Objective In this study,we analyzed the transcriptome sequences of Kupffer cells exposed to simulated microgravity for 3 d and conducted biological experiments to determine how microgravity initiates apoptosis in Kupffer cells. Methods Rotary cell culture system was used to construct a simulated microgravity model.GO and KEGG analyses were conducted using the DAVID database.GSEA was performed using the R language.The STRING database was used to conduct PPI analysis.qPCR was used to measure the IL1B,TNFA,CASP3,CASP9,and BCL2L11 mRNA expressions.Western Blotting was performed to detect the level of proteins CASP3 and CASP 9.Flow cytometry was used to detect apoptosis and mitochondrial membrane cells.Transmission electron microscopy was used to detect changes in the ultrastructure of Kupffer cells. Results Transcriptome Sequencing indicated that simulated microgravity affected apoptosis and the inflammatory state of Kupffer cells.Simulated microgravity improved the CASP3,CASP9,and BCL2L11 expressions in Kupffer cells.Annexin-V/PI and JC-1 assays showed that simulated microgravity promoted apoptosis in Kupffer cells.Simulated microgravity causes M1 polarization in Kupffer cells. Conclusion Our study found that simulated microgravity facilitated the apoptosis of Kupffer cells through the mitochondrial pathway and activated Kupffer cells into M1 polarization,which can secrete TNFA to promote apoptosis.

Objective To evaluate the effect of endoscopic laryngeal mask on perioperative airway management and postoperative recovery in patients undergoing gastric endoscopic submucosal dissection(ESD).Methods Ninety patients,aged 18-64 years,BMI 18-25 kg/m2,ASA physical statusⅠorⅡ,who underwent elective gastric ESD were randomly divided into two groups:the endoscopic laryngeal mask group(group E)and the endotracheal tube group(group C),45 patients in each group.After induction of general anesthesia,group E received endoscopic laryngeal mask airway ventilation,and the endoscope was inserted through the endoscopic channel of the laryngeal mask,group C received tracheal intubation,and the endoscopy was inserted through the mouth.The successful time and one-time success rate of intubation,and the insertion time and withdrawal rate of endoscopy were recorded.The operative time,extubation time and PACU residence time were recorded.HR,MAP were recorded when the patient entered the room(T0),at the time of intubating(T1),inserting gastroscopy(T2),exiting gastroscopy(T3),extubation(T4),and leaving PACU(T5).The average airway pressure and peak airway pressure at T1-T3 were recorded.The airway sealing pressure and endoscopic view grading system(EVGS)grading of group E were recorded before and after changing the position,and at the end of surgery.The adverse reactions and the satisfaction of anesthesiologists and gastroenterologists were recorded.Results Compared with T0,HR and MAP were significantly increased at T1 and T4 between the two groups(P＜0.05).Compared with group C,the suc-cessful time of intubation,the extubation time,and PACU residence time were significantly shortened,HR and MAP were significantly decreased at T1 and T4,the incidence of choking cough during extubation,post-operative pharyngeal pain,and hoarseness were significantly decreased(P＜0.05).There were no signifi-cant differences in the one-time success rate of intubation,the insertion time and withdrawal rate of endosco-py between the two groups.Endoscopic laryngeal mask showed good sealing and alignment in group E.Conclusion Endoscopic laryngeal mask could shorten the success time of establishment of artificial airway in patients with gastric ESD,without interfering with digestive endoscopy operations,shorten extubation time and PACU retention time,maintain intraoperative hemodynamic stability,and reduce adverse reactions.

Objective To investigate the effect of nasal mask on preventing respiratory depression and hypoxia during anesthesia under painless gastroscopy.Methods 246 patients underwent elective painless gastroscopy from September 2022 to March 2023 were selected and divided into nasal catheter oxygen group(group C)and nasal mask oxygen group(group M)according to random number table method.The group C was inhaled oxygen by conventional nasal cannula,and in group M,oxygen was inhaled by a nasal mask.Patients in both groups were given 5 L/min preoxygenation for 3 min.After induction of anesthesia,gastroscopy was performed when modified observer's assessment of alertness/sedation(MOAA/S)score≤1.During anesthesia,hypoxia interventions were performed in group C based on percutaneous arterial oxygen saturation(SpO2)and in group M based on partial pressure of end-tidal carbon dioxide(PetCO2)and SpO2.The incidence of subclinical respiratory depression,hypoxia and severe hypoxia during anesthesia was recorded.The minimum SpO2 value during anesthesia was recorded;Implementation of intervention measures of jaw lifting,mask pressure oxygen and tracheal intubation.Record the number of gastroscope withdrawal cases.Mean arterial pressure(MAP),heart rate(HR),and respiratory rate(RR)were recorded at the time of entry(T0),immediately after induction of anesthesia(T1),at the end of gastroscopy(T2),and 5 minutes after awakening(T3).The occurrence of perioperative adverse events and the satisfaction of anesthesiologists and endoscopists were recorded.Results Compared with group C,the incidence of subclinical respiratory depression,hypoxia and severe hypoxia in group M was significantly decreased(P<0.05).The minimum value of SpO2 during anesthesia in group M was higher than that in group C(P<0.05).The incidence of jaw-lifting and mask ventilation were lower in group M than that in group C(P<0.05).The incidence of gastroscope withdrawal due to airway intervention in group M was lower than that in group C(P<0.05).Compared with T0,MAP,HR and RR of the two groups were significant reduction at T1 and T2(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).The satisfaction of endoscopists in group M was higher than that in group C(P<0.05).Conclusion Compared with nasal catheter oxygen inhalation,anesthesia nasal mask can timely detect hypopnea and respiratory depression during gastroscopy,reduce the occurrence of hypoxia,and improve the airway safety of painless gastroscopy patients.

Laparoscopic right hemicolectomy is currently the most commonly used surgical procedure for right-sided colon cancer. Although this procedure is maturing in terms of key tech-niques such as the extent of surgical resection, the extent of lymph node dissection, and the recons-truction of digestive tract, it still lacks a standardized surgical procedure and quality control system. In the pre-preparation phase of the COLOR Ⅳ study (an international, multicenter, randomized contro-lled trail comparing the efficacy of intracorporeal anastomosis versus extracorporeal anasto-mosis in laparoscopic right hemicolectomy for right-sided colon cancer), the research team of the authors formulates a standardized procedure for laparoscopic right hemicolectomy based on the Delphi survey, and develops a competency assessment tool for surgical ability and quality. Attempts are being made to automate the evaluation of surgical techniques using artificial intelligence. It is hoped that the above work will help colorectal surgeons to standardize surgical operations and reduce complications, provide support for the homogenization of multicenter clinical studies, and promote the implementation of structured training for this procedure.

Objective To investigate the levels and clinical significance of serum microRNA-625 (miR-625) and serum microRNA-203 (miR-203) in patients with multiple myeloma (MM). Methods A total of 103 patients diagnosed as MM in the hospital from June 2021 to August 2023 were selected as observation group, and they were classified into stage Ⅰ (n=23), stage Ⅱ (n=31) and stage Ⅲ (n=49) according to the International Staging System (ISS) for multiple myeloma. The patients were divided into newly diagnosed group (n=75) and recurrent group (n=28) based on their diagnosis and treatment status. Additionally, 103 healthy individuals with physical examination in the hospital in the same period were selected as control group. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to determine the levels of serum miR-625 and miR-203. A multivariate Logistic regression model was used to analyze the influencing factors of MM. The diagnostic value of serum miR-625 and miR-203 for MM patients was evaluated by receiver operating characteristic (ROC) curve. Results The levels of protein M, hemoglobin, albumin, miR-625 and miR-203 in the observation group were significantly lower than those in the control group, while the levels of serum creatinine, 24-hour urine protein, urea nitrogen, serum β₂-microglobulin and serum calcium were significantly higher than those in the control group (P < 0.05). Serum levels of miR-625 and miR-203 in newly diagnosed MM group were significantly higher than those in the recurrent group (P < 0.05). The serum levels of miR-625 and miR-203 in patients with stage Ⅱ and Ⅲ were significantly lower than those in patients with stageⅠ, and the levels of miR-625 and miR-203 in patients with stage Ⅲ were significantly lower than those in patients with stage Ⅱ (P < 0.05). The serum miR-203 level in MM patients with osteolytic lesions less than 2 was significantly lower than that in patients with osteolytic lesions greater than or equal to 2 (P < 0.05). Serum miR-625 level in MM patients with grades 1 to 2 of bone disease was significantly higher than that in patients with grades 3 to 4 of bone disease (P < 0.05). The miR-625 and miR-203 were protective factors for the occurrence of MM (P < 0.05). The area under the curve (AUC) of serum miR-625 and miR-203 for diagnosing MM was 0.808 and 0.866 respectively, and the AUC of the combineddiagnosis of miR-625 and miR-203 was 0.919. The combined diagnosis of miR-625 and miR-203 was superior to the individual diagnosis of serum miR-625 and miR-203 (Z_{combined-miR-625}=3.816, Z_{combined-miR-203}=2.157, P=0.001, 0.031). Conclusion Serum levels of miR-625 and miR-203 decrease in MM patients, and their combination has a high diagnostic value for MM.

Objective:To investigate the status of height and weight of 3-18-year-old children and adolescents in urban China, and to provide a basis for establishing puberty phase specific curves for age-specific height and age-specific weight.Methods:A cross-sectional survey of 218 185 children and adolescents aged 3-18 years in urban China was conducted by using the method of stratified random cluster sampling from January 2017 to December 2019. The sampling areas included 12 provinces municipalities in China and autonomous regions in total. Data were collected on weight, height, waist circumference, hip circumference and secondary sexual characteristics. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile reference values and growth curves of height and weight for boys and girls aged 3-18 years. Wilcoxon rank sum test was applied to compare the P 50 value of height and weight between children of each Tanner stage and children of the same age ignoring the different puberty phase. Results:The 3rd, 50th, and 97th percentile curves for height and weight for age were developed for boys and girls aged 3-18 years. The 3rd, 50th, and 97th percentile curves for age-specific height and age-specific weight for each puberty phase were developed for boys and girls. Compared with all children ignoring the different puberty phase, boys aged 9 and over and girls aged 7 and over who are at Tanner stage 1 showed shorter height and lighter weight than those of the same age group (all P<0.01), the difference ranges of height at P 50 are -4.0 to -0.6 cm for boys, and -4.4 to 0.5 cm for girls; the difference ranges of weight are -4.8 to 0.4 kg for boys, and -4.0 to -0.3 kg for girls; children at Tanner stage 2 & 3 initially were taller and heavier than those of the same age group; and later grew shorter and lighter than those of the same age group, the two sets of curves cross over; boys aged 16 and under and girl aged under 14 who are at Tanner stage 4 were taller and heavier than those of the same age group (all P<0.01), the difference ranges of height at P 50 are 0.2 to 10.0 cm for boys, and 0.2 to 9.4 cm for girls; the difference ranges of weight at P 50 are 0.7 to 10.9 kg for boys, and 1.0 to 11.2 kg for girls, and the differences showed narrowing trend with age. Conclusion:The puberty phase specific growth curves of age-specific height and age-specific weight for boys and girls aged 3-18 years are established, it is useful for clinical work to evaluate physical development of children at different puberty phases.

Objective To evaluate the accuracy of different biomarkers for early diagnosis of acute kidney injury ( AKI ) in the patients undergoing cardiovascular surgery under cardiopulmonary bypass ( CPB) . Methods A total of 200 patients, aged 22-86 yr, weighing 46-87 kg, scheduled for elective cardiovascular surgery under CPB, were enrolled in this study. The concentration of serum creatinine was determined at 1 day before operation and 1-7 days after operation. At 1 day before operation and 0, 2, 6 and 12 h after operation, the concentrations of urine neutrophil gelatinase-associated lipocalin (NGAL), cystatin C ( Cys C) , tissue inhibitor of matrix metalloproteinase type 2 ( TIMP-2) and insulin-like growth factor binding protein-7 ( IGFBP-7) were determined. The TIMP-2 and IGFBP-7 product ( TI) was calcu-lated. AKI was diagnosed after surgery according to Kidney Disease Improving Global Outcomes criteria. The receiver operating characteristic curve was plotted, and the area under receiver operating characteristic curve ( AUC) was calculated. Results The incidence of AKI was 20. 5％. The AUC of AKI diagnosed by the concentration of urine NGAL was 0. 689, 0. 709, 0. 713 and 0. 803 at 0, 2, 6 and 12 h after opera-tion, respectively ( P<0. 05) . The AUC of AKI diagnosed by the concentration of urine Cys C was 0. 639, 0. 762, 0. 774 and 0. 812 at 0, 2, 6 and 12 h after operation, respectively ( P<0. 05) . The AUC of AKIdiagnosed by TI was 0. 687, 0. 721, 0. 740 and 0. 779 at 0, 2, 6 and 12 h after operation, respectively ( P<0. 05) . The AUC of AKI diagnosed by combined three indices the parallel test was 0. 694, 0. 773 and 0. 794 at 0, 2 and 6 h after operation, respectively ( P<0. 05) . The AUC of AKI diagnosed by the serial test was 0. 610, 0. 631 and 0. 667 at 0, 2 and 6 h after operation, respectively. Conclusion Urine NGAL or Cys C concentrations or TI single detection and parallel test have a certain accuracy for early diag-nosis of AKI in the patients undergoing cardiovascular surgery under CPB.

Objective To investigate the effects of simulated microgravity by RCCS on proliferation and cell cytoskeleton of human HaCaT keratinocyte. Methods The rotary cell culture system (RCCS) was used to simulate the microgravity environment, and human HaCaT keratinocytes were divided randomly(random number) into the simulated microgravity group (SMG) and normal gravity group (NG). HaCaT cells in the two groups were harvested respectively after 32, 36 and 42 h culture. The HaCaT cells proliferation and cycles were detected by flow cytometry, the concentration of hb-EGF in supernatant was detected by ELISA, and the cell cytoskeleton was observed after 42 hours' culture under laser confocal microscope with FITC-labeled technique. SPSS 23.0 statistical software was used for statistical analysis, and P <0.05 was considered statistically significant. Results The flow cytometry showed that the proportions of human HaCaT keratinocytes in G1 and G2/M phases were increased while the proportion of HaCaT cells in S stage was decreased significantly after 32, 36 and 42 h RCCSculture compared with those in the normal gravity group. The HaCaT cells in G1 stage were declined along with incubation time. ELISA results showed that the hb-EGF concentration in HaCaT supernatant under simulated microgravity culture for 24 and 36 h was lower than that in the normal control group (P<0.01). The laser confocal microscope revealed that the HaCaT fluorescence intensity was decreased,and there were disordered microfilaments, structural ambiguity, pseudopodia reduction and irregularshape among FITC-labeled HaCaT cells cultured 42 h in RSSC compared with the normal gravity group.Conclusions RCCS simulated microgravity environment could inhibit the cell cycle transformation and proliferation of human HaCaT keratinocyte, affect the keratinocyte-secreting function, and induce alterations of the cell cytoskeleton.

Objective To verify and evaluate the prognostic models for extranodal natural killer/T-cell lymphoma, nasal type (ENKL). Methods ENKL patients in the 105th Hospital of PLA from January 1990 to December 2015 were retrospectively analyzed, and patients were followed to the August 2016 through telephone and medical records. The models were evaluated by C-index, and the prognostic ability of each factor was assessed by survival curves. Results A total of 76 patients met the inclusion criteria, with a median age of 41.9 years old (range, 14-74 years old), all patients received chemotherapy, and 49 received radiation therapy. During the median observation time (37.0 months), 37 patients died in a median of 28.4 months. The prognostic factors of Eastern Cooperative Oncology Group performance status (ECOG PS) score, level of lactate dehydrogenase (LDH) and Ann Arbor staging were the influencing factors of overall survival in the univariate survival analysis (all P<0.05), and only ECOG PS score was significant in the multivariate Cox regression (OR: 4.231, 95 ％ CI 2.172-8.240, P= 0.000). C-index of international prognostic index (IPI) was 0.541 (95 ％ CI 0.534- 0.555), and those of model with ECOG PS score, Ann Arbor staging, primary lesion invasion, LDH and age as the indicators and model with ECOG PS core, Ann Arbor staging, primary lesion invasion, LDH and hemoglobin as the indicators were both 0.726 (95 ％ CI 0.626-0.826). Conclusion Both model with ECOG PS score, Ann Arbor staging, primary lesion invasion, LDH and age as the indicators and model with ECOG PS core, Ann Arbor staging, primary lesion invasion, LDH and hemoglobin as the indicators can accurately predict the prognosis of patients with ENKL and are significantly better than the IPI model.

OBJECTIVE: To detect VHL gene mutation in a pedigree affected with von Hippel-Lindau syndrome (VHL). METHODS: Clinical data of the pedigree was reviewed. Patients were subjected to Sanger sequencing to detect mutation of the VHL gene. Structure of pVHL was predicted by 3D modeling using the swiss-model. RESULTS: A novel c.426delT(p.V142fs) [NM_000551] mutation was found in exon 2 of the VHL gene. 3D modeling suggested that the alpha-structure of pVHL is completely absent. CONCLUSION The novel c.426delT(p.V142fs) mutation probably underlies the VHL in this pedigree.
DNA Mutational Analysis ; Exons ; Humans ; Mutation ; Pedigree ; Von Hippel-Lindau Tumor Suppressor Protein ; genetics ; von Hippel-Lindau Disease ; genetics