Objective To evaluate the safety and feasibility of laparoscopic cholecystectomy(LC) in patients with cirrhosis,and compare the value of model for end-stage liver disease (MELD) score and Child-Pugh classification in predicting prognosis.Methods We reviewed the records of 55 laparoscopic cholecystectomies in cirrhotic patients in our department in the recent 11 years.Indications included symptomatic gallbladder disease,cholecystitis,cystic polyps and cystic adenoma.MELD score and Child-Pugh class were preoperatively calculated and associated with postoperative results.Data regarding patients and surgical outcome were retrospectively analyzed.Results No perioperative death occurred.Total cholecystectomy was employed in 53 patients and subtotal cholecystectomy in 2 patients.Median operative time was(77?5.1)min.Median intraoperative blood loss was(51.0?3.33)mL.Median hospital stay was(5.0?1.3)days.Postoperative complications occurred in 9.09% of the patients,including hemorrhage,intra-abdominal collections and wound complications,which were all controlled conservatively.The incidence of postoperative complications in Child A patients was 7.27%,in Child B was 10.0%;in MELD score below 14 was 2.44%,and in MELD score above 14 was 28.57%.The difference between rates of postoperative complications in patients with preoperative MELD score above 14 and below 14 was significant(P0.05).Conclusions Laparoscopic cholecystectomy is a safe procedure for selected cirrhotic patients,and with controllable complications.MELD score appears to predict morbidity more accurately than Child-Pugh classification system.

Objective For patient-specific open-wedge high tibial osteotomy(OWHTO),a novel anatomical fixation plate was designed,and the effects of geometric parameters and material selection on biomechanical fixation were studied.Methods A patient-specific OWHTO anatomical fixation plate was designed and constructed,and the effects of design parameters(thickness,width,and length of the fixation plate)and four different materials(stainless steel,titanium alloy,magnesium alloy,and PEEK)on the biomechanics of the OWHTO fixation system were studied using finite element analysis.The biomechanical differences between the anatomical fixation plate and TomoFix fixation plate were also compared.Results The thickness had a greater effect on the micromotion of the osteotomy space than the length and width of the fixation plate did.Titanium alloy or magnesium alloy fixation plates were more conducive than stainless steel and PEEK materials in obtaining reasonable stability and mechanical transfer simultaneously.Compared with that of the TomoFix plate,the maximum von Mises stress of the anatomical fixation plate was reduced by 13.5%;the maximum von Mises stress of the screws and tibia was increased by 9.8%and 18.4%,respectively;and the micromotion at the maximum osteotomy space cc was increased by 49.3%.Conclusions Anatomical fixation plates have a positive effect on reducing the stress-shielding effect and improving biomechanical properties under the premise of ensuring stability.This study provides a reference for the development of OWHTO anatomical fixation plates.

Objective:To identify and analyze the genuine medicinal plant Gentiana scabra Bge. from 9 regions in Liaoning Province using DNA barcode technology based on the base sequence of internal transcribed spacer. Methods:DNA was extracted from the medicinal parts of 26 Gentiana scabra Bge. samples by using DNA kit extraction method. The ITS sequence was amplified through polymerase chain reaction (PCR), and then two-way sequencing was carried out. Other sources and outgroup sequences of the medicinal plant Gentiana scabra Bge. were downloaded from Genbank. After the sequencing results were spliced by using SeqMan 7.1.0 software, MEGA 7.0 software was used to analyze and compare the data, and calculate the genetic distance of K2P (Kimura 2-parameter). The phylogenetic tree was established by Neighbor-Joining (NJ) method for analysis. Results:According to the results of NJ cluster tree, all Gentiana scabra Bge. samples from different sources were clustered into one large branch, and Gentiana scabra Franch. and Gentiana triflora Pall. were clustered into one branch respectively, with obvious differences; Gentiana scabra and Gentiana manshurica Kitag. were clustered into one branch, and the genetic relationship was relatively close. In combination with the variation site and genetic distance, the base sequences of Gentiana scabra and Gentianamanshurica were very similar, and the interspecific differences were very small. Except for the intraspecific variation of only one sample collected in Liaoning Province, the base sequences of the other samples were the same, and there was no difference between " Gentiana scabra Bge. in Qingyuan" and Gentiana scabra Bge. samples from other regions in Liaoning Province. Conclusion:The DNA barcode technology of ITS sequence can be used to differentiate and identify medicinal plant Gentiana scabra Bge. and its original plants from different sources with a high success rate.

Objective:To use rbcL sequences to identify the rhizomes of the Liaoning collection of Atractylodes chinensis (DC.) Koidz.; To provide a basis for ensuring the feasibility of cultivation of the native herb in Liaoning Province. Methods:A total of 30 rhizomes of Atractylodes chinensis (DC.) Koidz. were collected from 10 regions cultivated in Liaoning Province, and the total DNA was extracted. DNA barcodes were screened by PCR, and the rbcL sequences of the samples were amplified and sequenced, and the amplification and sequencing success rates were calculated. Sequence alignment was performed using MEGA 7.0 software; a systematic clustering tree was constructed using the neighbour-joining method. Results:The success rates of DNA extraction from the rhizomes of Atractylodes chinensis (DC.) Koidz. were all 93.3%, and the success rates of PCR amplification and sequencing were all 100%. Among the 30 samples of Atractylodes chinensis (DC.) Koidz. in Liaoning Province, two samples had intraspecific variation, and the rest of the base sequences of Atractylodes chinensis (DC.) Koidz. were identical. Atractylodes chinensis (DC.) Koidz. was closer to the herbs of the genus Cangzhu, a relative species of Asteraceae, and was genetically more distant from the rest of Asteraceae. The NJ tree could distinguish Atractylodes chinensis (DC.) Koidz. and its relatives. Conclusion:The quality of Atractylodes chinensis (DC.) Koidz. cultivars in Liaoning Province is basically similar, and the rbcL sequence can be used as a valid sequence fragment for the identification of Atractylodes chinensis (DC.) Koidz. DNA barcode.

OBJECTIVETo evaluate the diagnostic efficiency of colloidal gold and dot ELISA rapid tests in clinical screening of influenza A virus.

METHODSThe pharyngeal swabs were collected from 297 outpatients suspected of influenza between June and October, 2009 for detection with colloid gold and dot ELISA rapid test, with real-time PCR as the golden methods. The discrepant results of colloid gold and dot ELISA methods were confirmed by sequencing, and the diagnostic efficiency of the two methods was evaluated.

RESULTSAmong the 166 samples with influenza A virus infection as confirmed by real-time PCR and sequencing, the diagnostic sensitivity of dot ELISA and colloid gold methods was 54.82% (91/166) and 4.22% (7/166), respectively. The total concordance rate with PCR was 66.67% (Kappa value of 0.35). Among the 133 samples negative for influenza A virus, the specificity of dot ELISA and colloid gold methods was 81.68% (107/131) and 98.47% (129/131), respectively, with a total concordance rate with PCR of 45.79% (Kappa value 0.02). Of the 99 H1N1 influenza samples confirmed by real-time PCR, the detection rate of dot ELISA was 67.3%, whereas that of colloid gold was 5.1%. Out of the 107 dot ELISA-positive but colloid gold-negative samples, 84 were confirmed to be influenza A virus-positive by real-time PCR and sequencing. One sample negative for dot ELISA but positive for colloid gold test was confirmed to be influenza A virus-negative. The detection rate and diagnostic concordance rate for influenza A virus by dot ELISA were significantly higher than those of colloid gold (P<0.05).

CONCLUSIONDot ELISA is better than colloid gold in influenza A virus detection and shows great prospect in clinical screening.

Objective:To conduct a scoping review of domestic and international guidelines on high-intensity physical activity, low-intensity physical activity, sedentary behavior, and sleep in adults, in order to understand the best combination of 24-hour activity and behavior for promoting adult health development, and to provide guidance for research in this field.Methods:Based on the scoping review guidelines of the Joanna Briggs Institute (JBI) of Australia as a methodological framework, we searched PubMed, Embase, Ovid, CINAHL, ClinicalKey, CNKI, Wanfang, MEDLINK Clinical Guidelines Network, UpToDate, BMJ Best Practice, International Guidelines Network, US National Guidelines Library, UK National Clinical Optimization Research Institute and Scotland Intercollegiate Guidelines Network. Guidelines that made recommendations for different intensity physical activities, sedentary behavior, and sleep in adults over a 24-hour period were included. The search time limit was from January 1, 2010, to August 31, 2022, and included literature was summarized and analyzed.Results:A total of 11 guidelines were included, of which only 2 guidelines from Canada and Saudi Arabia made specific time recommendations for 24-hour physical activity (frequency, intensity, type, and time) , sedentary time, and sleep in adults. The remaining 9 guidelines only made recommendations for adult physical activity and sedentary behavior, or only for physical activity.Conclusions:Future research should comprehensively measure the impact of the best time distribution of physical activity, sedentary behavior, and sleep on physical and mental health, and develop personalized guidelines on 24-hour activity suitable for the national conditions of China.

Agrocybe cylindracea, an edible mushroom, is widely cultivated for its abundance of nutrients and flavor, and many of its metabolites are reported to have beneficial roles, such as medicinal effects on tumors and chronical illnesses. However, the lack of genomic information has hindered further molecular studies on this fungus. Here, we present a genome assembly of A. cylindracea together with comparative genomics and pathway analyses of Agaricales species. The draft, generated from both next-generation sequencing (NGS) and single-molecule real-time (SMRT) sequencing platforms to overcome high genetic heterozygosity, is composed of a 56.5 Mb sequence and 15,384 predicted genes. This mushroom possesses a complex reproductive system, including tetrapolar heterothallic and secondary homothallic mechanisms, and harbors sev-eral hydrolases and peptidases for gradual and effective degradation of various carbon sources. Our pathway analysis reveals complex processes involved in the biosynthesis of polysaccharides and other active substances, including B vitamins, unsaturated fatty acids, and N-acetylglucosamine. RNA-seq data show that A. cylindracea stipes tend to synthesize carbohydrate for carbon seques-tration and energy storage, whereas pilei are more active in carbon utilization and unsaturated fatty acid biosynthesis. These results reflect diverse functions of the two anatomical structures of the fruiting body. Our comprehensive genomic and transcriptomic data, as well as preliminary compar-ative analyses, provide insights into the molecular details of the medicinal effects in terms of active compounds and nutrient components.

Exploring the genetic basis of human infertility is currently under intensive investigation.However,only a handful of genes have been validated in animal models as disease-causing genes in infertile men.Thus,to better understand the genetic basis of human spermatogenesis and bridge the knowledge gap between humans and other animal species,we construct the FertilityOnline,a data-base integrating the literature-curated functional genes during spermatogenesis into an existing sper-matogenic database,SpermatogenesisOnline 1.0.Additional features,including the functional annotation and genetic variants of human genes,are also incorporated into FertilityOnline.By searching this database,users can browse the functional genes involved in spermatogenesis and instantly narrow down the number of candidates of genetic mutations underlying male infertility in a user-friendly web interface.Clinical application of this database was exampled by the identifi-cation of novel causative mutations in synaptonemal complex central element protein 1(SYCE1)and stromal antigen 3(STAG3)in azoospermic men.In conclusion,FertilityOnline is not only an integrated resource for spermatogenic genes but also a useful tool facilitating the exploration of the genetic basis of male infertility.

Objective: To investigation on the occupational hazardous factors exposed to the female workers, from 14 prefectures and municipalities in Gansu province. Methods: The survey was conducted from June to October 2015. A total of 8 538 female employees from 30 enterprises in 14 prefectures and cities of the province were selected by cluster sampling method. The occupational hazard factors were investigated and analyzed statistically. Results: The survey found that the proportion of female workers in Gansu province who are exposed to chemical and physical harmful factors at the same time is relatively large. Most female workers are exposed to 2-4 occupational hazards, and women who are exposed to 3 and 4 chemical harmful factors account for 28.8 % and 38.0 %, respectively. Women workers who were exposed to two or three physical factors at the same time accounted for 59.44 per cent, while 61.5% were exposed to two biological factors at the same time. The number of female workers exposed to two or three physical factors at the same time and the number of four and five physical factors at the same time after being tested by χ². The difference is statistically significant (χ²= 8.17, P<0.05) . The difference in the number of female workers who simultaneously exposed 3 and 4 chemical factors and simultaneously exposed 2 and 5 or more chemical factors is statistically significant (χ²=11.26, P<0.05) . There was no significant difference in the exposure of female workers to biological factors. Conclusion This survey shows that the exposure of female workers in Gansu Province to occupational hazards is not optimistic. We should strengthen enterprise supervision and improve the working environment and conditions of female workers.

Objective:To explore the clinical efficacy of disease-modifying drug nusinersen on children with spinal muscular atrophy.Methods:The baseline and longitudinal clinical data of 15 children who were treated with nusinersen in the Children′s Hospital, Zhejiang University School of Medicine from October 2019 to October 2021 were retrospectively collected. The general data (gender, age, genotype, and clinical classification, etc.), motor function, nutritional status, scoliosis and respiratory function were analyzed. Wilcoxon rank-sum test was used for comparing multi-system conditions before and after treatment.Results:The age of 15 cases (7 males, 8 females) was 6.8 (2.8, 8.3) years, with 2 cases of type 1, 6 cases of type 2, and 7 cases of type 3 respectively, and the course of disease was 55.0 (21.0, 69.0) months. After 9.0 (9.0, 24.0) months of treatment, the motor function scale evaluations of the Hammersmith neurological examination section 2 (13.0 (7.0, 23.0) vs. 18.0 (10.0, 25.0) scores, Z=-2.67, P=0.018) of 15 children, the Hammersmith functional motor scale expanded (38.0 (18.5, 45.5) vs. 42.0 (23.0, 51.0) scores, Z=-2.38, P=0.018), and the revised upper limb module (27.0 (19.5, 32.0) vs. 33.0 (22.5, 35.5) scores, Z=-2.52, P=0.012) of children with type 2 and 3 had significantly improved. Thirteen patients achieved clinically significant motor function improvement, and 2 of them had kept stable scale scores. Subjective reports also indicated that the muscle strength and daily exercise ability of these children improved after treatment, and no serious adverse reactions were reported. Supplemented by the multi-disciplinary team management, the levels of some indicators such as Cobbs angle of scoliosis and forced vital capacity all had significantly improved (all P<0.05). Conclusions:Nusinersen can improve the motor function of patients with 5q spinal muscular atrophy, which is also proved safe to be used in children. The drug treatment supplemented by the multi-disciplinary team management is helpful to improve the multi-system function of the children with spinal muscular atrophy.