Objective To investigate the risk factors and prevention of the ERCP-related upper gastrointestinal bleeding in patients with choledocholithiasis.Methods The clinical data of 678 patients who received ERCP in Yijishan Hospital of Wannan Medical College between January 2014 and December 2014 were reviewed.Univariate and multivariate analyses were performed to define the independent risk factor(s) for delayed hemorrhage following ERCP.Results A total of 383 patients,in whom 157 were males and 226 were females,the age ranged from 19 to 88 years,were recruited to the study.ERCP-related upper gastrointestinal bleeding occurred in 41 patients(10.7％),intraoperative bleeding occurred in 27(7.0％) and postoperative hemorrhage in 14 (3.7％).Twenty-eight cases were mild bleeding,9 moderate (4 caused by laceration of the cardiac mucosa) and 4 were severe bleeding.All patients recovered and were discharged,and no death occurred.No single case required surgical conversion.Univariate analysis revealed that cholangitis,medical history of aspirin/clopidogrel,giant diverticulum and the major papilla inside the diverticulum were risk factors for delayed hemorrhage following ERCP (P ＜ 0.05).Multivariate analysis indicated that independent risk factors were associated with cholangitis (OR =4.125,95％ CI:1.306-13.031,P ＜ 0.05),medical history of aspirin/clopidogrel (OR =10.220,95％ CI:2.997-34.853,P ＜ 0.01) and major papilla occurred inside the diverticulum(OR =14.064,95％ CI:1.888-104.762,P ＜ 0.05).Conclusion Cholangitis,medical history of aspirin/clopidogrel and major papilla at the diverticulum may increase the risks for upper gastrointestinal bleeding in ERCP in patients with choledocholithiasis.However,the hemorrhage should be actively managed,especially in endoscopy,once the bleeding occurs.

Objective To investigate the risk factors of standard selectivity biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) for patints with choledocholithiasis,and the effect and safety of assistant cannulation methods.Methods The clinical data were retrospectively analyzed in 372 patients,who received ERCP for choledocholithiasis in the Yijishan Hospital of Wannan Medical College from January 2014 to December 2014.The risk factors of standard biliary cannulation were assessed by univariate and multivariate logistic regression analysis.The success rate of assistant biliary cannulation and the incidence of post-ERCP pancreatitis (PEP) of standard biliary cannulation were compared with doubleguide wire technique (DGT) and precut sphincterotomy (PS),which were used when standard biliary cannulation failed.Results The univariate analysis showed that floppy and long duodenal papilla (P=0.000),angulated common bile duct(P=0.013) were related to failure of standard biliary cannulation.Multivariate analysis showed that floppy and long papilla (P=0.000,OR=0.131,95％CI:0.056-0.307),angulated common bile duct (P =0.003,OR =0.378,95 ％ CI:0.197-0.726) were independent risk factors for standard biliary cannulation.The success rate of standard biliary cannulation was 83.3％ (310/372),62 cases undergone DGT or PS after standard biliary cannulation failure,and the total success rate of cannulation was 99.7％ (371/372).There were 29 cases suffered from PEP in 371 successful cases of biliary cannulation,including 18 cases (5.8％,18/310) of standard biliary cannulation,8 cases (16.3％,8/49) of DGT,and 3 cases (25.0％,3/12) of PS.The incidence of PEP by DGT (x2 =5.532,P =0.019) and PS (x2 =6.994,P=0.008) was significantly higher than that of standard biliary cannulation,but there was no statistical difference on the incidence of PEP between DGT and PS (x2 =0.079,P =0.778).Conclusion Floppy and long duodenal papilla and angulated common bile duct could easily induce the failure of standard biliary cannulation in ERCP for patients with choledocholithiasis.DGT and PS are effective assistant cannulation methods when the standard cannulation fails.

OBJECTIVETo study the clinic presentation, radiology, pathology of recurrent ameloblastoma (RAB).

METHODSAll RAB cases accepted treatment in School of Stomatology of Nanjing University during 1996.1-2008.3 were retrospected. The clinic presentation, the radiological classification and pathological classification were summarized and analyzed.

RESULTSThere were 23 RAB patients during 1996.1-2008.3. 3 patients recurred twice, 20 patients recurred once, and 26 cases were found together. 19 patients were performed conservative surgery while 4 patients were performed radical surgery in the primary treatment; 4 patients were performed conservative surgery and 19 patients were performed radical surgery in the recurrence. The radiological classification included 12 cases multicystic, 6 cases unicystic, and 8 cases extraosseous. The pathological classification included 21 cases follicular ameloblastoma, and 5 cases plexiform ameloblastoma. The multicystic after conservative surgery (11 cases) and extraosseous ameloblastoma after radical treatment (8 cases) were more than others according the radiological classification and treatment.

CONCLUSIONConservative surgery has apparent higher recurrences rate than radical surgery. The follicular ameloblastoma has more aggressive biological behave and is more liable to recurred.

Nannochloropsis has been considered as a promising feedstock for biodiesel production in recent years. To improve its lipid productivity, heavy-ion irradiation mutagenesis, an effectively breeding method used in plants and microorganisms was applied in Nannochloropsis oceanica OZ-1. After large-scale screening using Imaging-PAM and microplate-reader, two mutants (HP-1 and HP-2) with higher growth rate were isolated from the wild type N. oceanica. Subsequently analysis showed that after 18 days of cultivation biomass accumulation of the HP-1 and HP-2 mutant was increased by 18% and 26% respectively compare to the wild type. Total lipid productivity of the HP-1 and HP-2 mutant was 295 mg/(L x d) and 275 mg/(L x d), respectively, whereas that of the wild type was 247 mg/(L x d). Both mutants showed significantly advantage over their wild type concerning biomass accumulation and lipid productivity.
Heavy Ions ; Lipids ; biosynthesis ; Microalgae ; growth & development ; metabolism ; radiation effects ; Mutagenesis ; genetics ; Mutation ; genetics ; Stramenopiles ; genetics ; metabolism ; radiation effects

We studied the effect of surfactin on cell proliferation, apoptosis and the cytoskeleton in human breast cancer cell line MCF-7 in vitro. The result of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) showed that the surfactin inhibited proliferation of MCF-7 cells in a dose- and time-dependent manner, with IC50 at 48 h of 27.3 micromol/L. Surfactin-induced cell death was considered to be apoptotic by observing the typical apoptotic morphological changes by AO/EB staining. Flow cytometric analysis also demonstrated that surfactin caused time-dependent apoptosis of MCF-7 cells through cell arrest at G2/M phase. Immunofluorescence and Western blotting showed that surfactin significantly suppressed the expression of vimentin, induced the alpha-tubulin depolymerization and rearrangement and then the skeleton system of the cells changed dramatically. Based on our findings, surfactin can significantly inhibit the growth of MCF-7 cells and induce apoptosis.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Breast Neoplasms ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cytoskeleton ; drug effects ; Female ; Humans ; Lipopeptides ; pharmacology ; Peptides, Cyclic ; pharmacology

Objective? To explore the value of individualized health education in early rehabilitation therapy after surgery in patients with intracranial tumor and its effects on patients＇ limb function recovery. Methods? Totally 88 patients with intracranial tumor treated in the First Affiliated Hospital of Hainan Medical University from June 2015 to November 2017 were selected by cross-sectional sampling and divided into the treatment group (n=44) and the control group (n=44) according to the random number table. All the patients received surgery. Patients in the control group received conventional nursing intervention, while patients in the treatment group received individualized health education. Short Form 36 Questionnaire (SF-36) and Simplified Fugl-Meyer Assessment of Motor Recovery (SFMA) were used to evaluate the quality of life and limb function recovery of the two groups after nursing care. Results? The quality of life score of the treatment group was (90.47±5.67), better than that of the control group, which was (79.84±4.77), and there was statistically significant difference between the two groups (P＜0.05) after nursing care. The limb function score of the treatment group was (89.68±5.77), better than that of the control group, which was (80.10±4.02), and there was statistically significant difference between the two groups (P＜ 0.05) after nursing care. Conclusions? Individualized health education provided as early as possible for patients with intracranial tumor is of great significance in improving patients＇ quality of life and limb function recovery, which is worth promoting in clinical practice.

WRKY transcription factors, one of the largest families of transcriptional regulators in plants, involve in multiple life activities including plant growth and development as well as stress responses. However, little is known about the types and functions of WRKY transcription factors in Catharanthus roseus, an important medicinal plant. In this study, we identified 47 CrWRKY transcriptional factors from 26 009 proteins in Catharanthus roseus, and classified them into three distinct groups (G1, G2 and G3) according to the structure of WRKY domain and evolution of the protein family. The expression profiling showed that these CrWRKY genes expressed in a tissue/organ specific manner. The 47 CrWRKY genes were clustered into three types of expression patterns. The first type includes the CrWRKYs highly expressed in flowers and the protoplast treated with methy jasmonate (MeJA) or yeast extraction (YE). The second type contains the CrWRKYs highly expressed in stem and hairy root. The third type represents the CrWRKYs highly expressed in root, stem, leaf, seedling and the hairy root treated by MeJA. Real time quantitative PCR was employed to further identify the expression patterns of the 16 selected CrWRKY genes in various organs, the MeJA-treated protoplasts and hairy roots of Catharanthus roseus, and similar results were obtained. Notably, the expresion of more than 1/3 CrWRKY genes were regulated by MeJA or YE, indicating that these CrWRKYs are likely involed in the signalling webs which modulate the biosynthesis of terpenoid indole alkaloid and plant responses to various stresses. The present results provide a framework for functional identification of the CrWRKYs and understanding of the regulation network of terpenoid indole alkaloid biosynthesis in Catharanthus roseus.
Amino Acid Sequence ; Catharanthus ; genetics ; metabolism ; Gene Expression Regulation, Plant ; Genes, Plant ; Molecular Sequence Data ; Plant Proteins ; biosynthesis ; genetics ; Plants, Medicinal ; genetics ; metabolism ; Transcription Factors ; biosynthesis ; genetics

Objective The bispectral index (BIS) was introduced into the sedation strategy of critical patients in intensive care unit (ICU) and replaced the Richmond agitation sedation scale (RASS).The ventilation time,ICU length of stay,and 90-day mortality were compared between the two groups of patients who performed early goal-directed sedation (EGDS) or standard traditional directed sedation (STDS) strategies.Methods A prospective controlled study of severe patients with mechanical ventilation ≥48 h in ICU (20 cases from April 2016 to May 2017,46 cases from June 2017 to April 2018) were randomly divided into EGDS or STDS group.There were no significant differences in age,gender,and acute physiology and chronic health evaluation score Ⅱ (APACHE Ⅱ) score between the two groups in the two periods.The correlation between RASS and BIS was analyzed in the first period.The BIS of the patients in a RASS range of (-2-1) was 73.65 ± 7.87 in the EGDS group,and that of RASS range of (-3--1) was 64.14 ± 7.25 in the STDS group.The above BIS was applied to the two sedation strategies in the second period respectively.The ventilation time,ICU length of stay,and 90-day mortality were recorded.Results There was no significant difference in the ventilation time between the two groups [(164.12 ± 137.96) h and (155.33 ±64.86)h,P =0.08].ICU length of stay of the EGDS group was longer than that of the STDS group.The 90-day mortality of the EGDS group was higher than that of the STDS group.Conclusions Correlations between RASS and BIS were found in this study,and BIS can be used for sedation assessment in ICU patients.Large sample study is still needed to compare EGDS and STDS with BIS.

Palmitoleic acid (16:1delta9), an unusual monounsaturated fatty acid, is highly valued for human nutrition, medication and industry. Plant oils containing large amounts of palmitoleic acid are the ideal resource for biodiesel production. To increase accumulation of palmitoleic acid in plant tissues, we used a yeast (Saccharomyees cerevisiae) acyl-CoA-delta9 desaturase (Scdelta9D) for cytosol- and plastid-targeting expression in tobacco (Nicotiana tabacum L.). By doing this, we also studied the effects of the subcellular-targeted expression of this enzyme on lipid synthesis and metabolism in plant system. Compared to the wild type and vector control plants, the contents of monounsaturated palmitoleic (16:1delta9) and cis-vaccenic (18:1delta11) were significantly enhanced in the Scdelta9D-transgenic leaves whereas the levels of saturated palmitic acid (16:0) and polyunsaturated linoleic (18:2) and linolenic (18:3) acids were reduced in the transgenics. Notably, the contents of 16:1delta9 and 18:1delta11 in the Scdelta9D plastidal-expressed leaves were 2.7 and 1.9 folds of that in the cytosolic-expressed tissues. Statistical analysis appeared a negative correlation coefficient between 16:0 and 16:1delta9 levels. Our data indicate that yeast cytosolic acyl-CoA-delta9 desaturase can convert palmitic (16:0) into palmitoleic acid (16:1delta9) in high plant cells. Moreover, this effect of the enzyme is stronger with the plastid-targeted expression than the cytosol-target expression. The present study developed a new strategy for high accumulation of omega-7 fatty acids (16:1delta9 andl8:1delta11) in plant tissues by protein engineering of acyl-CoA-delta9 desaturase. The findings would particularly benefit the metabolic assembly of the lipid biosynthesis pathway in the large-biomass vegetative organs such as tobacco leaves for the production of high-quality biodiesel.
Fatty Acid Desaturases ; genetics ; metabolism ; Fatty Acids, Monounsaturated ; metabolism ; Plants, Genetically Modified ; Recombinant Proteins ; genetics ; metabolism ; Saccharomyces cerevisiae ; enzymology ; Saccharomyces cerevisiae Proteins ; genetics ; metabolism ; Tobacco ; genetics ; metabolism

Objective:To analyze the correlation between related indexes of serum lipid and insulin resistance and cognitive impairment in middle-aged and elderly people with mild cognitive impairment (MCI).Methods:In this cross-sectional study, 262 middle-aged and elderly patients with a Montreal Cognitive Function Scale (MoCA) cognitive score greater than or equal to 18 points who underwent physical examination in the Health Management Center of Beijing Tiantan Hospital Affiliated to Capital Medical University from January 1 to July 31, 2021 were selected as subjects. According to the cognitive function and MoCA score, the patients were divided into MCI group (143 cases) and normal cognition group (119 cases). Basic data, fasting blood glucose, triglyceride (TG), total cholesterol, apolipoprotein E(ApoE) genotype and other clinical indicators were collected. Hypothesis test was used to compare the differences in basic data, related indicators of blood lipid and insulin resistance between the two groups. Spearman correlation analysis was used to analyze the correlation between related indicators of blood lipid and insulin resistance and MoCA score in the two groups.Results:The age and the proportion of patients with hypertension, coronary heart disease and diabetes in the MCI group were all significantly higher than those in normal cognition group [(54.83±8.29) vs (50.76±6.34) years, 37.76% vs 31.93%, 4.20% vs 0.84%, 16.08% vs 8.40%] (all P<0.05). The elevation of serum TG ( r=-0.50, 95% CI:-0.88--0.12), TG glucose product index (TyG) ( r=-0.75, 95% CI:-1.29--0.20) and TG to high-density lipoprotein cholesterol ratio (TG/HDL-C) ( r=-0.52, 95% CI:-0.91--0.13) were all negatively correlated with MoCA score (all P<0.05). After adjusting for age and gender, the elevation of TG ( r=-0.39, 95% CI:-0.75--0.31) and TG/HDL-C ( r=-0.43, 95% CI:-0.80--0.05) were both still negatively correlated with MoCA score (both P<0.05). There was no significant correlation between all indexes and MoCA scores in the normal cognition group (all P>0.05). The elevated TG was negatively correlated with MoCA score in the MCI group ( r=-0.70, 95% CI:-1.23-0.16, P=0.017). There was no significant correlation between elevated TG and MoCA score in patients carrying ApoE ε2 and ApoE ε3 genotypes in MCI group (all P>0.05). Conclusion:Elevated related indexes of blood lipids and insulin resistance are negatively correlated with cognitive scores in middle-aged and elderly people with MCI, and it′s more obvious in patients with ApoE ε4 genotype.