0.05). Conclusions Our prospective study suggests that mode of anesthesia does not influence significantly the outcome of newborn infants delivered by elective cesarean section. It seems that both general and epidural anesthesia can be used in elective term cesarean sections safely.

Objective To analyzed the effects of the positioning errors and weight variability of the head and neck cancer patients with intensity modulated radiation therapy (IMRT),or volumetric modulated arctherapy (VMAT) based on the kilovoltage cone-beam computed tomography (kV-CBCT).Methods CBCT images of 102 patients with head and neck cancer patients receiving IMRT or VMAT were screened by CBCT once a week for consecutively 6 weeks.The positioning errors were measured by comparing CBCT and planning CT in left-right (LR),anterior-posterior (AP) and cranio-caudal (CC) directions.Meanwhile,the weight of patients were measured every week.Results The positioning errors were (0.011 5±0.125 3) cm,(-0.017 6±0.123 3) cm and (-0.014 1±0.156 7) cm in LR,AP and CC directions,respectively.The mean systematic errors were all less than 0.02 cm in three axial directions,while the mean random errors were all within 0.2 cm.There was no statistically significant difference was observed among the setup errors in all three axial directions according to different week.Though the body weight of patients continued to drop during the radiation by with the mean weight loss of 3.5 kg and had a negative correlation with treatment course.Bivariate correlation analysis showed just the positioning errors in CC direction were significantly correlated with body weights loss.Conclusion There is no statistical relationship with in position errors of the patients with their treatment course,and the body weight loss seemed to influence the position errors in CC direction.

It is very important to obtain high yield mutant strains on the base of metabolic flux analysis of Actinobacillus succinogenes S.JST for the industrial bioconversion of succinic acid. The metabolic pathway was analized at first and the flux of the metabolic networks was calculated by matrix. In order to decrease acetic acid flux, the strains mutated by soft X-ray of synchronous radiation were screened on the plates with high concentration of fluoroacetic acid. For decreasing the metabolic flux of ethanol the site-directed mutagenesis was carried out for the reduction of alcohol dehydrogenase(Adh) specific activity. Then the enzyme activity determination and the gene sequence analysis of the mutant strain was compared with those of the parent strain. Metabolic flux analysis of the parent strain indicated that the flux of succinic acid was 1.78(mmol/g/h) and that the flux of acetic acid and ethanol were 0.60 (mmol/g/h) and 1.04( mmol/g/h), respectively. Meanwhile the metabolic pathway analysis showed that the ethanol metabolism enhanced the lacking of H electron donor during the synthesis of succinic acid and that the succinic acid flux was weakened by the metabolism of byproducts ethanol and acetic acid. Compared with the parent strain, the acetic acid flux of anti-fluoroacetic mutant strain S.JST1 was 0.024 (mmol/g/h), decreasing by 96%. Then the enzyme determination showed that the specific activity unit of phosphotransacetylase(Pta) decreased from 602 to 74 and a mutated site was founded in the pta gene of the mutant strain S.JST1. Compared with that of the parent strain S.JST1 the ethanol flux of adh-site-directed mutant strain S.JST2 was 0.020 (mmol/g/h), decreasing by 98%. Then the enzyme determination showed that the specific activity unit of Adh decreased from 585 to 62 and the yield of end product succinic acid was 65.7 (g/L). The interdiction of Adh and Pta decreased the metabolism of byproducts and the H electron donor was well balanced, thus the succinic acid flux was strengthened by the redundant carbon flux from these byproducts. The mutant strain S.JST2 obtained in this paper deserves being extended to application of industrial fermentation.
Actinobacillus ; enzymology ; genetics ; growth & development ; Alcohol Dehydrogenase ; metabolism ; Metabolic Networks and Pathways ; genetics ; Mutagenesis, Site-Directed ; Mutation ; Phosphate Acetyltransferase ; metabolism ; Succinic Acid ; metabolism

OBJECTIVE:To observe therapeutic efficacy and safety of infliximab (IFX) in the treatment of Crohn's disease (CD),and to investigate its influential factors. METHODS:In retrospective study,a total of 120 CD patients received IFX treat-ment in our hospital during Jan.-Dec. 2015 were selected as research objects. All patients were given IFX for injection 5 mg/kg intra-venously at 0,2nd,6th week and later every 8 weeks continously. Therapeutic efficacy indexes(body weight,CRP,ESR,WBC, mucosal healing under endoscope),liver and renal indexes (ALT,AST,AKP,γ-GT,TB,DB,Cr),the occurrence time of ADR,organs/systems involved,clinical manifestations and outcomes were compared before and after treatment. Influential factors were analyzed. RESULTS:Compared with before medication,body weight of patients were increased significantly,while ESR were decreased significantly,with statistical significance (P<0.05). There was positively correlation between above two indexes (r=0.275,P=0.016). Mucosal healing was found in 78.57％ of patients by colonoscopy. There was statistical significance in the levels of AST,AKP and Cr before and after treatment(P<0.05),but those indexes were increased slightly. AKP exceeded 2 times the upper limit of normal value in only 1 case,but AST did not exceed 2 times the upper limit of normal limit,Cr did not exceed the upper limit of normal value. There was no statistical significance in CRP,WBC or other liver and renal function indexes before and af-ter treatment(P>0.05). There were 24 cases of ADR with incidence of 20.00％. Respiratory system,digestive system,skin mucous membrane,body defense and other organs/systems were involved,mainly manifestating as uper respiratory tract infetion,liver func-tion indexes order etc. Ten patients(41.67％)delayed the treatment,and 6 cases(25.00％)discontinued. Standard rate of ESR in pa-tients with regular/primary medication (78.21％) was higher than those with intermittent medication history (57.14％),but without statistical significance(P>0.05). Combined use of mesalazine had no significant effect on the increase of AST and AKP(P=0.002). CONCLUSIONS:IFX significantly increases body weight of CD patients,decreases ESR and improves mucosal healing. It shows def-inite therapeutic efficacy. It is suggested that CD patients should use IFX regularly. The overall safety of IFX is good,but it may cause transfusion reaction and transient increase of liver function index. So,the patient's condition should be closely monitored during the in-fusion.

OBJECTIVE: To observe the anticancer mechanism of allicin by observing the inhibitory effect of allicin on human salivary gland carcinoma cell line MEC-1. METHOD: Cell proliferation were measured by MTT assay at different doses and different hours. In the meantime, cell cycle was detected via flow cytometry after different dose incubation with different hours. RESULT: MTT results showed that the inhibitory rates of MEC-1 proliferations were increased in a concentration-and time-dependent manner. Flow cytometry analysis showed percent-age of MEC-1 cells decreased in G0/G1 phase and increased in G2/M. But there was no evident change in S phase. The cells were mainly blocked in M phase, and the inhibitory effect of the allicin on MEC-1 cells increased with the increasing of concentration and time. CONCLUSION Allicin can inhibit the growth of MEC-1 cells in vitro dramatically.
Cell Cycle ; drug effects ; Cell Line, Tumor ; Dose-Response Relationship, Drug ; Humans ; Sulfinic Acids ; pharmacology

BACKGROUNDFollicle stimulating hormone is necessary for normal reproduction in men. The biochemical actions of follicle stimulating hormone result from binding to the follicle stimulating hormone receptor in the plasma membrane of Sertoli cells. Here, we investigated the expression of the follicle stimulating hormone receptor in different testicular histological phenotypes of patients with idiopathic azoospermia.

METHODSFifty-seven cases of idiopathic azoospermia were classified into three groups according to the results of testicular biopsy: patients with hypospermatogenesis, patients with maturation arrest, and patients with Sertoli cell-only syndrome. Thirteen azoospermic patients identified by testicular biopsy as being capable of completing spermatogenesis acted as the control group. Immunohistochemistry and real-time quantitative reverse-transcriptase polymerase chain reaction were performed in each case, and the serum hormone level was also measured in all patients.

RESULTSThe serum follicle stimulating hormone level in patients with Sertoli cell-only syndrome was significantly higher than in patients with hypospermatogenesis, maturation arrest, and complete spermatogenesis (P < 0.01). The serum follicle stimulating hormone level in patients with maturation arrest was significantly higher than in patients with hypospermatogenesis and complete spermatogenesis (P < 0.05). There was no difference in serum follicle stimulating hormone levels in patients with hypospermatogenesis and complete spermatogenesis. The follicle stimulating hormone receptor expression level of testicular samples with Sertoli cell-only syndrome was significantly higher than in those with hypospermatogenesis, maturation arrest, and complete spermatogenesis (P < 0.05), but no significant difference was observed among hypospermatogenesis, maturation arrest, and complete spermatogenesis testicular samples.

CONCLUSIONSDifferent serum follicle stimulating hormone levels and follicle stimulating hormone receptor expression were found in the different testicular histology phenotypes in azoospermic patients. Differential follicle stimulating hormone receptor expression in testicular tissue of patients with idiopathic azoospermia may be associated with the degree of spermatogenesis.

Adult ; Azoospermia ; blood ; metabolism ; Follicle Stimulating Hormone ; blood ; Humans ; Male ; Oligospermia ; blood ; metabolism ; Receptors, FSH ; genetics ; metabolism ; Spermatogenesis ; physiology ; Testis ; metabolism

Objective     To report our experience with enhanced recovery after surgery (ERAS) protocol in patients undergoing transapical transcatheter aortic valve implantation (TAVI) and to determine perioperative predictors for ERAS failure. Methods     Between May 2018 and January 2019, 80 patients undergoing TAVI in our hospital were recruited. Among them, 40 patients (24 males, 16 females, aged 73.0±5.0 years) successfully received ERAS, defined as successful extubation in operating room (an ERAS group) and the other 40 patients (28 males, 12 females, aged 73.0±7.0 years, a non-ERAS group) failed to perform ERAS.  Results     Compared with the non-ERAS group, patients in the ERAS group were associated with a significantly lower incidence of postoperative complications (30.0% vs. 52.5%, P=0.04), shorter postoperative ICU stay (2.2±0.4 d vs. 4.0±4.8 d, P=0.00) and hospital stay (7.0±2.3 d vs. 9.5±4.8 d, P=0.00), and less medical cost (311±20 thousand yuan vs. 347±80 thousand yuan, P=0.00). Independent predictors of ERAS failure were poor preoperative heart function and elevated B-type natriuretic peptides.  Conclusion     ERAS protocol is feasible and effective in patients undergoing TAVI. Poor preoperative heart function is an independent predictor of failure in early extubation which, in turn, is associated with prolonged ICU and hospital stay and dramatic worsening of patient outcomes.

Objective     To discuss the key points of anesthesia for patients undergoing transcatheter aortic valve implantation (TAVI) surgery. Methods     We retrospectively collected and analyzed the data of 70 patients who underwent TAVI in the Department of Cardiovascular Surgery, West China Hospital from March 2014 to October 2015. There were 39 males and 31 females with an average age of 73.7±4.5 years. The perioperative preparation and anesthesia points of TAVI were summarized. Results     All of the 70 included patients were aged and at high risk severe comorbidities such as ischemic heart disease and stroke. The aortic stenosis and regurgitation occurred in 39 and 31 patients respectively. No patients died during the surgery. The total success rate was 95.7%. Conclusion     TAVI is a complex procedure for high risk patients and need more attention during anesthesia. The successful conduction of the procedure requires the whole team to prepare carefully and cooperate closely.