Objective:To investigate the impact of single incision laparoscopic radical resection of colon cancer on postoperative quality of life and prognosis in patients with colon cancer.Methods:A prospective study was conducted on 84 colorectal cancer patients admitted to Suzhou Municipal Hospital between June 2019 and June 2022. The patients were divided into two groups of 42 each according to their wishes. The control group underwent traditional laparoscopic radical surgery for colon cancer; The observation group underwent single incision laparoscopic radical resection for colon cancer. Two sets of surgical related indicators, postoperative stress response, immune inflammatory response, tumor markers, complications, and prognosis were compared.Results:Compared with the control group, the observation group had less intraoperative bleeding [(142.58±23.76)ml vs (121.37±20.23)ml], faster recovery of intestinal function [(3.87±0.65)d vs (3.12±0.45)d], lower postoperative Visual Analog Scale (VAS) scores [(3.52±0.70)points vs (2.46±0.49)points], and a lower incidence of postoperative complications [26.19%(11/42) vs 7.14%(3/42)] (all P<0.05); There was no statistically significant difference in the surgical time, hospitalization time, and levels of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA199) between the two groups (all P>0.05). The postoperative level of cortisol (Cor) [(473.25±52.58)nmol/L vs (447.53±49.73)nmol/L], adrenaline (E) [(662.41±73.60)μg/L vs (622.84±69.20)μ g/L], norepinephrine (NE) [(18.52±2.06)μ g/L vs (17.48±1.94)μ g/L], interleukin-6 (IL-6) [(51.24±5.26)pg/ml vs (47.33±5.26)pg/ml], high-sensitivity C-reactive protein (hs-CRP) [(21.47±3.58)ng/ml vs (19.26±3.26)ng/ml] of the observation group was lower than that of the control group (all P<0.05). The postoperative levels of CD3 + [(58.34±3.89) vs (60.21±4.01)] and CD4 + /CD8 + [(1.24±0.14) vs (1.31±0.15)] in the observation group were higher than those in the control group (all P<0.05). There was no statistically significant difference in the survival curve analysis between the two groups ( P>0.05). Conclusions:Both traditional conventional laparoscopic radical surgery and single incision laparoscopic radical surgery have good therapeutic effects on colorectal patients, which can effectively reduce tumor marker levels and have a good prognosis. However, single incision laparoscopic radical surgery has less stress damage to patients, can reduce immune inflammatory reactions, and has fewer postoperative complications, which can promote postoperative recovery.

Objective:To explore the feasibility of the maze design of a proton therapy system.Methods:According to the construction scheme of a medical proton therapy system, the ambient neutron dose equivalent rate outside the maze entrance was estimated by numerical analytical formula, and compared with the monitoring result.Results:The ambient neutron dose equivalent rate was estimated at between 3.85×10 -2 μSv/h and 7.57 μSv/h and measured to be ≤1.56 μSv/h. Conclusions:The maze entrance was designed to have 5 sections of tunnel for cyclotron room and 3 sections of tunnel for treatment room, respectively, each with designated length and width. The levels of ambient dose equivalent rate outside the maze entrance is acceptable.

Objective:To explore the long-term therapeutic efficacy and outcomes of liver transplantation for patients with hepatic myelopathy (HM).Methods:Retrospective analysis of 24 adult liver transplantation recipients due to HM at First Central Municipal Hospital from January 2006 to October 2022. HM was extensively classified by the severity of lower extremity symptoms, degree of muscle stiffness, capability for independent ambulation and muscle strength. Furthermore, their long-term outcomes were examined. From January 2000 to October 2022, the databases of China National Knowledge Infrastructure (CNKI) , Google Scholar, PubMed and Web of Science were searched with such keywords as "肝性脊髓病and肝移植" "Hepatic Myelopathy and Liver Transplantation" .Results:After liver transplantation, liver functions and blood ammonia normalized and most clinical symptoms improved. During a follow-up period of (12-190) months, 19 patients showed a lowered grade of HC as compared to pre-transplantation. Four cases achieved a complete recovery of extremity function. No change occurred in severity grade for the remaining 5 patients. However, 4 of them experienced varying degrees of improvement in muscle strength and independent walking capability. This review summarized the clinical characteristics and clinical outcomes of 17 patients from both domestic and international sources. Most of them experiences varying degrees of symptomatic improvements after liver transplantation (16 cases).Conclusions:This study has confirmed the effectiveness of liver transplantation for HM and its contribution to the long-term patient recovery.

Objective:To compare the clinical effects of platelet-rich plasma (PRP) and sodium hyaluronate on rotator cuff injury.Methods:From February 2022 to December 2022, 226 patients with rotator cuff injury caused by military training were treated at Department of Orthopaedics, Jinling Hospital, School of Medicine, Nanjing University. They were all male, aged (24.5±3.7) years, and their time from injury to treatment was (4.6±2.2) months. They were divided into 2 even groups according to different treatments: an observation group of 113 cases into whose subacromial space PRP was injected, and a control group of 113 cases into whose subacromial space sodium hyaluronate was injected. In both groups, the injection was performed once a week for consecutive 3 weeks. The 2 groups were compared in terms of visual analogue scale (VAS) and Constant-Murley shoulder function scale (CMS) before treatment and 4 and 8 weeks after treatment, and the levels of TNF- α and IL-6 in the shoulder synovial fluid before treatment and 8 weeks after treatment. Results:There was no statistical difference between the 2 groups in general clinical data before treatment, indicating comparability ( P>0.05). At 4 and 8 weeks after treatment, compared with the pre-treatment values, the VAS scores were significantly decreased and the Constant-Murley scores significantly increased in both groups ( P<0.001). At 4 and 8 weeks after treatment, the VAS scores in the observation group (3.1±0.9 and 1.5±0.5) were significantly lower than those in the control group (3.7±0.8 and 2.3±0.6) while the Constant-Murley scores in the observation group (58.6±4.5 and 72.2±4.1) significantly higher than those in the control group (55.2±5.3 and 67.8±5.0) ( P<0.001). At 8 weeks after treatment, the levels of TNF- α and IL-6 in the 2 groups were significantly lower than the levels before treatment ( P<0.001). At 8 weeks after treatment, the levels of TNF- α and IL-6 in the observation group [(2.9±0.9) μg/L and (0.8±0.2) μg/L] were significantly lower than those in the control group [(4.0±0.4) μg/L and (1.1±0.4) μg/L] ( P<0.001). Conclusion:Injection of PRP or sodium hyaluronate can relieve pain and improve shoulder function obviously in patients with rotator cuff injury, but PRP is superior to sodium hyaluronate in the treatment of rotator cuff injury.

Objective:To explore the pathogenesis and prognostic factors of brain metastasis of hepatocellular carcinoma(HCC)after liver transplantation(LT).Methods:Retrospective review was performed for 17 HCC cases with brain metastasis after liver transplantation from 2000 to 2020.All cases were diagnosed as hepatitis B cirrhosis complicated with HCC.All of them were beyond the Milan Criteria.The immunosuppressive regimen consisted of baliximab + mycophenolate mofetil + calcineurin inhibitors(CNIs)+ corticosteroids in early postoperative period with a gradual tapering of corticosteroids and mycophenolate mofetil.Three patients received sirolimus immunotherapy after tumor recurrence and withdrew CNIs.One of three cases received sorafenib.Results:Other organ involvements included lung metastasis( n=16, 94.1%), bone metastasis( n=5, 29.4%)and liver metastasis( n=6, 35.3%). The median survival time after brain metastasis was 7 months and the 1-year cumulative survival rate 29.4%.The median survival time post-LT was 14 months and the 1-year cumulative survival rate 64.7%.Among 7 patients with a resection of brain metastasis, two deaths at Month 1 post-operation were due to cerebral hemorrhage.The longest survival time was 214 months and the median survival time 9 months. Conclusions:The prognosis of brain metastasis post-LT remains poor.However, early detection and reasonable treatment can prolong patient survival time and even achieve long-term survival.Most brain metastases are accompanied by lung metastases.And the finding of lung metastatic tumor hints at a presence of intracranial lesions.

Acute-on-chronic liver failure (ACLF) is a disease of rapid deterioration of liver function caused by the acute exacerbation of chronic liver diseases, and it is often associated with multiple organ failure and has a poorer prognosis than common liver cirrhosis. Many studies suggest that timely liver transplantation can significantly improve the survival rate of patients with ACLF; however, there are currently no reliable guidelines that point out the indications for liver transplantation in patients with ACLF. This article summarizes recent studies and discusses the indication, timing, and prognosis of liver transplantation in ALCF patients.

Objective: To analyze the epidemiological characteristics of latent syphilis in Yancheng City from 2016 to 2020, so as to provide insights into syphilis control. Methods: All reported cases with latent syphilis in Yancheng City from 2016 to 2020 was collected from the Communicable Disease Report System of China Disease Prevention and Control Information System, and the prevalence of latent syphilis was estimated and standardized by the seventh population census data in Yancheng City. The trends in the incidence of latent syphilis were evaluated using annual percent change (APC), and the temporal, regional and human distributions of latent syphilis patients were descriptively analyzed. In addition, the spatial clusters of latent syphilis incidence were identified using spatial autocorrelation analysis. Results: A total of 7 790 cases with latent syphilis were reported in Yancheng City from 2016 to 2020, and the standardized incidence of latent syphilis increased from 15.35/105 in 2016 to 28.70/105 in 2020 (APC=17.54%, t=5.357, P=0.013). Latent syphilis cases were reported in each month, and no obvious seasonable characteristics were seen. During the period from 2017 to 2020, the highest incidence of latent syphilis was seen in residents at ages of 70 to 79 years, with incidence rates of 41.71/105, 43.04/105, 75.79/105 and 72.94/105, respectively, and most cases were farmers (4 711 cases, 60.47%). The three highest incidence of latent syphilis was reported in Funing County (191.40/105), Tinghu District (137.13/105) and Yandu District (126.23/105). There was a positive spatial correlation of latent syphilis incidence in Yancheng City from 2016 to 2020 (Moran's I=0.23, Z=4.457, P=0.001), and two high-high clusters were identified in 14 townships (streets) of Funing County, Binhai County, Tinghu District, Sheyang County and Yandu District and 3 low-low clusters in 7 townships (streets) in Jianhu County, Tinghu District, Dongtai City and Sheyang County. Conclusions The incidence of latent syphilis appeared a tendency towards a rise, and there were remarkable spatial clusters identified in latent syphilis incidence in Yancheng City from 2016 to 2020. The elderly people and farmers are at high risk of latent syphilis.

Osteoarthritis (OA), in which M1 macrophage polarization in the synovium exacerbates disease progression, is a major cause of cartilage degeneration and functional disabilities. Therapeutic strategies of OA designed to interfere with the polarization of macrophages have rarely been reported. Here, we report that SHP099, as an allosteric inhibitor of src-homology 2-containing protein tyrosine phosphatase 2 (SHP2), attenuated osteoarthritis progression by inhibiting M1 macrophage polarization. We demonstrated that M1 macrophage polarization was accompanied by the overexpression of SHP2 in the synovial tissues of OA patients and OA model mice. Compared to wild-type (WT) mice, myeloid lineage conditional Shp2 knockout (cKO) mice showed decreased M1 macrophage polarization and attenuated severity of synovitis, an elevated expression of cartilage phenotype protein collagen II (COL2), and a decreased expression of cartilage degradation markers collagen X (COL10) and matrix metalloproteinase 3 (MMP3) in OA cartilage. Further mechanistic analysis showed thatSHP099 inhibited lipopolysaccharide (LPS)-induced Toll-like receptor (TLR) signaling mediated by nuclear factor kappa B (NF-κB) and PI3K-AKT signaling. Moreover, intra-articular injection of SHP099 also significantly attenuated OA progression, including joint synovitis and cartilage damage. These results indicated that allosteric inhibition of SHP2 might be a promising therapeutic strategy for the treatment of OA.

Objective:To compare the treatment outcomes of neoadjoint therapy combined with liver transplantation versus radical hepatectomy for patients with surgically resectable hilar cholangiocarcinoma.Methods:A retrospective study was performed on the data of 64 patients with resectable hilar cholangiocarcinoma operated from January 2009 to December 2014 at the Organ Transplantation Department of the First Central Hospital of Tianjin. There were 43 males and 21 females, with an average age of 61.2 years. There were 45 patients who underwent radical hepatectomy in the liver resection group, and 19 patients who underwent combined neoadjuvant therapy (radiotherapy combined with 5-fluorouracil intravenous drip, transcatheter lumen radiotherapy, capecitabine oral administration) and liver transplantation in the liver transplantation group. The recurrence rates and survival rate were compared between groups.Results:The 1, 3 and 5 years cumulative survival rates of the liver transplantation group were 89.5%, 73.7% and 63.2%, respectively, which were significantly better than those of the liver resection group (80.0%, 53.3% and 35.6%) ( P<0.05). The postoperative tumor recurrence rate in the liver transplantation group was 31.6% (6/19), which was significantly lower than that in the liver resection group of 60.0% (27/45) ( P<0.05). Subgroup analysis using postoperative pathological results showed the cumulative survival rates of patients without lymph node metastasis (N 0) and those with negative resection margins (R 0) were not significantly different between groups ( P>0.05). However, for patients with regional lymph node invasion (N 1) and with R 0 resection margin, the cumulative survival rates at 1, 3 and 5 years after liver transplantation were 83.3%, 66.7% and 50.0%, respectively, which were significantly superior to the 64.3%, 28.6% and 14.3% of the liver resection group ( P<0.05). Conclusion:Hepatectomy is recommended for patients with N 0 R 0 resectable hilar cholangiocarcinoma. For patients with hilar cholangiocarcinoma with marginally resectable N 1R 0, neoadjuvant therapy combined with liver transplantation resulted in significantly better long-term overall survival than resection.

Lycopene, as a high value-added terpene compound, has been widely concerned by researchers at home and abroad. Firstly, the ability of lycopene synthesis of Saccharomyces cerevisiae model strains S288c and YPH499 was analyzed and compared. The results showed that YPH499 was more suitable for lycopene synthesis as yeast chassis. Subsequently, the effects of constitutive promoters GPDpr, TEF1pr and inducible promoters GAL1pr, GAL10pr on Lycopene synthesis were compared. The results showed that when GPDpr and TEF1pr were used as promoters of crtE, crtB and crtI in lycopene synthesis pathway, the production of lycopene was 15.31 mg/L after 60 h fermentation in shaking flask. When GAL1pr and GAL10pr were used as promoters, the production was 123.89 mg/L, which was 8.09 times higher. In addition, the methylvaleric acid (MVA) pathway was further modified to overexpress the key enzyme gene of N-terminal truncation, tHMG1 (3-hydroxy-3-methylglutaryl coenzyme A reductase). The lycopene production was 265.68 mg/L, and the yield per cell was 72.79 mg/g. The Saccharomyces cerevisiae strain designed and constructed in this study can express lycopene in high yield per cell, thus could be used in the industrial production of lycopene after further construction and optimization.
Biosynthetic Pathways ; genetics ; Fermentation ; Industrial Microbiology ; Lycopene ; metabolism ; Saccharomyces cerevisiae ; genetics ; metabolism ; Species Specificity