Objective To explore the influencing factors and timing of acute cholecystitis laparoscopic surgery.Methods One hundred and sixty acute cholecystitis patients treated with laparoscopic surgery were divided into group A (56 cases,performed treatment within 24 h),group B (42 cases,performed treatment at 24 -48 h),group C ( 40 cases,performed treatment at 49 -72 h),group D (22 cases,performed treatment after 72 h).The operation time,rate of conversion to laparotomy,length of stay and average costs were compared among four groups and analyzed the impact of laparoscopic surgery conversion to laparotomy.Results The rate of conversion to laparotomy of group D [ 59.09％(13/22) ] was significantly higher than that in group A [ 19.64％(11/56) ] (P ＜ 0.01 ).The operation time of group A was the shortest and group D was the longest.The length of stay of group D was significantly longer than other groups (P ＜ 0.05 ).The costs of the four groups had no significant difference(P ＞ 0.05 ).Single factor analysis showed that white blood cell (WBC) count,body temperature,timing of surgery,gallbladder neck calculi incarceration were correlated with conversion to laparotomy(P ＜ 0.05 ).Multifactor analysis showed that WBC count,timing of surgery were independent risk factors of conversion to laparotomy (P ＜ 0.05 ).Conclusions WBC count,body temperature,timing of surgery,gallbladder neck calculi incarceration are correlated with acute cholecystitis laparoscopic surgery conversion to laparotomy.While WBC count and timing of surgery are independent risk factors.The best time of laparoscopic surgery is within 72 h and WBC count ＜ 15 x 109/L.

Fungal elicitors are a group of chemicals that can stimulate the secondary metabolite production in plants and microbial cells. After being recognized, it could enhance the expression of related genes through the signal-transduction pathway; regulate the activity of the enzyme involved in the biosynthesis of secondary metabolites. In recent years, the inducible mechanism of fungal elicitors has been studied deeply worldwide. Meanwhile, it has acquired wide concern in the area of biological industry, especially in the fermentation industry. This paper addresses the application and prospect of fungal elicitors in the secondary metabolites of plant and microbial cells.
Alkaloids ; biosynthesis ; genetics ; Camptothecin ; biosynthesis ; Fermentation ; Fungi ; genetics ; metabolism ; Industrial Microbiology ; methods ; Paclitaxel ; biosynthesis ; Plants, Medicinal ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; Secondary Metabolism

Objective:To understand the coronavirus disease 2019(COVID-19)prevention and control work and the problems and difficulties faced by non-government primary medical institutions in China during the epidemic period.Methods:A survey on the coronavirus disease 2019(COVID-19)prevention and control work of non-government primary medical institutions was conducted on April 14 to 21, 2020 with the self-designed questionnaire. The questionnaire contained three parts: the first part was basic information of medical staff in non-government primary medical institutions, including position and institutional information; the second part was the status quo of non-government primary medical institutions participating in the prevention and control of COVID-19, including the specific work and difficulties faced by the responders during the epidemic period; and the third part was the prevention and control effect of COVID-19 in the responders′ institutions, including whether there were confirmed cases and infected medical staff. An online invitation was issued among the members of General Practice Branch of Chinese Non-government Medical Institution Association. The invited participants included the heads, general practitioners and other medical personnel of the non-government primary medical institutions the invited participants voluntarily scanned the online two-dimensional code to fill in.Results:A total of 761 individuals in primary health institutions from 20 provinces, municipalities and autonomous regions in China participated in the survey. There were 290 (38.1%) men and 471 (61.9%) women with age of 40(32, 48) years; 83.0% (632/761) had worked for more than 5 years; 33.8% (257/761) owned primary professional titles and 33.0% (251/761) owned intermediate titles. Among all participants 28.5% (217/761) were general practitioners, 26.9% (205/761) were institutions/department managers, 14.6% (111/761) were specialists and 40.3% (307/761) were other related personnel. A total of 549 institutions continued to operate during the epidemic period and 96.5% (530/549) participated in the work related to the prevention and control of the epidemic, including prescreening and triage, health consultation, follow-up of suspected patients, donation, quarantine of suspected cases, follow-up of close contacts/discharged patients, diagnosis and treatment of patients with new coronavirus pneumonia. 44.7% (340/761) of respondents participated in the epidemic prevention as front-line staff and directly contacted patients/suspected patients, and 63.1% (480/761) participated in the epidemic prevention work of primary medical institutions, including clinical outpatient service, prescreening triage and screening. The working sites were not limited to the institutions, but also other sites including high-speed railway station. The 97.8% (744/761) responders expressed their willingness to participate in epidemic prevention work under the unified leadership and command of the state. The 63.9% (486/761) of the responders were worried about the lack of protective equipments and measures, and 90.4% (688/761) respondents showed that they needed medical supplies (protective equipment: masks, goggles, protective gowns, etc.).Conclusion:The participation of non-government primary medical institutions and their staff in COVID-19 infection prevention and control is a key component of the epidemic prevention process.

Objective To make a preliminary investigation and summary of the technique and efficacy of the novel intracranial stent, Enterprise, together with hydro-detachable coils for the treatment of very small intracranial wide-necked aneurysms (diameter<3 nun and body-to-neck ratio<1.5). Methods Six cases with very small intracranial wide-necked aneurysms were treated with Enterprise stents and hydro-detachable coils. In 5 cases the Enterprise stent was implanted to cover the neck of the aneurysm, which was followed by the introduction of a microcatheter into the aneurysmal sac through the stent mesh to stuff hydro-detachable coils in order to fill the aneurysmal sac. In the remaining case, the microcatheter was placed into the aneurysmal sac before the Enterprise stent was inserted to embolize the aneurysm. Postoperative follow-up was conducted for 3-6 months. Results The operation was successfully completed in all 6 patients, with the implanted stents being in right place. The parent arteries remained patency in all patients. No complications occurred. Complete occlusion of aneurysmal cavity was obtained in four cases, and the occlusion degree of the aneurysmal cavity above 95% was seen in 2 cases. After the procedure, all the patients recovered well. Neither rebleeding nor symptoms related to thrombosis occurred during a clinic follow-up of 3-6 months. Conclusion Endovasculur embolization with Enterprise stent together with hydro-detachable coils is a safe and effective method for the treatment of very small intracranial wide-necked aneurysms. However, its long-term effect needs to be further observed.

The response of glueagon to the change of glucose and its relation to blood pressure in 71 eidely patients with type 2 diabetes was investigated. The results showed that the postprandial increment of glucagon in the group of patients with postprandial 2h plasma glucose increment<2.5 mmol/L was significantly higher than that in the group with plasma glucose inerement≥ 2.5 mmoi/L (P<0. 05). The postprandial increment of glucagon in patients with normal blood pressure was significantly higher than that in patients with hypertension (P<0.05). The results suggest that the decreased response of glucagon to the change in plasma glucose in elderly patients with type 2 diabetes is related to increased blood glucose and high blood pressure.

AIM　To compare the bioactivity and bioavailability of domestic and imported salcaltonin injections in Chinese healthy volunteers. METHOD　Using randomized cross design, to determine the concentrations of calcium and salcaltonin in serum of healthy volunteers after single dose of domestic and imported injections. RESULT　Two preparations reduced concentration of calcium in serum obviously and there was no difference of mean changes of calcium between the two kinds of injections (P>0.05). The main pharmacokinetic parameters are: Cmax: (2.31±0.16) μg*L-1 and (2.44±0.20) μg*L-1；Tmax: (48.75±12.99) min and (52.50±16.31) min；T1/2ke: (92.93±11.86) min and (97.61±11.23) min；Ke: (0.0079±0.0023) min-1 and (0.0084±0.0014) min-1；AUC(0～360 min): (297.70±44.45) μg*min*L-1 and (313.64±46.03) μg*min*L-1 respectively in domestic and imported salcaltonin injections. The relative bioavailability of domestic formulation is 97.6%±25.6%. CONCLUSION　The domestic and imported salcaltonin injections administered produce similar biological response and bioavailability and they are bioequivalent.

To investigate the protective effects of scutellarin benzyl ester on neonatal rats' cardiomyocytes injured by ischemia and its anti-apoptosis mechanism.

Objective To discuss the technical points, safety and clinical effectiveness of DSA-guided percutaneous acetabuloplasty (PA) for the treatment of acetabular metastases. Methods Fifteen patients, including 6 males and 9 females, with acetabular malignant metastases were enrolled in this study.A total of 19 lesions were detected. The lesions were 13 - 25 mm in size (mean 19 ± 4 mm), the dose of PMMA used for per lesion was 5 - 13 ml (mean 8.2 ± 2.3 ml). All patients complained of greater or less degree of pain in their hips, 8 patients had to use walking stick, 4 patients showed limping although they could walk independently and three patients could not walk alone. DSA-guided percutaneous acetabuloplasty was performed in all patients and follow-up after the procedure was conducted for 1 - 12 months. Visual analogue score (VAS), walking state score and analgesic dosage taken by the patients were used for the evaluation of the clinical effectiveness. The complications were analyzed. All the data obtained were statistically analyzed with paired samples t test and analysis of variance by using SPSS12.0 statistical software.Results The procedure was technically successful in all patients. Pain rating evaluated by the VAS decreased from a mean of 7.8 before surgery to a mean of 4.2 in 24 hours after surgery (P < 0.01 ), which further decreased to 2.5 in one month (P < 0.01 ), while walking state score increased from a mean of 1.5before surgery to a mean of 2.5 in 24 hours after surgery (P < 0.01 ). The analgesic dosage taken by the patient was reduced in 14 patients and remained the same in one patient. The bone cement leakage into paraacetabular soft tissues occurred in three cases and peripheral vascular exudation of acetabulum was observed in three cases with no obvious clinical symptoms. Conclusion As a safe, reliable and minimally-invasive technique, DSA-guided percutaneous acetabuloplasty has excellent anti-pain effect in treating acetabular metastases. This therapy can markedlyimprove the patient's walking ability and the quality of life.

Objective To compare the effects of higher dosage of atorvastatin alone and combination of lower dosage of atorvastatin with ezetimibe on levels of lipid and metalloproteinases in patients with coronary artery disease. Methods Forty-two patients with coronary artery stenosis (50% to 70% stenosis) without stent replacement were selected, and were randomly divided into atorvastatin group (treated with 20 mg or 40 mg atorvastatin alone, n = 19) and combined-therapy group(treated with 5 mg, 10 mg atorvastatin and 10 mg ezetimibe, n =23). The levels of serum lipid, hepatic and renal functions, creatine kinase, metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of MMP-1 (TIMP-1) were detected 12 weeks after treatment. Results Twelve weeks after treatment, the level of LDL-C in atorvastain group was (1.94 ± 0.49) mmol/L (37.82% decrease from baseline), and that in combined-therapy group was (1.92 ±0.54) mmol/L(38. 26% decrease from baseline), and there was no significant difference between these two groups (P >0.05). Twelve weeks after treatment, the levels of MMP-2 and MMP-9 were significantly decreased and that of TIMP-1 was significantly increased compared with baseline levels in atorvastatin, while no such changes were detected in combined-therapy group. Conclusion In patients with coronary artery stenosis, combined therapy with lower dosage of atorvastatin and ezetimibe may lead to the same lipid-lowing effects compared with therapy with higher dosage of atorvastatin, but it may not result in a significant reduction in serum levels of MMP-2, MMP-9 and increase of TIMP-1.

Background and purpose: Hepatocellular carcinoma (HCC) is a hypervascular tumor associated with a poor prognosis and lack of effective treatments. Consequently, identifying novel therapeutic strategies are urgently needed. We have previously shown that the kringle 1 domain of human hepatocyte growth factor (HGFK1) is a more effective anti-angiogenesis molecule than angiostatin. In this study, we observed the effects and mechanisms of HGFK1 gene on the HCC. Methods: A recombinant adeno-associated vires carrying the HGFK1 gene (rAAV-HGFK1) was constructed.HCC of rat was induced by McA-RH7777. rAAV-HGFK1 was used to treat the rat, median survival time and metastasis rate were observed. Results: Ten days after tumor cell inoculation, surgery were performed to confirm the tumor formation, PBS, rAAV-EGFP or rAAV-HGFK1 was injected directly into the tumor nodule followed by portal vein injection. Results from our study demonstrated that rAAV-HGFK1 treatment significantly prolonged the median survival time of the HCC bearing rats from 30 days (PBS and rAAV-EGFP groups) to 49 days (rAAV-HGFK1 group). More importantly rAAV-HGFK1 inhibited tumor growth and completely prevented liver, lung and peritoneal metastasis. In the controlled PBS and AAV-EGFP group, liver and peritoneal metastasis rate were both 100%, and lung metastasis rate was 100% and 83%, respectively. While there was no metastasis found in treatment group, with only 33% of ascites happened. This was most possibly due to the primary tumor in liver but not due to the metastasis. Moreover, at a higher magnification (1000×), it was clear that the HGFK1 protein was expressed mainly in the cytoplasma of liver cells. In parallel, IHC staining of CD31 also demonstrated a significantly lower level of microvessel density (MVD) (6.21±1.6) in the liver tumor of the AAV-HGFK1 treatment group, as compared to the two control PBS and AAV-EGFP groups (25.1±2.1 and 26.8±2.5, respectively, P<0.01). HE staining showed that AAV-HGFK1 treatment induced large areas of necrosis in the tumor tissues, while minimal areas of necrosis were observed in the tumor tissue in the control groups. In addition, no toxicity appeared when high dosage (4.8× 1012 vg/rat) of rAAV-HGFK1 was administered in rats. Conclusion: Results from this study demonstrated that HGFK1 inhibited the growth and metastasis of HCC and prolonged the survival time of animals with HCC through anti-angiogenesis effects. No obvious toxicity was observed. It might be the novel promising treatment for HCC and other cancers.