literature collected.Results The result show that quantity of paper publishing are increasing annually,the most common cooperation was co-authorship of 2～3 people,cooperation among institutions mainly focused in big cities like Beijing,Shanghai,Guangzhou at its core has taken shape,regional cooperation formed a scattering cooperation with Beijing as the center,research topics has shifted from cognition and treatment to prognosis,rehabilitation and related chronic disease gradually.Conclusions It is necessary to expand the scale of coopreation in stroke study,policies encouraging cooperation should be adopted,strengthen regional cooperation between west China and middle-east,establish a multi-stage stroke unit and strengthen stroke treatment from the multi-level and multi-angle,pay more attention to the occurrence and development of chronic diseases associated with stroke.And finally,contribute to the further development of stroke research.

Objective To investigate the expressions of programmed death-ligand 1 (PD-L1) and PD-L2 and phosphorylated protein kinase B (p-AKT) in diffuse large B-cell lymphoma (DLBCL) patients and their correlations with clinicopathological features and prognosis. Methods A total of 68 paraffin-embedded specimens of DLBCL patients diagnosed in Shanxi Provincial Cancer Hospital with detailed follow-up record from January 2010 to December 2012 were included in the study. The expressions of PD-L1, PD-L2 and p-AKT proteins in DLBCL were detected by using immunohistochemistry (IHC). Results The positive rate of PD-L1 protein in DLBCL patients was 22.1％ (15/68), which was related to germinal center B-cell (GCB) subtype or not (χ2= 5.591, P= 0.018), clinical stage (χ2= 3.969, P= 0.046), international prognostic index (IPI) grades (χ2=4.178, P=0.041) and treatment remission rate (χ2=6.587, P=0.010). The positive rate of PD-L2 protein in DLBCL patients was 14.7％ (10/68), which was related to extranodal metastasis or not (χ2=6.772, P= 0.009). The positive rate of p-AKT for DLBCL patients was 61.8％ (42/68), which was correlated with age (≥60 years old) or not (χ2=6.227, P=0.013), Eastern Cooperative Oncology Group (ECOG) grades (χ2=4.005, P=0.045), B symptoms (χ2=10.187, P=0.001) and treatment remission rate (χ2=4.096, P=0.043). Univariate survival analysis showed that the overall survival (OS) rate and progression free survival (PFS) rate of PD-L1 protein positive expression group were lower than those of PD-L1 protein negative expression group (both P< 0.05). In the patients with non-GCB subtype, OS rate and PFS rate of PD-L1 protein positive expression group were lower than those of PD-L1 protein negative expression group (both P<0.05). p-AKT protein positive expression group had poorer OS rate and PFS rate compared to p-AKT negative expression group (both P< 0.05). Correlation analysis showed that PD-L1 protein expression was correlated with PD-L2 and p-AKT proteins expressions (r= 0.380, P= 0.001;r= 0.273, P= 0.025). The prognosis was worse when p-AKT and PD-L1 proteins was co-expressed (P< 0.05). Multivariate analysis suggested high expressions of PD-L1 and p-AKT proteins were independent prognosis risk factors in DLBCL (both P<0.05). Conclusions The expressions of PD-L1 and p-AKT proteins may be involved in the occurrence and development of DLBCL. Blocking PD-1 and PD-L1 access or combined blocking could provide a promising future for the clinical therapy.

To evaluate the efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) over 75 years. A total of 82 patients with AF who underwent LAAO successfully in Beijing Anzhen Hospital from March 2014 to March 2019 were divided into two groups according to age: the elderly group (aged>75 years) and the young group (aged ≤75 years). Risk of perioperative complications and incidence of ischemic stroke and major bleeding during follow-up were retrospectively analyzed. The results showed that there were no significant differences in procedure-related ischemic stroke(0 vs.1.6%, P=0.768) and major bleeding (0 vs.1.6%, P=0.768) during perioperative period between the two groups. No complications as death or pericardial tamponade occurred in the two group. During a (25.9±15.9) months period of followed up, ischemic stroke event rate was 3.6/100 person-years in the elderly group and 4.9/100 person-years in the young group, respectively. Major bleeding event rate was 2.5/100 person-years in the elderly group and 0/100 person-years in the young group, respectively. Compared with the expected ones, the relative risk reduction (RRR) of stroke in the elderly group was more profound than that in the young group (32.0% vs. 25.0%), while the risk of major bleeding in the young group was significantly lower than that in the elderly group (RRR 100% vs. 56.9%). Therefore, LAAO might be suitable for stroke prevention in the elderly AF patients.

Objective : A convolutional neural network (CNN) model was established to automatically analyze flow cytometry (FCM) data to achieve the preliminary diagnosis of acute myeloid leukemia(AML) , and explore the feasibility of applying CNN model to FCM data analysis. Methods : The exploratory study of CNN application was carried out using the bone marrow FCM data obtained by the FlowRepository database and the Clinical Testing Center of Xinjiang Uygur Autonomous Region People ′ s Hospital , and the data had been clinically confirmed whether AML was present. Among them , the public data was divided into training sets , validation sets and test sets according to 6 ∶ 2 ∶ 2 , and local data was used for external test; In order to adapt the FCM data to the CNN model , an FCM data structure based on the image matrix principle was proposed , and after preprocessing the original data , the variables related to the preliminary diagnosis of AML were extracted , including sidescattered light and the expression levels of CD45 , CD13 , CD33 , HLA⁃DR , CD117 , CD34 , and each variable was written into the matrix. Cell sampling and data augmentation methods were used to increase the sample size of the training set , the keras software package was used to build the LeNet⁃5 CNN model in Python , and the training set and the validation set were used for model training and parameter tuning respectively to evaluate the performance of the model on the test set. Results : The accuracy of CNN to identify AML on the two test sets was 0. 931 , 0. 851 , the sensitivity was 0. 667 , 0. 636 , the specificity was 0. 968 , 0. 940 , and the area under the receiver operating characteristic curve was 0. 940 and 0. 917. Conclusion Based on the proposed FCM data structure , the CNN model can realize the preliminary diagnosis of AML , indicating that CNN has certain application value in FCM data analysis.