Objective To evaluate the role of D-serine in nerve cell apoptosis induced by multiple exposures to sevoflurane anesthesia in newborn mice and its relationship with glycogen synthase kinase-3 beta (GSK-3β).Methods Thirty healthy male C57B/L6 mice,aged 6 days,weighing 3.5-4.5 g,were divided into 3 groups (n =10 each) using a random number table:control group (group C),multiple exposures to sevoflurane anesthesia group (group S) and D-serine group (group D).On postnatal days 6,7 and 8,3％ sevoflurane in 30％ oxygen was inhaled for 2 h starting from 10:00 daily,and normal saline 0.1 ml and D-serine 500 mg/kg were intraperitoneally injected at 30 min before inhalation in S and D groups,respectively.In group C,30％ oxygen was inhaled for 2 h starting from 10:00 daily,and normal saline 0.1 ml was intraperitoneally injected at 30 min before inhalation.The animals were sacrificed after the end of oxygen or sevoflurane inhalation on postnatal day 8,and the brains were removed for determination of the expression of phosphorylated GSK-3β (pGSK-3β) and activated caspase-3 in brain tissues by Western blot.Results Compared with group C,the expression of pGSK-3β in brain tissues was significantly down-regulated,and the expression of activated caspase-3 in brain tissues was up-regulated in group S (P＜ 0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Compared with group S,the expression of pGSK-3β in brain tissues was significantly up-regulated,and the expression of activated caspase-3 in brain tissues was down-regulated in group D (P＜0.05).Conclusion D-serine is involved in the nerve cell apoptosis induced by multiple exposures to sevoflurane anesthesia through inhibiting the activation of GSK-3β in newborn mice.

Objective To compare the difference in binocular visual function after implantation of different types of intraocular lenses(IOL).Methods A total of 63 patients(126 eyes)with age-related cataract who underwent phacoe-mulsification combined with IOL implantation in Yantai Affiliated Hospital of Binzhou Medical University from October 2021 to June 2023 were collected.Among them,22 patients(44 eyes)were implanted with monofocal IOL in both eyes(mono-focal group),21 patients(42 eyes)were implanted with monofocal and multifocal IOL in both eyes,respectively(mixed group),and 20 patients(40 eyes)were implanted with multifocal IOL in both eyes(multifocal group).Another 22 patients(44 eyes)with physiological presbyopia were selected from the medical examination center of the same hospital during the same period as the control group.Uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),defocus curve,amplitude of accommodation(AMP),positive relative accommodation(PRA),negative relative accommo-dation(NRA),binocular cross-cylinder(BCC),accommodative convergence/accommodation ratio(AC/A),rupture point at the near point of convergence(NPC),near-far distance positive fusional vergence(PFV)and negative fusional vergence(NFV)rupture points,and near-far distance stereopsis of patients in the four groups were recorded and compared during the 3-month follow-up.Results After three months of follow-up,there was no significant difference in UDVA among the four groups(P＞0.05),while the UNVA of patients in the multifocal group and the mixed group was better than that in the control group and the monofocal group(all P＜0.05).The defocus curves of patients in the mixed group and the multifocal group were bimodal.There were statistically significant differences in AMP,NRA,PRA,and BCC among the four groups(all P＜0.05).There was no statistically significant difference in the AC/A ratio and far-distance NFV and PFV rupture points among the four groups(all P＞0.05).There were statistically significant differences in NPC rupture point and near-distance NFV and PFV rupture points among the four groups(all P＜0.05).There was no statistically significant difference in the proportion of patients with normal far-distance stereopsis among the four groups(P＞0.05).The proportion of pa-tients with normal near-distance stereopsis in the mixed group was significantly lower than that in the other three groups(all P＜0.05).Conclusion Multifocal IOL can effectively improve postoperative UDVA and UNVA in cataract patients.Binocular implantation of multifocal IOL is beneficial to the reconstruction of binocular visual function in far-and near-dis-tance conditions after cataract surgery.The mixed implantation of monofocal and multifocal IOL affects the recovery of near-distance binocular stereopsis in the short term.

Objective To explore the expression and clinical significance of lysine oxidase(Lox)in primary lesion of esophageal carcinoma(ESC A)and bone metastasis lesion based on bioin-formatics.Methods The Cancer Genome Atlas(TCGA)and Gene Expression Profiling Interactive Analysis(GEPIA)databases were used to screen for differentially expressed genes between ESCA and normal esophageal tissues.Follow-up information of patients with surgery for esophageal cancer in the Fourth Hospital of Hebei Medical University from January 2016 to December 2020 were screened,and the clinical materials of patients diagnosed as bone metastasis during the follow-up period were collected.Western blot was used to verify the expression of Lox in ESCA and normal esophageal tis-sues;immunohistochemical staining was used to detect the expression of Lox in human ESCA tissue and normal tissue;the impact of Lox expression on survival was explored by Kaplan-Meier curve and Cox regression.Results Through the analysis of ESCA data in GEPIA and TCGA databases,it was found that the expression of Lox in ESCA lesions was significantly higher than that in normal tissues(P＜0.05);the Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses found that Lox may be involved in the information conduction of various signaling pathways;the Western blot result showed that the expression of Lox in cancer tissue was higher than that in adjacent normal tissue(P＜0.05);the analysis of follow-up data found that patients with high expression of Lox were more likely to have multiple bone metastases;survival analysis revealed that patients with high Lox expression had significantly shorter bone metastasis free survival and o-verall survival compared to patients with low Lox expression(P＜0.05);Cox regression found that Lox was an independent risk factor for prognosis of patients with esophageal cancer bone metastasis.Conclusion Lox is highly expressed in ESCA and significantly related to clinical prognosis,which can be used as an effective target for the diagnosis and treatment of ESCA.

Objective To explore the expression and clinical significance of lysine oxidase(Lox)in primary lesion of esophageal carcinoma(ESC A)and bone metastasis lesion based on bioin-formatics.Methods The Cancer Genome Atlas(TCGA)and Gene Expression Profiling Interactive Analysis(GEPIA)databases were used to screen for differentially expressed genes between ESCA and normal esophageal tissues.Follow-up information of patients with surgery for esophageal cancer in the Fourth Hospital of Hebei Medical University from January 2016 to December 2020 were screened,and the clinical materials of patients diagnosed as bone metastasis during the follow-up period were collected.Western blot was used to verify the expression of Lox in ESCA and normal esophageal tis-sues;immunohistochemical staining was used to detect the expression of Lox in human ESCA tissue and normal tissue;the impact of Lox expression on survival was explored by Kaplan-Meier curve and Cox regression.Results Through the analysis of ESCA data in GEPIA and TCGA databases,it was found that the expression of Lox in ESCA lesions was significantly higher than that in normal tissues(P＜0.05);the Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses found that Lox may be involved in the information conduction of various signaling pathways;the Western blot result showed that the expression of Lox in cancer tissue was higher than that in adjacent normal tissue(P＜0.05);the analysis of follow-up data found that patients with high expression of Lox were more likely to have multiple bone metastases;survival analysis revealed that patients with high Lox expression had significantly shorter bone metastasis free survival and o-verall survival compared to patients with low Lox expression(P＜0.05);Cox regression found that Lox was an independent risk factor for prognosis of patients with esophageal cancer bone metastasis.Conclusion Lox is highly expressed in ESCA and significantly related to clinical prognosis,which can be used as an effective target for the diagnosis and treatment of ESCA.

OBJECTIVETo evaluate the efficacy and safety of transumbilical single-site laparoscopic surgery for congenital duodenal obstruction (CDO) in neonates.

METHODSA retrospective analysis of clinical data of 15 patients with CDO undergoing transumbilical single-site laparoscopic treatment during November 2017 and January 2018 (single-site group), and 20 patients with CDO undergoing conventional three-hole laparoscopic treatment during August 2017 and October 2017 (three-hole group) was performed. All patients were from the Children's Hospital, Zhejiang University School of Medicine. The operation time, time of initial feeding, time of adequate feeding, length of hospital stay after operation and postoperative complications were compared between two groups.

RESULTSThe operations were completed in all patients. No patient converted to laparotomy, and no massive hemorrhage was observed during operation. The operation time of single-site group was (90±10) min for patients with duodenal diamond-shaped anastomosis and (81±15) min for patients with Ladd operation, while those of three-hole group were (85±9) min and (72±11) min, respectively. Postoperative initial feeding time of single-site group was (5.0±1.0) d, and that of the three-hole group was (4.8±0.8) d. The adequate feeding time was (9.0±1.2) d in the single-site group, and (9.3±0.8) d in the three-hole group. The length of hospital stay after operation was (11.2±2.5) d in the single-site group, and (11.5±2.8) d in the three-hole group. There was no significant difference in operation time, postoperative initial feeding time, adequate feeding time and length of hospital stay after operation between two groups (all >0.05).

CONCLUSIONSTransumbilical single-site laparoscopic surgery for CDO in neonates is safe and effective, and the postoperative abdominal scar is more hidden.