Intersphincteric resection (ISR) is a limited sphincter preserving surgery for low rectal cancer. The 4K laparoscopic system has the advantage of enhancing the accurate recognition of anatomical structures for operators. The authors investigate the imaging evaluation and technical standard of 4K laparoscopic ISR of low rectal cancer through surgical examples.

Background: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. Methods: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Jin Yin-tan Hospital, Wuhan, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. Results: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8–99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6–87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. Conclusion: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.

·AIM:To study the effects of phacoemulsification on ocular surface and corneal endothelial cells in cataract patients with diabetes mellitus.·METHODS:This study used a retrospective analysis of the clinical data to compare curative effect, the research object was 98 cases ( 98 eyes ) of cataract patients with phacoemulsification from January 2016 to December 2016 in our hospital. Patients were divided into the observation group and the control group according to whether diabetes merged. The observation group had 50 cases of cataract patients with diabetes, the control group had 48 cases of pure cataract patients. Two groups of patients underwent phacoemulsification surgery and transparent corneal incision, surgeries were completed by the same doctor, no xeroma before surgery. Preoperative glycemic control was normal for diabetic patients, no changes in eye fundus. Observation of ocular surface at postoperative 1, 3, 7d and 1mo was taken. Dry eye symptoms, lacrimal film breakup time ( BUT ) , corneal fluorescein staining ( FL ) score, SchirmerⅠtest ( SⅠt ) and corneal endothelial cell density were compared.·RESULTS: Dry eye symptom score of the two groups before and after operation had significant difference;data of the observation group at postoperative 7d and 1mo was significantly higher than that of the control group, there was statistical significance (P<0. 05), there was no significant difference at 1 and 3d after operation (P>0. 05 ). BUT of the two groups before and after surgery showed significant difference; data of the observation group at 7d and 1mo after operation was significantly lower than that of the control group, there was statistical significance ( P<0. 05 ); at 1 and 3d after operation there was no significant difference (P>0. 05). The FL score of the two groups before and after surgery had significant difference, and at 3, 7d and 1mo after operation, data of the observation group was significantly higher than that of the control group, there was statistical significance ( P< 0. 05 ); there was no significant difference at postoperative 1d (P>0. 05). The two groups' before and after surgery SⅠt had significant difference, at 1, 3, 7d and 1mo after operation, data of the observation group was significantly higher than that of the control group, there was statistical significance (P< 0. 05 ). Corneal endothelial cell density showed apparent difference of the two groups before and after surgery;at 1, 3, 7d and 1mo after operation, data of the observation group was significantly lower than that of the control group, there was statistical significance ( P<0. 05).· CONCLUSION: Phacoemulsification has significant effects on tear film break-up time, SⅠt and dry eye symptoms in patients with diabetes mellitus, which may be related to the impaired repair ability of diabetic patients.

Appendectomy ; adverse effects ; Appendicitis ; surgery ; Diagnosis, Differential ; Hernia, Abdominal ; diagnosis ; etiology ; surgery ; Herniorrhaphy ; methods ; Humans ; Male ; Radiography, Abdominal ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVESpinal muscular atrophy (SMA) is a common and fatal autosomal recessive disorder. Approximately 94% of SMA patients are caused by homozygous deletion of SMN1 gene. SMA carrier screening is recommended considering the high carrier frequency (1 in 35-50) as well as severity of the disease.

METHODSA prospective population-based cohort study was carried out on 4719 pregnant women from Shanghai region. Copy numbers of SMN1 and SMN2 genes were effectively determined with denaturing high performance liquid chromatography (DHPLC) technique. The method has detected 94% of SMA cases with deletion or conversion of the SMN1 genes.

RESULTSNinety SMA carriers with only one copy of the SMN1 gene were identified among the 4719 pregnant woman. The carrier rate was 1.9%. Respectively, 1.2% and 0.6% of the carriers were caused by SMN1 gene deletion and SMN1 gene conversion.

CONCLUSIONThrough this study, we have determined the frequency of SMA mutation carriers in a population of pregnant women. The result may provide a basis for genetic counseling in order to reduce the rate of SMA affected births.

Adult ; China ; Female ; Gene Deletion ; Genetic Testing ; methods ; Humans ; Muscular Atrophy, Spinal ; diagnosis ; genetics ; Pregnancy ; Prenatal Diagnosis ; methods ; Prospective Studies ; Survival of Motor Neuron 1 Protein ; genetics ; Survival of Motor Neuron 2 Protein ; genetics ; Young Adult

BACKGROUNDRecent evidence has implicated the gene for phosphodiesterase 4D (PDE4D) as susceptibility gene for ischemic stroke (IS) in Icelandic population. However, there are few reports on the associations between PDE4D gene polymorphisms and IS in Chinese individuals. The present study aimed to investigate the possible association of genetic polymorphisms in PDE4D gene with IS in Henan Han population.

METHODSA total of 400 patients with IS and 400 matched controls were examined using a case-control design. Two single nucleotide polymorphism (SNPs) (rs918592 and rs2910829) in PDE4D gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to test the association between the genetic factors and IS. Genetic parameter and association studies were carried out with SPSS 16.0.

RESULTSAmong the two SNPs tested, the rs918592 was significantly associated with IS (OR: 1.351, 95%CI: 1.110 - 1.645), especially in male patients (OR: 1.427, 95%CI: 1.105 - 1.844). Haplotype analysis showed that A-T was associated with an increased risk of the IS (OR: 2.114, 95%CI: 2.005 - 2.230) while G-T was associated with decreased risk of IS (OR: 0.419, 95%CI: 0.302 - 0.583). Protecting effect of haplotype G-T was also significant in males (OR: 0.264, 95%CI: 0.162 - 0.431).

CONCLUSIONSThe present study demonstrated a strong association of rs918592 with IS. Haplotype A-T increased the risk of IS while haplotype G-T had a protective effect in Henan Han population. The association was sex-dependent with male patients showing stronger effect.

Aged ; Brain Ischemia ; genetics ; Cyclic Nucleotide Phosphodiesterases, Type 4 ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Genotype ; Haplotypes ; genetics ; Humans ; Linkage Disequilibrium ; Male ; Middle Aged ; Polymorphism, Genetic ; genetics ; Sex Factors ; Stroke ; genetics

OBJECTIVETo explore and evaluate the therapeutic efficacy of surgical treatment for cancer of the pancreatic head.

METHODSThe clinical data of 96 patients with cancer of the pancreatic head admitted in our hospital from January 2002 to December 2009 were retrospectively analyzed. pancreatoduodenectomy was performed in 48 cases, extended pancreatoduodenectomy in 30 cases, and Roux-Y cholangiojejunostomy in 18 cases.

RESULTSThe 1, 2 and 3-year survival rates were 59.2%, 41.8% and 13.2%, respectively, in the patients treated with pancreatoduodenectomy, and 73.2%, 58.2% and 24.1%, respectively, in the patients treated with extended pancreatoduodenectomy. The 1, 2 and 3-year survival rates were 36.8%, 15.8% and 5.3%, respectively, in the patients with unresectable tumor who received radiotherapy and (or) chemotherapy in Roux-Y cholangiojejunostomy. The postoperative morbidity was 29.2%, 30.0% and 27.8% in the patients treated with pancreatoduodenectomy, extended pancreatoduodenectomy and Roux-Y cholangiojejunostomy, respectively.

CONCLUSIONSPancreatoduodenectomy is the most effective treatment. Extended pancreatoduodenectomy can improve the surgical resection rate, reduce the recurrence rate and improve the survival rate. Internal drainage is an important palliative measure.

Adult ; Aged ; Anastomosis, Roux-en-Y ; methods ; Female ; Follow-Up Studies ; Humans ; Jejunostomy ; methods ; Male ; Middle Aged ; Pancreatic Neoplasms ; mortality ; surgery ; Pancreaticoduodenectomy ; methods ; Postoperative Complications ; Retrospective Studies ; Survival Rate

Objective To establish an automatic synthesis method for 11C-carfentanil (CFN) as an novel opiate receptor radioligand and study its biodistribution in rats. Methods 11C-Triflate-CH3 was bubbled into 0.5 mg precursor desmethyl-CFN (which was dissolved in 0.15 ml DMSO) to generate 11C-CFN in a V-tube at room temperature. Sep-Pak C2 column was used for purification of 11C-CFN, which was eluted by 3ml binary system aqueous solution, 10 ml water thrice, and then I ml ethanol. The biodistribution (% ID/g) of 11C-CFN in SD rats was studied. SPSS 13.0 was used for statistical analysis. Non-normal distribution data were analyzed using nonparametric test. Results The synthesis time for 11C-CFN was 20 min (end of bombardment, EOB). The synthesis yield was (35.5 ± 2.2) % on average (n = 12, uncorrected)with the radiochemical purity over 98%. Biodistribution study in rats showed that the tracer had a high brain uptake, rapid blood clearance, and a metabolic pathway via liver and kidney. The highest tracer uptake was in thalamus (4.26 ± 0.89) % ID/g and striatum (4.05 ± 1.08) % ID/g at 5 min after injection, followed by cerebral cortex (2.63±0.89) %ID/g, pons (2.26 ±0.57) % ID/g, hippocampus (2. 17 ±0.55) %ID/g and cerebellum (2. 15 ±0.39) %ID/g. Conclusions The automatic synthesis of 11C-CFN is fast and reliable, and this radioligand can be used for opiate receptor imaging.

OBJECTIVETo investigate the differentiation-related proteins in human gastric carcinoma cell lines by comparative proteomics.

METHODSThe holoproteins of human gastric carcinoma cell lines MKN28, SGC7901 and BGC823 were measured by two-dimensional gel electrophoresis and matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Some proteins identified by proteomics were tested by Western blot in the cell strains and tissues of gastric carcinoma.

RESULTS14 differential protein spots were found in the 3 gastric carcinoma cell lines, among them 8 spots were identified by MALDI-TOF-MS. These proteins were probably thioredoxin peroxidase, glyceraldehyde-3-phosphate dehydrogenase (GAPD), beta-tubulin polypeptide, hypothetical protein, zinc finger protein (ZNF) 139, protein-tyrosine kinase, calreticulin precursor, and tropomyosin, proteins related with biological behavior of gastric carcinoma cells such as signal transduction, cellular homeostasis, glycolysis, antioxidation action, multidrug resistance(MDR), etc. The expressions of those proteins in gastric cancer cells and tissues identified by Western blot were consistent with the results obtained by proteomics.

CONCLUSIONDifferential proteins are found in 3 human gastric carcinoma cell lines, mainly, proteins related with cell signaling, maintenance of homeostasis, glycolysis, metabolism of anti-cancer drug and anti-oxidative injury, etc.

Adenocarcinoma ; metabolism ; pathology ; Adult ; Aged ; Blotting, Western ; Cell Line, Tumor ; Electrophoresis, Gel, Two-Dimensional ; Female ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Glyceraldehyde-3-Phosphate Dehydrogenases ; metabolism ; Humans ; Male ; Middle Aged ; Protein-Tyrosine Kinases ; metabolism ; Proteome ; analysis ; Proteomics ; methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Stomach Neoplasms ; metabolism ; pathology

OBJECTIVETo evaluate the effect of snail control through soil pasting mixed with niclosamide.

METHODSFour sites were selected in different epidemic areas in Sichuan province. Soil pasting mixed with niclosamide was carried on, and the dosage was 0 g/m2, 4 g/m2, 6 g/m2, 8 g/m2 and 10 g/m2 respectively. The mortality rate of snail and the density of snail were observed after 7, 15, 30, 90 and 180 days.

RESULTSThe mortality rate of snail was more than 43.3% in blank group after 30 days. The mortality rate of snail was from 75.3% to 100.0% at 4 g/m2 group after 30 days. The mortality rate of snail in 4 g/m2 group was significantly higher than that in the blank group (chi2 = 31.27, P < 0.05). There was no significant difference in the mortality rate of snail among all study groups (chi2 = 1.07, P > 0.05). The decrease rate of snail density was more than 90%. The mortality rate of snail was about 30% higher in Chantu group than Qutu group. The unit cost of Pasting-Mixing Drug with Soil was from 5 to 7 times of spray method, but the total cost was similar for the. two methods at the endpoint of the snail control.

CONCLUSIONThe effect of soil pasting mixed with niclosamide is good, and the dosage of 4-6 g/m2 is suggested in snail control.

Animals ; Molluscacides ; Niclosamide ; Pest Control ; Schistosomiasis ; epidemiology ; prevention & control ; Snails ; Soil