Objective To investigate the protective effect of non-wounded ischemic preconditioning (N-WIP) on lung ischemia/reperfusion (I/R) injury.Methods Two animal models with N-WIP and the classical ischemic preconditioning respectively were used. Forty New Zealand White rabbits were randomly divided into 4 groups, each group having 10 animals: control group (C), ischemia/reperfusion group (I/R), classical ischemic preconditioning group (C-IP), and N-WIP group. Lung injury was assessed by arterial oxygen tension (PaO2), wet to dry weight ratio (W/D), activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) and level of malondialdehyde (MDA).Results In I/R group, PaO2 was descended constantly, especially within 30 min after reperfusion. PaO2 and the activities of SOD, GSH-PX in serum and lung tissue in N-WIP group and C-IP group were both significantly higher than those in I/R group (P

Objective To investigate management strategy of minimally invasive surgery for common bile duct stones. Methods Three hundred and four cases of common bile duct stones were divided into 3 groups receiving respectively endoscopic papillary balloon delation plus laparoscopic cholecystectomy ( EPBD group, 35 cases ), endoscopic sphincterotomy plus LC ( EST group, 138 cases), and Laparoscopic common bile duct exploration plus LC (LCBDE group, 131 cases). Results There was no significant difference in treatment success rate, short-term complications and bile duct retained stones among these three group ( x2 = 1. 930, 0. 038, and 0. 427 respectively, P > 0. 05 ). There was significant difference among these three groups in operation time ( F = 17.941, P = 0. 000 ), and the operation time in LCBDE group was shorter than that in other two groups( EPBD-EST: P = 0. 122, EST-LCBDE:P = 0. 000, EPBD-LCBDE:P = 0. 020 ). There was significant difference among these three groups in postoperative hospital stay (F =24. 016,P =0. 000) ,and the postoperative hospital stay in EPBD group was shorter than that in other two groups ( EPBD-EST: P = 0. 000, EST-LCBDE : P = 0. 198, EPBD-LCBDE : P = 0. 000 ). In EPBD group,bile duct recurrent stones was found in 2 cases(6. 7% ) and cholangitis in 1 case(33% ) and no duodenal papilla stenosis was encountered; In LCBDE group, bile duct recurrent stones were found in 7 cases (6. 0% ), cholangitis in 3 cases ( 2. 6% ), and there was no duodenal papilla stenosis; In EST group, bile duct recurrent stones were complicated in 18 cases ( 15.8% ), duodenal papilla stenosis in 9 cases (7.9%), and cholangitis in 14 cases( 12. 3% ). There were significant differences among these three groups for these three complications( x2 = 6. 482, 9. 160, and 12. 020 respectively,P < 0. 05 ), and the rate of complications in EST group was higher than that in other two groups. Conclusion For common bile duct stones, EPBD is the first choice followed by LCBDE while EST is only indicated for very few cases.

Objective To observe the influence of human umbilical cord wharton′s jelly‐mesenchymal stem cells(WJ‐MHCs) on the tumor necrosis factorα (TNF‐α) and N‐terminal pro‐brain natriuretic peptide(NT‐proBNP) in rats with heart failure of a‐cute myocardial infarction .Methods Totally 80 male rat models of heart failure of acute myocardial infarction were made by isopre‐naline(ISO) 200 mg/kg injected subcutaneously twice at an interval of 24 hours .After one week ,24 survival rats were randomly di‐vided into WJ‐M HCs transplantation group and normal control group .Sham group was made of 12 health rats ,and then each of the three groups was subdivided into pre‐transplantation group and post‐transplantation group 4 weeks later .WJ‐MHCs transplantation group was transplanted with WJ‐MHCs with DAPI labeled after ISO injected one week .Sham group and normal group were un‐treated and normally bred .The left ventricular ejection fraction(LVEF) measured by before transplantation and post‐transplantation 4 weeks later .The injected cells and the expression of TNF‐αwas measured .Results Compared to pre‐transplantation group ,WJ‐M HCs transplantation group increased the LVEF(P<0 .05);compared to pre‐transplantation and normal control ,WJ‐M HCs trans‐plantation group reduced the TNF‐αand NT‐proBNP in the serum(P<0 .05)and the expression of TNF‐α from the heart tissue (P<0 .05);compared to normal transplantation ,WJ‐M HCs transplantation group reduced the mortality from 33 .3% to 16 .7% ;immunofluorescence demonstrated that transplanted cells were still found alive in the heart after transplantation 4 weeks later .Con‐clusion Transplantation of WJ‐MHCS down‐regulates TNF‐α and NT‐proBNP in the serum in the serum and the expression of TNF‐αfrom the heart tissue and up‐regulates the LVEF in rats with heart failure of acute myocardial infarction .

Objective To explore the learning curve characteristics of Mckeown-type minimally invasive esophagectomy and effects of the para-recurrent laryngeal nerve lymphadenectomy on efficacy.Methods The retrospective cohort study was conducted.The clinicopathological data of 163 patients with esophageal squamous cell carcinoma (ESCC) who underwent Mckeown-type minimally invasive esophagectomy in the Affiliated Tumor Hospital of Xinjiang Medical University between January 2011 and December 2015 were collected.According to the para-recurrent laryngeal nerve lymphadenectomy in the different learning curve stages (early,medium and later stages),49 patients who didn't undergo right para-recurrent laryngeal nerve lymphadenectomy were allocated into the group A,65 who underwent para-recurrent laryngeal nerve lymphadenectomy were allocated into the group B,and 49 underwent bilateral para-recurrent laryngeal nerve lymphadenectomy were allocated into the group C.Observation indicators:(1) comparisons of intra-and post-operative recovery among groups;(2) comparisons of follow-up and survival among groups;(3) correlation analysis between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to April 2017.Measurement data with normal distribution were represented as-x±s.Comparison among groups was analyzed using the ANOVA,and pairwise comparison was done using the independent-sample t test.Measurement data with skewed distribution were described as M (range),and comparison of count data was done using the chi-square test.The survival time was calculated by the Kaplan-Meier method,and Log-rank test was used for survival analysis.Correlation analysis was done by Spearman rank correlation.Results (1) Comparisons of intra-and post-operative recovery among groups:patients in the 3 groups underwent successful Mckeown-type minimally invasive esophagectomy of ESCC,without conversion to open surgery.The operation time,total number of lymph node dissected,number of thoracic lymph node dissected and volume of intraoperative blood loss were respectively (395±94) minutes,14.7±6.9,9.6±5.4,(175± 100) mL in the group A and (329±67) minutes,20.4±9.1,11.4±7.3,(117±49) mL in the group B and (301±51)minutes,25.8±11.0,14.8±10.1,(115±50) mL in the group C,with statistically significant differences in above indicators among groups (F=21.962,1.992,5.775,12.744,P＜0.05),between group A and group B (t =3.135,3.741,4.324,4.375,P＜0.05) and between group A and group C (t=5.120,3.415,5.712,6.130,P＜0.05).There was no statistically significant difference in operation time and volume of intraoperative blood loss between group B and group C (t =2.325,2.459,P＞0.05).There were statistically significant differences in total number of lymph node dissected and number of thoracic lymph node dissected between group B and group C (t =2.751,3.245,P＜0.05).Cases with unilateral recurrent laryngeal nerve injury,anastomotic leakage and pneumonia were respectively 7,8,7 in the group A and 17,19,10 in the group B and 11,15,10 in the group C,with no statistically significant differences (x2 =0.968,3.292,0.773,P＞0.05).Number of lymph node dissected at right and left para-recurrent laryngeal nerve were respectively 0,0 in the group A and 1.9±1.8,0 in the group B and 2.6±2.1,1.1±0.8 in the group C.Of 35patients with unilateral recurrent laryngeal nerve were treated with symptomatic and supportive treatment of neuro nutrition,18 encountered permanent hoarseness and 17 recovered well.Patients with anastomotic fistula and pneumonia were improved by sufficient drainage and antibiotic therapy.(2) Comparisons of follow-up and survival among groups:149 of 163 patients were followed up for 17-65 months,with a median time of 32 months,including 43 in the group A,61 in the group B and 45 in the group C.Survival time of patients who received follow-up was recpectively (31.3±2.6) months,(32.2± i.6) months and (25.5±2.5) months in group A,B and C,with no statistically significant differences (x2=4.412,P＞0.05).(3) Correlation analysis between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy:results of correlation analysis showed that there was a significant negative correlation between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy (r=-0.632,-0.451,P＜0.05),showing a decreasing trend in operation time and volume of intraoperative blood loss with increasing surgical cases.Conclusions The operation time and volume of intraoperative blood loss are gradually declining with learning curve process of Mckeown-type minimally invasive esophagectomy.Para-recurrent laryngeal nerve lymphadenectomy cannot increase the incidence of recurrent laryngeal nerve injury,with more completely lymphadenectomy.

Objective To observe the value of clinical and CT radiomics features for predicting microsatellite instability-high(MSI-H)status of gastric cancer.Methods Totally 150 gastric cancer patients including 30 cases of MSI-H positive and 120 cases of MSI-H negative were enrolled and divided into training set(n=105)or validation set(n=45)at the ratio of 7∶3.Based on abdominal vein phase enhanced CT images,lesions radiomics features were extracted and screened,and radiomics scores(Radscore)was calculated.Clinical data and Radscores were compared between MSI-H positive and negative patients in training set and validation set.Based on clinical factors and Radscores being significant different between MSI-H positive and negative ones,clinical model,CT radiomics model and clinical-CT radiomics combination model were constructed,and their predictive value for MSI-H status of gastric cancer were observed.Results Significant differences of tumor location and Radscore were found between MSI-H positive and negative patients in both training and validation sets(all P＜0.05).The area under the curve(AUC)of clinical model,CT radiomics model and combination model for evaluating MSI-H status of gastric cancer in training set was 0.760,0.799 and 0.864,respectively,of that in validation set was 0.735,0.812 and 0.849,respectively.AUC of clinical-CT radiomics combination model was greater than that of the other 2 single models(all P＜0.05).Conclusion Clinical-CT radiomics combination model based on tumor location and Radscore could effectively predict MSI-H status of gastric cancer.

Objective:To explore the correlation of serum albumin level at admission with clinical prognoses in patients with acute traumatic brain injury (TBI).Methods:One hundred and fifty-four patients with acute moderate-extreme severe TBI (Glasgow Coma Scale [GCS] scores of 3-12 at admission) in Department of Neurosurgery, General Hospital of Western Theater Command from January 1, 2019 to December 31, 2020 were chosen. The comprehensive clinical data of these patients were collected, including age, gender, GCS scores, serum albumin level (hypoalbuminemia defined as<35 g/L), hemoglobin level, comorbidities, treatment measures, and prognoses 6 months after discharge (poor prognosis defined as Glasgow outcome Scale [GOS] scores of 1-2, and good prognosis defined as GOS scores of 3-5). Univariate and multivariate Logistic regressions were used to identify the independent factors for clinical prognoses of these patients, and differences in poor prognosis rate, length of ICU stay, and total hospital cost were compared between different groups.Results:Among the 154 patients, 43 had poor prognosis and 111 had good prognosis. Serum albumin level at admission ( OR=0.916, 95% CI: 0.843-0.996, P=0.001) and GCS scores at admission ( OR=0.701, 95% CI: 0.594-0.828, P<0.001) were independent factors for prognosis. Patients with hypoalbuminemia ( n=70) displayed significantly higher poor prognosis rate, longer ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=84, P<0.05); specifically, in patients with GCS scores of 9-12 at admission ( n=58), those with hypoalbuminemia ( n=27) exhibited significantly higher poor prognosis rate, longer ICU stays, and higher total hospitalization cost than their non-hypoalbuminemia counterparts ( n=31, P<0.05); similarly, in patients with GCS scores of 3-8 at admission ( n=96), those with hypoalbuminemia ( n=74) had significantly higher poor prognosis rate than their non-hypoalbuminemia counterparts ( n=22, P<0.05). In patients with good prognosis, those with hypoalbuminemia ( n=56) showed significantly longer total hospital stays, prolonged ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=55, P<0.05). Conclusion:Low serum albumin level at admission is likely to lead to poor prognosis, prolonged ICU stays and increased total hospitalization cost in patients with acute TBI.

Objective:To investigate the risk factors affecting the completion of postoperative adjuvant chemotherapy in elderly patients with progressive gastric cancer.Methods:Clinicopathological data of patients diagnosed with gastric adenocarcinoma and treated with radical surgery at our hospital between January 2017 and December 2018 were retrospectively collected, and 96 patients were finally included in the study according to the inclusion and exclusion criteria.Patients were divided into a completed chemotherapy group and an uncompleted chemotherapy group depending on whether they had completed 6 cycles of adjuvant chemotherapy after surgery.The optimal cut-off value was derived from the receiver operating characteristic(ROC)curve, and the Youden Index was calculated.Relevant factors that might affect the completion of postoperative adjuvant chemotherapy in elderly patients with progressive gastric cancer were included in univariate and multivariate Logistic regression analyses to identify independent risk factors affecting the completion of postoperative adjuvant chemotherapy in gastric cancer patients.The Kaplan-Meier(K-M)method was used to plot the survival curves for the groups, and the log-rank test was used to compare the survival rates between the groups.Results:A total of 96 patients, aged 60-89 years, with a mean age of(70.3±7.0)years, were included.Sixteen patients completed postoperative adjuvant chemotherapy, while 80 patients did not.The following analysis was performed on clinicopathological data of patients in the two groups.Univariate Logistic regression analysis showed that patient age ≥70 years( OR=8.135, 95% CI: 1.735-38.153, P=0.008)or a preoperative prognostic nutritional index(PNI)score <49.5( OR=4.765, 95% CI: 1.549-14.656, P=0.006)affected the completion of postoperative adjuvant chemotherapy.The risk factors that might affect the completion of postoperative adjuvant chemotherapy in elderly gastric cancer patients were analyzed using multivariate Logistic regression and the results showed that age ≥70 years( OR=9.815, 95% CI: 1.947-49.485, P=0.006)and a preoperative PNI score <49.5( OR=5.895, 95% CI: 1.711-20.305, P=0.005)were independent risk factors hindering the completion of postoperative adjuvant chemotherapy. Conclusions:Age ≥70 years and PNI<49.5 are independent risk factors for the completion of postoperative adjuvant chemotherapy.Failure to complete postoperative adjuvant chemotherapy is associated with a poor prognosis.PNI is a valid predictor for whether postoperative adjuvant chemotherapy will be completed and helps to screen chemotherapy patients who need nutritional intervention.

Objective:Standardized sample resources and high-quality clinical big data are important resources for medical research, only through resource sharing can maximize its utilization.Which can be utilized to the max only through resource sharing.Methods:This paper attempts to explore the sharing mechanism of the resource sharing platform and proposes some aspects such as the platform construction background, management regulations, legal ethical system, data sharing principles, benefit distribution, etc.This article attempts to explore the sharing mechanism based on the resource sharing platform of the respiratory disease biobank, proposes the contents that should be included in the sharing mode.Detailed information including the platform construction background, management procedures, legal and ethical system, data sharing principles and benefit distribution should take into consideration in the operating mechanism of the platform.Results:Establishing a resource sharing platform matches the development of clinical research in China.The tailored sharing model which is suitable for the field of respiratory diseases will also guide the rapid development of clinical research.Conclusions:The construction of a respiratory disease biobank sharing platform is conducive to promoting the opening and sharing of biological samples and information resources in the context of big data.

In recent years, the incidence of digestive disorders has risen steadily. Among which, biliary dyskinesia, particularly biliary hyperkinesia, has become a growing concern. The basic concept, epidemiology, pathogenesis, pathology, clinical and imaging manifestations, diagnosis, and treatment of biliary hyperkinesia are systematically reviewed in this paper based on the current status of research in this field worldwide. On this basis, prospective future research directions are also provided.

Bacitracin is a broad-spectrum antibiotics mainly produced by Bacillus, and is used as veterinary medicine in the fields of livestock and poultry breeding. Insufficient supply of precursor amino acids might be an important factor that hinders high-level microbial production of bacitracin. We investigated the effect of strengthening L-cysteine supply on bacitracin production by an industrial bacitracin producer, Bacillus licheniformis DW2. Overexpression of cysK encoding L-cysteine synthase led to a 9.17% increase of the bacitracin titer. Moreover, overexpression of cysE encoding L-serine acetyltransferase and cysP encoding thiosulfate/sulfate intracellular transporter increased the bacitracin titers by 7.23% and 8.52%, respectively. Moreover, overexpression of a putative cystine importer TcyP led to a 29.19% increase of intracellular L-cysteine, and bacitracin titer was increased by 7.79%. Subsequently, the strong promoter PbacA was used to replace the promoters of genes cysP, cysE and tcyP in strain DW2::ysK, respectively. The resulted strain CYS4 (DW2::cysK-PbacA-(cysP)-PbacA(cysE)- PbacA(tcyP) produced 910.02 U/mL bacitracin, which was 21.10% higher than that of the original strain DW2 (747.71 U/mL). Together with the experiments in 3 L fermenters, this research demonstrated that enhancing intracellular L-cysteine supply is an effective strategy to increase bacitracin production of B. licheniformis.
Amino Acids ; Bacillus licheniformis/genetics* ; Bacitracin ; Cysteine ; Metabolic Engineering