Objective To investigate the relationship between serum and glucocorticoid regulated protein kinase 1(SGK1),tumor necrosis factor receptor-associated protein 1(TRAP1),forkhead box Q1(FOXQ1)levels and chemotherapy efficacy and prognosis in patients with advanced gastric cancer.Methods A total of 127 patients with advanced gastric cancer(gastric cancer group)admitted to the hospital from October 2017 to October 2020 were selected.All patients received SOX regimen(oxaliplatin+tiggio)chemotherapy for at least 2 cycles,and were divided into effective group(52 cases)and ineffective group(75 cases)according to the chemotherapy efficacy.A total of 62 healthy volunteers in the hospital were selected as the control group.Serum SGK1,TRAP1 and FOXQ1 levels were detected and compared in each group.Patients were followed up for 2 years after discharge.Receiver operating characteristic(ROC)curve was used to analyze the value of SGK1,TRAP1 and FOXQ1 in predicting the efficacy of chemotherapy in gastric cancer.Kaplan-Meier survival curve and Cox proportional hazard regression analysis were used to analyze the relationship between SGK1,TRAP1,FOXQ1 and the chemotherapy efficacy and prognosis of advanced gastric cancer.Results The serum levels of SGK1,TRAP1 and FOXQ1 in the gastric cancer group were higher than those in the control group(P＜0.05),and the serum levels of SGK1,TRAP1 and FOXQ1 in the ineffective group were higher than those in the effective group(P＜0.05).The area under the curve(AUC)of SGK1,TRAP1 and FOXQ1 in predicting the chemotherapy efficacy of gastric cancer was 0.836,0.833 and 0.778,respectively.The AUC of combined prediction was 0.91 7,which was higher than that of single index prediction.The overall survival(OS)rate of advanced gastric cancer patients with high SGK1 level,TRAP1 level and FOXQ1 level were low-er than that of patients with low SGK1 level,TRAP1 level and FOXQ1 level(Log-Rank x2=12.092,10.825,11.653,P＜0.05).Multiariable Cox proportional hazard regression results showed that the risk proportion chemotherapy drug resistance,SGK1 high level,TRAP1 high level,FOXQ1 high level were risk factor for poor prognosis of patients with advanced gastric cancer(P＜0.05).Conclusion Serum SGK1,TRAP1 and FOXQ1 levels are increased in patients with advanced gastric cancer,which are associated with poor chemo-therapy efficacy and low OS rate.

Objective:To compare carotid endarterectomy (CEA) and carotid artery stenting (CAS) in perioperative, medium and long term prognosis of patients with carotid artery stenosis.Methods:A retrospective analysis was performed on 1 329 cases of carotid artery stenosis treated at Department of Vascular Surgery, Beijing Anzhen Hospital from Jan 2011 to Aug 2020, as all cases being divided into CAS group and CEA group.Results:There were significant differences in age ( t=0.098, P=0.023) and drinking habits ( χ2=8.055, P=0.005) between the two groups. There were more unstable plaques in CEA group ( χ2=4.392, P=0.038), and more bilateral lesions in CAS group ( χ2=9.673, P=0.038). In perioperative period, there were more mannitol use in CEA group ( χ2=78.614, P<0.001), more incision/puncture site complications ( χ2=5.158, P=0.035), lung infection ( χ2=6.355, P=0.013), cerebral hyperperfusion syndrome (CHS) ( χ2=5.158, P=0.035) and extracranial nerve injury ( χ2=23.760, P<0.001) in CEA group than in CAS group, and more acute renal failure in CAS group ( χ2=10.393, P=0.001). There was no significant difference in survival rate and ischemic stroke, myocardial infarction, cerebral hemorrhage and renal insufficiency between the two groups (all P>0.05). The mean survival time of CAS group was 53.195 months (95% CI: 52.040-54.350), and 54.492 months (95% CI: 53.790-55.195) in CEA group ( P=0.051). Conclusions:Patients in CEA group had more unstable plaque and a lower perioperative stroke rate. CEA group had higher risk of CHS,while CAS was with lower postoperative lung infection rate and less wound local complications. There was no significant difference in long-term survival between the two groups.

Objective:To compare the perioperative complications of carotid endarterectomy with patch angioplasty or primary closure.Methods:The clinical data of 492 carotid endarterectomy patients at the Vascular Surgery Department of Anzhen Hospital from Mar 2003 to Dec 2016 was analyzed retrospectively.Results:There were 364 cases (74%) in the patch angioplasty group and 128 cases (26%) in the primary closure group. The incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than that in the primary closure group (0.8% vs. 3.9%, P=0.031), and there was no difference in the incidence of the remaining perioperative complications. By subgroup analysis, the incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than in the primary closure group when the diameter of the internal carotid artery was <5 mm (0.7% vs. 6.0%, P=0.001), whereas there was no difference between the two groups when the diameter of the internal carotid artery was ≥5 mm. Conclusions:Carotid endarterectomy with patch angioplasty can reduce the incidence of perioperative cerebral infarction, especially in cases with an internal carotid artery diameter <5 mm.

Objective: To investigate the etiology, treatment method and prevention of gastrointestinal complications(GCs) after endovascular and open repair of abdominal aortic aneurysm (AAA). Methods: The clinical data of 716 cases who were diagnosed as AAA and underwent endovascular(EVAR) or open repair (OR) from Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University April 2009 to March 2017 were collected and analyzed retrospectively. There were 608 males (84.9%)and 108 females(15.1%), aging of 69.4 years (range: 52-86 years). There were 539 cases(75.3%) underwent EVAR and 177 cases(24.7%) underwent OR. The morbidity of GCs and mortality of GCs, such as acute pancreatitis, cholecystitis, ischemic colitis, intestinal obstruction and peptic ulcer, between EVAR and OR group were compared. The treatment of the GCs and the prognosis of the patients were reported. Results: The morbidity of GCs in EVAR and OR group were 4.6%(25/539)and 35.0%(62/177), respectively. There were 10 cases and 28 cases suffering from acute pancreatitis in EVAR and OR group, respectively; 4 cases and 6 cases suffering from cholecystitis in the two groups; 6 cases and 13 cases suffering from ischemic colitis in the two groups; 5 cases suffering from intestinal obstruction in OR group; 5 cases and 10 cases suffering from peptic ulcer in the two groups. Two patients died in EVAR group, and the peri-operative mortality was 0.37%, one died of ischemic colitis with acute myocardial infarction, the other died of ischemic colitis with septic shock. Six patients died in OR group, and the peri-operative mortality was 3.39%, two patients died of acute pancreatitis with intestinal necrosis, one patient died of cholangitis with peritonitis and septic shock, three patients died of ischemic colitis with acute renal failure or septicemia. Conclusions The etiology of peri-operative GCs after AAA repair may include inferior mesenteric artery occlusion or ligation, pancreas injury, organ hypoperfusion and so on.

Glutamate dehydrogenase (GDH)a key enzyme in the nitrogen metabolism pathway catalyzes the con-version between α-ketoglutarate and glutamate reversibly using NAD(P)H as a cofactor. Based on genomic stud-ies,it was concluded that SHJG_7666 was a potential GDH in Streptomyces hygroscopicus 5008(S5008),and its expression level in vivo was positively correlated with the biosynthesis of an important aminocyclol compound vali-damycin. Phylogenetic tree analysis showed that the S5008 SHJG_7666 GDH belonged to the Glu/Leu/Phe/Val dehydrogenase family,with conserved glutamate-α-ketoglutarate binding domain and the classical GXGXXG dinu-cleotide binding motif. Further homologous modeling and structural comparison revealed that SHJG_7666 con-tained conserved Lys60,Lys78and Asp120catalytic functional sites and ligand binding residues Ser36,Gly38,Gln119 and Asp166,Asn300,Ala330. Moreover,recombinant expression of SHJG_7666 in E. coli and in vitro enzyme activity demonstrated that glutamate dehydrogenase can convert ammonium salt to glutamate with pH and temperature being optimal at 7. 5 and 37 °C respectively. Enzyme activity under optimum reaction condition has Kmvalue of (25. 3 ±9. 1)μmol/L and kcatof (3 ±0. 8)×10 -5s-1for the substrate α-ketoglutarate. Results of this study further improved the catalytic activity of SHJG_7666,thus laying the foundation for the ultimate increase of vali-damycin production.

Objective To investigate the clinical curative effect of the surgical method of transferring the radialis proper digital nerve of damaged index finger and its dorsal branch to repair the thumb nerve evulsion.Methods 13 patients with thumb nerve evulsion were treated.There were 8 males and 5 females with an average age of 28 years (ranged 18-52 years old).The injuries were caused by machine twist (8 cases),gear(4 cases),electric saw (1 case).And thumb rotational avulsion amputation (10 cases),thumb incompleteness amputation(3 cases).The time from injury to admission was 1-3.5 h (mean 2.2 h).The average time from injury to admission was (1.1 ± 1.5) h.The amputate level of skin was at the juxtra-articular of metacarpophalangeal joint.The amputate level of bone was at the base of proximal phalanx (6 patients) and metacarpophalangeal joint (4 patients),interphalangeal joint(3 patients).Using transferring the radialis proper digital nerve of index finger without reimplantation and its dorsal branch to.repair the both side injuries of thumb nerve evulsion.According to routine method to repair digital bone,veins,arteries and tendons.Results All 13 chases were followed up for 6 months to 2 years and 7 months postoperatively,with an average of 22 months.The wounds and incisions at donor sites were healed by first intention.All 13 cases of thumb reimplantation were successful.Two-point discrimination of ulnaris finger pulp was 2 to 6mm,average 4.2mm,and the radialis was 5 to 9mm,average 7.8mm.Sensory function was rated as S4(the ulnaris in 12 cases and the radialis in 2 cases) and S3 + (the radialis in 11 cases and the ulnaris in 1 cases).Conclusion Transferring the radialis proper digital nerve of damaged index finger and its dorsal branch to the digital nerve on the neighboring thumb is a simple and effective method to restore sensory function of the pulp.

Objective To evaluate retrograde transpopliteal access for femoral-popliteal artery total occlusion with blind puncture.Methods Clinical data of 22 cases admitted from Sep 2014 to June 2016 undergoing endovascular treatment of the femoral-politeal artery occlusion with transpopliteal artery retrograde access by blind puncture were analyzed.Results A total of 22 patients underwent retrograde popliteal access with blind puncture after antegrade attempts failed.Puncture above the knee was performed in 18 cases and below the knee in 4 cases.The average increase of ABI was 0.57.Hematoma of puncture site was observed in 2 patients,other complications included pneumonia in 1 case and renal insufficiency in 2 cases.The mean follow-up time was (13 ± 5)months.Restenosis occurred in 8 patiens(36.4％)during the follow-up time.The primary patency was (86.4 ± 0.07) ％ at 6 months and (70.7-± 0.12) ％ at 12 months.There was no major amputation rate and mortality during the follow-up.Conclusions Retrograde transpopliteal access for femoral-popliteal artery occlusion with blind puncture is safe and effective.

Objective To compare the effect after endovascular repair (EVAR) or open repair (OR) of ruptured abdominal aortic aneurysm (rAAA) in Department of Vascular Surgery,Beijing Anzhen Hospital.Methods Clinical data of 46 repaired rAAAs patients was retrospectively analyzed from 2005 to 2015.The difference between the EVAR group and the OR group in perioperative mortality,operation time,ICU stay,blood transfused,length of stay (LOS),complication rate were compared by x2 test and t test.Results 18 rAAA patients were repaired by EVAR,aged from 51 to 91 with a mean of (68 ±9).28 were repaired by OR,aged from 41 to 83 with a mean of (70 ± 11).Perioperative mortality was 21.0％ for EVAR and 28.6％ for OR (P ＞0.05).LOS was (15.3 ±9.5) days for EVAR,and (23.9 ± 10.5) days for OR (P ＜0.05).Blood transfused was (3 210 ± 3 780) ml for EVAR and (4 814 ± 3 392) ml for OR (P＜0.05).ICU stay time was (7.7 ±4.2) d for EVAR and (4.2 ±2.5) d for OR (P＜0.05).Conclusion EVAR is a reliable approach for the treatment of acute rAAA.

Objective:The aim is to establish L-glutamate specific aminotransferase-L-glutamate dehydrogenase coupling 96-well high throughput screening method,which is applied to molecular evolution of aminotransferase WecE from E.coli.Methods:An optical assay for aminotransferase catalytic activity based on aminotransferase-glutamate dehydrogenase coupling system is established by optimization of coupling enzyme loading,signal molecule NADH concentration and coupling time.Mutants library of WecE is obtained by sitedirected saturation mutagenesis.Positive mutants can be screened out through 96-well preliminary screening and flask second screening.Results:The target transamination reaction is coupled with L-glutamate dehydrogenase indicative reaction system which consists of 0.5 U/ml enzyme loading and 0.4 mmol/L NADH.A positive mutant Y321F whose catalytic activity increases 3.4 fold compared to that of wild type is screened out in Tyr 321 saturation mutagenesis library of WecE.Conclusion:An accurate high throughput screening method with weak background interference is established.It offers feasible solution for molecular evolution of L-glutamate specific aminotransferase.

Objective To evaluate the perioperative and long-term effects of endovascular aneurysm repair(EVAR) of infrarenal abdominal aortic aneurysm (AAA).Methods Clinical data of 131 AAA cases undergoing EVAR were retrospectively evaluated for the safety and long-term efficacy.Results The operative time was (137 ±29) min,blood loss was (142 ±20) ml,blood transfusion was (46 ± 26) ml,ICU staying time was (17 ± 4) h.Major perioperative complications were severe heart failure in 8 cases,myocardial infarction in 2 cases,pulmonary complications in 5 cases,internal leakage in 4 cases.During the period of up to 60 months there were15 cases of endoleak including 8 cases of type Ⅰ,5 cases of type Ⅱ,1 each case of type Ⅲ and Ⅳ and 2 deaths.By Kaplan-Meier survival analysis there were complications developing after 60 months and up to 40％ of them needing reintervention.Conclusions Endovascular repair is the safe treatment for AAA,but discharged patients need close long-term follow-up.Complications that ensued need intensive management.