【Objective】 To explore the feasibility, safety and clinical application value of laparoscopic radical rectal cancer surgery with natural orifice specimen extraction (NOSE) by comparing the postoperative pathological data, surgery-related variables and postoperative recovery between laparoscopic radical rectal cancer surgery with NOSE and laparoscopic-assisted radical rectal cancer surgery. 【Methods】 A retrospective analysis was conducted on 74 patients who underwent radical rectal cancer surgery with anus preservation in the Department of General Surgery of The First Affiliated Hospital of Xi’an Jiaotong University from July 2017 to April 2022. Among them, 38 cases underwent surgery with specimen extraction through an abdominal auxiliary incision (auxiliary incision group), and 36 cases underwent surgery with specimen extraction through a natural orifice (NOSES group). The differences in the efficacy of the two surgeries were evaluated by comparing the postoperative pathological data, surgical variables, and postoperative recovery of the two groups. 【Results】 There were no statistically significant differences in general data and postoperative pathological data between the two groups (all P>0.05). The NOSES group exhibited significantly shorter operative time, time to first flatus, time to first oral intake postoperatively, and postoperative hospital stay compared to the auxiliary incision group (all P<0.05). However, there were no statistically significant differences in intraoperative blood loss, postoperative complications, and whether secondary surgeries were performed (all P>0.05). 【Conclusion】 Laparoscopic surgery with NOSE for rectal cancer is safe and feasible with minimally invasive and accelerated recovery, which is worth promoting and applying in clinical practice.

Since the utilization of anthracyclines in cancer therapy, severe cardiotoxicity has become a major obstacle. The major challenge in treating cancer patients with anthracyclines is minimizing cardiotoxicity without compromising antitumor efficacy. Herein, histone deacetylase SIRT6 expression was reduced in plasma of patients treated with anthracyclines-based chemotherapy regimens. Furthermore, overexpression of SIRT6 alleviated doxorubicin-induced cytotoxicity in cardiomyocytes, and potentiated cytotoxicity of doxorubicin in multiple cancer cell lines. Moreover, SIRT6 overexpression ameliorated doxorubicin-induced cardiotoxicity and potentiated antitumor efficacy of doxorubicin in mice, suggesting that SIRT6 overexpression could be an adjunctive therapeutic strategy during doxorubicin treatment. Mechanistically, doxorubicin-impaired mitochondria led to decreased mitochondrial respiration and ATP production. And SIRT6 enhanced mitochondrial biogenesis and mitophagy by deacetylating and inhibiting Sgk1. Thus, SIRT6 overexpression coordinated metabolic remodeling from glycolysis to mitochondrial respiration during doxorubicin treatment, which was more conducive to cardiomyocyte metabolism, thus protecting cardiomyocytes but not cancer cells against doxorubicin-induced energy deficiency. In addition, ellagic acid, a natural compound that activates SIRT6, alleviated doxorubicin-induced cardiotoxicity and enhanced doxorubicin-mediated tumor regression in tumor-bearing mice. These findings provide a preclinical rationale for preventing cardiotoxicity by activating SIRT6 in cancer patients undergoing chemotherapy, but also advancing the understanding of the crucial role of SIRT6 in mitochondrial homeostasis.

Although primary vesical calculi is an ancient disease, the mechanism of calculi formation remains unclear. In this study, we established a novel primary vesical calculi model with d,l-choline tartrate in mice. Compared with commonly used melamine and ethylene glycol models, our model was the only approach that induced vesical calculi without causing kidney injury. Previous studies suggest that proteins in the daily diet are the main contributors to the prevention of vesical calculi, yet the effect of fat is overlooked. To assay the relationship of dietary fat with the formation of primary vesical calculi, d,l-choline tartrate-treated mice were fed a high-fat, low-fat, or normal-fat diet. Genetic changes in the mouse bladder were detected with transcriptome analysis. A high-fat diet remarkably reduced the morbidity of primary vesical calculi. Higher fatty acid levels in serum and urine were observed in the high-fat diet group, and more intact epithelia in bladder were observed in the same group compared with the normal- and low-fat diet groups, suggesting the protective effect of fatty acids on bladder epithelia to maintain its normal histological structure. Transcriptome analysis revealed that the macrophage differentiation-related gene C-X-C motif chemokine ligand 14 (Cxcl14) was upregulated in the bladders of high-fat diet-fed mice compared with those of normal- or low-fat diet-fed mice, which was consistent with histological observations. The expression of CXCL14 significantly increased in the bladder in the high-fat diet group. CXCL14 enhanced the recruitment of macrophages to the crystal nucleus and induced the transformation of M2 macrophages, which led to phagocytosis of budding crystals and prevented accumulation of calculi. In human bladder epithelia (HCV-29) cells, high fatty acid supplementation significantly increased the expression of CXCL14. Dietary fat is essential for the maintenance of physiological functions of the bladder and for the prevention of primary vesical calculi, which provides new ideas for the reduction of morbidity of primary vesical calculi.

Objective: In order to analyze the characteristics of the outbreak of acute respiratory tract infection in children caused by respiratory syncytial virus(RSV). Methods: The field epidemiological investigations were conducted for the two outbreaks in kindergartens in Hangzhou. Data were analyzed by descriptive method. Samples with positive respiratory syncytial virus nucleic acid were sequenced using PCR. Results: The two outbreaks occurred in kindergartens. There were 21 cases in kindergarten A, lasting 11 days, and 43 cases in kindergarten B, lasting 33 days. The epidemic curve showed a proliferation pattern. The cases were concentrated in nurseries and K1 classes, primarily among children aged 2-4 years. The most common symptoms were fever and cough, mainly upper respiratory tract infection, and no severe cases were found. Upper respiratory tract samples were collected and detected as positive for RSV. Four samples were sequenced and identified as subgroup B. Conclusion During the outbreak of acute respiratory infection in kindergartens, respiratory syncytial virus should be given primary consideration in the process of identification of the outbreak caused by other respiratory infections, and strictly control measures should be taken to reduce the long term impact of the epidemic.

Objective:To explore the hope level and influencing factors of infertile patients with first or repeated in vitro fertilization-embryo transfer (IVF-ET).Methods:Female patients receiving IVF-ET treatment during January to June, 2019 in reproductive Medicine Center, Ruijin Hospital, Shanghai Jiaotong University School of medicine, were enrolled in this study. All patients were divided into first and repeated cycles (≥2 cycles), then a questionnaire survey was conducted. The questionnaire included demographic information, Herth hope index (HHI) scale, Locke-Wallace short marital-adjustment test scale and social support rating scale. Multiple linear regression was used to analyze the associated influencing factors of hope level.Results:A total of 251 IVF-ET patients were recruited in the study, including 142 (56.6%) in the first cycle and 109 (43.4%) in the repeated cycle. The HHI score of the repeated cycle was significantly lower than that of the first cycle [(32.0±3.3) vs (36.0±3.1) points] ( P<0.001). Multiple linear regression analysis indicated that repeated IVF-ET was independently negatively correlated with HHI, with a standardized coefficient β of -0.406 ( P<0.001). While living in a city ( P=0.013), high monthly income ( P=0.026), high degree short marital-adjustment test ( P=0.006) and social support rating ( P=0.002) were independently positively correlated with HHI. Conclusions:Repeated IVF-ET treatment patients have a significantly lower HHI score. The residence, monthly income, marital-adjustment, and social support are significantly associated with hope level.

Objective:To study the effects of cryptotanshinone on proliferation and apoptosis of human bladder carcinoma J82 cells in vitro and its mechanisms.Methods:The J82 cells were treated with cryptotanshinone of different concentrations including 0, 0.5, 1.0, 2.0, 3.0, 4.0, 5.0 and 8.0 μmol/L.After 48-hour treatment, the proliferation of J82 cells was determined by CCK-8 assay method.Flow cytometric analysis with Annexin V-FITC/PI staining was used to evaluate the apoptosis of J82 cells, and Western blotting was adopted to observe the protein expressions of p65, caspase-3, caspase-8 and caspase-9 related to proliferation and apoptosis.Results:CCK-8 results showed that the A values of 450nm-wavelength were as following: the control group (1.77±0.06), 0.5μmol/L group (1.78±0.08), 1.0μmol/L group (1.64±0.05), 2.0μmol/L group (1.48±0.12), 3.0μmol/L group (1.20±0.07), 4.0μmol/L group (0.93±0.10), 5.0μmol/L group (0.76±0.02), 8.0μmol/L group (0.05±0.01), and the A values were significantly different among the three groups ( F=329.83, P=0.00), there were statistically significant differences between any two groups except the 0.5 μmol/L group(all P<0.05). The early and total apoptosis rates were both significantly different among the three groups ( F=32.49, P=0.00; F=6.39; P=0.03), the early apoptosis rates of 3.0, 1.0μmol/L group were higher than that of the control group(all P<0.05), and the early apoptosis rate in the 3.0 μmol/L group was higher than that in the 1.0μmol/L group[(11.83±1.12)% vs.(7.01±1.84)%, t=3.73, P<0.05]. The expression of p65 protein decreased, while both the expressions of caspase-3 and caspase-9 proteins increased after treatment with cryptotanshinone. Conclusion:Cryptotanshinone can significantly inhibit proliferation and induce apoptosis of human bladder carcinoma J82 cells in vitro, probably via suppressing NF-κB signal pathway and activating mitochondrial pathway, respectively.

The metabolic chamber system is a new-developed method of energy metabolism examination by indirect calorimetry. Recently, metabolic chambers have been applied in energy expenditure affected by the changes of diet, sleep and physical activities, and metabolic diseases such as obesity and type 2 diabetes mellitus, to underlie the potential mechanisms. This review is aimed to summarize the applications of metabolic chambers in China and abroad in researches on energy metabolism involved in physiology, endocrine diseases and energy metabolism disorders. A more extensive use of metabolic chambers in clinical practice is well expected in the foreseeable big-data era.

Abstract]? Objective? To explore the effects of nurses' sense of meaning in life and psychological resilience on their occupational attitude and provide a basis for finding effective nursing management methods. Methods? Totally 620 nurses from 3 ClassⅢ Grade A hospitals in Wenzhou were selected by convenient sampling between June and August 2018 and investigated with the General Information Questionnaire, Meaning in Life Scale, Psychological Resilience Scale and Nurse Occupational Attitude Scale. Results? A total of 620 questionnaires were distributed and 613 questionnaires were effectively collected. The nurses' sense of Meaning in Life Scale,Psychological Resilience Scale and Nurse Occupational Attitude Scale scored (47.03±7.18), (115.04±19.28) and (5.06±0.83), respectively. Univariate analysis revealed that there was statistically significant difference in occupational attitude scores between nurses with different gender, educational background, professional title, position and night shift (P＜0.05). The total scores in sense of meaning in life and psychological resilience as well as the scores in various dimensions were positively correlated with their occupational attitude (P＜0.01). Multivariate linear regression analysis was conducted taking the 5 statistically significant variables (gender, educational background, professional title, position and night shift) in univariate analysis as dependent variables and nurses' sense of meaning in life and psychological resilience scores as independent variables. Multivariate linear regression analysis showed that professional title, educational background, position, sense of meaning in life and psychological resilience were the main influencing factors to nurses' occupational attitude (P＜0.01). Conclusions? Nurses' occupational attitude is affected by multiple internal and external factors. Nursing managers should take targeted management measures to enhance nurses' sense of meaning in life and psychological resilience, provide proper guidance and motivation to their occupational attitude, and improve the quality of clinical nursing care.

Triclosan, a broad-spectrum antimicrobial agent, was reported to have been widely detected in various human biological samples such as urine, blood and human milk among foreign populations. In China, limited reports have been found on human exposure to triclosan, and the reported urinary triclosan concentrations were significantly lower than that of American populations. Besides, the potential influencing factors still remain unclear regarding human exposure to triclosan, but evidences suggest that those in middle age and with higher household income and higher social class tend to have higher urinary triclosan concentrations. Furthermore, triclosan exposure tend to differ by sex, geography, heredity, metabolism and life style.
China ; Environmental Exposure ; analysis ; Humans ; Middle Aged ; Triclosan ; analysis