Objective To explore the value of protective lung ventilation mode in patients undergoing single lung ventilation in thoracic surgery operation.Methods 59 patients undergoing surgical treatment in Ankang Central Hospital from January 2012 to January 2015 were analyzed.According to the ventilation mode adopted in the operation,the patients were divided into the protective group (30 cases) and conventional group (29 cases).The protective group took tidal volume 8 ml/kg.According to the patient's circulatory function,we gradually increase the end expiratory positive pressure ventilation,until 10 cmH2O.The conventional group took tidal volume 8 ml/kg and was maintained positive end expiratory pressure at 3 cmH2O.Results There was no statistically significant difference in operation time,blood volume,infusion volume,and single lung ventilation time between the protective group and the conventional group (P ＞ 0.05).There was also no statistically significant difference in T1,T2,T3,T4,inhalation of oxygen partial pressure (FiO2),mean arterial pressure (MAP) level between the two groups (P ＞ 0.05).The T2 and T3 moment of arterial oxygen partial pressure (PaO2) oxygenation index (OI) level in protective group was significantly higher than that in conventional group (P ＜ 0.05).The preoperative serum tumor necrosis factor-α (TNF-α),interleukin-8 (IL-8),superoxide dismutase (SOD),macrophage inflammatory protein Ⅰ (MIP-Ⅰ),malondialdehyde (MDA) level between the two group showed no significant difference (P ＞0.05).While after the operation,the serum TNF-alpha,MIP-Ⅰ,IL-8 and the level of MDA in protective group was significantly lower than that of conventional group (P ＜ 0.05),the SOD level showed the opposite (P ＜ 0.05).Conclusions The protective lung ventilation mode is beneficial to maintain the blood gas indexes,at the same time reduce the inflammatory response and protect the lung function of the patients.

Objective:To investigate the role and mechanism of Leptospira interrogans ( L. interrogans) vWF-A gene products binding to human collagen proteins. Methods:Bioinformatic software was used to analyze the structure and function of the vWF-A genes (LA_0012, LA_0697 and LA_4207) of L. interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai. Prokaryotic expression systems for the vWF-A domain segments in the vWF-A genes were generated. The target recombinant proteins, rLep0012, rLep0697 and rLep4207, were purified by Ni-NTA affinity chromatography and analyzed by SDS-PAGE. ELISA and surface plasmon resonance (SPR) were performed to detect the binding ability of the target recombinant proteins to humanⅠ, Ⅲ, Ⅳ and Ⅵ types of collagen proteins (hCOL1/3/4/6). Expression of the vWF-A genes at mRNA and protein levels were detected by real-time fluorescent quantitative RT-PCT and Western blot during infection of human umbilical vein endothelial cells (HUVEC) and mouse hemangioendothelioma endothelial cells (EOMA). Results:The products of vWF-A genes were vWF-A superfamily domain-containing surface or transmembrane proteins, but LA_0697 and LA_4207 genes also contained metal ion-dependent adhesion sites (MIDAS). The established prokaryotic expression systems efficiently expressed the target recombinant proteins and each of the proteins extracted by Ni-NTA affinity chromatography showed a single band in SDS-PAGE. ELISA results showed the strong binding of rLep0697 to hCOL3/6 and rLep4207 to hCOL1/4. SPR results showed the rapid binding and dissociation of rLep0697 with hCOL3/6 ( KD values=5.71×10 -8 and 5.89×10 -8 mol/L) and the rapid and stable biding of rLep4207 with hCOL1/4 ( KD values=6.4×10 -9 and 3.2×10 -9 mol/L). Expression of the vWF-A genes at both mRNA and protein levels were significantly elevated ( P<0.05) during infection of HUVEC and EOMA cells. Conclusions:The products of LA_0697 and LA_4207 genes could act as the adherence factors of L. interrogans during infection.

Objective:To confirm the Sigma N transcription factor activity of a gene product encoded by LA2404 gene of Leptospira interrogans ( L. interrogans) and to identify the target genes of Sigma N signaling system. Methods:L. interrogans LA2404 gene and its regulated target genes were predicted using bioinformatic analysis according to the promoter sequence signature in Sigma N-regulated genes. A LA2404 gene-knockout (ΔLA2404) strain of L. interrogans was constructed based on homologous sequence recombinant of suicide plasmid. Real-time fluorescent quantitative RT-PCR (qRT-PCR) was used to detect the changes in the expression of target genes at mRNA level in the ΔLA2404 mutant. A prokaryotic expression system for LA2404 gene was established and the target recombinant protein rSigma N was extracted by Ni-NTA affinity chromatography. Gel electrophoresis mobility shift assay (EMSA) was used to screen out the target genes regulated by rSigma N. Results:Pathogenic L. interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai carried one Sigma N gene and 22 Sigma N promoter sequence-containing target genes. Qualitative examination of the ΔLA2404 mutant by microscopy revealed no defect in motility and appearance. Expression of LA1188, LA2306, LA3426, LA1968, LA1313, LA3806 and LA0773 genes at mRNA level in the ΔLA2404 mutant was significantly down-regulated ( P<0.05), but no significant changes in the expression of other target genes at mRNA level were detected. EMSA results confirmed that rSigma N could bind to the promotor sequences of the target genes mentioned above. Conclusions:Sigma N transcription factor was encoded by LA2404 gene. LA1188, LA2306, LA3426, LA1968, LA1313, LA3806 and LA0773 genes contained Sigma N promoter sequence and the expression of them was regulated by Sigma N signaling system.

OBJECTIVETo investigate the risk factors for congenital external malformation.

METHODSA 1:2 matched case-control study was conducted with 52 cases of congenital external malformation during perinantal period collected from surveillance in Baoan District of Shenzhen City from January to June in 2000.

RESULTSSimple and multiple conditional logistic regression analysis showed that the major risk factors for congenital external malformations during perinatal period were preterm labor (beta(k) = 1.4171, s(theta, beta(kappa)) = 0.4601, OR = 4.115), adverse mental stimulus (beta(kappa) = 2.1870, s(theta beta(kappa)) = 0.7873, OR = 8.909), taking medicine (beta(k) = 1.9178, s(theta beta(kappa)) = 0.8072, OR = 6.808) and exposure to hazardous chemicals during early pregnancy (beta(k) = 0.9602, s(theta beta(kappa)) = 0.4262, OR = 2.612).

CONCLUSIONSCongenital external malformation during perinatal period was caused by multiple risk factors and results of the study showed that environmental and mental factors were in obvious connection with its occurrence.

Case-Control Studies ; Congenital Abnormalities ; etiology ; Female ; Humans ; Male ; Multivariate Analysis ; Perinatal Care ; Pregnancy ; Risk Factors

ObjectiveTo analyze the genetic characteristics of the hemagglutinin （H） gene of measles virus （MeV） in Shanghai， 2001‒2018. MethodsNasopharyngeal swab specimens were collected from suspected measles cases reported in Shanghai from 2001 to 2018， and the isolation of measles virus was conducted with Vero/hSLAM cell line. RT-PCR amplification and sequencing were conducted after RNA extraction to analyze the genetic characteristics of the complete H gene. ResultsIn total， 5 665 nasopharyngeal swab samples were collected by suspected measles case surveillance from 2001 to 2018， and 1 394 measles virus strains were isolated. The homology of nucleotide acid and amino acid among 349 representative measles virus isolates was 87.4%‒100.0% and 85.1%‒100.0%， respectively. The homology of nucleotide acid and amino acid between representative measles virus isolates and China vaccine strain （S191） was 85.7%‒100.0% and 84.1%‒100.0%， respectively. All the sub-genotype H1a MeV isolates had an amino acid substitution （Ser240Asn）， which removed a predicted N-linked glycosylation site. ConclusionMost of the MeV isolates are sub-genotype H1a analyzed based on H gene， which are identical to those of the N gene. The predicted amino acid sequences of the H protein are relatively conserved at most of the functionally significant amino acid positions.

【Objective】 To explore the effect of Genistein on the proliferation and cell cycle regulation of ovarian cancer cells. 【Methods】 Ovarian cancer OVCAR-5 cells were treated with Genistein. Cell counting and MTS assays were performed to determine the alterations of cell proliferation. Real-time PCR and Western blotting were conducted to examine the expression changes of key cell cycle regulators. 【Results】 Genistein significantly promoted the proliferation and viability of OVCAR-5 cells. After Genistein treatment, cellular mRNA and protein expression levels of cell cycle activators such as PCNA, Cyclin D1 and CDK4 were increased, but those of cell cycle inhibitors such as p21 and p27 were decreased. 【Conclusion】 Genistein can upregulate the proliferation and G1-S transition of ovarian cancer OVCAR-5 cells. The discrepancy may be caused by diverged experimental conditions and/or different ER expression patterns of cell lines. The findings may provide basic information for in-depth analysis of the role(s) and mechanisms by which genistein confers its effect on ovarian cancer cells.

OBJECTIVE To explore the safety， effectiveness and cost-effectiveness of a multimodal analgesic regimen in patients who underwent laparoscopic sleeve gastrectomy under the guidance of enhanced recovery after surgery principles. METHODS Data from weight loss patients who underwent laparoscopic sleeve gastrectomy at our hospital were retrospectively collected. The trial group patients received a multimodal analgesic regimen， which included the use of 0.375% ropivacaine for local infiltration of the surgical incision before the end of surgery； intravenous infusion of flurbiprofen axetil 50 mg twice daily； intravenous infusion of methylprednisolone 40 mg once daily and oral administration of extended-release hydrocodone hydrochloride tablets 10 mg twice daily after surgery. The control group patients received a conventional analgesic regimen， which included intravenous infusion of flurbiprofen axetil 100 mg twice daily， with a daily dose twice that of the trial group； and intravenous injection of dexamethasone 5 mg once daily. Propensity score matching was used to balance the baseline data between the two groups. Then the pain scores during movement and at rest at 2， 12， 24 and 36 hours postoperatively， as well as the length of postoperative hospital stay， total length of hospital stay， time to first ambulation after surgery， adverse reactions during hospitalization， total drug costs， and costs of antimicrobial drugs during hospitalization were compared between the two groups. RESULTS The trial group had significantly lower pain scores during movement at 2， 24 and 36 hours postoperatively， and at rest at 2， 12 and 24 hours postoperatively compared to the control group （P＜0.05）. The time to first ambulation after surgery， total length of hospital stay， and length of postoperative hospital stay were significantly shorter in the trial group compared to the control group （P＜0.05）. The incidence of shoulder and back soreness， and costs of antimicrobial drugs were significantly lower in the trial group compared to the control group （P＜0.05）. No statistically significant differences were observed in the total incidence of drug-related adverse reactions and total drug costs during hospitalization between the two groups （P＞0.05）. CONCLUSIONS The multimodal analgesic regimen provides marked pain relief， demonstrates good safety profiles， and has a more economic advantage than the conventional analgesic regimen.