Objective To investigate the eftect of radiation dose of dual-source computed tomography (CT) dual energy single-phase enhanced scan in patients with esophageal cancer.Methods The prospective study was conducted.The clinicopathological data of 56 patients with esophageal cancer who were admitted to the Lishui Hospital of Zhejiang University between January 2015 and December 2016 were collected.All the patients were divided into the experimental group (undergoing dual-source CT dual energy single-phase enhanced scan) and control group (undergoing dual-phase CT enhanced scan) bv randomised block method.TNM classification of esophageal cancer (Seventh Edition) published by American Joint Committee on Cancer (AJCC) was used as a standard TNM staging.Two observers independently read films.All the patients underwent radical resection of esophageal cancer or palliative surgery,and then received adjuvant radiochemotherapy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to March 2017.Observation indicators:(1) consistencies of T staging,N staging and M staging;(2) accuracies of T staging,N staging and M staging (pathological results as a gold standard);(3) radiation dose of CT scan;(4) treatment and follow-up situations.The Kappa test was used for evaluating the consistency,κ≥0.75 as a good consistency,0.40≤κ＜0.75 as a normal consistency and κ＜0.40 as a poor consistency.Comparisons of count data and ratio were done by the chi-square test.Comparisons of measurement data were analyzed by the t test.Results A total of 50 patients were enrolled in the study,including 25 in the experimental group and 25 in the control group.(1) Consistencies of T staging,N staging and M staging:all the 50 patients finished successfully CT scans.Two observers considered that consistencies of T staging,N staging and M staging in the 2 groups were normal (κ =0.452,0.618,0.729,P＜0.05).Consistencies of N staging and M staging were superior to T staging.(2) The pathological results were used as a gold standard.Accuracies of T staging,N staging and M staging in the experimental and control groups were 72％,76％ and 88％,84％ and 92％,88％,respectively,with no statistically significant difference between the 2 groups (x2 =0.10,0.37,0.50,P＞0.05).(3) Radiation dose of CT scan:volume CT dose index (CTDIvol),dose length production (DLP) and effective radiation dose (E) were (10.35±2.01) mGy,(400.63± 34.13) mGy · cm,(5.61 ± 0.47) mSv in the experimental group and (3.55 ± 0.60)mGy,(140.66± 10.89) mGy · cm,(1.98±0.17) mSv in the control group,respectively.There were statistically significant differences in CTDIvol and E between the 2 groups (t =16.23,36.30,P＜0.05).(4) Treatment and follow-up situations:of 50 patients,43 patients received treatments,including 32 undergoing radical resection (11 receiving postoperative adjuvant chemotherapy),6 undergoing palliative surgery,3 receiving single radiotherapy and 2 receiving single chemotherapy.Thirty-six of 43 patients were followed up for 3-18 months,with a median time of 6 months.During follow-up,1-year survival rate was 61.1％.Conclusion Dual-source CT dual energy single-phase enhanced scan in patients with esophageal cancer cannot reduce accuracy of TNM staging,but decreased effectively radiation dose.

Objective:To assess the anatomy of superficial circumflex iliac artery perforator (SCIP) and its feasibility for tongue re-construction after tumor resection. Methods:From January 2014 to January 2015, a total of 15 patients with oral maxillofacial defects underwent SCIP flap surgery. Perforator identification and SCIA course were performed intra-operatively. The relationships among the SCIA, deep circumflex iliac artery (DCIA), and superficial inferior epigastric artery (SIEA) were determined intra-operatively. Surgical procedures, measurement of vessel's caliber and pedicle's length, SCIP flap anatomy, and their outcomes were described. Results:Flap mean thickness was approximately 1.2±0.3 cm. The mean diameter of the SCIA was 0.7±0.2 cm, and that of the superficial circumflex iliac vein was 1.2±0.2 cm. The relationships among SCIA, DCIA, and SIEA were described and subdivided into typeⅠ(8/15), typeⅡ(2/15), typeⅢ(2/15), typeⅣ(2/15), and typeⅤ(1/15) in intra-operative dissection. The flap sizes were in the range from 6 cm × 4.5 cm to 11 cm × 10 cm. A total of 14 SCIP flaps survived, and 1 SCIP flap underwent necrosis. Conclusion:The SCIP flap is a reliable, thin, and pliable flap with long vascular pedicles and hidden donor site morbidity. Its texture is a perfect match for tongue defect reconstruc-tion.

BACKGROUNDTo study the effect of gene amplification and selection system with DHFR plus GS and DHFR or GS gene on the foreign gene expression.

METHODSUsing the N-terminal truncated hTPO(T184) gene as target gene, two plasmidsre were constructed: pDC- T184 and pGC-T184 where DHFR and GS gene were used respectively as the selective amplification marker. They were cotransfected into CHO dhfr cells to establish dual gene amplification and selection system of DHFR plus GS gen and respectively transfected to establish single gene amplification and selection system of DHFR or GS gene. Three selective methods in dual selective system to compare expression efficiency of hTPO were designed: the first method (DG) was to use drug pressure of MTX, then use MSX; the second method (GD) was reversed; the third method was simultaneously to use MTX and MSX as drug pressure.

RESULTSDHFR+GS dual system had not only higher gene amplification efficiency but also higher level expression. There was no distinct affect in different method of drug pressure.

CONCLUSIONSMTX plus MSX dual drug pressure in dual selection system was an efficient and simple method to increase the expression of foreign gene in mammalian cells.

Animals ; CHO Cells ; Cricetinae ; Gene Amplification ; drug effects ; Gene Expression ; Glutamate-Ammonia Ligase ; genetics ; Methotrexate ; pharmacology ; Plasmids ; genetics ; Tetrahydrofolate Dehydrogenase ; genetics

Nine mutants (P2M1-9) were obtained using PCR with 5-BU based on DNA template (P2Y) encoding the active region of Parasporin-2. Mutant proteins were purified after expressing in E. coli BL21 cells, followed by assayed against hepatoma cells and normal liver cells by MTT. They showed diverse anti-hepatoma activities, in which two mutant proteins, P2M1 and P2M8, exhibited high cytotoxicity against hepatoma cell lines SMMC7721 and Be17402, meanwhile leaving normal liver cells Chang-liver unaffected. Structural comparison among P2Y, P2M1 and P2M8 showed that the length of beta-sheet or beta-fold, and the amount of alpha helix greatly affected the anti-hepatoma activity of Parasporin-2. Results based on amino acid alignment, molecular docking between P2Y, P2M1 or P2M8 and receptor, and mimic mutation demonstrated that amino acid residues at the sites of 52, 56, 58 and 208 on P2Y, especially the aromatic amino acids such as Trp, Phe, and Tyr were involved in the interactions.
Amino Acid Sequence ; Amino Acids, Aromatic ; biosynthesis ; genetics ; pharmacology ; Antineoplastic Agents ; pharmacology ; Carcinoma, Hepatocellular ; pathology ; Cell Line, Tumor ; Endotoxins ; chemistry ; pharmacology ; Escherichia coli ; genetics ; metabolism ; Humans ; Liver Neoplasms ; pathology ; Molecular Sequence Data ; Mutant Proteins ; pharmacology ; Recombinant Proteins ; biosynthesis ; genetics ; pharmacology

Objective:To explore the effect of diclofenac sodium suppository combined with tramadol sustained-release tablets on postoperative pain relief and recovery in patients with mixed hemorrhoids.Methods:Sixty patients with mixed hemorrhoids who underwent external dissection and internal ligation at the Shenzhen Traditional Chinese Medicine Proctology Hospital from September to October 2023 were selected and randomly divided into A group and AS group using a random number table method, with 30 patients in each group. The group A patients received oral tramadol sustained-release tablets 4 hours after surgery, while the group AS received diclofenac sodium suppositories for anal canal therapy in addition to the group A. Two groups were compared for postoperative pain [Visual Analog Scale (VAS)] and patient comfort [Numerical Rating Scale (NRS)], cumulative tramadol consumption, supplementary rescue pethidine needs, and adverse reactions at 4, 8, 24, and 48 hours.Resultsl:The VAS of the AS group were lower than those of the A group at 4, 8, 24, and 48 hours after surgery. The NRS scores of the group A patients at 4, 8, and 24 hours were significantly better than those of the group AS. The cumulative consumption of tramadol in the AS group at 4, 8, 24, and 48 hours after surgery was significantly lower than that in the A group; The demand rate for postoperative rescue of pethidine in the group A was significantly higher than that in the group AS. The incidence of nausea in the group A was significantly higher than that in the group AS.Conclusions:The combination of postoperative diclofenac sodium suppositories and oral tramadol sustained-release tablets for mixed hemorrhoid surgery has a significant improvement effect on pain. It can reduce the dosage of tramadol, reduce the need for rescue and supplementary analgesia, and have fewer adverse reactions.

Objective To explore the prevalence of mild cognitive impairment (MCI) among elderly veterans. Methods 2 674 veterans ( aged 60 years and over) from 26 military sanatorium in Shijiazhuang city were studied. The Mini-Mental State Examination, Global Deterioration Scale, Activity of Daily Living, Hachinski Ischemic Scale and Hamilton Depression Scale were served as screening tools. Results The prevalence of total MCI was 8 08% in elderly people. The standardized prevalence of MCI was 6 87% in male and 10 38% in female (P

Objective:To evaluate the effect of driving pressure-guided individualized positive end-expiratory pressure (PEEP) titration on atelectasis in elderly patients undergoing robot-assisted radical prostatectomy.Methods:Fifty elderly patients, aged 65-80 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index of 19-28 kg/m 2, undergoing elective robot-assisted radical prostatectomy under general anesthesia, were divided into 2 groups ( n=25 each) according to the random number table method: traditional lung-protective ventilation group (group C) and driving pressure-guided individualized PEEP group (group D). The method for setting PEEP was as follows: PEEP 5 cmH 2O was used throughout operation in group C. In group D, the optimal PEEP was titrated after intubation and mechanical ventilation and Trendelenburg position-pneumoperitoneum construction, the initial value was the lowest PEEP allowed by the anesthesia machine, the PEEP was increased by 1 cmH 2O (PEEP≤12 cmH 2O) every 4 min, the plateau pressure and PEEP were simultaneously recorded to calculate the driving pressure, and the corresponding PEEP was considered as the optimal PEEP for the individual when the driving pressure reached the minimum.Ultrasound examination was performed after catheterization of radial artery (T 0), after anesthesia induction (T 1), 4 min after developing optimal PEEP ventilation (T 2, 4 min after developing ventilation in group C), after restoration of body position (T 3), before extubation (T 4), and at 2 h after admission to postanesthesia care unit (T 5). Atelectatic aeration loss scores were recorded at T 0, T 1, T 4 and T 5.Bilateral optic nerve sheath diameter was measured at T 0-4.Arterial blood gas analysis was performed at T 0, T 2, T 3 and T 5, PaO 2 and PaCO 2 were recorded, and oxygenation index was calculated.The postoperative pulmonary complications within 3 days after operation were recorded. Results:Compared with group C, atelectasis aeration loss scores at T 4, 5 and PaCO 2 at T 2, 3 were significantly decreased, and PaO 2 and oxygenation index were increased at T 2, 3, 5 in group D ( P<0.05). There were no significant differences in the bilateral optic nerve sheath diameter and incidence of postoperative pulmonary complications between the two groups ( P>0.05). Conclusion:Driving pressure-guided individualized PEEP can increase intraoperative oxygenation and decrease the development of atelectasis in elderly patients undergoing robot-assisted radical prostatectomy.

Objective To investigate the prognostic factors of renal cell carcinoma and to establish a prognostic model for patients with non-metastasis renal cell carcinoma (RCC) after operation.Methods We retrospectively reviewed the clinical data of patients with RCC who underwent radical or partial nephrectomy from January 2008 to December 2012,including 392 males (67.6％) and 188 females (32.4％),with an average age of 56 years(range 24-86 years).The average diameter of tumor was 4.8 cm (range 1.5-17.5 cm).The pathological slides of tumor tissue were reviewed by pathologist,and the tissue microarray (TMA) were constructed.The immunohistochemical staining of TMA were carried out.All patients were followed up the prognosis information of the overall survival (OS),cancer specific survival (CSS) and progression free survival (PFS).Based on these data,univariate and multivariate analysis and survival analysis were performed.Independent prognostic factors related to different follow-up endpoints of patients were screened out.A Nomogram prognostic model for RCC was established and verified.Internal validation were performed by boots value analysis.Results Among 580 cases,160 cases (27.6％) accepted nephron sparing surgery and 420 cases (72.4％) radical nephrectomy,included 514 cases (88.6％) of laparoscopic surgery and 66 cases (11.4％) of open surgery.There were 468 cases of clear cell carcinoma (80.7％),56 cases of papillary carcinoma (9.7％),32 cases of chromophobe cell carcinoma (5.5％),24 patients with other subtypes of cancer cells (4.1％).In pathological staging,stage Ⅰ,Ⅱ,Ⅲ,Ⅳ were 442 cases (76.2％),88 cases (15.2％),48 cases (8.3％),2 cases (0.3％),respectively.There were 424 cases (73.1％) with high expression of CA9,and 156 cases (26.9％) with low expression.The median followup was 66 (4-82) months,and 41 cases (7.1％) were lost of follow-up.For 3 and 5 years,OS,CSS and PFS were 83.4％,88.2％,72.4％ and 69.6％,73.0％,55.8％ respectively.Multivariate analysis showed that tumor pathological subtypes,tumor stage,tumor diameter and positive expression of carbonic anhydrase 9 (CA9) were independent prognostic factors associated with the survival of RCC patients.The Nomogram prognostic model was established by the above four factors.The established Nomogram prognostic model for RCC patients was verified by Harrell's consistency index,and the c-index of OS,CSS and PFS of RCC patients were 0.72 (95％ CI 0.69-0.75),0.77 (95％ CI 0.74-0.81),0.79 (95％ CI 0.76-0.83),respectively.Conclusions Tumor pathological subtypes,staging,tumor diameter and CA9 are independent risk factors for patients with non metastatic renal cell carcinoma.The established Nomogram prognostic model certified by internal validation should be tested by large samples and multicenter studies need tested.

Objective: To investigate the prospective effects of the consumption of protein and animal foods before menarche on the age at menarche among Chinese girls. Methods: This paper was based on the data collected in the China Health and Nutrition Survey(CHNS) from 1997 to 2015. A total of 683 girls aged 6 and over who had completed information on age at menarche, height, weight, per capita annual household income, maternal education level and participated in at least one complete dietary survey within 1 to 4 years before menarche were included. Urban-rural stratified multivariable linear regression model was used to examine the effects of protein and animal foods intake before menarche on Chinese girls age at menarche in urban and rural areas. Results: After adjusted for total energy intake, body mass index standard deviation score and per capita annual household income, the consumption of meat before menarche was negatively associated with the age at menarche among rural Chinese girls(B=-0.003, P=0.00), but not among urban Chinese girls(B=0.002, P>0.05). Total protein, dairy, eggs and aquatic products intake before menarche were not associated with Chinese girls age at menarche in urban and rural areas(B=0.002, -0.001, 0.003, 0.000; 0.001, 0.001, -0.001, -0.003, P>0.05). Conclusion Higher intake of meat before menarche might lead to earlier menarche onset in rural Chinese girls. The consumption of total protein, dairy, eggs, and aquatic products before menarche did not affect the age at menarche in Chinese girls.

Objective: To explore the differences in the gut microbiota of primary school students with different levels of sugar sweetened beverage intake, so as to provide scientific evidence for better identification of health risks in children and the development of targeted health policies. Methods: In June 2022, a total of 192 healthy primary school students from Chengdu were selected using a stratified cluster random sampling method. The sugar sweetened beverage intake was assessed through a dietary frequency questionnaire. Based on the median daily sugar sweetened beverage intake, primary school students were categorized into a low intake group ( n =96) and a high intake group ( n =96). The gut microbiota in fresh fecal samples from the two groups of primary school students was analyzed using 16S rRNA high throughput sequencing, and the diversity and community structure differences in the gut microbiota were compared. Results: Children in the low intake group had a sugar sweetened beverage intake of (21.3±1.6) mL/d, while the high intake group had an intake of (269.6±37.3) mL/d. Diversity analysis results showed that there were no statistically significant differences between the low intake and the high intake group in terms of α diversity metrics: Observed_otus index [298.50 (259.75, 342.25), 305.50 (244.25, 367.75)], Goods_coverage index [1.00 (1.00, 1.00), 1.00 (1.00, 1.00)], Chao index [304.18 (260.75, 348.78), 305.88 (245.68, 370.88)], Shannon index [5.88 (5.29, 6.45), 5.71 (4.89, 6.28)] and Simpson index [0.95 (0.91, 0.97), 0.94 (0.88, 0.97)] ( Z =-0.64, -0.76, -0.54, -1.76, -1.67, P >0.05). Furthermore, no statistically significant difference was observed in β diversity between the two groups ( R 2=0.006, P >0.05). At the genus level, the abundance of Blautia [0.033 (0.018, 0.055)] and Fusicatenibacter [0.009 (0.005, 0.015)] were higher in the low intake group compared to the high intake group [0.024 (0.013, 0.041),0.006 (0.003, 0.011)]and differences were statistically significant ( Z =-2.52, -2.81, P <0.05). LEfSe analysis highlighted intergroup differences primarily in Blautia, Fusicatenibacter and Sarcina( LDA= 3.56,3.12,3.53, P <0.05). Conclusions There is no significant difference in the diversity and overall structure of the gut microbiota in primary school students with different levels of sugar sweetened beverage intake. However, there are species variations at the genus level. The information can serve as a scientific basis for identifying health risks in primary school students and formulating targeted health strategies.