Aim To explore the proteomics mechanism of the differentiation induction effect of 4-amino-2-trif-luoromethyl-phenyl retinate(ATPR)on human leukemi-a K562 cells. Methods Human leukemia K562 cells were incubated with the same concentration (1 × 10 - 6 mol·L - 1 ) of ATPR or ATRA for 48 hours. The total cell proteins were collected, purified and digested by trypsin, solid phase extraction, and the peptides were detected by ESI-LC-MS / MS. The difference of the pro-tein expression between the cells treated with ATPR and ATRA was compared by using the Discoverer Pro-teome 1. 2 software, and the molecular function, the biological process and other information of those pro-teins were analyzed based on the DAVID, KEGG, STRING databases. Results 120 specific proteins were identified only in the ATPR group, 143 only in the ATRA group, and 422 other proteins in both groups. Results of DAVID analysis showed that ATPR-induced specific proteins were mainly involved in 39 biological processes of proteins and macromolecules metabolism, protein transport and localization and so on. Results of KEGG analysis revealed that ATPR-in-duced proteins participated in signal pathways, mainly metabolic pathways, PI3K-Akt signal pathway, TGF-beta signal pathway and other pathways in cancer. String protein interaction network analysis displayed that ATPR-induced proteins, like EIF3A, EIF6, RPL3, RPL8, RPL13, RPL7A, RPL21, RPS3, RPS14, NACA, BTF3, NHP2L1, PPP2CA proteins had direct interactions with more than or equal to 10 associated proteins. Conclusion The differentiation induction effect of ATPR on K562 cells might be as-cribed to the ATPR-induced proteins interaction net-work and the specific central proteins it induced, which are involved in the regulation of cell prolifera-tion, differentiation and apoptosis.

OBJECTIVETo analyze the associated predictive factors of lymph node metastasis in intramucosal early gastric cancer, and to provide reference for individualized treatment protocol.

METHODSClinical data of 498 patients who were pathologically confirmed to be intramucosal early gastric cancer after radical resection of gastric cancer were retrospectively reviewed. Univariate and multivariate analyses were applied to evaluate the associated factors.

RESULTSForty-three out of 498 patients (8.6%) had lymph node metastasis. Tumor size (HR=1.525, 95%CI:1.040-2.236), depth of invasion (HR=1.656, 95%CI:1.158-2.368) and histological type (HR=8.149, 95%CI:1.770-37.513) were the independent risk factors for lymph node metastasis in intramucosal early gastric cancer.

CONCLUSIONSPrediction and therapeutic guidance for lymph node metastasis in intramucosal early gastric cancer can be carried out according to clinicopathological risk factors.

Adult ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; pathology ; surgery

Objective:To investigate the learning curve of laparoscopic transanal total mesorectal excision (taTME) for rectal cancer operated by one or two surgery teams.Methods:The retrospective cross-sectional study was conducted. Based on the concept of real-world research, the clinical data of 1 458 patients undergoing laparoscopic rectal cancer taTME from 44 medical centers who were registered in the Chinese taTME registry collaborative (CTRC) database from May 2010 to May 2020 were collected. The 1 458 patients were divided into cohorts with one surgery team or two surgery teams according to the operation method. Patients with one surgery team underwent taTME by transabdominal operation and then by transanal operation. Patients with two surgery teams underwent taTME by transabdominal and transanal operation simultaneously with duration of the simutaneous operation time ≥30 minutes. The entire surgical process of patients with two surgery teams is not required to be performed by two surgery teams simutaneously. The clinical data were collected from the medical centers with similar operation amount according to the operation time sequence to analyze the difference between different operation stages and explore the learning curve. The operation time was taken as the parameter to carry out cumulative sum analysis and draw the learning curve of laparoscopic rectal cancer taTME in each medical center. The clinicopathological characteristics of patients from two medical centers with the largest difference in learning curves were analyzed. Observation indicators: (1) screening results of clinical data; (2) clinical data collection of patients with one surgery team; (3) surgical situations of laparoscopic rectal cancer taTME from the one surgery team in different operation stages; (4) learning curve of the one surgery team; (5) clinical data collection of patients with two surgery teams; (6) surgical situations of laparoscopic rectal cancer taTME from the two surgery teams; (7) learning curve of the two surgery teams. The cumulative sum was calculated by the CUSUM=∑i=1nXi-U, where Xi represented the operation time of each taTME, U represented the average operation time of all cases, and n represented the operation number. Fitting process was conducted on scatter plot of learning curves. Taking the apex of learning curve as the boundary, the learning curve was divided into two stages. The abscissa corresponding to the apex of learning curve was the number of operations that needed to be performed to cross the learning curve. Measurement data with normal distribution were represented as Mean±SD. Comparison between two groups was conducted using the t test and comparison between multiple groups was conducted using the ANOVA. Measurement data with skewed distribution were represented as M( P25,P75), and comparison between groups was conducted using the Mann-Whitney U test. Comparison of ordinal data was analyzed using the rank sum test. Count data were analyzed using the chi-square test or Fisher exact probability. Results:(1) Screening results of clinical data:the clinical data of 661 patients from 7 medical centers with one surgery team and two surgery teams were collected. (2) Clinical data collection of patients with one surgery team: the clinical data of 312 patients undergoing laparoscopic rectal cancer taTME from 5 medical centers were collected including 42 cases in the number 2 medical center, 97 cases in the number 20 medical center, 82 cases in the number 33 medical center, 35 cases in the number 37 medical center and 56 cases in the number 39 medical center, respectively. (3) Surgical situations of laparoscopic rectal cancer taTME from the one surgery team in different operation stages: three medical centers including the number 2, number 37 and number 39 medical center with close operation volume provided the clinical data of cases distributed in five operation stages. Among the five operation stages, the proportion of high-quality operation of total mesorectal excision (TME) was ≥17/18, the incidence of postoperative complications was ≤13.3%(4/30) and the incidence of anastomotic leakage was ≤10.0%(3/30). There was no significant difference in the TME quality, postoperative complications or anastomotic leakage among the five operation stages ( P>0.05). There was no significant difference in the operation time among the five operation stages ( χ2=6.950, P>0.05). (4) Learning curve of the one surgery team: the number of operations corresponding to the turning point of learning curve in number 2 and number 20 medical center was 22 and 39, respectively. The number of operations corresponding to the turning points of learning curve in number 33 and number 37 medical center was 15, 66 and 10, 28, respectively. The number of operations corresponding to the turning point of learning curve in number 39 medical center was 20. The overall curve of number 20 medical center was in line with the trend of learning curve and 39 cases of operations was the minimum number needed to cross the learning curve. The biggest difference in learning curve was shown between the number 20 and number 33 medical center. Cases with the gender of male or female, age, body mass index, cases classified as stage 1, stage 2, stage 3 or stage 4 of the American Society of Anesthesiologists (ASA) Classification, cases with neoadjuvant therapy, duration of postoperative hospital stay of the number 20 medical center were 77, 20, (60±10)years, 24 kg/m 2(22 kg/m 2, 26 kg/m 2), 1, 88, 8, 0, 8, 8, 11 days (9 days, 13 days), respectively, versus 51, 31, (64±11)years, 23 kg/m 2(21 kg/m 2, 26 kg/m 2), 0, 35, 43, 1, 31, 16 days (13 day, 21 day) of number 33 medical center, showing significant differences in the above indicators between the two medical centers ( χ2 =6.442, t=-2.265, Z=-2.032, -6.870, χ2 =22.120, Z=-8.408, P<0.05). (5) Clinical data collection of the two surgery teams: the clinical data of 259 patients undergoing laparoscopic rectal cancer taTME from 5 medical centers were collected, including 46 cases in the number 2 medical center, 47 cases in the number 8 medical center, 78 cases in the number 18 medical center, 43 cases in the number 33 medical center and 45 cases in the number 44 medical center, respectively. (6) Surgical situations of laparoscopic rectal cancer taTME from the two surgery teams: four medical centers including the number 2, number 8, number 33 and number 44 medical center with close operation volume provided the clinical data of cases distributed in four operation stages. Among the four operation stages, the proportion of high-quality operation of TME was ≥50.0%(13/26), the incidence of postoperative complications was ≤35.0%(14/40) and the incidence of anastomotic leakage was ≤22.5%(9/40). There was no significant difference in the TME quality, postoperative complications or operation time among the four operation stages ( χ2 =3.252, 4.733, 8.848, P>0.05). There was a significant difference in the incidence of anastomotic leakage among the four operation stages ( P<0.05). (7) Learning curve of the two surgery teams: the number of operations corresponding to the turning point of learning curve in number 2 and number 8 medical center was 28 and 16, respectively. The number of operations corresponding to the turning points of learning curve in number 18, number 33 and number 44 medical center was 12 and 58, 10 and 36, 14 and 36, respectively. The overall curve of number 2 medical center was in line with the trend of learning curve and 28 cases of operations was the minimum number needed to cross the learning curve. The biggest difference in learning curve was shown between the number 2 and number 33 medical center. The age and cases with tumor in stage T0 and (or) Tis, stage T1, stage T2, stage T3 or stage T4 of the T staging of the number 2 and number 33 medical center were (60±12)years, 3, 1, 9, 11, 20 and (65±10)years, 2, 3, 22, 15, 0, respectively, showing significant differences in the above indicators between the two medical centers ( t=-2.280, Z=-4.033, P<0.05). Conclusion:Thirty-nine cases of operations was the minimum number for the one surgery team to cross the learning curve of laparoscopic rectal cancer taTME and 28 cases of operations was the minimum number for the two surgery teams to cross the learning curve of laparoscopic rectal cancer taTME.

OBJECTIVETo explore the different effects of systolic blood pressure (SBP) and low density lipoprotein on carotid plaques (LDL-C).

METHODSA total of 101 510 serving and retired workers of a company who participated in the health examination in 2006-2009, 5852 participants were selected as study subjects by stratified random sampling according to the age and sex ratio. These subjects took their health examination in 2010-2011 including the carotid ultrasound. Finally, 5361 eligible participants with complete data were included in the analysis. The detection and weighted rates of carotid plaques were calculated for four groups: normal SBP and LDL-C group (3524 subjects), normal SBP and high LDL-C group (356 subjects), elevated SBP and normal LDL-C group (1308 subjects) and elevated SBP and high LDL-C group (173 subjects). The effects of different baseline SBP and LDL-C on detection rates of the carotid artery plaques were analyzed by logistic regression.

RESULTSThe detection rate of carotid plaques in normal SBP and LDL-C group, normal SBP and high LDL-C group, elevated SBP and normal LDL-C group, elevated SBP and high LDL-C group was 33.7% (1186/3524), 41.3% (147/356), 64.8% (847/1308), 68.8% (119/173) (χ(2) = 425.75, P < 0.05) and the weighted detection rate was 36.0%, 42.0%, 64.5% and 68.3% respectively. For men, the detection rate was 44.2% (877/1985), 51.1% (97/190), 70.6% (657/930), 71.3% (82/115) (χ(2) = 194.02, P < 0.05) and the weighted detection rate was 31.2%, 36.1%, 49.8% and 50.3% respectively. For women, the detection rate was 20.1% (309/1539), 30.1% (50/166), 50.3% (190/378), 63.8% (37/58) (χ(2) = 180.17, P < 0.05) and the weighted detection rate was 30.9%, 46.3%, 70.3%, and 88.1% respectively. After adjusted for other risk factors, the OR (95%CI) value was 1.37 (1.05 - 1.78), 2.05 (1.74 - 2.43) and 2.12 (1.45 - 3.12) for normal SBP and high LDL-C group, elevated SBP and normal LDL-C group and elevated SBP and high LDL-C group respectively compared with normal SBP and LDL-C group.

CONCLUSIONElevated SBP and high LDL-C were risk factors of the carotid artery plaques. Compared with high LDL-C, elevated SBP may add a higher risk for carotid plaques.

Adult ; Aged ; Blood Pressure ; Carotid Stenosis ; blood ; epidemiology ; physiopathology ; Cholesterol, LDL ; blood ; Dyslipidemias ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Systole

Objective To investigate the clinical and pathological features, diagnosis and treatment of Castleman disease (CD).Methods Clinical features and related information on diagnosis and treatment of eight cases of CD were retrospectively analyzed.The size of involved lymph nodes ranged from (2 cm×2 cm×3 cm)-(4 cm×3 cm×2 cm).The lymph nodes were found in level Ⅰ (1 case), level Ⅱ (3cases) ,level Ⅲ (3 cases) and level Ⅳ (1 case).CT examination in eight patients showed the lesions manifested as ellipse soft masses.Dynamic contrast CT scan in four patients showed ring-enhanced area around the masses.Blood routine examination in eight patients were generally normal, with six patients had mild anemia.Results Based on the clinical classification, all lesions in this group were localized CD.Histopathology indicated that all lesions were of hyaline-vascular type. After surgery, there was no recurrence during the follow-up period. ConclusionsPatients with localized CD mainly have lymphadenectasis in a single location.The CT scan can give some evidence.Surgery should be given first priority.

OBJECTIVETo study the clinicopathologic features of fatal enterovirus 71 (EV71) infection.

METHODSAutopsy was performed in 5 neonates died of EV71 infection. Tissue samples from major organs were collected, formalin-fixed and examined under light microscopy. Immunohistochemical study was carried out in selected examples.

RESULTSFour of the 5 cases showed predominant changes in central nervous system, with encephalitis and encephalomyelitis identified mainly in brainstem and upper cervical spinal cord. Histologic findings included neuronal degeneration and necrosis, neuronophagia, perivascular cuffing and diffuse or nodular hyperplasia of macrophages/microglia. Cerebral edema, brain herniation and aseptic meningitis were also noted. The lungs showed mainly pulmonary congestion, neurogenic pulmonary edema and focal hemorrhage. There were minimal changes in the intestinal epithelium. The intestinal lymphoid tissue however was hyperplastic and associated with apoptosis of follicular center cells. The remaining case had cerebral edema and mild meningitis. The lung alveolar septa were thickened with lymphocytic infiltrates. Some alveolar cells were hyperplastic and associated with diffuse hyaline membrane formation. No specific abnormalities were identified in gastrointestinal tract. In all the 5 cases studied, there was enlargement of lung hilar and mesenteric lymph nodes, coupled with apoptosis of follicular center cells. In general, no significant pathologic changes were demonstrated in heart, liver and kidneys.

CONCLUSIONSIn fatal EV71 infection, the major pathologic changes lie in the central nervous system. The pulmonary lesions are mainly secondary in nature. The usual cause of death is cerebral edema complicated by brain herniation and pulmonary edema. It is also noteworthy that some cases show only lung damages, without classic neurologic changes.

Autopsy ; Brain Edema ; etiology ; pathology ; Brain Stem ; pathology ; Child, Preschool ; Encephalitis, Viral ; etiology ; pathology ; Encephalomyelitis ; etiology ; pathology ; Enterovirus A, Human ; isolation & purification ; Enterovirus Infections ; complications ; pathology ; virology ; Female ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; pathology ; Spinal Cord ; pathology

Haemonchosis remains a significant problem in small ruminants. In this study, the assay of recombinase polymerase amplification (RPA) combined with the lateral flow strip (LFS-RPA) was established for the rapid detection of Haemonchus contortus in goat feces. The assay used primers and a probe targeting a specific sequence in the ITS-2 gene. We compared the performance of the LFS-RPA assay to a PCR assay. The LFS-RPA had a detection limit of 10 fg DNA, which was 10 times less compared to the lowest detection limit obtained by PCR. Out of 24 goat fecal samples, LFS-RPA assay detected H. contortus DNA with 95.8% sensitivity, compared to PCR, 79.1% sensitivity. LFS-RPA assay did not detect DNA from other related helminth species and demonstrated an adequate tolerance to inhibitors present in the goat feces. Taken together, our results suggest that LFS-RPA assay had a high diagnostic accuracy for the rapid detection of H. contortus and merits further evaluation.

Haemonchosis remains a significant problem in small ruminants. In this study, the assay of recombinase polymerase amplification (RPA) combined with the lateral flow strip (LFS-RPA) was established for the rapid detection of Haemonchus contortus in goat feces. The assay used primers and a probe targeting a specific sequence in the ITS-2 gene. We compared the performance of the LFS-RPA assay to a PCR assay. The LFS-RPA had a detection limit of 10 fg DNA, which was 10 times less compared to the lowest detection limit obtained by PCR. Out of 24 goat fecal samples, LFS-RPA assay detected H. contortus DNA with 95.8% sensitivity, compared to PCR, 79.1% sensitivity. LFS-RPA assay did not detect DNA from other related helminth species and demonstrated an adequate tolerance to inhibitors present in the goat feces. Taken together, our results suggest that LFS-RPA assay had a high diagnostic accuracy for the rapid detection of H. contortus and merits further evaluation.

The global patent data on extracorporeal membrane oxygenation(ECMO)in IncomPat Global Patent Database as of August 29,2022 were retrieved.The development trend and layout of ECMO industry were analyzed in terms of global patent application trend,patent distribution,patent technology,major patent applicants and their patent layout.Some suggestions were put forward for the innovation and development of ECMO industry in China so as to provide references for the formulation of national industrial policy,planning of industry technology direction and enterprise technology research and development and patent layout.[Chinese Medical Equipment Journal,2023,44(10):68-75]

Objective:The present study was to observe the effect of Qianjin Weijingtang on the differentiation of helper T cells 17 （Th17）/T regulatory cell （Treg） and the expressions of related cytokines in the lung tissues of the model rats exposed to cigarette smoke. Method:Totolly 60 male rats were randomly assigned into six groups （control group， model group， acetylcysteine group and Qianjin Weijingtang high， moddle and low dose groups）， with 10 rats in each group. After 30 day's modeling and 30 day's intervention， rats were killed peacefully with their tissues collected. Real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） was used to detect the expression of retinoic acid associated orphan receptor （ROR-γt） and forkhead/pterygoid helix transcription factor 3 （Foxp3） mRNA， enzyme-linked immunosorbent assay （ELISA） was used to check the concentration of interleukin-17（IL-17）， IL-6， IL-10 and transforming growth factor-β₁（TGF-β₁）. Htoxylin eosin （HE） staining was used to observe the pathological changes of lung tissues， while flow cytometry was used to detect Treg（Foxp3⁺CD25⁺）， Th17（CD4⁺IL-17⁺） and Treg/Th17 ratio. Result:As compared with the control group， the ROR-γt mRNA expression in model group was higher（P<0.01）. As compared with the model group， various doses of Qianjin Weijingtang down-regulated the expression（P<0.05，P<0.01）. As compared with the control group， the expression of the Foxp3 mRNA was down-regulated in model group（P<0.05）， but was up-regulated in Qianjin Weijingtang middle and low dose groups（P<0.05）. Compared with the control group， the concentration of IL-17 and IL-6 in the model group were significantly increased， while the concentration of IL-10 and TGF-β₁ in the model group were significantly decreased（P<0.05，P<0.01）. As compared with the model group， intervention with various doses of Qianjin Weijingtang could help to decrease the concentration of IL-17 and IL-6 in lung tissues， and increase the concentration of IL-10（P<0.05）， which were consistent with those of Real-time PCR results. Flow cytometry examination showed that the Th17（CD4⁺IL-17⁺） proportion decreased and Treg/Th17 ratio increased after Qianjin Weijing Tang middle and low dose intervention（P<0.05，P<0.01）. Conclusion:Qianjin Weijingtang could regulate Treg/Th17 ratio and help to achieve Th17/Treg balance.