Objective:To investigate the effect of dandelion polysaccharide(DP)on inflammatory response and the protein expression of S100 calcium binding protein A8/A9(S100A8/A9)in lung tissue and small intestinal tissue of rats with multiple organ dysfunction syndrome(MODS).Methods:The two-hit method of hemorrhagic shock and intraperitoneally injected lipopolysaccharide was used to establish a rat model of MODS,and the rats were divided into sham-operation group,model group,low-dose DP group,and high-dose DP group.The organ coefficient and wet/dry weight ratio of the lung and the small intestine were observed for each group of rats;HE staining was used to observe the pathomorphological changes of lung tissue and small intestinal tissue;immunohistochemical staining was used to measure the expression of interleukin-1β(IL-1β),interleukin-6(IL-6),and interleukin-10(IL-10)in lung tissue and small intestinal tissue;Western blot was used to measure the protein expression level of S100A8/A9 in lung tissue and small intestinal tissue.Results:Compared with the sham-operation group,the model group had significant increases in the organ coefficient of the lung(5.849±0.824),the wet/dry weight ratio of the lung(6.556±0.631),the wet/dry weight ratio of the small intestine(6.356±0.535),and the wet weight/length ratio of the small intestine(73.950±5.569).HE staining showed that that the model group had massive in-flammatory cell infiltration in alveolar space and pulmonary interstitium,thickened alveolar wall,and disintegration and fragmentation of the villi of the small intestine,with inflammatory cell infiltration and proliferation of segmental aggregated lymphoid follicles.In the model group,S100A8/A9 was mainly expressed in neutrophils and macrophages,and there were increases in the expression of S100A8/A9,IL-1β,and IL-6 and a reduction in the expression of IL-10 in the lung tissue and small intestinal tissue of rats.After treatment with high-dose DP,there were reductions in the organ coefficient of the lung(4.297±0.462),the wet/dry weight ratio of the lung(5.313±0.495),the wet/dry weight ratio of the small intestine(5.398±0.388),and the wet weight/length ratio of the small intestine(59.417±2.891).The high-dose group also had alleviation of pathological injury in the small intestine,with reductions in the expres-sion of S100A8/A9,IL-1β,and IL-6 and an increase in the expression of IL-10 in lung tissue and small intestinal tissue.Conclusion:DP may alleviate inflammatory response in lung and small intestinal injuries of rats with MODS by inhibiting the expression of S100A8/A9.

Esophageal cancer cases in China account for more than 50% of the world, among which approximately 90% are histological subtypes of esophageal squamous cell carcinoma. Over 50% of esophageal cancer patients are initially diagnosed at locally advanced or advanced stages. The R0 resection rate with surgical treatment alone is relatively low, and local recurrence and distant metastasis are prone to occur, resulting in a low 5-year survival rate. Recent research has focused on neoadjuvant therapy for esophageal cancer, but the most effective form of such therapy remains undetermined. Immunotherapy is currently the most active research field in tumor treatment. Further exploration of the treatment model combing immunotherapy with neoadjuvant chemotherapy or chemoradiotherapy is expected to improve the therapeutic effect and survival benefit in patients with locally advanced resectable esophageal squamous cell carcinoma.

Objective:To analyze the efficacy and prognosis of surgical patients with traumatic epidural hematoma straddling the transverse sinus (TEHSTS).Methods:Clinical data of 4 360 patients with epidural hematoma admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2010 to April 2024 were collected. Among them, 109 cases (2.5%) were diagnosed with TEHSTS. Based on the rapid progression criteria for posterior fossa epidural hematoma [sudden deterioration of Glasgow Coma Scale (GCS) score within hours (a decrease of ≥1 point in the best motor response and/or a decrease of ≥2 points in GCS score), and progressive enlargement of TEHSTS on repeat CT scan], the timing and method of surgery were determined. Two surgical approaches were compared: combined supratentorial and infratentorial craniotomy (craniotomy group) and modified supratentorial burr-hole drainage (burr-hole group). Clinical data, surgical timing, surgical outcomes, and prognosis were compared between the two groups.Results:There were 57 cases (52.3%) in the craniotomy group and 52 cases (47.7%) in the modified burr-hole group. The proportion of patients presenting with vomiting upon admission was higher in the craniotomy group than in the burr-hole group [77.2%(44/57) vs 59.6%(31/52), P=0.048], and the proportion of patients with linear occipital fractures on CT was also higher in the craniotomy group [91.2%(52/57) vs 75.0%(39/52), P=0.023]. No significant differences were observed in other admission symptoms or CT findings between the two groups (all P>0.05). The GCS score upon admission was significantly lower in the craniotomy group [(11.0±1.0)points] than in the modified burr-hole group [(13.0±1.0)points] ( P<0.05). Four cases in the burr-hole group developed delayed hematomas, including two cases of bilateral delayed epidural hematomas. The preoperative GCS score in the craniotomy group [(9.0±0.5)points] was significantly lower than upon admission [(11.0±1.0)points] ( P<0.05), and the surgical timing was (6.5±1.5)hours after injury. The preoperative GCS score in the burr-hole group [(11.5±0.5)points] was also significantly lower than upon admission [(13.0±1.0)points] ( P<0.05), with surgical timing at (19.5±5.5)hours after injury. Preoperative CT scans showed no significant difference in hematoma volume between the burr-hole group [(35.5±7.5)ml] and the craniotomy group [(36.5±9.5)ml] ( P>0.05). The preoperative GCS score was significantly lower in the craniotomy group than in the burr-hole group ( P<0.05). The GCS scores at 24 hours postoperatively were significantly improved compared to preoperative scores in both groups (all P<0.05). The burr-hole group had significantly shorter operative time, less intraoperative blood loss, shorter intensive care unit (ICU) stay, and shorter hospital stay than the craniotomy group (all P<0.01). The incidence of postoperative pulmonary infection was lower in the burr-hole group than in the craniotomy group ( P<0.05). At 3-month follow-up, the rate of good recovery [Glasgow Outcome Scale (GOS) score≥4 points] was significantly higher in the burr-hole group (98.1%) than in the craniotomy group (93.0%) ( P<0.01). Conclusions:TEHSTS should be managed with different surgical approaches based on admission symptoms, GCS score, and the speed of disease progression. The modified burr-hole drainage procedure is convenient, safe, and associated with better prognosis.

Objective:To analyze the efficacy and prognosis of surgical patients with traumatic epidural hematoma straddling the transverse sinus (TEHSTS).Methods:Clinical data of 4 360 patients with epidural hematoma admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2010 to April 2024 were collected. Among them, 109 cases (2.5%) were diagnosed with TEHSTS. Based on the rapid progression criteria for posterior fossa epidural hematoma [sudden deterioration of Glasgow Coma Scale (GCS) score within hours (a decrease of ≥1 point in the best motor response and/or a decrease of ≥2 points in GCS score), and progressive enlargement of TEHSTS on repeat CT scan], the timing and method of surgery were determined. Two surgical approaches were compared: combined supratentorial and infratentorial craniotomy (craniotomy group) and modified supratentorial burr-hole drainage (burr-hole group). Clinical data, surgical timing, surgical outcomes, and prognosis were compared between the two groups.Results:There were 57 cases (52.3%) in the craniotomy group and 52 cases (47.7%) in the modified burr-hole group. The proportion of patients presenting with vomiting upon admission was higher in the craniotomy group than in the burr-hole group [77.2%(44/57) vs 59.6%(31/52), P=0.048], and the proportion of patients with linear occipital fractures on CT was also higher in the craniotomy group [91.2%(52/57) vs 75.0%(39/52), P=0.023]. No significant differences were observed in other admission symptoms or CT findings between the two groups (all P>0.05). The GCS score upon admission was significantly lower in the craniotomy group [(11.0±1.0)points] than in the modified burr-hole group [(13.0±1.0)points] ( P<0.05). Four cases in the burr-hole group developed delayed hematomas, including two cases of bilateral delayed epidural hematomas. The preoperative GCS score in the craniotomy group [(9.0±0.5)points] was significantly lower than upon admission [(11.0±1.0)points] ( P<0.05), and the surgical timing was (6.5±1.5)hours after injury. The preoperative GCS score in the burr-hole group [(11.5±0.5)points] was also significantly lower than upon admission [(13.0±1.0)points] ( P<0.05), with surgical timing at (19.5±5.5)hours after injury. Preoperative CT scans showed no significant difference in hematoma volume between the burr-hole group [(35.5±7.5)ml] and the craniotomy group [(36.5±9.5)ml] ( P>0.05). The preoperative GCS score was significantly lower in the craniotomy group than in the burr-hole group ( P<0.05). The GCS scores at 24 hours postoperatively were significantly improved compared to preoperative scores in both groups (all P<0.05). The burr-hole group had significantly shorter operative time, less intraoperative blood loss, shorter intensive care unit (ICU) stay, and shorter hospital stay than the craniotomy group (all P<0.01). The incidence of postoperative pulmonary infection was lower in the burr-hole group than in the craniotomy group ( P<0.05). At 3-month follow-up, the rate of good recovery [Glasgow Outcome Scale (GOS) score≥4 points] was significantly higher in the burr-hole group (98.1%) than in the craniotomy group (93.0%) ( P<0.01). Conclusions:TEHSTS should be managed with different surgical approaches based on admission symptoms, GCS score, and the speed of disease progression. The modified burr-hole drainage procedure is convenient, safe, and associated with better prognosis.

Radical cystectomy combined with pelvic lymph node dissection is the standard procedure for the treatment of muscle invasive bladder cancer and complex non-muscle invasive bladder cancer.Our department has routinely carried out laparoscopic radical cystectomy(ELRC)through the extraperitoneal approach in 340 cases.This article summarizes the establishment of the peritoneal space,the expansion of the peritoneal space,the operation steps of bladder resection and lymph node dissection through the peritoneal channel,and how to shorten the operation time and reduce the difficulty of the operation.During the surgery,the bladder is removed periperitoneally without destroying the peritoneum to preserve the functions of peritoneum support,secretion,protection and lubrication,which has little impact on the abdominal organs,reduces the incidence of complications,and provides favorable conditions for subsequent treatment.

【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.

【Objective】 To investigate the efficacy and safety of single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy in the treatment of upper tract urothelial carcinoma (UTUC). 【Methods】 Clinical data of 31 UTUC cases treated in our hospital during Nov.2018 and Jun.2022 were retrospectively analyzed, including 11 tumors in the right side, and 20 in left side. There were 14 cases of renal pelvic carcinoma, 16 cases of ureter carcinoma, and 1 case of renal pelvic carcinoma plus ureter carcinoma. 【Results】 All surgeries were successfully performed without conversion to open surgery. The mean operation time was (81.45±19.80) min, and the estimated blood loss was (69.03±24.13) mL. No serious perioperative complications were observed. The average postoperative hospital stay was (6.13±2.44) d, and the median follow-up was 28 (3.0-49.0) months. At the last follow-up, 2 patients died, 3 had recurrence, but no contralateral recurrence was observed. 【Conclusion】 Single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy is safe, effective and feasible in the treatment of UTUC. It is worth clinical popularization.

The aim of this study was to prepare tandem multimeric proteins of BmSPI38, a silkworm protease inhibitor, with better structural homogeneity, higher activity and stronger antifungal ability by protein engineering. The tandem multimeric proteins of BmSPI38 were prepared by prokaryotic expression technology. The effects of tandem multimerization on the structural homogeneity, inhibitory activity and antifungal ability of BmSPI38 were explored by in-gel activity staining of protease inhibitor, protease inhibition assays and fungal growth inhibition experiments. Activity staining showed that the tandem expression based on the peptide flexible linker greatly improved the structural homogeneity of BmSPI38 protein. Protease inhibition experiments showed that the tandem trimerization and tetramerization based on the linker improved the inhibitory ability of BmSPI38 to microbial proteases. Conidial germination assays showed that His₆-SPI38L-tetramer had stronger inhibition on conidial germination of Beauveria bassiana than that of His₆-SPI38-monomer. Fungal growth inhibition assay showed that the inhibitory ability of BmSPI38 against Saccharomyces cerevisiae and Candida albicans could be enhanced by tandem multimerization. The present study successfully achieved the heterologous active expression of the silkworm protease inhibitor BmSPI38 in Escherichia coli, and confirmed that the structural homogeneity and antifungal ability of BmSPI38 could be enhanced by tandem multimerization. This study provides important theoretical basis and new strategies for cultivating antifungal transgenic silkworm. Moreover, it may promote the exogenous production of BmSPI38 and its application in the medical field.
Animals ; Antifungal Agents/pharmacology* ; Escherichia coli/metabolism* ; Proteins/metabolism* ; Protease Inhibitors/chemistry* ; Bombyx/chemistry* ; Saccharomyces cerevisiae/metabolism* ; Peptide Hydrolases

Objective:To investigate the effect of sequential suture and adhesion on craniomaxillofacial skin contusion and laceration.Methods:A total of 189 patients with craniomaxillofacial skin contusion and laceration (CMFSCL) were randomly divided into three groups: 66 cases in SSA group, 63 cases in CS group and 60 cases in TS group. Operation time, visual analogue scale (VAS), Vancouver scar scale (VSS) and adverse reactions incidence were compared and analyzed between the three groups. Effect and satisfactory scale were evaluated.Results:Operation time in SSA group (10.67±1.26) min was significantly less than that in CS (18.91±1.38) min and TS group (17.96±1.43) min ( P<0.05). VAS in SSA group 24 h post-operation (3.11±1.01) was significantly lower than that in CS and TS group ( P<0.05). VSS in SSA group 6 months post-operation (1.18±0.21) was significantly lower than that in CS (3.78±1.01) ( P<0.05) and TS group (5.98±1.06) ( P<0.01). Total effective rate of SSA group (96.5%) was significantly higher than that in CS (85.7%) ( P<0.05) and TS group (56.1%) ( P<0.01); total effective rate in CS group was significantly higher than that in TS group ( P<0.05). Infection and dehiscence rates in SSA group were lower than those in CS and TS group ( P<0.01). Satisfactory rate of SSA group (99%) was significantly higher than that of CS (89.1%) and TS group (71.3%) ( P<0.05); the satisfactory rate of CS group was significantly higher than that of TS group ( P<0.05). Conclusions:Sequential suture and adhesion technique is simple and effective for craniomaxillofacial skin contusion and laceration, which is worthy of clinical promotion.

Esophageal cancer is one of the most common malignant tumors in clinic, and its morbidity and mortality are always high. Staging is the main basis for comprehensive treatment and prognosis evaluation. Accurate staging is essential for proper diagnosis, individualized treatment and good prognosis. Related technologies of endoscopic ultrasonography can determine the depth of tumor invasion and local lymph node metastasis, which makes the diagnosis of esophageal cancer more accurate, and plays an increasingly important role in the diagnosis and treatment of early esophageal cancer.