Objective: The purpose of this study was to evaluate the safety and effectiveness of fast track surgery in laparoscopic gastrectomy for gastric cancer. Methods: All patients received elective gastric cancer resection, and were divided into three groups: group Ⅰ (open gastrecomy, n = 30) , group Ⅱ (open gastrecomy with fast track surgery, n = 30) , and group Ⅲ (laparoscopic gastrecomy with fast track surger-y ,n =30) . Clinical data and gut function were assessed in three groups. Results: There were no significant differences in postoperative complication and the number of lymph node harvest between 3 groups. Blood loss was less in group Ⅲ than group Ⅰ and group Ⅱ (P <0.01) ,but its operative time was longer and its cost was more than other two open surgery groups (P < 0. 01). Recovery of bowel function in group Ⅲ was faster,and postoperative hospital stay was shorter than group Ⅰ (P<0.01). However, recovery of bowel function and postoperative hospital stay in group Ⅲ was not different from group Ⅱ (P > 0. 05). Conclusion: Postoperative hospital stay can be shorter and recovery of bowel function can be faster in laparoscopic gastrectomy with fast track surgery plan compared to traditional care group. But when using fast track surgery plan, laparoscopic gastrectomy was not superior to open surgery.

Objective To determine the clinical features of systemic lupus erythematosus (SLE) patients with pancreatitis.Methods The medical records of 46 patients with pancreatitis among 5 233 SLE patients admitted into Peking Union Medical College Hospital from January 1983 to January 2012 were reviewed for retrospective analyses of clinical manifestations,laboratory tests,radiological findings,treatments and prognosis.Results The prevalence of pancreatitis was 0.88％ (46/5 233) in SLE patients.There were 7 males and 39 females with an average age of (33 ± 13) yeats.Acute pancreatitis (n =40) occurred more frequently than chronic pancreatitis (n =6).It appeared mostly in active course of SLE with an involvement of more organs.Hypertriglyceridemia was found in 81.0％ (17/21) lupus-associated acute pancreatitis patients.The average level of triglycerides in severe acute pancreatitis was higher than that in mild acute pancreatitis (P =0.023).The mortality rate of lupus-associated acute pancreatitis was 37.5％ (15/40).Most patients received high-dose glucocorticoid and immunosuppressants.Acute pancreatitis appeared in only 5 patients during the course of steroids pulse therapy and most symptoms were mild.Concomitant infections were correlated with poor prognosis (P ＜ 0.01).The most common manifestations of lupus-associated chronic pancreatitis were abdominal pain,jaundice and pancreatic enlargement.Autoimmune pancreatitis could be the initial manifestation of lupus.Conclusions Pancreatitis with SLE includes acute and chronic pancreatitis.Among them,acute pancreatitis is more common and severe and it usually occurs in patients with active SLE with a high mortality.Hypertriglyceridemia may induce and aggravate lupus-associated acute pancreatitis.Early aggressive management with high-dose steroids and immunosuppressants is recommended.Concomitant infection is a risk factor of poor prognosis.

Abstract: Objective　To compare the mosquito trapping effect of BG-trap mosquito trap using carbon dioxide versus BG-lure attractant under filed conditions. Methods　In August and September 2020, two areas were set with a distance of 100 m. Two sites were set at each area, and one mosquito trap BG trap was set with a distance of 5 m. Each site was set with different flow of CO2 and different amount of BG-lure attractants. The BG-trap mosquito traps on the same area would exchange positions every other day. The mosquitoes captured by each mosquito trap was collected and classified. and the species, sex and number of mosquitoes captured were recorded and counted. Results　The densities of Aedes albopictus captured by BG+/CO2-and BG-/CO2+were 14 and 31, and that of Culex pipiens pallens were 2 and 16, respectively. The differences were statistically significant (Aedes albopictus, t=-2.675, P<0.05; Culex pipiens pallens, t=-4.873, P<0.05). With BG-lure attractant, the females of Aedes albopictus and Culex pipiens pallens in the CO2+group were 2.6 (25/9.5) and 12.0 (12 /1) times higher than those in the CO2-group, and the differences were statistically significant (female Aedes albopictus, t=-4.119, P<0.01; female Culex pipiens pallens, t=-4.592, P<0.01), suggesting that the most important attractant to female mosquitoes is CO2. With BG-lure attractant, the male Aedes albopictus in the CO2+ group was 3.0 (12/4) times higher than that in the CO2-group, and the difference was statistically significant (male Aedes albopictus, t=-3.284, P<0.01). Without BG-lure attractant, female Aedes albopictus and female Culex pipiens pallens in the CO2 + group were 1.8 (18 / 10) and 15.5 (15.5/1.0) times higher than those in the CO2-group, and the difference was statistically significant (female Aedes albopictus, t=-2.868, P<0.05; female Culex pipiens pallens, t=-5.259, P<0.05). Without BG-lure attractant, the male Aedes albopictus in the CO2+group was 2.0 (9.0/4.5) times higher than that in the CO2-group, with a statistically significant difference (t=-2.508, P<0.05). With CO2, Aedes albopictus and Culex pipiens pallens in the BG + attractant group were 1.4 (43.5/31) and 0.78 (12.5/16.0) times higher than those in the BG-attractant group, and the differences were not statistically significant (Aedes albopictus, t=-0.943, P>0.05 ; Culex pipiens pallens, t=0.709, P>0.05). Without CO2, Aedes albopictus and Culex pipiens pallens in the BG + attractant group were 1.0 (14/14) and 2.0 (2.0/1.0) times higher than those in the BG + attractant group, and the differences were not statistically significant (Aedes albopictus, t=-0.500, P>0.05; Culex pipiens pallens, t=-1.000, P>0.05). Without BG-lure attractant, the densities of female Aedes albopictus captured by adding 0, 1 and 2 parts of dry ice were 10, 17.5 and 18 respectively, and the difference was statistically significant among the three groups (F=3.942, P<0.05). The densities of female Culex pipiens pallens captured were 1, 13 and 18 respectively, and the difference was statistically significant among the three groups (F=13.881, P<0.05). However, there was no significant difference between the capture of female Aedes albopictus and female Culex pipiens pallens by adding 1 part of dry ice and 2 parts of dry ice (female Aedes albopictus, t=0.112, P>0.05; female Culex pipiens pallens, t=-0.540, P>0.05). Without CO2, 10, 10, 9.5 and 1, 1 and 1.5 female Aedes albopictus and Culex pipiens pallens were captured by adding 0, 1 and 2 portions of BG-lure attractants, respectively. There were no significant differences between the three groups (female Aedes albopictus, F=0.120, P>0.05; female Culex pipiens pallens, F=0.477, P>0.05). Conclusions　In the monitoring of BG-trap mosquito trap, the mosquito trapping effect of CO2 is better than that of BG-lure attractant. When the same monitoring effect is obtained, the use of CO2 (100 mL/min) can save the use cost.

Objective To discuss the feasibility and curative effect of intra-radiation stenting(125Iparticle stent)for the treatment of advanced esophageal cancers.Methods Fifteen patients with advanced esophageal cancer were enrolled in this study.Under X-ray guidance the esophageal stent,which was tied up with 125I radioactive particles,was orally inserted to the diseased region of the esophagus.The clinical manifestations and imaging findings were observed and the results were analyzed.Results After the operation all the clinical symptoms such as dysphasia showed an obvious improvement.No serious complications such as infection,hemorrhage,radiation pneumonia,etc.Occurred.The re-examination at 3-6 months after the treatment showed that the tumor size Was decreased in a certain degree in 14 patients,and in the remaining one patient the lesion became bigger and grew to the upper opening of the stent,resulting in esophageal restenosis.Conclusion The intra-esophageal implantation of radioactive stent is a feasible and safe treatment for the advanced esophageal cancers with excellent curative results.

Objective To evaluate the efficacy and safety of tacrolimus exposure in stable liver transplant recipients converted from FK506 twice a day to Advagraf (tacrolimus extended-release capsules) once daily. Methods This was an open-label, random, control and multi-center study.Eligible patients were 19 to 70 years of age, 6 months post-transplant with stable renal and hepatic function and receiving stable doses of tacrolimus twice a day for 2 weeks prior to enrollment. There were 86 patients in the experimental group and the control group, separately. The average age of experimental group and control group was 46 ± 10 and 49 ± 9, respectively. Patients in experimental group received Advagraf, once daily, and the dose was adjusted according to the drug concentration,and the drug concentration was between 2 to 10 μg/L. The control group given tacrolimus, twice daily, and the drug concentration was between 2 to 10 μg/L. Results The incidence of acute rejection reaction was 1.20 % and 1.18 % respectively in experimental group and control group, and the 95 %confidence interval was -3.25% ～3.31 % and -3.26% ～ 3.34 %, individually. There was 1 case of acute rejection reaction in experimental group and control group, respectively. The patient and organ survival rate was 100%. Sixteen adverse events occurred in 15 patients (17.65 %) of the experimental group, and 10 adverse events occurred in 10 patients (11.63 %) of control group. Severe adverse events relating to the test drug in experimental group occurred in 4 patients (4. 71 %). and 2 patients (2. 33) in control group.Conclision Clinical trials indicated that Advagraf has efficacy and safety profiles similar to those of tacrolimus. The drug is safe and may improve patient compliance.

Objective To optimize the process conditions of one-step pelletization of Rouganbao Granules. Methods The factors influencing the pelletization of Rouganbao Granules were investigated by L9(34)orthogonal test, with the indexes of forming rate and fluidity. Results The spraying speed had the greatest effect on one-step pelletization, followed by atomization pressure and material temperature, and wind temperature had the smallest effect. At last, the best process parameters were relative density 1.15 (60 ℃), spray speed 55 mL/min, atomization pressure 0.25 MPa, wind temperature 75 ℃, material temperature 55 ℃, and critical relative humidity was 63%. Conclusion One-step pelletization technology can improve the preparation level and product quality, which can be used for the industrial production of Rouganbao Granules.

With global warming, mosquitoes and mosquito-borne diseases are spreading rapidly in many regions across the world and producing substantial morbidity and mortality.According to recent studies, mosquito population structure, density and distribution in urban environment are under dynamical changes with continuous urbanization and the consequent environment changes.Surface sewers and under-ground catch basins are becoming major mosquito breeding habitats. Population structure in surface sewers varies with the environment, Aedes albopictus is the dominant species in residential areas.Charac-terized with high population density and mobility, residential areas are easier for mosquito-borne disease spreading, so more attention should be paid to Aedes albopictus control in urban residential areas.Increased underground garages and subway traffic generated new breeding habitats and over wintering sites for mosquitoes in urban environment, control measures should be taken for such environments, since urban underground spaces are always the transit hub of vehicles, which may facilitate the spread of mosquito and its vectored virus, particularly, Culex molestus, Aedes albopictus and Culex tritaeniorhynchus can all be found breeding in underground catch basins.Frequent reports of Culex tritaeniorhynchus breeding in urban surface and underground environment suggest that Culex tritaeniorhynchus is gradually adapted to the new urbanized habitats, which may produce great effect for mosquito population structures in urban environment.Breeding habitats management is the most effective measures for mosquito control, qualified mosquito surveillance can help understand the fluctuation of mosquito species and provide timely warning, at the same time, regular risk assessment for mosquito-borne disease is essential for disease control and prevention.

Objective: The aim of this study was to evaluate the impact of fast track surgery on host cell-mediated immunology and inflammatory responses in colorectal cancer patients.Methods: Sixty colorectal cancer patients were prospectively divided into fast track surgery(FTS)group(n=30)and conventional perioperative care group(n=30).In addition to clinical parameters(recovery of gastrointestinal function,complication rates and postoperative length of stay), the parameters of perioperative cell-mediated immunology function,and the serum level changes of CRP and IL-6 were determined.Results: FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group(P<0.05).Serum concentration of CRP and IL-6 in FTS group were lower(P<0.05) than in the conventional care group on postoperative day(POD) 1 and POD 3(P<0.05).CD4/CD8 ratio in FTS group were higher(P<0.05) than in the conventional care group on postoperative day(POD)1 and POD 3(P<0.05).Conclusion: Fast track surgery for colorectal cancer patients can preserve cell-mediated immunity and control inflammatory responses when compared with conventional postoperative care.

Objective To optimize plan for right lobe living donor hepatectomy based on the territorial volume drained by the middle hepatic vein (MHV) as shown by preoperative MR image in donors.Methods Utilizing preoperative MR dynamic enhancement scanning image,virtually plot three types of hepatic parenchyma transsection plane based on the variation of including MHV for right lobe graft procurement. Results From June 2006 to May 2010,65 adult-to-adult right lobe living donor liver transplantations was performed at General Hospital of Chinese PLA,in which there were 43 grafts including MHV (66.2％,43/65 ), eight grafts including partial MHV which was dissected before the V4b abouchement ( 12.3％,8/65) and 14 grafts not including MHV (21.5％,14/65). There was no postoperative death in donors and the postoperative complications developed in 10.76％ (7/65). The recipients' perioperative mortality was 7.69％ (5/65). Ttwenty-one complications developed in 18 recipients,and the morbidity was 32.31％. The cumulative survival rates were 86％,77％ and 68％respectively for 1,2 and 3 years. Conclusions The optimizing liver resection plane could be practically designed preoperatively for right lobe graft procurement based on the territorial volume drained by MHV.

D-lactonohydrolase is useful in the procedure of resolution of racemic pantolactone to produce D-pantolactone, but the activity and stability under low pH of the wild type enzyme is not satisfactory enough to be applied to industrial production. The expected properties of wild type enzyme were enhanced by directed evolution. According to the formation of products and pH indicators, a screening system was designed. After three sequential error prone PCR and one round DNA shuffling followed by screening, Mut E-861, the best mutant with improved activity and stability under low pH situation was obtained. Gene analysis of the Mut E-861 mutant indicated that the mutant enzyme had A352C, G721A mutations and a silent mutation of position 1038. Moreover, the activity and stability of Mut E-861 were determined. The results showed that the activity of this mutant was 5.5-fold higher than that of wild type, and the stability under low pH was improved at no expense of D-lactonohydrolase activity. After incubated at pH 6.0 and pH 5.0 the activity of D-lactonohydrolase could be retained 75% to 50%, however, compared with 40% to 20% for wild type.
Carboxylic Ester Hydrolases ; biosynthesis ; genetics ; DNA Shuffling ; Directed Molecular Evolution ; Enzyme Stability ; Escherichia coli ; enzymology ; genetics ; Mutagenesis, Site-Directed ; Mutant Proteins ; genetics ; metabolism ; Polymerase Chain Reaction ; methods ; Protein Engineering ; Saccharomyces cerevisiae ; enzymology ; genetics