IgA nephropathy is a common primary glomerulopathy; the main clinical manifestation is hematuria, with or without proteinuria. However, the pathogenesis associated with mucosal immunity is not completely clear. At present, modern medical treatment delays the progression of IgA nephropathy mainly by controlling blood pressure, reducing proteinuria and delaying renal function failure. The method of combination of disease and syndrome of TCM has received satisfactory efficacy in the treatment of IgA nephropathy. Based on the relationship between mucosal immune and treated from pharynx, this article investigated the occurrence, development and treatment of IgA nephropathy.

Thioesterase catalyzes the hydrolysis of acyl-ACP and saturated fatty acyl chain. It plays a key role in the accumulation of medium chain fatty acids in vivo. In this study, to construct an engineering strain to produce MCFAs, the Arabidopsis acyl-ACP thioesterase gene AtFatA was amplified by PCR from cDNA of arabidopsis and double digested by EcoR I/Xba I, then linked to the plasmid digested with same enzymes to get the recombinant plasmid pPICZaA-AtFatA. We transformed the gene into Pichia pastoris GS115 by electroporation and screened positive colonies by YPD medium with Zeocin. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) results showed that the recombinant enzyme had a molecular of 45 kDa band which was consistent with the predicted molecular mass and we constructed the expression system of gene AtFatA in fungus for the first time. Under shake-flask conditions, Gas Chromatograph-Mass Spectrometer-computer results indicated that recombinant strain produced 51% more extracellular free MCFAs than the wild and its yield reached 28.7% of all extracellular fatty acids. This figure is 10% higher than the control group. The result provides a new way to produce MCFAs.
Arabidopsis ; genetics ; Arabidopsis Proteins ; biosynthesis ; DNA, Complementary ; Electrophoresis, Polyacrylamide Gel ; Electroporation ; Pichia ; metabolism ; Plasmids ; Polymerase Chain Reaction ; Recombinant Proteins ; biosynthesis ; Thiolester Hydrolases ; biosynthesis ; Transformation, Genetic

Objective To investigate the feasibility and safety of trans-gastric route combined with trans-colonic or trans-vaginal route endoscopic salpingectomy and liver biopsy, as methods of natural orifice translumenal endoscopic surgery (NOTES). Methods Endoscopic salpingectomy and liver biopsy were per-formed in 4 female porcine models, in 2 of which the procedure was achieved via trans-gastric and trans-co-Ionic route (Group A), while in other 2 was via trans-gastric and trans-vaginal route (Group B). The ani-mals were sacrificed after the procedure and the related complications were observed. Results Abdominal cavity exploration, salpingectomy and liver biopsy could be performed successfully through two combined routes. Perforation of adjacent colon was found in 1 animal with the trans-colonic route NOTES. Conclusion NOTES via trans-gastric and trans-colonic routes or via trans-gastric and trans-vaginal for salpingectomy and liver biopsy are both feasible, while trans-vaginal route seems to be safer than trans-colunic route.

OBJECTIVETo assess the association between peripheral blood dendritic cells subtype distribution and plasma monocyte chemoattractant protein 1 (MCP-1) concentration in patients with coronary heart disease (CHD).

METHODSSixty consecutive CHD patients admitted in our department during the period from November, 2010 to December, 2011 were enrolled, including 10 with stable angina pectoris (SAP), 25 with unstable angina pectoris (UAP), and 25 with acute myocardial infarction (AMI), with 28 healthy volunteers as normal controls. All the subjects underwent routine tests and coronary angiography. The percentages of peripheral blood myeloid dendritic cells (mDCs) and plasma cell-like dendritic cells (pDCs) in peripheral blood mononuclear cells were detected by flow cytometry, and plasma MCP-1 levels were detected using enzyme-linked immunosorbent assay.

RESULTSThe percentage and absolute quantity of mDCs and pDCs were significantly lower in AMI and UAP groups than in the normal control and SAP groups (P<0.001). In the CHD patients, the plasma MCP-1 level was significantly higher than that in the normal control group (P<0.001) with an inverse correlation with the percentage of peripheral mDCs.

CONCLUSIONMCP-1 may promote the migration of mDCs into atherosclerotic plaques and mediate the local immune and inflammatory responses to aggravate plaque instability in CHD patients.

Adult ; Aged ; Case-Control Studies ; Chemokine CCL2 ; blood ; Coronary Disease ; blood ; Dendritic Cells ; cytology ; Female ; Humans ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged

Objective:To evaluate the safety and efficacy of endoscopic ultrasound (EUS)-guided iodine-125 seed implantation to treat dysphagia in patients with advanced esophageal cancer.Methods:Data of 4 patients with dysphagia of advanced esophageal cancer who received EUS-guided iodine-125 seed implantation in Chinese PLA General Hospital between December 2017 and November 2018 were collected in the retrospective study. The evaluation contents included technical success rate of seed implantation, complication, dysphagia grade, tumor size and other follow-up results.Results:Four patients successfully completed EUS-guided iodine-125 seed implantation. No haemorrhage, chest pain, fever, cough or other postoperative complications were reported. Three months after treatment, dysphagia grade reduced from Ⅱ-Ⅳ to 0-Ⅰ, and the tumor size in all patients showed a decrease. After 12-23 months of follow-up, 3 patients were alive, and 1 died due to advance of the cancer.Conclusion:EUS-guided iodine-125 seed implantation is a safe and effective palliative treatment method for dysphagia in patients with advanced esophageal cancer.

Objective With the help of the cloud platform software of ancient and modern medical records,to analyze the prescription medication rule of Chinese medical master Chen Keji's application of Corydalis yanhusuo in the treatment of heart diseases,and to summarize and inherit the medication experience.Methods Medical record prescriptions with Corydalis yanhusuo used by Academician Chen Keji to treat heart diseases from 2002 to 2010 were collected and sorted out.Improved mutual information method,association rules,complex system clustering,unsupervised entropy hierarchical clustering and other methods were used to conduct statistical,correlation and cluster analysis on the normalization,frequency of application and combination of drug pairs in the prescriptions.Results A total of 146 clinical cases of by Academician Chen Keji were collected,and the main diseases were chest arthralgia,palpitation,and vertigo.In addition to Corydalis yanhusuo,Radix Salviae liguliobae,Radix chuanxiong and Radix Paeoniae Rubra had the highest frequency of single drug use.In the treatment of chest Bi disease,the use of xin,bitter,warm drugs,liver,heart,spleen meridian,high frequency drug for Radix chuanxiong-Corydalis yanhusuo,Radix Paeoniae Rubra-Corydalis yanhusuo;Commonly used angle herbs are Radix Paeoniae Rubra-Radix chuanxiong-Corydalis yanhusuo,Trichosanthes Kirilowii Maxim-Bulbus Allii Macrostemi-Corydalis yanhusuo.Cluster analysis suggested that the commonly used prescriptions for the treatment of chest Bi were Guanxin No.2,Gualsankyu Baibanxia Decoction and Bupleurum Shugan Powder.In the treatment of palpitation,sweet,bitter and warm drugs are mainly used,which are classified into liver,lung and spleen channels.The high-frequency counterpart herbs are Radix Sophorae flavescentis-Corydalis yanhusuo;Commonly used horn medicine is Ophiopogon japonicus-Corydalis yanhusuo-Schisandra chinensis.Cluster analysis suggested that Shengmai Decoction and Tianwang Buxin Dan were commonly used by Academician Chen,and Corydalis yanhusuo,Radix Sophorae flavescentis and Rhizoma Coptidis were his characteristic herbs for palpitation.In the treatment of vertigo,sweet,bitter,warm and plain Chinese medicines were mainly used.The correlation analysis of drug combinations suggested that Ramulus Uncariae cum Uncis-Corydalis yanhusuo and Gastrodia elata-Corydalis yanhusuo were commonly used as paired herbs,Gastrodia elata-Ramulus Uncariae cum Uncis-Corydalis yanhusuo were commonly used as angle herbs.Conclusion Academician Chen Keji,based on the combination of traditional Chinese and western medicine,used Corydalis yanhusuo to promote blood circulation and relieve pain in the treatment of chest Bi,to promote blood circulation and eliminate palpitation in the treatment of palpitation,and to calm down and eliminate daze in the treatment of vertigo.

Objective:To explore the predictive value of multimodal ultrasound (MMU) for upper urinary tract damage (UUTD) in children with neurogenic bladder (NB).Methods:This was a case-series study.From January 2022 to December 2023, 87 children with NB admitted to the First Affiliated Hospital of Zhengzhou University were examined by MMU.During the filling of bladder, vesical volume (VV), bladder wall thickness (BWT), shear wave velocity (SWV) of the anterior wall, resistance index (RI), and vascularization index (VI) were measured.After the emptying of bladder, VV and anterior wall SWV were measured, and ultrasound bladder compliance (△C) was calculated.The anterior posterior diameter (APD) of the renal pelvis and ureteral diameter (UD) were also measured.According to the upper/lower urinary tract dysfunction classification criteria, NB children were divided into a UUTD group and a non-UUTD (NUUTD) group.The differences in clinical data and related examinations between the 2 groups were analyzed to screen out independent risk factors, and an early warning model was established based on these factors.The prediction efficiency of the model and the urodynamic study (UDS) for UUTD was compared.Results:(1) There were 47 children in the UUTD group and 40 children in the NUUTD group.There was no significant difference in gender, age and body mass index between the 2 groups (all P>0.05).(2) In the UUTD group, the total glomerular filtration rate (tGFR) was (70.45±16.17) mL/min, the incidence of hydronephrosis was 38.30%, and the incidence of ureteral dilatation was 23.40%.No morphological changes were found in the imaging examination of the urinary system in the NUUTD group, and its tGFR was (100.55±16.27) mL/min.There was a significant difference in tGFR between the 2 groups ( P<0.05).(3) The filling VV, emptying VV, mean BWT, filling SWV, emptying SWV, VI, mean RI, △C, maximum cystometric capacity (MCC), maximum detrusor pressure during filling (Pdet.max), bladder compliance (BC), and detrusor leak point pressure (DLPP) in the NUUTD group were (218.43±87.53) mL, (14.62±6.14) mL, (3.08±0.65) mm, (2.64±0.54) m/s, (1.88±0.41) m/s, (6.20±1.04)%, 0.68±0.04, (147.58±49.18) mm 2·s, (309.50±66.54) mL, (59.83±19.79) cmH 2O(1 cmH 2O=0.098 kPa), (25.80±10.34) mL/cmH 2O, and (34.00±6.16) cmH 2O, respectively.Compared with the NUUTD group, the UUTD group showed decreased filling VV [(167.21±85.63) mL], △C [(78.49±31.86) mm 2·s], VI [(5.01±0.81) %], MCC [(255.32±75.10) mL], and BC [(12.57±6.44) mL/cmH 2O], and increased emptying VV [(19.50±7.65) mL], mean BWT [(4.02±0.82) mm], filling SWV [(3.99±1.07) m/s], emptying SWV [(2.15±0.35) m/s], mean RI (0.70±0.08), Pdet.max [(75.94±26.23) cmH 2O], and DLPP [(48.13±12.61) cmH 2O] (all P<0.05).(4) The decreased BC ( OR=0.841, 95% CI: 0.562-1.256, P=0.045), △C ( OR=0.427, 95% CI: 0.202-0.904, P=0.026) and VI ( OR=0.461, 95% CI: 0.091-2.325, P=0.010) and the increased DLPP ( OR=1.139, 95% CI: 0.894-1.451, P=0.040), filling SWV ( OR=1.895, 95% CI: 1.082-3.321, P=0.007) and mean BWT ( OR=1.191, 95% CI: 0.850-1.669, P=0.025) were independent risk factors for UUTD.Among MMU parameters, filling SWV had the highest prediction efficiency for UUTD, with a threshold of 3.33 m/s, sensitivity of 72.34% and specificity of 92.50%. Conclusions:MMU can well predict the occurrence of UUTD in children with NB, and filling SWV has the highest prediction efficiency.

Objective:To evaluate the clinical effect of autologous nanofat combined with pearl fat transplantation in comprehensive improvement of lacrimal groove depression.Methods:Seventy-eight patients (age ranges from 28 to 56 years, with average 38 years) who desired for lacrimal groove improvement were involved in this study from Jan. 2019 to Jun. 2020 in the Department of Plastic Surgery in Peking Union Medical College Hospital. Primary fat tissue was obtained and purified by liposuction. Nanofat and pearl fat were prepared and injected into lacrimal groove area in different layers and multiple points evenly to ameliorate depression. Visual analogue scoring (VAS) was used for evaluating injection pain. Dark eye circles, faint lines on lower eyelid, color spots and lacrimal groove depression between pre-operation pictures and post-operation pictures of 1 year follow-up were evaluated by patients＇ satisfaction scores.Results:All 78 patients revealed mild swelling and disappeared in 3 to 4 days. Injection areas were stable in 3 months. All patients appeared no complications such as infection, hematoma, fat liquefaction, local induration and so on. Among 78 patients, 2 patients showed ecchymosis after surgery which disappeared in 10 days, and 1 patient showed uneven appearance which disappeared after timely treatment. After 1 year of follow-up, the average satisfaction score of improvement was 8.9±0.5, which showed satisfied post-operative effect.Conclusions:Autologous nanofat combined with pearl fat transplantation has high feasibility, short operation time, which could achieve good effect of facial rejuvenation with high patients＇ satisfaction. In this case, this technique is worthy of clinical promotion.

Objective:To investigate the clinical effect of facial depression correction by using free anterolateral thigh adipofascial flap and human acellular dermal matrix.Methods:Nineteen facial depression patients (3 males and 16 females), age ranges from 16 to 56 years (average age: 29.1±10.37 years), caused by different reasons were selected in this research from Jan. 2008 to Dec. 2020. In the stage I operation, anterolateral thigh adipofascial flap was designed according to facial depression area and harvested to fill in the depression with vascular anastomosis; In the stage II operation, the human acellular dermal matrix was used to fill in the remained depression edge according to facial subunit.Results:All free anterolateral thigh adipofascial flap survived well. All patients revealed fascial subunit tissue atrophy of different degree in infraorbital, nasolabial sulcus and temporal areas which were repaired by using cellular dermal matrix and obtained satisfying effect during 1 to 8 years of follow-up with no obvious rejection. 18 of 19 patients showed flap hypertrophy and corrected by liposuction. All patients recovered well after 1 to 8 years of follow-up.Conclusions:Humana cellular dermal matrix could make up the limitations of treating fascial depression deformity when using anterolateral thigh adipofascial flap. The combination method of above approaches could obtain satisfying clinical effect, which is worthy of clinical promotion.

Objective To evaluate the feasibility and safety of the robot - assisted system YunSRobot for remote manipulation endoscopy. Methods When the master of YunSRobot was installed in the gastroenterology office in Chinese PLA General Hospital, the robot slave and upper gastrointestinal simulation model (Takahashi Lm103,Japan) were installed at the same time in the State Key Laboratory of Robotics, Shenyang Institute of Automation. Three physicians were trained to operate the master robotics and performed gastroscopy on the simulation model based on network cloud. Each physician performed 3 procedures of oesophagogastroduodenoscopy (EGD) by YunSRobot using traditional manual endoscopy, on-site operating mode, and remote manipulation mode, respectively. The operating time, lumenal anatomic exposure,man-machine interaction and other parameters were recorded. Results The number of standard pictures obtained by traditional manual endoscopy group, on-site operating group and remote manipulation group were 39.9±0.3, 39.8±0.4, 39.9±0.3, respectively. The images of all five lesions could be obtained by each operation. The operating time in the duodenum of remote group was longer than that of on-site group, with average time (78.2±16.0)s vs. (68.9±15.8)s (P=0.021) respectively. As to the operating time on other parts or total time, all three groups were comparable. Although there was a mean delay of (572.1±48.5) ms in remote operation group, the operation was still smooth. However, compared with on-site group, the percentage of clear view time in the duodenum was significantly shortened in remote group: [(77.8±8.2)% vs. (83.9 ± 6.4)% , P=0.024]. Statistically significant difference was detected in percentage of clear view time neither in other sites, nor was in the total operating time between two groups. The operating time in each part of remote group was obviously longer than that of manual group as followings, pharyngeal (27.3±4.2) s vs. (9.2±1.3)s (P<0.001), esophageal (29.7±6.4)s vs. (19.3±1.6)s (P=0.004), stomach (56.7±17.0)s vs. (40.3±7.0)s (P=0.003), pylorus (20.2±5.5)s vs. (9.3±1.3)s (P<0.001), duodenum (78.2±16.0)s vs. (29.3±5.6)s (P<0.001). Thus the total operating time was also longer in remote group as (559.0±87.2)s vs. (253.1±16.6)s (P<0.001). The respective time in pharynx, esophagus, stomach, pylorus, duodenum, or the overall time was all longer in remote group than that in manual group. Conclusions The soft endoscopy robot YunSRobot has satisfactory safety and stability. Remote upper gastrointestinal endoscopy can be completed based on common network and an endoscope simulation model with smooth operation. The inspection time by YunSRobot robot per part and the overall time are longer than those of manual operation on site, still, remote operating time meets the standard of upper gastrointestinal endoscopy.