The cis-epoxysuccinate hydrolase (CESH) from Rhizobium strain BK-20 is the key enzyme for L(+)-tartaric acid production. To establish a highly efficient and stable production process, we first optimized the enzyme production from Rhizobium strain BK-20, and then developed an immobilized cell-culture process for sustained production of L(+)-tartaric acid. The enzyme activity of free cells reached (3 498.0 +/- 142.6) U/g, and increased by 643% after optimization. The enzyme activity of immobilized cells reached (2 817.2 +/- 226.7) U/g, under the optimal condition with sodium alginate as carrier, cell concentration at 10% (W/V) and gel concentration at 1.5% (W/V). The immobilized cells preserved high enzyme activity and normal structure after 10 repeated batches. The conversion rate of the substrate was more than 98%, indicating its excellent production stability.
Alginates ; chemistry ; Cells, Immobilized ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Hydrolases ; metabolism ; Rhizobium ; enzymology ; metabolism ; Tartrates ; metabolism

Objective To explore the characteristics and surgical managements of recurrent retinal detachment in silicone oil tamponade eyes.Methods The records of consecutive series of 134 patients (134 eyes) with recurrent retinal detachment in silicone oil tamponade eyes from January 2012 to December 2015 in our hospital were reviewed retrospectively,the vitrectomy combined with silicone oil replacement or scleral buckling procedure were performed.The follow-up time was 6 months,the surgical efficient was evaluated.Results 101 eyes underwent vitrectomy combined with silicone oil replacement.Retina was completely reattached in 79 eyes,and vitrectomy was reperformed in the left 22 eyes,the successful rate was 78.2％ (79/101);The visual acuity improved in 16 eyes,unchanged in 56 eyes,decreased in 29 eyes;The intraocular pressure of 31 eyes increased more than 25 mmHg (1 kPa =7.5 mmHg).33 eyes underwent scleral buckling procedure.Retina was completely reattached in 23 eyes,and vitrectomy combined with silicone oil replacement was performed in the left l0 eyes,the successful rate was 69.7％ (23/33);The visual acuity improved in 5 eyes,unchanged in 16 eyes,decreased in 12 eyes;The intraocular pressure of 14 eyes increased more than 25 mmHg.Conelusion For limited retinal detachment caused by inferior or peripheral holes,proliferative vitreoretinopathy in the A or B-class,the refractive medium does not affect the fundus examination,scleral buckling surgery is preferred;For the hole in the posterior pole or extensive retinal detachment caused by giant retinal holes,proliferation or retinal fixed fold formation,vitrectomy combined with silicone oil replacement is a better option.

Biomedical research involving human body needs to be reviewed and oversight by the Institute Review Board (IRB) is the important international rule,aimed to protect human subjects.Ethics,however,may limited the freedom and innovation of medical research.It is an important task for the medical researchers on how to make the medical research to meet the demands of ethics,to avoid the risk,and to promote the innovation for the better development of the medical research.

Objective: To compare nephrotoxicity and ototoxicity of gentamycin administered in single dose or multiple dose daily in guinea pigs. Methods: Thirty two male guinea pigs were divided into physiological saline control, single dose group daily (gentamycin, 120 mg/kg, 1/d) and multiple dose group daily (gentamycin, 60 mg/kg, 2/d). The physiopathology of renal and cochlea in guinea pigs were examined using auditory brainstem response (ABR), SC sound irritation and electron microscope. The gentamycin concentrations in serum and in perilymph were monitored by fluorescene polarization immunoassay (FPIA). Results: (1) Compared with control group, both gentamycin single and mulitiple daily doses injuried kidney and cochlea to some extent.The injury of multiple dose groups were worse than that the single dose groups ( P

BACKGROUNDE-cadherin is a subclass of the cadherin family that plays an important role in the maintenance of intercellular junctions in normal epithelium.Decreased expression of E-cadherin might be closely related to invasiveness and dedifferentiation in human cancers.There is increasing evidence that modulation of the E-cadherin-catenin cell-cell adhesion complex is an important step in the initiation and progression of human cancers.The aim of this study is to investigate the relationship between the level of E-cadherin mRNA expression and pathological grades and clinical stages of non-small cell lung cancer(NSCLC).

METHODSRT-PCR was used to measure the level of E-cadherin mRNA expression in 53 specimens of NSCLC,46 of para-cancer lung tissues,5 of benign nodal lung diseases,and the stages of disease was determined according to the results of surgery,pathology and imaging diagnoses.Then analyses were carried out between the level of E-cadherin mRNA expression and the clinical variables.

RESULTS45.3%(24/53) and 45.7%(21/46) specimens of NSCLC and para-cancer lung tissue were positive for E-cadherin mRNA expression respectively(P > 0.05);NSCLC with low differentiation,advanced stages and nodal metastases showed a magnificantly lower expression of E-cadherin mRNA(P < 0.05).The median survival time for E-cadherin mRNA positive and negative patients were 15.5 months and 46 months,respectively,but the expression of E-cadherin mRNA did not correlate with patient's survival(P > 0.05).

CONCLUSIONSE-cadherin expression is related to the differentiation,lymph node metastasis and pathological staging of NSCLC,but probably does not effectively affect its prognosis.

Objective:To investigate the advantages and disadvantages of percutaneous compression plate (PCCP) for femoral neck fractures in the elderly patients.Methods:A retrospective study was conducted of the 31 elderly patients with femoral neck fracture who had been treated with PCCP from January 2012 to December 2018 at Orthopaedic Department, The First People's Hospital of Yancheng, Orthopaedic Department, The Ninth People's Hospital of Wuxi and Department of Orthopaedics, The People's Hospital of Wuxi. They were 16 men and 15 women, aged from 65 to 80 years (average, 70.5 years). By the Garden classification, 7 cases were type Ⅱ, 15 cases type Ⅲ and 9 cases type Ⅳ; by the Singh index, 4 cases were level Ⅲ, 11 cases level Ⅳ, 10 cases level Ⅴ and 6 cases level Ⅵ. The time from injury to operation ranged from 3 to 14 days (average, 5.8 days). The operation time, intraoperative blood loss, fracture reduction, fracture union time, complications and functional recovery of the hip were observed.Results:The operation time averaged 73.4 min and intraoperative blood loss 116.4 mL. At one week after operation, the Garden alignment index was level Ⅰ in 25 cases and level Ⅱ in 6. Superficial incision infection was noted in one case intraoperatively. Follow-ups for the 31 patients ranged from 12 to 47 months (mean, 18.9 months). All the fractures united after 4.9 months on average (from 4 to 8 months). Delayed union occurred in 2 cases, neck shortening in 12 cases, and avascular necrosis of femoral head in 3 displaced subcranial fractures 2 of which were high shear ones. The necrosis of femoral head was treated by arthroplasty in 2 and by conservative treatment in one. The Harris hip scores at the last follow-up for the 31 patients averaged 90.9 (from 75 to 100), giving 15 excellent, 12 good and 4 fair cases and an excellent to good rate of 87.1% (27/31).Conclusions:In treatment of femoral neck fractures in the elderly patients, PCCP has advantages of allowing early weight-bearing after operation, a high rate of fracture union, limited complications and quick and fine functional recovery of the hip. However, it should be used with caution in patients with severe osteoporosis, displaced subcranial or high shear fracture.

Objective:To evaluate the efficacy and safety of non-submucosal injection in endoscopic submucosal excavation (ESE) for small submucosal tumors originating in the muscularis propria of the stomach.Methods:A total of 138 patients diagnosed as having small gastric muscularis propria tumors (≤2 cm) at Digestive Endoscopy Center of Zhejiang Provincial Hospital of Chinese Medical from November 2018 to October 2020 were randomly divided into the observation group with non-submucosal injection of ESE and the control group with submucosal injection of ESE for a randomized controlled trial. The exposure time, tumor removal time, operation cost, hospitalization period, numbers of metal clips and complications of the two groups were analyzed and compared.Results:A total of 138 patients were enrolled, including 76 patients in the observation group and 62 patients in the control group. All lesions were successfully and completely removed. Compared with the control group, the observation group had shorter median tumor exposure time [2.00 min VS 3.30 min, Z=-2.426, P =0.045], shorter median tumor removal time [16.8 min VS 34.4 min, Z=-4.324, P<0.001], less median surgical cost [2 903 yuan VS 3 178 yuan, Z=-5.112, P<0.001], and fewer metal clips used (4.0±0.6 VS 5.1±1.3, t=1.452, P=0.003). The incidence of postoperative abdominal distension of the observation group was lower [9.2% (7/76) VS 22.6% (14/62), χ2=2.512, P=0.049], the incidence of postoperative abdominal pain of this group was lower too [11.8% (9/76) VS 32.3% (20/62), χ2=4.242, P=0.014], but there was no significant difference in the period of hospitalization, incidence of postoperative fever or perforation ( P>0.05). Conclusion:Non-submucosal injection of ESE is safe and effective for submucosal tumors smaller than 2.0 cm originating from the muscularis propria of the stomach , which might be more advantageous than traditional ESE.

The optimal operation room cooling source can be selected to save energy in the whole hospital life cycle ac-cording to special cooling load characteristics of specialized hospital.This paper demonstrates the energy-saving performance of the system of water-cooled and air-cooled dual cooling source based on theoretical analysis.Taking the operation room of Zhongs-han Ophthalmic Center,Sun Yat-sen University as an example,the energy consumption data is analyzed under different season and different chilled water temperature of the transformed dual cooling source operation room.It is proposed that utilizing central-ized water-cooling system may not be more energy saving than the that of individual air-cooling system during transitional season or winter,and the vertical temperature rise and cold loss of chilled water should be considered as well,providing a reference for the dual cooling source in domestic specialized operation rooms.

Objective To summarize the experiences of diagnosis and treatment for blunt tracheobronchial injuries ( BTI) . Methods From January 1993 to December 2013, 15 patients were diagnosed with BTI and underwent surgical treatment at our hospital.Mean age of the 15 patients (11 men and 4 women) was 26.4 ±4.5 years.All the patients had a history of trauma, which included crushing injury in 8 cases, deceleration injury in 4, fall injury in 2, and traction-type injury in 1.BTI loca-tion: right main bronchus in eight cases, left main bronchus in four cases, upper trachea in one case, lower trachea with the right main bronchus in one case, and cervico-thoracic trachea with left main bronchus in one case .Thoracic computerized tomo-graphy was performed in 15 patients, which showed pneumothorax, subcutaneous emphysema, pneumomediastinum or falling lung sign of Kumpe.Preoperative fiberoptic bronchoscopy examination was performed in 15 cases, which included bronchial atresia in 9 cases, bronchial transection in 3 cases, laceration of trachea in 2 cases, and tracheal transection in 1 case.An e-lective surgical procedure after BTI was performed in 10 cases, and emergency surgery was performed in 5 cases.Tracheo-bron-chial laceration repair were performed in 2 cases, tracheal end-to-end reanastomosis in 1 case, and bronchial end-to-end re-anastomosis in 12 cases.Results There was no operative death, and one case was complicated with anastomotic stenosis.The average operation time was 205.7 ±41.3 minutes, and the average blood loss was 268.4 ±109 ml.The postoperative hospi-tal stay was 11.6 ±3.7 days on average.Follow-up was completed in 15 patients (mean, 29.3 months), and 15 patients were all symptomatic improvement .Conclusion The most common site of BTI was the right main bronchus near Carina parts .Al-though the diagnosis and treatment are often delayed , our findings indicate that chest CT and endoscopic findings could be used for the diagnosis of BTI.Surgical resection and reconstruction are effective methods to repair BTI successfully even many months after they occur.Often they do not require the resection of pulmonary parenchyma .

Objective To evaluate the efficacy and safety of transthoracic echocardiography (TTE) guided by transcatheter closure of patent ductus arteriosus (PDA) through the femoral artery.Methods From February 2016 to December 2017,53 patients with simple PDA were selected,the funnel type in 30 cases,cast type in 23 cases.All patients were guided by TTE and transcatheter closure of PDA through the femoral artery.The femoral artery was guided by TTE by establishing the orbit of the femoral artery-catheter-pulmonary artery to the right ventricle.The right ventricular septal defect was placed under the femoral artery approach,and the therapeutic effect was evaluated by echocardiography after occlusion.The outpatient visits were made at 1,3,and 6 months after operation.Results PDA closure was successfully completed under TTE guidance in 53 patients.In one adult PDA,the ultrasonic diagnosis of the inner diameter of the catheter was incorrect due to the image quality,which resulted in the replacement of the occluded device several times,but the occlusion was successful.The operative time was (30 ± 10)min.And the back diameter of the transcatheter closure device was (12 ± 6) mm and the murmur of the transmission sheath disappeared.There was no shunt between the main pulmonary artery and the main pulmonary artery,and the length of hospitalization was 3-4 days.No shunt signal was found at 1,3 and 6 months follow-up.Left atrial diameter (LAD) [(25.8 ± 6.1) mm vs (30.6 ± 8.4) mm] and left ventricular end diastolic diameter (LVEDD) [(38.5 ±9.1)mm vs (45.2 ± 11.5)mm],were decreased significantly (P ＜0.05).Conclusions It is safe and effective to block PDA by using femoral artery approach under the guidance of TTE,which avoids the damage of X-ray and contrast agent,and its prospect of clinical application is promising.