A systematic analysis of the typeⅢ secretion genes of Aeromonas hydrophila strain AH-1 by constructing ahyR and ahyI mutant revealed that they are under quorum-sensing control. This observation was supported by the down-regulation of the TTSS genes in the presence of lacZ-TTSS gene promoter and the corresponding advanced secretion of AexT in ahyI mutant.

A series of poly(ethylene terephthalate-Co-ethylene 2,5-furandicarboxylate) (PEFT) copolyesters were synthesized with different terephthalic acid (PTA) /2,5-furandicarboxylic acid (FDCA) molar ratios by direct esterification method. In order to investigate their chain structures, 1 H-NMR and 13 C-NMR spectra of these copolyesters were recorded. The average length ( L) , the degree of randomness ( B) and composition of copolyesters were calculated from the intensities of four kinds of signals, which corresponding to the chemical shifts of hydrogen and carbon atoms in ethylene glycol unit in PEFT copolyesters chains. It was shown that the degree of randomness B of all purified copolyesters reached to 1 by the formula of Yamadera and Murano, which indicated that they were random copolymers. Comparatively, the PEF-block-PET of B value was 0. 577, and the PEF-blend-PET of B value was 0 . It was also consistent with the previous results of differential scanning calorimeter ( DSC) that each of the PEFT copolyesters had only one glass transition temperature and the copolyesters were random copolymers. The randomness B of PEFT-50 was the greatest of all, the value was 1. 012 based on the result of 1 H-NMR, and the value was 1. 028 based on the result of 13 C-NMR. Furthermore, the results above displayed that the activity of 2,5-furandicarboxylic acid and terephthalic acid was similar in this nucleophilic substation reaction with ethylene glycol.

Objective:To explore the ameliorative effect and machanism of MSCs conditioned medium on the ovarian granulosa cells damage induced by triptolide.Methods: Cell Counting Kit 8 assay was used to examine the cell vitality of KGNs with the treatment of triptolide.The mixed enzyme digestion method were used for the isolation of human umbilical cord mesenchymal stem cells (MSCs),and flow cytometry was used for the subsequent immunotype identification.MSCs conditioned medium was collected ,and Cell Counting Kit 8 assay and PI staining was used to analyse the effect of MSCs conditioned medium on the cell vitality and cell cycle distri -bution of triptolide-damaged KGN.Real-time PCR method was used to examine the expression of cell cycle related gene CDKN1A.Results:Triptolide can inhibit KGN cell growth with the inhibition of cell vitality and cell cycle of KGN.MSCs conditioned medium did not influence the proliferation and cell cycle of normal KGN , but improved the triptolide-induced vitality inhibition and extent of S-phase arrest, and inhibit the abnormal up-regulation of CDKN1A in KGN.Conclusion: MSCs conditioned medium ameliorated the KGN cell damage induced by triptolide.

Objective To investigate the effect of optimized radiological examination strategy on iatrogenic radiation exposure in severe trauma patients so as to provide scientific basis for standardized application of radiological examination.Methods A controlled, three-stage intervention study from April 2010 to November 2011 was carried out.From April 2010 to July 2010, a pre-intervention study was conducted and enrolled 60 patients [43 males, 17 females;age (50 ± 14)years, age range 23-78 years].From August 2010 to March 2011, optimized strategies of radiological examination were implemented, including improving clinicians' knowledge to the standardization of radiological examination and iatrogenic radiation injury and limiting frequency of CT scans through the electronic medical record.From April 2011 to November 2011, post-intervention study was conducted and enrolled 100 patients (81 males, 19 females;age (47 ± 14) years, age range 18-79 years].During this period, major trauma patients were analyzed with respect to the clinical information, radiation examination frequency, ionizing radiation dose and influencing factors.Radiation examination frequency and radiation dose were compared before and after the intervention.Results Radiological examinations were mainly X-ray and CT before the implication of optimized strategies.Of the 60 patients, median frequency of X-rays and CT scan was 6.0(3.0-11.0) and 10.0(8.0-13.8).Median frequency of CT scan was positively correlated with the injury severity score (ISS) and ICU length of stay (r =0.369 and 0.523, P ＜ 0.05).Of the 100 patients, median frequency of CT scan was significantly reduced after the optimization of radiological examination (8.0 vs.10.0, P ＜ 0.05).Total frequency of radiological examination was significantly reduced as well (13.6 vs.17.8, P ＜0.01).There was no significant difference in the treatment success rate before and after the optimization of radiological examination (85.0％ vs.88.3％, P ＞ 0.05).When the frequency of head and chest CT scan was limited, the frequency of radiological examination, radiation exposure and radiological examination expenses were greatly reduced.Conclusions Too much X-ray,CT or other radiological examinations are noted in major trauma patients during the treatment period.Improved understanding of radiation-induced injury, optimizing radiological examination and controlling the repeated radiological examinations of the same site contribute to reducing iatrogenic radiology exposure without affecting the outcome.

Objective To summarize microskin grafting in recent 15 years.Methods Microskin grafting was performed in 162 patients with extensive burn. The indications and forms of the grafting, mechanization in making microskin and outcome of wound recovered by micrografts were discussed.Results Extremely extensive third degree burns, common extensive third degree burns and extensive granulation wound were healed by different ways of microskin grafting. A new machine was used to mince micrografts with good clinical results. The homografts as covertures were exfoliated in either necrosis or desquamation. Scar formation was related to wound repair. Conclusions Microskin grafting has made progress in recent years. The orientation and even spread of micrografts are very important for good wound repair. The technique should be further improved.

Objective To explore the application value of magnetic resonance molecular functional imaging diffusion weighted imaging(DWI) in the identification of pancreatic carcinoma and mass-type pancreatitis of animal model.Methods Each 8 cases of laboratory pancreatic head transplantation tumor model,chronic mass-type pancreatitis model and normal rabbits were selected and performed the MR DWI molecular functional imaging,the b values were 333,667,1 000 s/mm2 respectively.The apparent diffusion coefficients(ADC) of pancreatic carcinoma model,mass-type pancreatitis model and normal pancreas under different b values were observed.Then the change situation of ADC values of pancreatic carcinoma model,mass-type pancreatitis model and normal pancreas under different b values and difference of ADC(DADC) was analyzed.Moreover the differences in molecular diffusion,tissue perfusion among various groups were observed.Results Throughout the study period,the mortality rate of pancreatic head transplantation tumor model was 50%;the mass-type pancreatitis model and 8 normal rabbits were normally survival.The ADC value of pancreatic carcinoma under the same b value was significantly lower than that of chronic inflammation and normal pancreas area.The ADC value in each group was decreased with the increase of b value,and there was significant difference in ADC value when the b value was 333 s/mm2(F=6.662,P=0.014),in the pairwise comparison among groups,the difference between pancreatic cancer and pancreatitis (t=6.773,P=0.003) and between pancreatic cancer and normal pancreas(t=5.883,P=0.016) had statistical significance (P<0.05).The b value was increased,DADC was smaller,the difference change of DADC between pancreatic cancer area and chronic pancreatitis mass area,between pancreatic cancer area and normal pancreatic head area had statistical significance (P<0.05).Conclusion Rationally selecting the molecular functional imaging DWI technology of b value can better distinguish pancreatic cancer from mass-type pancreatitis,which may be promoted and applied in the evaluation of animal pancreatic head cancer model.

Objective To investigate the clinical effect of relaying reversed peroneal artery perforator flaps in repairing skin and soft tissue defects at ankle and donor site.Methods A retrospective case series study was conducted on the clinical data of 23 cases of skin and soft tissue defects at ankle and donor site from September 2015 to May 2017.There were 16 males and seven females,with an average age of 35 years (range,18-69 years).The soft tissue defects of ankle ranged from 4.0 cm ×4.0 cm to 11.0 cm × 7.0 cm.The distal perforator flap of the peroneal artery was firstly cut and used to repair the soft tissue defect of the ankle.The proximal perforator flap of the peroneal artery was used to repair the first donor site,and the second donor site was directly sutured at stage Ⅰ.The perforator flap area ranges of the distal and the proximal perforator of the peroneal artery were 6.0 cm ×5.0 cm to 14.0 cm × 8.0 cm and 7.5 cm × 4.0 cm to 14.0 cm × 5.0 cm,respectively.The shape of recipient area and donor area were observed.The clinical effects were evaluated by American Orthopedic Foot and Ankle Association (AOFAS) score and Weber two-point discrimination test.Results All patients were followed up for 6-19 months (mean,12 months).One case had partial necrosis of distal skin of ankle flap after operation and recovered 2 weeks after dressing change.All the other flaps survived smoothly in the first stage.The first donor site had no sunken area or rupture.Some linear scar remained at the second donor site,which did not affect the overall appearance.The flaps were smooth in appearance,good in texture,and close to normal color.The AOFAS score of the foot was 95-98 points,and the distance of two-point discrimination of flaps ranged from 8 to 10 mm.Conclusions The relaying reversed peroneal artery perforator flap has abundant blood supply,and the operation site is located at the lateral crural region,without sacrificing the main artery.It can improve the appearance and function of the first donor area while repairing the soft tissue defect of the ankle.

Objective: To investigate the effects of free mini-flap on tibial side of third toe on repairing skin and soft tissue defect of finger pulp at the end of finger. Methods: From August 2013 to May 2017, 18 patients with skin and soft tissue defect of finger pulp at the end of finger were admitted to our unit, with 12 men and 6 women aged 16 to 54 years. As the skin and soft tissue defect sites, there were 3 cases of thumb, 8 cases of index finger, 4 cases of middle finger, and 3 cases of ring finger. The area of defects ranged from 2.0 cm×1.4 cm to 3.5 cm×2.4 cm. Free mini-flaps on tibial side of third toes were designed according to area and shape of defects, and the length and width of flaps were 0.1 to 0.2 cm longer than the length and width of the defects, respectively. The area of flaps ranged from 2.1 cm×1.5 cm to 3.7 cm×2.6 cm. The end-to-end anastomosis of subcutaneous veins of flaps and superficial veins of the finger-palm side or superficial dorsal digital vein, the end-to-end tension-free anastomosis of the base metatarsal arteries on tibial side of third toe and proper digital arteries of recipient finger were performed. Besides, anastomosis of base metatarsal nerve on tibial side of third toe and proper digital nerve of recipient finger was performed. The donor sites on feet were sutured directly or repaired with full-thickness skin grafts on medial upper leg of the same side. The survival of flaps after operation and the follow-up of patients were observed. Results: All flaps survived well, with good blood supply. Among the 18 patients, 2 patients lost to follow-up, and 16 patients were followed up for 4 to 36 months. The shape and texture of flaps were good. After reconstruction, finger pulps at the end of finger were plump, with fingerprint. Function of the finger restored well, and the two-point discriminatory distances of flaps were 5 to 10 mm. The donor sites on feet of 14 patients healed after the operation, the other 2 patients had necrosis on edge and central area of skin grafts, and the necrotic area healed after dressing change. The skin graft areas on feet were wear-resistant, with slight damage to donor sites and did not influence shoes wearing and walking. Besides, patients did not feel uncomfortable. Conclusions Skin and soft tissue defects of finger pulp at the end of finger repaired by free mini-flaps on tibial side of third toe are with good shape and slight damage to donor sites, and the operation is simple. It is worthy of popularization and application in clinic.

Objective: To explore the clinical effects of heel lateral flap in repair of skin and soft tissue defects at posterior heel region. Methods: From September 2007 to April 2016, 24 patients (17 males and 7 females, aged 16-70 years) with skin and soft tissue defects at posterior heel region were admitted to our department. The size of skin and soft tissue defects after debridement ranged from 3.0 cm×2.0 cm to 5.0 cm×4.0 cm. The defects were repaired with heel lateral flaps, with size ranging from 3.5 cm×2.5 cm to 6.0 cm×5.0 cm. The flaps were transferred to the donor sites through the loose subcutaneous tunnel. The donor site was repaired by full-thickness skin graft collected from inguinal region. The survival of flaps and the follow-up of patients were observed. Results: All flaps of 24 patients survived successfully. The recipient sites and donor sites were all healed. The patients all had follow-up of 6 to 24 months. At the last follow-up, the flaps were in good shape, with nearly normal color and soft texture. There were 6 cases of grade S3 sensation and 16 cases of grade S3⁺ sensation. The distance of two-point discrimination of flaps ranged from 6 to 11 mm. The lateral foot skin grafts healed well, and the skin of the lateral foot was numb in the range of 4.0 cm×2.0 cm to 9.0 cm×3.0 cm. Conclusions Heel lateral flap can not only repair the skin and soft tissue defects in the posterior region, but also reconstruct the sensory function of the posterior region. It is an ideal method to repair the skin and soft tissue defects in the posterior region.

Objective To assess the clinical diagnostic performance of liver stiffness measurement (LSM) and aspartate transaminase (AST)-to-platelet (PLT) ratio index (APRI) for liver fibrosis in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) less than or equal to five times of the upper limit of normal (≤5×upper limit of normal [ULN]).Methods FibroScan,blood routine and liver function test were conducted at the day or one day before liver biopsy in 383 CHB patients with ALT≤5 × ULN.The Scheuer scoring system was used for liver histologic assessment.APRI was calculated.Based on the results of liver pathology,the areas under receiver operating characteristic curve (AUC) of LSM and APRI for diagnosis of liver fibrosis stage were compared.Results The median LSM were 5.10 kPa for S0 fibrosis stage,5.20 kPa for S1,6.60 kPa for S2,10.10 kPa for S3,and 18.80 kPa for S4.The median APRI values were 0.36,0.38,0.63,0.61 and 1.27,respectively.The AUC of LSM were 0.817 for ≥S2,0.891 for ≥S3 and 0.913 for ≥S4.And the AUC of APRI were 0.717 for ≥S2,0.711 for ≥S3 and 0.746 for ≥S4.The cut-offs of LSM values were 6.8 kPa for ≥S2,8.7 kPa for ≥S3,and 10.9 kPa for ≥S4.Conclusion LSM can accurately assess the degree of liver fibrosis in CHB patients with ALT ≤5 × ULN,which is superior to APRI in clinical utility.