Objective To explore the value of cardiac troponin-I (cTnI), B-type natriuretic peptide (BNP) and blood lactic acid (Lac) on evaluation of severity and prognosis in patients with septic myocardial dysfunction (SMD). Methods According to retrospective analysis of clinical data,161 cases with sepsis were divided in to SMD group and non-SMD group. And the SMD group was further divided in to death group and survival group. Blood cTnI, BNP and Lac value in each group were detected respectively. The ROC curve was used to evaluate the forecast value of cTnI, BNP and Lac on prognosis for patients. Results The value of cTnI, BNP and Lac in SMD group were significantly higher than those in non-SMD group(P<0.05);The value of cTnI, BNP and Lac in death group among the SMD patients were significantly higher than those in survival group(P<0.05);cTnI, BNP and Lac contribute to predict the 28 day mortality rate of SMD. Conclusions Blood cTnI, BNP and Lac contributes to the assessment of the severity and the prognosis of septic patients with myocardial dysfunction.

Objective: To investigate the relationship among physical activity, sleep duration and screen time and overweight and obesity among children and adolescents in Beijing Tianjin Hebei region, and to provide reference for children and adolescents in Beijing Tianjin Hebei region to maintain healthy physique. Methods: In November 2019, 4 262 primary and secondary school students in Beijing Tianjin Hebei region were surveyed on physical activity, sleep status and screen time according to the physical activity guidelines for children and adolescents, and the relationship between overweight and obesity was analyzed by Logistic regression. Results: The prevalence of overweight and obesity among children and adolescents in Beijing Tianjin Hebei region was 22.03%. The positive rate of overweight was 12.01% and obesity was 10.02%. The prevalence of overweight and obesity in male students (26.09%) was higher than that in female students (17.88%), the difference was statistically significant ( χ 2=41.77, P < 0.01 ). The prevalence of overweight and obesity in urban children (24.09%) and Han children (22.74%) was significantly higher than that in rural areas (21.05%) and ethnic minorities (17.70%) ( χ 2=5.00, 7.63, P <0.05). The proportion of children who met physical activity, screen time and sleep duration guideline was 24.85%, 38.69% and 57.09%, respectively. A total of 21.68% of children and adolescents did not meet the guideline of physical activity, screen time and sleep duration, among which 42.80% and 28.77% met the guideline for one or two out of three behaviors, respectively. Only 6.76% of children and adolescents met the guideline of all three behaviors. Logistic regression analysis showed that the risk of overweight and obesity was negatively correlated with sleep duration ( OR=0.72, 95%CI =0.52-0.98). The risk of overweight and obesity was lower in patients with 2 criteria than in those with less sleep duration and less screen time ( OR=0.57, 95%CI =0.36-0.87). Conclusion Percentage of sufficient physical activity among children and adolescents in Beijing Tianjin Hebei region is low, and ensuring sufficient sleep duration is helpful for overweight and obesity prevention. The impact of sleep duration and screen time on overweight and obesity in children and adolescents should be considered in childhood obesity prevention and control.

Tunicamycin, a potent reversible translocase I inhibitor, is produced by several Actinomycetes species. The tunicamycin structure is highly unusual, and contains an 11-carbon dialdose sugar and an α, β-1″,11'-glycosidic linkage. Here we report the identification of a gene cluster essential for tunicamycin biosynthesis by high-throughput heterologous expression (HHE) strategy combined with a bioassay. Introduction of the genes into heterologous non-producing Streptomyces hosts results in production of tunicamycin by these strains, demonstrating the role of the genes for the biosynthesis of tunicamycins. Gene disruption experiments coupled with bioinformatic analysis revealed that the tunicamycin gene cluster is minimally composed of 12 genes (tunA-tunL). Amongst these is a putative radical SAM enzyme (Tun B) with a potentially unique role in biosynthetic carbon-carbon bond formation. Hence, a seven-step novel pathway is proposed for tunicamycin biosynthesis. Moreover, two gene clusters for the potential biosynthesis of tunicamycin-like antibiotics were also identified in Streptomyces clavuligerus ATCC 27064 and Actinosynnema mirums DSM 43827. These data provide clarification of the novel mechanisms for tunicamycin biosynthesis, and for the generation of new-designer tunicamycin analogs with selective/enhanced bioactivity via combinatorial biosynthesis strategies.
Actinobacteria ; enzymology ; genetics ; Base Sequence ; Biological Assay ; Carbohydrate Sequence ; Carbohydrates ; biosynthesis ; genetics ; Cloning, Molecular ; Gene Deletion ; Gene Library ; High-Throughput Screening Assays ; Molecular Sequence Data ; Multigene Family ; Recombinant Proteins ; biosynthesis ; genetics ; Sequence Analysis, DNA ; Streptomyces ; enzymology ; genetics ; Tunicamycin ; biosynthesis ; chemistry ; genetics

Plastic surgery is characterized by high degree of specialization, a broadscope of diseases inclusion and rapid advancements in knowledge. It is closely related to many disciplines, and there is great heterogeneity among different patients, which requires comprehensive abilities of doctors. However, plastic surgery teaching in China is currently marked by a short training cycle, a uniform training mode, and students’ time constraints and heavy tasks. Chat generative pre-trained transformer (ChatGPT), a large-scale language model introduced by the artificial intelligence company OpenAI, can use deep learning technology to generate natural language texts, understand the context of a conversation and then generate responses similar to those of humans, and is widely used in various industries, including the medical field. This review began by identifying the current challenges in plastic surgery teaching, introduced potential applications of ChatGPT in the field, and outlined its advantages. It also discussed the limitations and potential future directions for its development.

Plastic surgery is characterized by high degree of specialization, a broadscope of diseases inclusion and rapid advancements in knowledge. It is closely related to many disciplines, and there is great heterogeneity among different patients, which requires comprehensive abilities of doctors. However, plastic surgery teaching in China is currently marked by a short training cycle, a uniform training mode, and students’ time constraints and heavy tasks. Chat generative pre-trained transformer (ChatGPT), a large-scale language model introduced by the artificial intelligence company OpenAI, can use deep learning technology to generate natural language texts, understand the context of a conversation and then generate responses similar to those of humans, and is widely used in various industries, including the medical field. This review began by identifying the current challenges in plastic surgery teaching, introduced potential applications of ChatGPT in the field, and outlined its advantages. It also discussed the limitations and potential future directions for its development.

In recent years,the incidence rate of chronic liver diseases continues to rise,such as chronic hepatitis B,nonalcoholic fatty liver disease,liver fibrosis,liver cirrhosis,and hepatocellular carcinoma,and the age of onset gradually becomes younger.At present,the role of many CC chemokines in chronic liver diseases has been confirmed.This article summarizes the research advances in CC chemokines and their receptors that affect chronic liver diseases in recent years and explore their potential application in chronic liver diseases,so as to provide new ideas for the prevention and treatment of chronic liver diseases.

Objective To investigate the value of qualitative and quantitative characteristics of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI in preoperative prediction of vessels encapsulating tumor clusters(VETC)pattern in hepatocellular carcinoma(HCC).Methods A total of 234 patients diagnosed with HCC by pathology were analyzed retrospectively.A total of 101 VETC-positive HCC patients and 133 VETC-negative HCC patients were included.All patients were divided into training group and validation group according to 7︰3.The training group data were used to construct a prediction model for VETC-positive HCC.Receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to verify the diagnostic efficiency of the model.Calibration curve was drawn to verify the calibration of the model.Results Multivariate logistic regression analysis predicted the independent risk factors for VETC-positive HCC:portal phase peripheral washout[odds ratio(OR)6.493],necrosis or severe ischemia(OR 4.756),targetoid transitional phase or hepatobiliary phase(OR 0.307),and lesion to liver signal intensity ratio(LLR)on arterial phase(OR 0.074).The AUC of the training group in predicting VETC-positive HCC was 0.790[95%confidence interval(CI)0.720-0.859].The AUC of the validation group in predicting VETC-positive HCC was 0.779(95%CI 0.668-0.889).The calibration curve diagram showed that the calibration curve(the slope was 0.91)almost coincides with the ideal curve,indicating that the prediction model had better calibration.Conclusion The qualitative and quantitative characteristics of Gd-EOB-DTPA enhanced MRI can be used to predict VETC-positive HCC preoperatively,the independent risk factors of VETC include portal phase peripheral washout,necrosis or severe ischemia,targetoid transitional phase or hepatobiliary phase,and LLR on arterial phase.

Objective To investigate the value of the liver imaging reporting and data system v2018(LI-RADS v2018)and other imaging features in predicting preoperative risk and postoperative prognosis of isolated macrotrabecular-massive hepatocellular carcinoma(MTM-HCC).Methods Patients with isolated hepatocellular carcinoma(HCC)confirmed by pathology after preoperative MRI examination were selected,and all patients were randomly assigned to a training group(n=146)and a validation group(n=62)in a 7∶3 ratio.Least absolute shrinkage and selection operator(LASSO)regression and multivariate logistic regression were used to screen independent prognostic factors of MTM-HCC and construct a nomogram.Patients were stratified into high-risk and low-risk subgroups based on the nomogram scores.Kaplan-Meier survival curves and Log-rank tests were used to compare the recurrence-free survival(RFS)among different subgroups of patients.Results Multivariate logistic regression analysis revealed that intratumoral vessels[odds ratio(OR)=3.480,95％confidence interval(CI)1.110-10.912,P=0.032],arterial phase hypovascular component ≥20％(OR=4.615,95％CI 1.728-12.321,P=0.002),and corona enhancement(OR=4.814,95％CI 1.816-12.766,P=0.002)were independent predictors of MTM-HCC.The nomogram constructed based on these indicators demonstrated area under the curve(AUC)of the receiver operating characteristic(ROC)curve was 0.834 and 0.764 for predicting MTM-HCC in the training and validation groups,respectively.The RFS predicted by the nomogram was significantly different between the high-risk and low-risk subgroups and both the pathologically confirmed MTM-HCC positive and negative groups(P＜0.05).Conclusion Intratumoral vessels,arterial phase hypovascular component ≥20％,and corona enhancement are independent predictors of MTM-HCC.The constructed nomogram based on these predictors demonstrates good diagnostic efficacy for MTM-HCC and has significant prognostic value for patients'RFS.

OBJECTIVETo investigate the association between maternal serum neutrophil-lymphocyte ratio (NLR) and placental inflammatory response (PIR) in late pregnancy.

METHODSWe retrospectively analyzed the clinical and follow-up data of 478 pregnant women undergoing routine prenatal examination and delivery in our hospital in the year 2016. According to the placental pathological results, the women were divided into PIR group (238 cases) and control group (240 cases). The levels of serum inflammatory makers including leukocytes, neutrophils, lymphocytes, C-reactive protein (CRP) and NLR were compared between the two groups to analyze the association of these markers with PIR. Multivariate analysis was performed to identify the independent risk factors of PIR. Logistic regression model was established and the area under the receiver operating characteristic curve (ROC) was used for analyzing the prognostic value of these makers in late pregnancy.

RESULTSThe areas under the curve (AUC) of leukocytes, neutrophils, lymphocytes, CRP and NLR were 0.698 (95%: 0.485-0.766), 0.716 (95%: 0.453-0.783), 0.329 (95%: 0.228-0.431), 0.725 (95%: 0.677-0.765) and 0.801 (95%: 0.742-0.856), respectively. After adjusting the confounders, multivariate logistic regression analysis showed that preterm labor (OR=2.446, 95%: 1.003-4.590), premature rupture of membranes (OR=2.304, 95%: 1.049-4.161), NLR > 7 (OR=3.268, 95%: 2.071-6.920), and CRP > 15 mg/L (OR=2.137, 95%: 1.412-8.236) were independent risk factors for PIR.

CONCLUSIONSAn increased NLR in late pregnancy can serve as an effective indicator for predicting the risk of PIR.