Over 2 million thoracoscopic pulmonary resections are performed globally each year,however,postoperative persistent air leak(PAL)remains a common and challenging complication.It not only prolongs hospital stays and increases treatment costs but may also lead to severe complica-tions,particularly inducing a higher risk in patients undergoing mechanical ventilation.In recent years,with the improvement of preoperative preventive measures,the advancement of surgical tech-niques,and the application of repair materials,the incidence of PAL has decreased.This review sys-tematically summarized the definition,clinical impact,risk factors and preventive strategies of PAL,and explored commonly used treatment modalities,such as thoracic drain management,pleurodesis and the application of novel repair materials.It also analyzed the effectiveness,safety and challenges of existing techniques.Furthermore,this review proposed the establishment of an enhanced recovery after surgery(ERAS)integrated pathway combining bovine pericardium(BP)patch with electro-me-chanical stapler and conducted corresponding treatment benefit-cost assessment.

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

To establish a platform to monitor the immune rejection after abdominal aortic patch suture in a xenotransplantation model.Methods The carotid was excised from wild-type Bama pigs,cut into 2.5 cmx 1.0 cm pieces in shuttle shape and subsequently sutured to the abdominal aorta of cynomolgus monkeys.No immunosuppressive agent was administered.General conditions of the recipient monkeys were observed.The morphological changes of the graft artery were assessed by pathological examination at postoperative 1 year.Before and 7,14,28 and 49 d after surgery,the blood samples were collected from the recipient monkeys.The serum levels of IgM and IgG antibodies were quantitatively measured by the red blood cell and peripheral blood mononuclear cell (PBMC) from Bama pigs.The quantity of lymphocytes in the recipient monkeys was detected by routine blood test and flow cytometry.Results All 3 monkeys undergoing transplantation survived well.At postoperative 1 year,the lateral tissues of the vascular wall at the artery graft were seen in dark red color.Hematoxylin-eosin (HE) staining revealed a large quantity of red blood cell and platelet deposition,accompanied with lymphocyte infiltration.Using porcine red blood cell and PBMC as target cells,the serum levels of anti-pig IgM and IgG antibodies peaked at postoperative 28 d,and slightly declined at postoperative 49 d.The quantity of lymphocytes and T cell subset also peaked at postoperative 28 d and began to decrease at postoperative 49 d.Conclusions Artery patch suture is a simple and reliable xenotransplantation model.The recipients can maintain normal physiological state without the use of immunosuppressive agents.The grafts can effectively activate the immune system of the recipients,induce the production of anti-pig antibodies and provoke cellular immune rejection.Therefore,this model can be utilized to monitor the immune rejection throughout the xenotransplantation process.

Objective To study the integration of traditional medical journals and new media in the Internet +era. Methods The papers published in journals were integrated and a characteristic single disease misdiagnosis database was developed for providing precise and accurate information by making full use of the contributing, revie-wing, editing and proofreading platform into which the short message service, alipay or third party payment service and WeChat service were linked. Results The platform makes convenient for the authors, editors and reviewers of manuscripts, the database contributes to the deep development of journal contents and activates the journal vitality. Conclusion The traditional media can improve the work efficiency, integrate the journal contents and provide the characteristic service by making full use of modern technologies, thus contributing to the further development of journals.

Objective To investigate the correlation between ACE gene polymorphisms and stroke of Han nationality people in Fangshan district of Beijing. Methods The Insertion/Deletion(ID) polymorphisms of ACE gene were detected in 63 patients with cerebral hemorrhage,and 713 patients with cerebral infarction and 235 health control by polymerase chain reaction(PCR). We observed the frequencies of genotype of deletion homozygote(DD),insertion homozygote(II) and insertion/deletion heterozygote (ID) and the alleles of D and I. Also we analyzed the association among I/D polymorphisms of ACE gene with serum glucose(GLU),triglyceride(TG),cholesterol(TC) levels. Results There was no significant difference in the frequencies of both genotypes of DD,ID,II and alleles of D and I in three groups. The serum GLU levels in patients carrying ID,II genotype were higher than those in healthy control(P

Objective To investigate the physiological characteristics and the association with low prevalence of hypertension in "desert people" ,as an isolated population,in Taklimakan Desert.Methods All data were obtained from each person by questionnaire and standardized physical examinations. Total 469 subjects received examinations,including 359 subjects of "desert people" (M/F=205/154),aged from 15~99 years; 101 subjects of Uyghur from Yutian county (M/F=51/50),aged from 20~85 years,as controls. Some parameters :TC,TG,LDL-C,HDL-C,Apo-A,Apo-B,Lp-a,BUN,UA and CRE were determined. The statistical analysis was performed with SAS9.1.3 Version (Inititute Inc. Cary,NC. USA). Continuos values were expressed as mean?SD.Differences between groups were examined by student's t test,and statistical difference was considered when the P value was less than 0.05.Results 1)The height in "desert people" was significantly taller than that in controls.P value was 0.0317 for male and P60 years,P value was 0.0127 and 0.0443,respectively.(3)The prevalence of hypertension in "desert people" was 7%(24/359),that was significantly lower than that in controls(30.7%,31/101),P

This study was conducted to amplify the cfpl0-esat6 fusion gene by SOE and insert into the integrating shuttle plasmid pMV361 to form the recombinant plasmid. Then another recombinant plasmid was constructed by insertinga-A g signal sequence of BCG. The two recombinant plasmids were introduced into BCG and the induced products from recombinant BCG were analyzed. In conclusion,the successful construction of rBCG expressing the fusion protein CFP10-ESAT6 will be the base of the development of novel Mycobacterium tuberclosis vaccines.
Antigens, Bacterial ; biosynthesis ; genetics ; Bacterial Proteins ; biosynthesis ; genetics ; Mycobacterium bovis ; genetics ; metabolism ; Mycobacterium tuberculosis ; genetics ; Plasmids ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; immunology ; Tuberculosis Vaccines ; biosynthesis

This study was conducted to potentiate the expression of outer membrane protein OmpL17 of the strong virulent L. interrogans serovar Lai and investigate its immunogenicity in rabbits. The OmpL17 was cloned into prokaryotic expression vector pGEX-1lambdaT. The recombination expression plasmid pGEX-OmpL17 was transformed into E. Coli JM109. The GST fused protein GST-OmpL17 was expressed after induction by IPTG, then GST-tag was by thrombin and purified using Bulk GST purification Modules. SDS-PAGE and Western blotting analysis indicated that the molecular weight of GST-OmpL17 and OmpL17 was about 54 KDa and 28 KDa respectively. The outer membrane protein OmpL17 was subcutaneously injected into rabbits and high titre anti-OmpL17 antibody was obtained (1:4896) which could conjugate specifical with OmpL17. In conclusion, OmpL17 and specifical anti-OmpL17 antibody were obtained, which provided an experimental basis for researching pathogenic effect and immunity functions of OmpL17.
Bacterial Outer Membrane Proteins ; biosynthesis ; genetics ; immunology ; Bacterial Proteins ; biosynthesis ; genetics ; immunology ; Cloning, Molecular ; Humans ; Leptospira interrogans ; genetics ; immunology ; Porins ; biosynthesis ; genetics ; immunology ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; Virulence

BACKGROUNDTo study the correlation among the number of tumor-infiltrating dendritic cells (TIDC) in cancer tissues and biological behavior and prognosis in lung cancer patients.

METHODSS-100 protein expression level was determined in 39 patients with lung cancer by immunohistochemistry technique. The number of S-100 + TIDC and DNA ploidy were measured by means of flow cytometry.

RESULTSThe rate of positive S-100 protein expression was 100% in 39 patients, S-100 + cells showed typical morphology of dendritic cells. The percentage of S-100 +TIDC in patients with heteroploid (21.81%±8.18%) was significantly higher than those with diploid (16.03%±4.75%) (P=0.006). There was no statistical difference between lymph node metastasis group (20.43%±7.74%) and no lymph node metastasis group ( 19.41% ±7.76%), between tumor size greater than 3cm group ( 20.90% ±8.65%) and less than 3cm group ( 19.70% ±7.61%), between non-small cell lung cancer group (19.48%±7.98%) and small cell lung cancer group (21.74%±6.17%). No correlation was found between survival time ( 1 year , 1-3 years, greater than 3 years, respectively) and percentage of S-100 +TIDC (21.96%±8.05%, 19.47%±6.18%, 19.14%±8.76%, respectively).

CONCLUSIONSThe number of TIDC should not be chosen as an independent prognostic criterion in human lung cancer.

Objective To observe the expression of PECAM-1 in colorectal cancer in rat and to explore the mechanism of lymphatic metastasis of tumor. Methods Wistar rats were used to make the animal model of primary colorectal cancer,by using HE staining,the cancer type and progression of cancer were devided.By immunohistochemistry staining,the expression of PECAM-1 in tumor tissue,blood vessels and lymphatic vessels were observed. Results PECAM-1 expression in blood vessels and lymphatic vessels were observed in normal tissue,while its expression on tumor tissue and lymphatic vessels decreased according to the cancer progression.Conclusion PECAM-1 may be involved in the early process of tumor cells adhering to the endothelium;decreased expresson of PECAM-1 on lymphatics may be related with lymphangiogenesis and the opening of endothelial junction of lymphatic vessels.