Gallbladder cancer with delayed diagnoses, as a malignant tumor diagnosed intraoperatively or postoperatively incidentally in benign gallbladder diseases, radical surgical treatment is its core treatment, and the necessity of re-operation, timing of surgery, choice of surgical procedure, definition of resection extent, and preoperative neoadjuvant therapy still remain controversial. Re-operation for gallbladder cancer with delayed diagnoses needs to balance tumor radicalization, postoperative risk, and survival benefit, and combining neoadjuvant therapy to facilitate radical treatment, and develop individualized protocols. The multidisciplinary team should integrate innovative technologies and multi-center prospective studies to promote the development of precise treatment strategies for gallbladder cancer with delayed diagnoses and optimize the survival of patients.

Objective    To identify the risk factors for hospital mortality in patients with acute myocardial infarction (AMI) after emergency coronary artery bypass grafting (CABG). Methods    We retrospectively analyzed the clinical data of 145 AMI patients undergoing emergency CABG surgery in Qingdao Municipal Hospital from 2009 to 2019. There were 108 (74.5%) males and 37 (25.5%) females with a mean age of 67.7±11.5 years. According to whether there was in-hospital death after surgery, the patients were divided into a survival group (132 patients) and a death group (13 patients). Preoperative and operative data were analyzed by univariate analysis, followed by multivariate logistic regression analysis, to identify the risk factors for hospital mortality. Results    Over all, 13 patients died in the hospital after operation, with a mortality rate of 9.0%. In univariate analysis, significant risk factors for hospital mortality were age≥70 years, recent myocardial infarction, left ventricular ejection fraction (LVEF)<30%, left main stenosis/dissection, operation time and simultaneous surgeries (P<0.05). Multivariate logistic regression analysis showed that LVEF<30%(OR=2.235, 95%CI 1.024-9.411, P=0.014), recent myocardial infarction (OR=4.027, 95%CI 1.934-14.268, P=0.032), operation time (OR=1.039, 95%CI 1.014-1.064, P=0.002) were independent risk factors for hospital mortality after emergency CABG. Conclusion    Emergency CABG in patients with AMI has good benefits, but patients with LVEF<30%and recent myocardial infarction have high in-hospital mortality, so the operation time should be shortened as much as possible.

This study aimed to investigate the prevalence and molecular characteristics of Listeria monocytogenes in cooked products in Zigong City, China. The overall occurrence of the L. monocytogenes in the ready-to-eat (RTE) shops and mutton restaurants surveyed was 16.2% (141/873). An occurrence of 13.5% was observed in RTE pork, 6.5% in RTE vegetables, and more than 24.0% in either cooked mutton or cooked haggis. Serotype 1/2b (45.4%), 1/2a (33.3%), and 1/2c (14.2%) were the predominant types. By comparing the clonal complexes (CCs) based on multilocus sequence typing (MLST) of the L. monocytogenes from cooked foods in Zigong City and 33 listeriosis cases from different districts of China, CC87, CC9, CC8, and CC3 were showed to be prevalent in cooked products and CC87 and CC3 were the first two frequent types in the 33 clinic-source strains. All CC87 stains harbored the newly reported Listeria pathogenicity island 4 (LIPI-4) gene fragment ptsA, and all CC3 strains possessed the Listeria pathogenicity island 3 (LIPI-3) gene fragment llsX. These may increase the occurrence of the strains belonging to CC87 and CC3 in listeriosis cases in China and also underline the risk of infection owing to the consumption of the cooked products from Zigong. ST619 (serotype 1/2b) harbored both llsX and ptsA, indicating a potential hypervirulent sequence type in Zigong.
China ; epidemiology ; Cooking ; Fast Foods ; microbiology ; Food Contamination ; Food Microbiology ; Humans ; Listeria monocytogenes ; genetics ; pathogenicity ; Listeriosis ; epidemiology ; microbiology ; Meat ; microbiology ; Multilocus Sequence Typing ; Prevalence ; Seasons

Matrix-assisted laser desorption/ionization tim e-of-flight im aging m ass spectrom etry (MALDI-TOF-IMS ) has been a classical technique for studying proteom ics in present and a tool for analyzing the distribution of proteins and sm all m olecules w ithin biological tissue sections. MALDI-TOF-IMS can analyze m ultiple unknow n com pounds in biological tissue sections sim ultaneously through a single m ea-surem ent w hich can obtain m olecule im aging of the tissue w hile m aintaining the integrity of cellular and m olecules in tissue. In recent years, im aging m ass spectrom etry technique develops relatively quickly in all biom edical dom ain. T his paper based on the relevant data and review s the present developing level of MALDI-TOF-IMS, the principle of im aging m ass spectrom etry, m ethology and the prospect in foren-sic pathology.

Objective To explore the application value of multi-slice spiral computed tomography (MSCT) in traffic accidents through observing and analyzing the injury features of the accidents. Methods Two fatal cases caused by traffic accidents were fully examined using MSCT, 3D imaging reconstruction and angiography through cardiac puncture. The features of traffic injury mechanism were analyzed through combination of MSCT and postmortem external examination. Results In case 1, right cardiac rupture was found by MSCT and angiography through cardiac puncture. The cause of death was cardiac tam-ponade and right ventricular rupture due to the crush injury of chest in the traffic accident. In case 2, splenic rupture and intra-abdominal hemorrhage was found and caused by injury of left trunk by MSCT. The cause of death was hemorrhage and traumatic shock. Conclusion MSCT could observe skeletal in-jury, soft tissue injury, and hematologic disorder well. The combination use of MSCT and angiography through cardiac puncture provided assistance to the diagnosis of cardiovascular system injury.

Postm ortem chem istry is becom ing m ore and m ore essential in routine forensic pathology and has m ade considerable progress over the past years. B iochem ical analyses of vitreous hum or, blood, urine and cerebrospinal fluid m ay provide im portant inform ation in determ ining the cause of death or in elucidating forensic issues. Postm ortem chem istry m ay be essential for the determ ination of cause of death w hen m orphological m ethods (diabetes m ellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide m any in-form ation in other forensic situations, including m yocardial ischem ia, sepsis, inflam m ation, infection, ana-phylaxis and horm onal disturbances. T he m ost recent relevant research advances on glucose m etabolism , liver function, cardiac function, renal function, sepsis, inflam m ation, infection, anaphylaxis and horm onal aspect are hereby review ed.

Objective To explore the clinical significance of peripheral blood smear and bone marrow examination in the etiological diagnosis of panhematopenia.Methods 180 cases of panhematopenia were selected and were given peripheral blood smear and bone marrow examination,and the results were analyzed.Results There were 50 cases of panhematopenia because of non hematopoietic system diseases.Among 50 cases of non-hematopoietic system disease,there were 20 cases of chronic hepatitis,3 cases of cirrhosis,4 cases of lung cancer,10 cases of malignant tumors,3 cases of endocarditis,7 cases of connective tissue-like illness,1 case of gastric cancer,1 case of systemic lupus erythematosus and 1 case of hypersplenism.Due to diseases of the hematopoietic system,there were 130 cases of panbematopenia.Among 130 cases of panhematopenia due to diseases of the hematopoietic system,there were 74 cases of acute leukemia(AL),13 cases of myelodysplastic syndrome(MDS),13 cases of aplastic anemia(AA) and 30 cases of megaloblastic anemia(MA).Conclusion Peripheral blood smear and bone marrow examination is conducive to diagnose the cause of the panhematopenia.Bone marrow examination could improve the accuracy rate of panhematopenia.

The newly emerged Middle East respiratory syndrome coronavirus (MERS-CoV) is a highly pathogenic respiratory virus with pathogenic mechanisms that may be driven by innate immune pathways. The goal of this study is to characterize the expression of the structural (S, E, M, N) and accessory (ORF 3, ORF 4a, ORF 4b, ORF 5) proteins of MERS-CoV and to determine whether any of these proteins acts as an interferon antagonist. Individual structural and accessory protein-coding plasmids with an N-terminal HA tag were constructed and transiently transfected into cells, and their native expression and subcellular localization were assessed using Wes tern blotting and indirect immunofluorescence. While ORF 4b demonstrated majorly nuclear localization, all of the other proteins demonstrated cytoplasmic localization. In addition, for the first time, our experiments revealed that the M, ORF 4a, ORF 4b, and ORF 5 proteins are potent interferon antagonists. Further examination revealed that the ORF 4a protein of MERS-CoV has the most potential to counteract the antiviral effects of IFN via the inhibition of both the interferon production (IFN-β promoter activity, IRF-3/7 and NF-κB activation) and ISRE promoter element signaling pathways. Together, our results provide new insights into the function and pathogenic role of the structural and accessory proteins of MERS-CoV.
Cell Line ; Coronavirus ; genetics ; pathogenicity ; Genes, Viral ; Humans ; Interferons ; antagonists & inhibitors ; Open Reading Frames ; Recombinant Proteins ; genetics ; metabolism ; Viral Matrix Proteins ; genetics ; metabolism ; Viral Regulatory and Accessory Proteins ; genetics ; metabolism ; Viral Structural Proteins ; genetics ; metabolism

Objective To explore the effect of stromal cell-derived factor-1 ( SDF-1 ) in combination with transplantation of peripheral blood endothelial progenitor cells (EPCs) for the treatment of nude mice hindlimb ischemia. Methods Hindlimb ischemia model was established in nude mice, mice were then divided into five groups randomly: ischemic control group, peripheral blood EPCs transplantation group, SDF-1 local application group, SDF-1 combined with EPCs group, SDF-1 combined with AMD3100 treated EPCs group. Local CD34+VEGFR+ cells in the hind gastrocnemius were detected at day 3,7 after transplantation. The intensity of neovasculorization were evaluated at day 28. Results The double-positive cells number of control group, EPCs group, SDF-1 group, SDF-1 + EPCs group, SDF-1 + AMD3100 EPCs group were 0.00 ±0.00,5. 30 ±0.65,0.00 ±0.00,10. 31 ±0. 63,1. 86 ±0. 17 at day 3 and 0. 00 ±0. 00, 7.05 ±0. 18,0. 00 ±0. 00,11. 81 ±0. 53,2. 83 ±0. 48 at day 7. The number of new capillaries were 3. 00 ± 0.13,6.15 ± 0. 04,6. 20 ± 0. 10,10. 65 ± 0.08,6. 21 ±0. 08 at day 28. SDF-1 increased the CD34 + VEGFR+ cells (P ＜0. 05) and the number of new vessels (P ＜0.05). SDF-1 combined EPCs further increased the number of new vessels (P ＜ 0. 05 ). Conclusions SDF-1 enhances blood vessel formation and promotes angiogenesis by promoting EPCs homing, which could be blocked by AMD3100.