Objective To investigate clinical efficacy of transforaminal approach debridement with fusion,thoracolumbar single segment of Brucella spondylitis pedicle screw fixation (TLIF surgery).Methods We analyzed retrospectively the clinical data of 28 patients with Brucella spondylitis treated in our department between January 2009 and January 2014 with TLIF surgery (Group A) and internal fixation with a simple posterior anterior interbody disease debridement,autogenous bone graft (Group B).The two groups were compared in operation time,blood loss,postoperative ambulation time,hospitalization days,erythrocyte sedimentation rate (ESR),Creactive protein (CRP),American Spinal Injury Association (ASIA) classification,visual analogue scale (VAS),Oswestry Disability Index (ODI),Cobb angle of vertebral bone graft healing,and complications.Results All the patients were followed up for an average of 20.2 months (18 to 27 months).They were all cured.Compared with those in Group B,patients in Group A had shorter operation time (164.60±59.19)min,significantly reduced blood loss (346.00±108.90)mL and complications (1 case);significantly shorter postoperative ambulation time (3.36±1.11 days),hospitalization days (17.36 ± 4.19) days and duration (13.16 ± 3.94) months (P ＜ 0.05).The two groups did not significantly differ in VAS scores,ODI,ESR CRP,or Cobb angle (P＞0.05).Conclusion On the basis of norms of anti-drug treatment for brucellosis,TLIF surgery on Brucella spondylitis has the advantages including less trauma,shorter operation time,easier operation,less bleeding,earlier postoperative ambulation,and lower complication rate.

Objective: To analyze the clinical pathologic characteristics of cases with fluorescence in situ hybridization (FISH) positive of exfoliated urothelial cells, so as to evaluate the clinical utility of FISH in the diagnosis of urothelial carcinoma (UC).Methods: A total of 271 cases of FISH positive in Department of Urology of Peking University First Hospital from Apr.2012 to Sep.2015 were recruited in this study.Retrospective analysis was made on their clinical data.For FISH analysis, labeled probes specific for chromosomes 3, 7, 17, and the p16 (9p21) gene were used to assess chromosomal abnormalities indicative of malignancy.The positive predict values (PPV) of all the techniques were analyzed.Results: Of the 271 patients, 207 cases were UC, 7 cases were non-UC, and 57 cases were benign diseases.The PPV of FISH in detecting UC was 76.4%, while the 95% confidence interval (CI) 71.3% to 81.5%.In the cohort of FISH positive, this value was similar to that of urinary cytology (PPV 86.8%, 95% CI: 78.5%-95.0%).The PPV of FISH was lower than that of cystoscopy and ureteroscopy (PPV 96.1%, 95% CI: 91.7%-100.0%).There were significant differences between this study and the PPV of FISH reported abroad (PPV 53.9%, χ2=33.048, P<0.001).Of all the UC with FISH positive, bladder cancer showed an earlier pathological stage versus renal pelvic carcinoma and ureteral carcinoma, with significance (χ2=5.894, P=0.015, and χ2=13.601, P<0.001, respectively).However, no difference was found in the size, pathological stage and pathological grade of tumors between the urinary cytology positive group and the urinary cytology negative group.The rate of high-grade UC in ureteral carcinoma of FISH positive was 92.3%, much higher than that of ureteral carcinoma reported domestically.Conclusion: The PPV of FISH in detecting UC is higher relatively, with a better clinic value for Chinese patients.The ureteral carcinoma with FISH positive obtains a higher pathological grade, which is of great guiding significance for UC.

Objective To investigate the complications of CT-guided percutaneous lung biopsy(CT-PTNB)and its correlation with improper operation.Methods The clinical data of 360 patients who underwent lung tumor needle biopsy were collected.The complications occurred in the process of needle biopsy and their correlation with improper operation were summarized,and the experience was further summarized to increase the success rate of needle biopsy and reduce the occurrence of complications.Results Biopsy tissue was successfully obtained in all 360 patients.There were 84 cases with complications after puncture,including 67 cases with pneumothorax,59 cases with hemorrhage(5 cases with hemoptysis,59 cases with needle tract hemorrhage with pulmonary hemorrhage,6 cases with intrathoracic hemorrhage),9 cases with subcutaneous emphysema of chest wall,and 3 cases with chest wall puncture point pain,and all patients did not undergo surgical treatment.All patients recovered from symptomatic treatment such as bed rest,hemostasis,anti-inflammatory and oxygen inhalation.Only 6 patients with pneumothorax had increased volume of pneumothorax after operation and underwent closed thoracic drainage,and all of them were decannulated successfully.No air embolism and other rare complications occurred.Conclusion The appropriate puncture path should be selected according to the different conditions of the patient.At the same time,the anatomy of the chest wall and lung should be familiar with,and pay attention to all the details of the needle biopsy process to reduce the occurrence of errors.

Dehydroascorbate reductase (DHAR) plays an important role in the recycling of ascorbic acid. In this work, we isolated the full length cDNA clones of two different DHAR genes (tentatively named as TaDHAR1 and TaDHAR2, respectively) from common wheat. Semi-quantitative PCR experiments showed that TaDHAR1 and TaDHAR2 were transcribed in many vegetative and reproductive organs examined in this work. Transient expression analysis using wheat protoplasts indicated that the protein products of TaDHAR1 and TaDHAR2 may be located in the cytoplasm. The cDNAs of TaDHAR1 and TaDHAR2 were expressed in the bacterial cells, and resultant histidine tagged recombinant proteins could be efficiently purified using nickel chelate affinity chromatography. In vitro enzyme activity assays revealed that the recombinant TaDHAR1 and TaDHAR2 proteins could all convert dehydroascorbate (DHA) to AsA. The two proteins exhibited higher activity levels at 37 degrees C than at 25 degrees C. Under the two temperature conditions, the optimal pH for TaDHAR1 and TaDHAR2 was both around 7.5. The major difference between TaDHAR1 and TaDHAR2 is the activity under pH 6.0 and 7.0 at 25 degrees C. The results and resources obtained in this study may be useful for further research into the physiological role of TaDHAR genes in AsA metabolism in crop plants under normal or stressed conditions.
Amino Acid Sequence ; Cloning, Molecular ; Genes, Plant ; genetics ; Molecular Sequence Data ; Oxidoreductases ; genetics ; metabolism ; Plant Proteins ; genetics ; metabolism ; Recombinant Proteins ; genetics ; metabolism ; Triticum ; enzymology ; genetics

Intrahepatic cholangiocarcinoma(ICC) is a malignant tumor that originates in the epithelium of the proximal proximal to the second-degree bile ducts and has a high degree of malignancy. The causes of ICC are widely geographically diverse. Pathogenesis of ICC involves multiple molecular alterations at the level of genome, epigenome and stromal environment resulting in several deregulated signal transduction pathways. There are three types of pathological classification: mass-forming, periductal infiltrating, and intraductal growth. The mixed type of mass-forming + periductal infiltrating has the highest degree of malignancy. Early diagnosis of ICC is not easy, and tumor biomarkers such as CA19-9, CEA and so on, have some reference values, and multiple imaging examinations are needed to confirm each other. The effect of surgery mainly depends on the characteristics of the tumor, the vascular invasion of the tumor, the resection margin of the tumor and lymphatic metastasis. Lymph node dissection is controversial. If local lymphatic metastasis is identified, standardized lymph node dissection can improve ICC prognosis. Some ICC patients benefit from laparoscopic staging. In experienced centers, minimally invasive treatment can provide oncological outcomes similar to open resection for specific ICC patients. Liver transplantation is feasible in early ICC patients, but further clinical validation is needed.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).