It was concerned with recent progress in the research of chitin/chitosan hydro-lases,which included chitinase ,chitosanase,lysozyme and non-specific hydrolases. Emphasis was placed on isolation and characterization,model of action,kinetics ,immobiliation and gene improvment of these enzymes.

OBJECTIVE To investigate the develop mental toxicity of muscone to embryos. METHODS With zebrafish embryos as a model,The 3 h post fertilization (hpf)embryos were exposed to muscone at 5,10,20,40,80 and 160 μmol·L -1 culture solutions for 96 h and inspected daily with mi-croscopy for larval morphology.The drug solution was replaced every 24 h.Spontaneous move ments were checked at 24 hpf.Heart rate at 48 hpf,hatching rate,e mbryo deformity rate and mortality rate were evaluated.The expression of sepn1 was determined with real-ti me quantitative PCR technique at 96 hpf.RESULTS The 24 hpf spontaneous move ments showed no significant difference.At 48 hpf, spine curvature,pericardial ede ma,yolk sac ede ma,and abnormal swi mming were observed.In addition, the 48 hpf heart beats(10 s)was decreased fro m 26.5 ±1 .0 to 18.0 ±1 .9(P <0.01 ).At 48 hpf , hatching rate of 5 ~40 μmol·L -1 decreased(P <0.05),while of 160 μmol·L -1 increased (P <0.05) co mpared with muscone 0 μmol·L -1 .Muscone had little effect on hatching rate at other ti me points;Mal-formation rate and mortality rate at higher concentrations were up to 100%.The sepn1 gene expression at 96 hpf in the exposure groups decreased co mpared with that of control group(P <0.01 ).CONCLU-SION Muscone had toxic effects on the develop ment of zebrafish embryos,including spine curvature, abnormal swi mming,and pericardial ede ma.These effects may be related to the inhibition of sepn1 gene expression by muscone.

Objective To discuss the surgical treatment of intraductal papillary mucinous neoplasms of the pancreas (IPMN).Methods The clinical data of 42 IPMN cases undergoing surgical treatment in our hospital during the past 4 years were analyzed retrospectively.Results Routine CT or MRI examination was made in 42 cases,ERCP in 6 cases,ultrasonic endoscopy in 12 cases,fine needle biopsy by endoscopic ultrasonography in 4 cases.There were 12 cases of the main duct IPMN,24 cases of branch duct IPMN,6 cases of mixed IPMN.Pancreatoduodenectomy was performed in 24 cases;6 cases underuent laparoscopic central pancreatectomy;10 cases did distal pancreatectomy,2 cases did total pancreatectomy.Postoperative pathology revealed that the malignant transformation rate of main pancreatic duct type was 66.7％,that of BD-IPMN was 12.5％ and 66.7％ of Mix-IPMN.The postoperative complication rate was 26.2％.All cases were followed up for 1 month to 4 years,with no tumor recurrence.Conclusions Imaging examination combined with endoscopic ultrasonography is the main method for clinical diagnosis of IPMN.The malignant transformation rate of MD-IPMN and Mix-IPMN is high.Most of the BD-IPMN is hyperplasia and adenoma.

The ancient herbal books, and literatures were reviewed, and the textual research and origin of Caryophylli flos were explored from the differences between Caryophylli flos and Caryophylli fructus, the alias of Caryophylli flos and Caryophylli fructus, the origin and introduction of Caryophylli flos, and its efficacy and indications. The results indicated that Caryophylli flos and Caryophylli fructus were different from each other in terms of synonyms, chemical components and pharmacological effects. Caryophylli flos was brought to China as a spice in the Wei, Jin, Southern and Northern Dynasties, and the efficacy of Caryophylli flos was almost same in ancient and modern time. Caryophylli flos is widely used in digestive and dental diseases, and Caryophylli flos is also one of the seven natural spices, which can be used for food preservation.

Objective To investigate the prevalence of feeding intolerance (FI),and to explore the FI within 7 days of ICU admission in association with clinical outcome in critically ill patients.Methods The adult patients from 14 general ICUs in Zhejiang Province with an expected admission to ICU for at least 24h were recruited from March 2014 to August 2014,and all clinical,laboratory,and survival data were prospectively collected.The AGI (acute gastrointestinal injury) grade was daily assessed based on gastrointestinal (GI) symptoms,feeding details and organ dysfunction within the first week of ICU stay.The intra-abdominal pressures (IAP) was measured using AbViser device.Results Of 550 patients enrolled,418 were assessed in GI symptoms and feeding details within 7 days of ICU stay.The mean age and SOFA score were (65.1 ± 18.3) years and (8.96 ±4.10),respectively.Of them,355 patients (84.9％) were under mechanical ventilation support,and 37 (8.85％) received renal replacement therapy.The mean length of time for enteral feeding was (30.8 ±26.2) h,and the prevalence of FI on the 3rd and 7th day of ICU stay accounted for 39.2％ and 25.4％,respectively.Compared to those with FI within 7 days of ICU stay,the patients without FI had higher rate of successively weaning from mechanical ventilation (21.3％ vs.5.7％,P =0.003) and higher rate of withdrawal of vasoactive medication (45.5％ vs.20.0％,P =0.037),as well as lower mortality rate of 28-day (24.4％ vs.38.7％,P =0.004) and 60-day (29.6％ vs.44.3％,P =0.005).In multivariate Cox regression model with adjustment for age,sex,participant center,serum creatinine and lactate,AGI grade on the first day of ICU stay,and comorbidities,the FI within 7 days of ICU stay (x2 ≥ 7.24,P ＜ 0.01) remained to be independent predictors for 60-day mortality.After further adjusted for SOFA score,the FI within 7 days of ICU stay (HR =1.71,95％ CI:1.18-2.49;P =0.006) and AGI grade on the first day of ICU stay (HR =1.33,95 ％ CI:1.07-1.65;P =0.009) could provide independent prognostic values of 60-day mortality.Conclusions There is high rate of FI occurred within 7 days of ICU stay,and is significantly associated with worse outcome.In addition,this study also provides evidence to further support that measurement of gastrointestinal dysfunction could increase value of SOFA score in outcome prediction for the risk of 60-day mortality.

Objective To investigate the clinical efficacy of pericardial devascularization (PCDV) combined with splenectomy and partial gsstric fundus resection (PGFR) in the treatment of portal hypertension-induced severe gastric varices complicated with gastrorenal shunt (GRS).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 18 patients with portal hypertension-induced severe gastric varices complicated with GRS who were admitted to the Fujian Provincial Hospital from January 2010 to December 2015 were collected.According to the stage of technical development,open surgery or laparoscopic surgery was selected based on patients' and their family's wishes.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival.The follow-up using outpatient examination and telephone interview was performed once every 3 months within 1 year postoperatively and once every 6 months after 1 year to detect long-term complications and survival up to June 2017.The reexaminations of gastroscopy,enhanced scan of X-ray computed tomography (CT) on the epigastric region or magnetic resonance imaging (MRI) were done at 1 month postoperatively for detecting resection of fundus ventriculi varicosity.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).The survival rate was calculated by the Kaplan-Meier method.Results (1) Surgical and postoperative recovery situations:18 patients underwent successful PCDV combined with splenectomy and PGFR,including 12 with open surgery and 6 with laparoscopic surgery (1 with conversion to open surgery due to intraoperatively uncontrollable bleeding).There was no perioperative death.The operation time,volume of intraoperative blood loss,recovery time of gastrointestinal function,time of postoperative drainagetube removal and duration of hospital stay were (192± 20) minutes,(280± 30) mL,(33 ±6) hours,8 days (range,5-9 days),8 days (range,5-12 days) in 12 patients with open surgery and (208±40)minutes,(210±10)mL,(28±5)hours,7 days (range,5-26 days),7 days (range,5-10 days) in 6 patients with laparoscopic surgery,respectively.One patient with laparoscopic surgery had intraoperative condensed erythrocyte infusion with 2 U.Seven,1,0 patients with open surgery and 4,1,1 patients with laparoscopic surgery were respectively complicated with pleural effusion,delayed gastric emptying and pancreatic leakage in level A,and they were cured by conservative treatment.(2) Postoperative pathological examination:results of postoperative pathological examination in 18 patients showed that a large number of varicose veins in the mucous and seresal layers of gastric fundus and moderate or severe hepatic cinr hosis.(3) Follow-up and survival:18 patients were followed up for 8-78 months with a median time of 39 months.The gastroscopy and enhanced scan of X-ray CT at 1 month postoperatively showed that no varicose veins in the gastric fundus.During the follow-up,there was no recurrence of gastric varices with GRS and esophageal stenosis.Of 4 patients with portal vein thrombosis,1 died of portal hypertensive gastropathy-induced upper gastrointestinal bleeding due to stop taking warfarin,and other 3 patients had portal vein patency by warfarin therapy.One patient was complicated with liver cancer at 32 months postoperatively and received radiofrequency ablation therapy.Two patients died,including 1 dying of hepatic failure at 35 months postoperatively and 1 dying of advanced liver cancer at 54 months postoperatively.The 1-,3-and 5-year overall survival rates of 18 patients were respectively 93.8％,84.4％ and 70.3％.Conclusion The PCDV combined with splenectomy and PGFR is safe and effective in the treatment of portal hypertension-induced severe gastric varices with GRS,with a dissemination value for appropriate patients.

Objective To evaluate surgical treatment for hepatocellular carcinoma (HCC) with hepatic vein tumor thrombus(HVTT).Methods We retrospectively analyzed the clinical and pathological data of 23 HCC patients with HVTT undergoing surgical treatment at the Department of Hepatobiliary Surgery,Fujian Provincial Hospital from June 2011 to June 2017,including 14 patients with HVTT and 9 patients with inferior vena cava tumor thrombosis (IVCTT).Results 21 patients with HVTT underwent anatomical hepatectomy and 2 underwent partial resection.The HVTT operation time was (235 ± 45) min,and the IVCTT operation time was (308 ± 75) min.The intraoperative blood loss was (880 ± 677) ml,(1 150 ±808) ml,respectively.The follow-up time after surgery was 3 to 44 months.The median tumor-free survival time of the 23 patients was 5 months,and the median survival time was 16 months.The median survival time of HVTT and IVCTT was 14 months and 17 months,respectively.The 1-,2-,and 3-year survival rates of the 23 HCC with HVTT/IVCTT were 56.5％,21.7％,and 8.7％,respectively.Conclusions Surgical treatment is a choice of therapy for HCC patients with HVTT/IVCTT having good liver function,limited and removable lesion,and no distant metastasis.

Objective:To investigate the clinical application value of craniotomy with hematoma evacuation combined with decompressive craniectomy in the treatment of severe traumatic brain injury.Methods:Sixty-eight patients with severe traumatic brain injury who received treatment in China Coast Guard Bureau Hospital, China between June 2016 and June 2019 were randomly assigned to receive either craniotomy with hematoma evacuation combined with decompressive craniectomy (observation group, n = 34) or conventional craniotomy (control group, n = 34). Surgical value for severe traumatic brain injury and the occurrence of complications were compared between the observation and control groups. Results:Before treatment, there were no significant differences in intracranial pressure, National Institute of Health Stroke Scale score, activity of daily living between the observation and control groups (all P > 0.05). After 7 days of treatment, intracranial pressure in the two groups was significantly decreased compared with before treatment, and intracranial pressure in the observation group was significantly lower than that in the control group ( t = 17.284, P < 0.001). After treatment, Glasgow Coma Scores were significantly increased in the two groups, and Glasgow Coma Scores in the observation group were significantly higher than those in the control group ( t = 5.823, 7.185, 9.234, all P < 0.05). In addition, the numbers of patients with grade I, II and III severe traumatic brain injury in the observation group were significantly lower than those in the control group (all P < 0.05). The number of patients with grade V prognosis in the observation group was significantly higher than that in the control group [20 (58.8%) vs. 8 (23.5%), χ2 = 8.743, P < 0.05]. After treatment, severe traumatic brain injury was mitigated in the two groups. National Institute of Health Stroke Scale score in the observation group was significantly lower than that in the control group, and the activity of daily living in the observation group was significantly higher than that in the control group. The numbers of patients with delayed hematoma, a need for reoperation, hydrocephalus, acute encephalocele, epilepsy, and intracranial infection in the observation group were significantly lower than those in the control group. Conclusion:Craniotomy with hematoma evacuation combined with decompressive craniectomy for treatment of severe traumatic brain injury can greatly decrease intracranial pressure, reduce the degree of injury and improve prognosis.

Objective To compare the perioperative efficacy and safety of da Vinci robot-assisted thoracoscopic surgery (RATS) for treatment of anterior mediastinal tumors through subxiphoid versus lateral thoracic approaches under the laryngeal mask anesthesia. Methods We retrospectively analyzed the clinical data of 102 patients with anterior-mediastinal tumors treated by RATS under laryngeal mask anesthesia completed by the same operator. Forty-five patients underwent the subxiphoid approach (subxiphoid group), and 57 patients were treated with the lateral thoracic approach (lateral thoracic group). The operating time, intraoperative bleeding, and total postoperative drainage volume in the two groups were compared and analyzed. Results All patients successfully completed resection of the anterior mediastinal tumor without the occurrence of perioperative death. In terms of total postoperative drainage volume, postoperative drainage time, postoperative hospital stay, and VAS pain on postoperative days 2 and 3, the subxiphoid group was more advantages (P < 0.05). No statistically significant difference was found between the two groups in terms of operative time, docking time, total operative time, intraoperative bleeding volume, postoperative day 1 VAS pain score, or postoperative complications (P > 0.05). Conclusion The subxiphoid approach of RATS is safe and feasible for resection of anterior mediastinal tumors. Compared with the lateral thoracic approach, the subxiphoid approach has advantages in terms of rapid postoperative recovery and postoperative pain.

Objective To explore the origin of ovarian high grade serous carcinoma(HGSC) through analysing the expression and significance of PAX8,PAX2,p53 and RAS in the ovary and fallopian tube of different types and grades of serous carcinoma. Methods A total of 44 cases tissue samples of ovarian tumor including 34 malignant ovarian tumor and 10 normal normal tissue (as control group) were collected from the admitted patients in Affiliated Tumor Hospital of Guangxi Medical University from January 2015 to January 2016. Fallopian tube tissues were segmented in accordance with the fimbria, ampulla, isthmus and the corresponding ovarian tissues were by the side. There were 34 cases of patients with ovarian cancer including 29 cases of epithelial ovarian cancer (27 serous carcinoma, 1 mucinous carcinoma,1 endometrioid adenocarcinoma)and 5 non-epithelial ovarian cancer(sex cord-interstitial tumor). Among 27 cases of patients with ovarian serous cancer,there were 23 HGSC and 4 low-grade ovarian serous cancer (LGSC). One hundred fifty-three cases of samples were diagnosed as ovarian serous cancer by Shandong University Affiliated Qilu Hospital from 2005 to 2013 and these samples were made tissue microarray.(1)To analyze the expression and differences of PAX8,PAX2,p53 and RAS in the above tissues and tissue microarray from ovarian and tubal of HGSC and control women by immunohistochemistry methods.(2)To compare the expression levels of PAX8,PAX2,p53 and RAS in ovarian and fallopian tubes of ovarian cancer patients with different pathological types. (3) To analyze the correlations of tubal and ovarian tissue in PAX8,PAX2,p53 and RAS expression of HGSC.(4)To analyze the factors of the prognosis of ovarian serous cancer in tissue microarray by single factor analysis method. Results (1)PAX8,PAX2, p53 and RAS expression was negative in normal ovarian epithelium of control group,but the expression of PAX8, PAX2, p53 and RAS were strongly positive brown in secrete cells of normal fallopian tube epithelium.(2)p53 and RAS expression of fallopian tube epithelium in the epithelial ovarian cancer group were significantly higher than those in the non-epithelial ovarian cancer groups(P<0.05),but the expression of PAX8 and PAX2 in fallopian tube and the expression of PAX8,PAX2,p53 and RAS in ovarian tissue was not statistically significant in the groups(P>0.05).PAX8,PAX2 and p53 expression of the ovarian in HGSC group were significantly higher than those in LGSC group(P<0.05),while the expression of RAS was lower in the ovarian of the high-grade group (P<0.05), while the expression of PAX8, PAX2, p53 and RAS in fallopian tube was not statistically significant in the groups(P>0.05).(3)There was a significantly positive correlation between fallopian tube and the corresponding ovary of HGSC in PAX8 and PAX2 expression(r=0.422, P=0.045; r=0.693, P=0.000), but not correlation in p53 and RAS expression (r=0.058, P=0.793; r=-0.190,P=0.384).(4)Univariate survival analysis showed that the progression free survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8, PAX2 and RAS(P<0.05),but there were not correlated with age,surgical staging,cell differentiation,lymph node metastasis and preoperative chemotherapy and p53 protein expression (P>0.05). The total survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8 (P<0.05),but there were not correlated with age,surgical staging,cell differentiation,lymph node metastasis and preoperative chemotherapy and the protein expression of PAX2, RAS and p53 (P>0.05). Conclusions PAX8, PAX2, p53, RAS are of great significance for the study of origin of HGSC. HGSC may be derived from fallopian tube, but further investigation would be necessary to confirm this. PAX8, PAX2, p53, RAS could be expected to be used as predictors of survival prognosis in patients with ovarian serous cancer.