Objective To investigate the effects of cinnamaldehyde and citral on DNA and RNA of Aspergillus flavus and A. fumigatus cells and their mechanisms. Methods A. flavus and A. fumigatus were incubated on Czapeks agar plate (treated with cinnamaldehyde and citral at different concentrations) at 26.5 ℃ for 3—6 d. The normal and treated cells were observed by laser scanning confocal microscope (LSCM) and image analysis to describe the DNA and RNA levels by quantity and localization. Results DNA and RNA levels were changed greatly and multinucleate coniospores appeared in the treated cells. Conclusion Cinnamaldehyde and citral have directly or indirectly interfered the conventional synthesis of fungal hereditary DNA and RNA and normal differentiation of conidiophore in A. flavus and A. fumigatus, thus inhibiting the normal cell cycle and the growth and propagation of fungi.

Purpose To analyze the imaging manifestations of solitary fibrous tumors (SFT) so as to improve its diagnosis. Materials and Methods The CT and MRI findings of 24 patients with SFT confirmed pathologically were analyzed retrospectively and compared respectively with their pathological results in terms of lesion's location, size, shape, density (signal), type of enhancement and relationship with the surrounding tissues. Seven patients underwent MRI scan, 5 were with enhanced scan; 17 patients were carried out plain CT scan and 11 were with enhanced CT scan. Results The lesions in the 23 cases were solid and 1 was solid and cystic. Through the imaging diagnosis, 20 cases were diagnosed as benign tumors, 2 cases were diagnosed as malignancies, and 2 benign tumors were misdiagnosed, which showed that the diagnose accordance rate was 91.7%(22/24). On plain CT scans, 5 lesions (maximum diameter<4 cm) showed homogeneous density; 7 cases (maximum diameter>5 cm) showed heterogeneous density, 4 of which had calcification and 7 had necrosis; the shapes were round-like or lobulated. On enhanced CT scans, 5 cases presented progressive enhancement pattern, 5 cases showed fast-in and slow-out pattern, 1 case showed slight enhancement pattern. On MRI scan, 4 cases of the solid part of tumors showed isointensity signals on T1WI and isointensity or slight hyperintensity signals on T2WI, 3 cases showed isointensity or low signals on T1WI and low, isointensity or slight hyperintensity signals on T2WI, and slight hyperintensity signal on DWI, the solid part of tumors were strongly enhanced. Two malignant tumors presented features like heterogeneous density, unclear boundary, invasive growth and progressive enhancement pattern. The pathological findings demonstrated that the tumor tissues mainly consisted of spindle cells with rich fibers and vessels. Conclusion The imaging findings of benign and malignant SFT have certain features, malignant SFT have invasive growth signs. The obvious progressive enhancement of solid component which shows isointensity and hyperintensity on T1WI or T2WI may be helpful in the diagnosis of SFT; however, the final diagnosis should be confirmed with histopathology.

Objective:To explore the efficiency of a new scoring system of gastric cancer screening for early gastric cancer in health examination population.Methods:The risk score of gastric cancer was assessed based on the new scoring system in health examination population. A notice for further gastroscopy was sent to the medium-risk and high-risk people. Gastroscopy was performed on those who agreed to undergo the examination.Results:From January to April 2019, a total of 5 357 people in health system visited the Physical Examination Center of Shanghai Songjiang Clinical Medical College of Nanjing Medical University for health examination. Seven hundred and forty people were classified as medium- and high-risk groups by the new screening system, 576 in medium-risk group, and 164 in high-risk group. Among them, 131 cases (17.70%) came for further gastroscopy, of whom 91 (69.47%) were in the medium-risk group and 40 (30.53%) in the high-risk group. After gastroscopy, 4 cases of gastric cancer and 1 case of esophageal cancer were detected, and both were early cancer. In the medium-risk group, 2 cases (2/91, 2.20%) of early gastric cancer and 1 case (1/91, 1.10%) of early esophageal cancer were found. In the high-risk group, 2 cases (2/40, 5.00%)of early gastric cancer were found. The tumor detection rate of high-risk group (5.00%) was higher than that of medium-risk group (3.30%), but there was no significant difference ( P>0.05). Conclusion:Risk stratification with the new scoring system of gastric cancer screening can improve the detection rate of early gastric cancer.

Objective To evaluate the feasibility and efficacy of twin grasper combined with endoloops on closing acute stomach perforation.Methods Two experimental porcines of stomach perforation underwent endoscopic closure by twin grasper combined with endoloops.Survival conditions and closure of perforating were observed.Results Mild infection and abdominal adhesions were observed in one week after operation.The nylon rope fell off and an ulcer-like lesion was presented in the closed position.The methylene blue leak test was negative.Histologic examination revealed chronic inflammatory cells infiltration,granulation,fibroplasias,and regenerative mucous membrane crawling toward the center of perforation.Conclusion The technique of twin grasper combined with nylon ropes in closing the acute stomach perforation is feasible and effective.

Objective This study assesses a feasible and safe volume threshold for chest tube removal following a VATS lobectomy.Methods The study included 168 consecutive patients who underwent VATS lobectomy or bilobectomy with two insicion between August 2012 and February 2014.Eligible patients were randomized into 3 groups:Group A (chest tube removal at the drainage volume of 150 ml/d or less.n =49) ; Group B (chest tube was removed when the drainage volume was less than 300 ml/d.n =50) ; Group C(chest tube removal when the drainage was less than 450 ml/d.n =51).And there were 18 patients who were excluded.All patients got the same postoperative care with a clinical pathway,and all patients were followedup 7 days after discharge from hospital.The time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic,incidence of complications and thoracocentesis were measured.Results There were no statistically significant differences among 3 groups with general information and incidence of complication (P ＞ 0.05).And there were statistically significant differences between Group A and Group B with the time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic(P ＜ 0.05).But there were no statistically significant differences between Group A and Group B with incidence of thoracocentesis(P ＞0.05).Analysis of data showed no statistically significant differences between Group B and Group C with postoperative hospital stay,postoperative VAS values and dosage of analgesic (P ＞ 0.05),but there were statistically significant differences for incidence of thoracocentesis (P ＜ 0.05).Conclusion A 300 ml/d volume threshold for chest tube removoal after VATS lobectomy is feasible and safe,and it can bring more advantages than the 150 ml/d volume threshold.On the other hand,a 450 ml/d volume threshold for chest tube removoal after VATS lobectomy may increase the risk of thoracocentesis.

Introduction：Neonatal tetanus is a major cause of neonatal mortality in many developing countries and remains a major public health problem. This study aimed to determine risk factors associated with neonatal tetanus in Wenzhou, China.Methodology：Medical records of neonatal tetanus cases from 17 hospitals over a 13-year period (2000–2012) were reviewed for potential risk factors. Controls were selected from neonates with diseases other than tetanus who were admitted to the same facility during the same period. The potential risk factors of the neonatal tetanus group were compared with the control group using univariate analysis and an unconditional logistic regression model.Results：A total of 246 neonates with tetanus and 257 controls were included in this study. Univariate analysis showed that having untrained birth attendants, home delivery, an unsterile method of delivery and being a migrant to Wenzhou were significantly different between the two groups (P < 0.001). Logistic regression analysis revealed that the odds of having an untrained birth attendant, home delivery and an unsterile method of delivery were significantly higher in the tetanus group than the control group (odds ratio: 1371.0; 95% confidence interval: 206.0, 9123.5).Conclusion：This study identified that the main risks of neonatal tetanus in cases from Wenzhou were having an untrained birth attendant, home delivery and an unsterile method of delivery. Preventive measures directed to these risk factors may reduce the occurrence of neonatal tetanus in the studied area.

OBJECTIVETo investigate the feasibility of a new mode to diagnose and treat intrathoracic gastroesophageal anastomotic leak.

METHODSFrom January 2007 to December 2014, fifty-five patients were confirmed intrathoracic gastroesophageal anastomotic leak among those were performed surgical operation due to esophageal or cardiac carcinoma in the First Affiliated Hospital of Soochow University. To retrospectively analyze the clinical data of these patients, thirty-six male and nineteen female were included with the ages from 49 to 81 years (average age of (67±6)years). Among them, forty-two were middle esophageal carcinoma, eleven were lower esophageal carcinoma and two were cardiac carcinoma. According to the differences of diagnosis and treatment methods for anastomotic leak, fifty-five patients were divided into two groups. Thirty-one patients distributed from January 2007 to November 2011 were received conventional management (conventional group): to definitively diagnose by contrast swallow when suspected to be developing anastomotic leaks, to place an esophageal stent when the drainage was sufficient and the infection was controlled. Twenty-four patients distributed from March 2011 to December 2014 were received new-mode management (new-mode group): to perform a anastomotic radioscopy under digital subtraction angiography -guidance instantly when suspected anastomotic leak and find out the fistula, search the shape and size, place a drainage tube into the fistula to drain or lavage the vomica according to the exploration results, pull back the tube gradually and close the leak by clips under endoscope later. The pathoclinical features, the confirmation time (time from clinical signs emergence to leak confirmation), the hospital duration after confirmation, the incidence of severe complications and total mortality were compared between the two groups by t-test and χ(2) test or Fisher's exact test.

RESULTSThere was no significant statistical differences in pathoclinical features between two groups (P>0.05). The confirmation time was significantly reduced in new-mode group than that in conventional group ((1.2±0.8) d vs. (3.6±2.2) d, t=5.212, P=0.000), and so was the hospital duration after confirmation ((26±12) d vs. (55±25) d, t=4.992, P=0.000) and the incidence of severe complications (16.7% vs. 48.4%, χ(2)=6.019, P=0.014), although there was no statistical differences in total mortality (4.2% vs. 22.6%, P=0.119).

CONCLUSIONThe new mode of early interventional diagnosis, early fistula drainage through nose and clipping under endoscope later is able to shorten diagnosis and treatment period, reduce incidence of severe complications.

Aged ; Aged, 80 and over ; Anastomosis, Surgical ; Anastomotic Leak ; diagnosis ; surgery ; Angiography, Digital Subtraction ; Carcinoma ; surgery ; Drainage ; Esophageal Fistula ; surgery ; Esophageal Neoplasms ; surgery ; Esophagectomy ; Female ; Fluoroscopy ; Heart Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents

Objective To evaluate the risk factors of patients with acute kidney injury (AKI) in patients with chronic kidney disease (CKD) for the early detection and early treatment of CKD.Methods One hundred and twenty-seven CKD patients were divided into groups according to AKI existing, 60 cases with out AKI (CKD group), 67 cases with AKI (A/C group) and then A/C group patients were divided into non-older age group (35 cases, ＜60 years old) and older age group (32 cases, ≥60 years old).The protopathy, causative factors and so on were analyzed.Results There was different causative factors in different age group.Logistic regression model indicated that the major risk flactors of AKI in CKD were severe infection (OR = 5.236),hypovolemia (OR = 5.083 ),heart failure (OR = 8.283) and using renal toxicity medicine (OR = 5.246),P ＜ 0.05.Conclusion The major risk factors of AKI in CKD patients include severe infection, hypovolemia, heart failure and renal toxicity medicine.

OBJECTIVETo study the effects of anti-oncogene WWOX on cell growth of cholangiocarcinoma.

METHODSThe expression of WWOX protein was detected with immunohistochemical method-SP in 54 patients with cholangiocarcinoma from July 2005 to May 2010 and 12 samples of normal bile duct tissues. The recombinant WWOX eukaryotic expression plasmid was introduced into RBE cells by liposome-mediated transfection and positive cell clones were selected and amplified. The mRNA and protein expressions in RBE cells stably transfected with WWOX were investigated by quantitative RT-PCR and Western Blot before and after transfection. Cell proliferation was tested by MTT, cell apoptosis was assessed by FCM, the alteration of mitochondria membrane potential (ΔΨm) was detected by JC-1 staining method, cell invasion was determined by Transwell chamber assay. The expression change of bcl-2, bax, FasL, caspase-3 mRNA and protein was detected by quantitative RT-PCR and Western Blot.

RESULTSThe expression of WWOX protein was significantly lower in cholangiocarcinoma than that in normal bile duct tissues and loss of WWOX protein expression was found in 40.7% of cholangiocarcinoma specimens (P < 0.05). RBE cells with stable transfection of WWOX were established. Quantitative RT-PCR showed that the expression of WWOX mRNA was significantly enhanced and Western Blot demonstrated that WWOX protein expression was markedly increased. MTT showed that WWOX gene transfection significantly decreased the proliferation of RBE cells (P < 0.05). FCM analysis showed that the apoptosis rate after transfection was significantly promoted [(1.1 ± 0.6)% vs. (1.7 ± 0.5)% vs. (35.2 ± 4.4)%, P < 0.01], JC-1 staining method indicated that the experimental group was loss of ΔΨm [(12.6 ± 1.9)% vs. (13.6 ± 1.8)% vs. (48.7 ± 2.9)%, P < 0.01], transwell chamber assay showed that the number of transfected cells that passed the transwell membrane was significantly less than those of control groups (77 ± 6 vs. 72 ± 8 vs. 48 ± 6, P < 0.01). Quantitative RT-PCR and Western blotting showed that the expression of bcl-2 mRNA and protein was markedly decreased and the expression of bax, caspase-3 were significantly increased. There was no significant change in the expression of FasL.

CONCLUSIONWWOX exerts its antitumor effect against proliferation through inducing cell apoptosis in cholangiocarcinoma.

Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Cholangiocarcinoma ; genetics ; metabolism ; pathology ; Genetic Vectors ; Humans ; Oxidoreductases ; genetics ; metabolism ; Plasmids ; genetics ; Transfection ; Tumor Suppressor Proteins ; genetics ; metabolism ; WW Domain-Containing Oxidoreductase

Objective To know the influencing factors for the severity of motor vehicle road traffic injures ,and to provide scientific basis for making appropriate intervention measures.Methods 7 977 patients with motor vehicle road traffic injuries who were first diagnosed in injury surveillance sentinel hospital of Tongxiang City in 2012 and 2013 were selected, and the factors influencing the severity of injury were analyzed.Results The multivariate logistic regression analysis showed an increased risk of the injure severity among the people aged over 65 years old,alcohol drinking before the injury and migrant workers,the values of OR(95%CI)were 3. 231(2. 091 -4. 993),2. 796(1. 697-4. 607)and 1. 424(1. 217-1. 666)respectively.However,women,motor vehicle drivers,collision with non motor vehicle driver and using safety belt may contribute to the less serious damage,and the values of OR (95%CI)were 0. 837 (0. 753 -0. 930 ),0. 769 (0. 622-0. 952),0. 753 (0. 598-0. 948)and 0. 691 (0. 492-0. 970)respectively.Conclusion The risk factors for the severity of motor vehicle road traffic injures are elderly people,migrant workers and alcohol drinking.The safety education should be provided among the people and the targeted interventions should be developed and implemented.