ObjectiveTo explore the clinical curative effect of different methods on anesthesia radical mastectomy. MethodsTo choose 120 patients with breast cancer,and divided into epidural group and general anaesthesia group according to different methods of anesthesia randomly, and monitored the changes of blood pressure, heart rate, blood oxygen saturation, norepinephrine, epinephrine and C-reactive protein of all patients during peroperative period, and analyzed the difference between the two groups. ResultsThe vital sign and level of stress hormone of patients of epidural group during peroperative period had no significant difference( all P ＜0.01 ). The vital sign and level of stress hormone of patients of general anaesthesia group intraoperation were significant different compared to preoperation and post operation( all P ＜ 0.01 ). ConclusionEpidural anesthesia had lighter stress reaction and stable vital sign than general anesthesia on radical mastectomy.

Objective To express the novel fibronectin-binding protein Fba of group A streptococcus(GAS)and analyze its immunogenicity,so that to evaluate the immune responses to GAS infection.Methods fba gene was amplified by polymerase chain reaction(PCR)and confirmed by sequencing.Then it was cloned into pGEX4T-2 vector and Fba protein was expressed in E.coli BL21.The protein expression was identified by enzyme-linked immunosorbent assay(ELISA)and Westernblot.The sera from mice infected with GAS and anti-streptolysin-O positive patients were detected using microtiter plates coated with purified Fba protein as antigen.Afterward Balb/C mice were immunized with this purified protein and the sera were collected after the third immunization for the detection of IgG titer.Results It was confirmed by ELISA and Western blot that the recombinant Fba protein had a specific affinity with anti-Fba sera of rabbit.The anti-serum IgG titer of mice imrnunized with Fba protein was up to 1:4800.Conclusions GAS infection or Fba protein immunization are able to induce high serum titer of anti-Fba which could react specifically with the recombinant Fba protein.It indicates that Fba protein has good immunogenicity and antigenicity.So Fba protein could be a GAS candidate vaccine and an important tool to detect anti-GAS titer in GAS infected patients.

Objective:To observe cellular,humoral and mucosal immune responses induced by DNA-or protein-based of FimH of UPEC type 1.Methods:After mice were immunized respectively with recombinant plasmid pcDNA3.1/fimH or pcDNA3.1/fimC,and the combinant FimH and FimC protein,the anti-FimH protein IgG of sera and SIgA in bladders were detected by ELISA.The lymphocyte phenotypes of CD3,CD4 and CD8 were analyzed by FCM.Results:The titers of IgG in sera and SIgA in the bladders were all low in the group immunized by recombinant FimH plamid,but the percentage of CD4+T cells in spleen was high,which revealed that recombinant FimH plamid was able to trigger better cellular immune response.The titers of IgG were very high in the group immunized by FimH protein,which suggested that the FimH protein was able to trigger better humoral immune response,but SIgA in the bladders was not detectable.Conclusion:The DNA for FimH can induce humoral,mucosal and cellular immune response.FimH protein can only induce humoral immune response.FimC protein is able to enhance the immunogenicity of FimH protein.

Objective To observe multimodal imaging characteristics in eyes with focal choroidal excavation (FCE) and preliminarily analyze the risk factors in FCE with complications correlated with RPE.Methods A retrospective case series.Thirty-one patients (31 eyes) with monocular FCE,first identified by spectral-domain (SD)-OCT in the Eye Center of The Second People's Hospital of Foshan from December 2014 to December 2018,were involved in this study.There were 14 males and 17 females,with the mean age of 45.84± 13.57 years.All patients underwent BCVA,optometry,and SD-OCT examinations.FFA and ICGA were simultaneously performed in 3 FCE patients with RPE complications.The subfoveal choroidal thickness (SFCT) and excavation width were measured with enhanced depth imaging OCT (EDI-OCT).The eyes with FCE were divided into two groups (FCE alone group 17 eyes vs.FCE complication group 14 eyes),based on whether complicated by RPE dysfunction.Among 14 eyes of FCE complication group,7 (22.6％) with choroidal neovascularization,4 (12.9％) with central serous chorioretinopathy,1 (3.2％) with polypoidal choroidal vasculopathy,and 2 (6.5％) with RPE detachment.No significant difference was found in the mean age (t=0.87),gender composition (x2=0.06),ocular laterality (x2=2.58),and spherical equivalent (t=-0.81) between two groups,respectively (P＞0.05),except that the BCVA was significantly different (t=-2.11,P＜0.05).The SFCT and excavation width of eyes in both groups and the ICGA imaging characteristics of eyes in FCE complication group were analyzed.Risk factors of FCE with RPE complications were analyzed by logistic regression analysis.Results Thirty-three excavations were identified in 31 eyes with FCE.The mean SFCT was 167.00± 85.18 μm in FCE alone group vs.228.36± 67.95 μm in FCE complication group,while the excavation width was 645.00 ± 231.93 μm vs.901.00± 420.55 μm and they were both significantly different (P＜0.05).Logistic regression analysis showed the SFCT (OR=1.016,P=0.026) and excavation width (OR=1.004,P=0.034) were risk factors for RPE complications of FCE.EDI-OCT showed the RPE at the excavation was impaired or vulnerable in all eyes of the FCE alone group,especially at the boundary area of excavation.The RPE damages were located at the boundary area of excavation in 10 eyes (71.4％) of FCE complication group.Constant choroidal hypofluorescence and filling defect were observed under the excavation in 3 eyes with ICGA imaging.Conclusions SFCT and excavation width may be risk factors for RPE complications of FCE.Impairment of RPE at boundary area of excavation and focal choroidal ischemia or aberrant circulation under the excavation may correlate with the development of FCE complications.

Objective:To observe the clinical features of high myopia domed-shaped macula (DSM) complicated with choroidal neovascularization (CNV) and the efficacy of intravitreal injection of anti-vascular endothelial growth factor (VEGF).Methods:A retrospective clinical study. A total of 23 eyes of 23 patients with high myopia DSM combined with CNV diagnosed by ophthalmology examination in Department of Ophthalmology of The Second People's Hospital of Foshan from January 2019 to December 2023 were included in the study.Best corrected visual acuity (BCVA), intraocular pressure, optical coherence tomography (OCT) were performed in all eyes. BCVA tests are performed using the international standard visual acuity chart, which was statistically converted to logarithm of the minimum angle of resolution (logMAR) visual acuity. DSM height, central macular thickness (CMT) and choroidal thickness (ChT) were measured by OCT. According to OCT image features, DSM was divided into horizontal and vertical elliptic bulges and circular bulges. According to the literature standard, CNV was divided into subfoveal CNV and parafoveal CNV. All patients were treated with 0.05 ml intravitreal injection of ranibizumab or conbercept (IVR or IVC). The treatment regimen was 1+ on-demand treatment. The first IVR and IVC treatment were performed on 17 eyes and 6 eyes, respectively, and were divided into IVR group and IVC group. Follow-up time ≥1 month after treatment. The clinical features of the patients and the changes of BCVA, intraocular pressure, CMT and ChT after treatment were observed. Independent sample t test was used for comparison between groups. Results:There were 23 eyes in 23 cases, 7 males had 7 eyes and 16 females had 16 eyes. There were 11 and 12 eyes in the right and left eyes respectively. Age were (49±16) years old; logMAR BCVA was 0.94±0.39. Shapes of DSM were in 13 (56.52%, 13/23), 6 (26.09%, 6/23), and 4 (17.39%, 4/23) eyes, respectively. The dome height was (97.83±46.14) μm. CMT and ChT were (276.39±98.35) and (49.48±31.66) μm, respectively. There were 17 eyes in the IVR group, including 4 males and 13 females. There were 6 cases in the IVC group, 3 cases were male and 3 cases were female. At the last follow-up, logMAR BCVA and CMT were 0.60±0.39 and (209.96±71.38) μm, respectively. BCVA was significantly increased and CMT was significantly decreased compared with before treatment, with statistical significance ( t=2.98, 2.62; P=0.005, 0.010). One month after treatment and at the last follow-up, there were no significant differences in the degree of BCVA improvement ( t=1.47, 1.35), intraocular pressure change ( t=-0.20, -0.56) and ChT reduction thickness ( t=0.80, -0.62) between IVR group and IVC group ( P>0.05). At 1 month after treatment and last follow-up, the CMT of patients in IVR group and IVC group was decreased by (57.94±67.61), (83.17±78.37) μm and (13.33±9.73), (18.17±17.88) μm compared with that before treatment, respectively, and the differences were statistically significant ( t=2.64, 3.21; P<0.05). Conclusions:IVR or IVC in the treatment of high myopia DSM combined with CNV can effectively improve BCVA. The reduction of CMT with ranibizumab is better than conbercept.

Objective To observe the clinical manifestation and gene mutation of a pedigree with Sorsby fundus dystrophy (SFD).Methods Ten members in 3 generations of a pedigree with SFD were included in this study.Four patients were observed in the pedigree,including 2 females and 2 males.All 10 members underwent comprehensive ophthalmic examinations,including best-corrected visual acuity,intraocular pressure,slit-lamp biomicroscopy,indirect ophthalmoscopy,fundus color photography and spectral domain optical coherence tomography.Genomic DNA was extracted from peripheral venous blood which was collected from all the members.Relevant exons of ocular diseases were detected by the next generation sequencing method from the proband.The other members underwent Sanger verification.Results Among the four patients,fading eyesight was appeared at their 44,46,47 and 40 year-old respectively.The two male patients had bilateral morbidity,and the two female patients had monocular symptoms.DNA sequencing results showed that the proband,other 3 patients and 2 members from the Ⅲ generation had heterozygous mutation of TIMP3 gene in exon 5.The amino acid encoded by TIMP3 gene No.204 codon changed from serine to cysteine (TIMP3:NM_000362:Exon5:c.A610T/p.S204C).Coclusions The invasion time of all the patients in this pedigree is after their 40 year-old.Heterozygous mutation at c.610A＞T (p.S204C) in TIMP3 gene is the causative gene of SFD in this pedigree.

Objective To investigate the expression of differential genes in testicular tissue of patients with obstructive and non-ob-structive azoospermia by bioinformatics,and provide new markers for the diagnosis of non-obstructive azoospermia(NOA).Methods The microarray data of azoospermia related genes(GSE45885 and GSE9210)were downloaded from the gene expression comprehensive database(GEO)and analyzed online by GEO2R,and the NOA related differentially expressed genes(DEGs)were obtained.The common DEGs were determined by using Wayne's intersection.GO annotation and KEGG enrichment analysis of DEGs were carried out by using R software.The DEGs-related protein interaction network(PPI)was constructed with STRING.Then,the most significant Hub gene of NOA was screened out by Cytoscape software and visualization was performed.The diagnostic value of Hub gene for NOA was estimated by the receiver operating characteristics(ROC)curve and verified in GSE145467 data set.Results A total of 83 DEGs were obtained,of which 78 were down-regulated and 5 were up-regulated.GO enrichment analysis showed that DEGs was involved in biological processes(BP),including the development and differentiation of sperm cells,development of germ cells,assembly of motor cilia,etc.Cell composition(CC)mainly included sperm flagella,motor cilia,acrosome vesicles,spermatogenic nuclei,etc.Molecular function(MF)mainly included structural components,protein binding,heat shock protein binding and so on,which endowed com-pressive strength for extracellular matrix.KEGG-related pathways were involved in longevity regulation pathways,cell cycle and apopto-sis,and meiosis of oocytes in multiple species.The five Hub genes closely related to NOA,including SPAG5,CCNB2,AURKC,NCAPH and PTTG1,were screened by PPI network.The ROC curve showed that all the five Hub genes were potential genetic markers of NOA.Conclusion SPAG5,CCNB2,AURKC,NCAPH and PTTG1 genes may play the key role in the development of NOA and may be used as the new biomarkers for NOA.

Objective To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0%(127/165) and 66.0%(140/212) respectively, the differences had significance (χ2=5.4, P=0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1%(256/294) and 13.3%(11/83) respectively, and the differences had significance (χ2=170.7, P<0.001) . Among the 21 investigated clinical doctors, the numbers of the doctors who correctly diagnosed the suspected cases, probable cases and lab-confirmed cases were only 3, 0 and 8 respectively. All of the clinical doctors knew that it is necessary to report the brucellosis cases within 24 hours after diagnosis. Conclusion The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.

There remains a significant gap in our quantitative understanding of crosstalk between apoptosis and necroptosis pathways. By employing the SWATH-MS technique, we quantified absolute amounts of up to thousands of proteins in dynamic assembling/de-assembling of TNF signaling complexes. Combining SWATH-MS-based network modeling and experimental validation, we found that when RIP1 level is below ~1000 molecules/cell (mpc), the cell solely undergoes TRADD-dependent apoptosis. When RIP1 is above ~1000 mpc, pro-caspase-8 and RIP3 are recruited to necrosome respectively with linear and nonlinear dependence on RIP1 amount, which well explains the co-occurrence of apoptosis and necroptosis and the paradoxical observations that RIP1 is required for necroptosis but its increase down-regulates necroptosis. Higher amount of RIP1 (>~46,000 mpc) suppresses apoptosis, leading to necroptosis alone. The relation between RIP1 level and occurrence of necroptosis or total cell death is biphasic. Our study provides a resource for encoding the complexity of TNF signaling and a quantitative picture how distinct dynamic interplay among proteins function as basis sets in signaling complexes, enabling RIP1 to play diverse roles in governing cell fate decisions.
Animals ; Apoptosis ; Caspase 8/metabolism* ; GTPase-Activating Proteins/metabolism* ; HEK293 Cells ; Humans ; Mice ; Mice, Knockout ; Necroptosis ; Receptor-Interacting Protein Serine-Threonine Kinases/metabolism*