Objective To discuss the perioperative anesthesia management strategy for the surgical resection of rec-tal cancer in a patient with a rare neuromuscular disease-Facioscapulohumeral Muscular Dystrophy(FSHD)compli-cated by restrictive ventilatory dysfunction.Methods Clinical data of a patient with FSHD complicated by moder-ate-to-severe restrictive ventilatory dysfunction undergoing rectal cancer surgery were retrospectively collected;the clinical manifestations,complication,preoperative evaluation,intraoperative anesthesia management and postopera-tive pain treatment were analyzed and summarized.Results FSHD is a rare genetic disorder,and preopera-tive multidisciplinary evaluation is critical.In this case,total intravenous anesthesia was employed,with invasive arterial pressure monitoring,blood gas analysis,body temperature,sufficient analgesia,close respiratory monitoring and lung protective ventilation strategy after preoperative multidisciplinary evaluation.After thorough sputum suction,lung expansion,and complete recovery of muscle strength,the patient was successfully extubated;ensuring respiratory monitoring after surgery,sufficient analgesia was administered,and transferred to the ICU for monitoring,and ultimately discharged with satisfactory treatment results.Conclusions For patients with rare neuro-muscular diseases such as FSHD,thorough preoperative evaluation and optimization are essential.Clinicians should be aware of related complications,such as restrictive ventilatory dysfunction,and develop individualized anesthesia plans.Intraoperative monitoring,particularly of the respiratory and hemodynamic systems,should aim to prevent hypoxia and carbon dioxide retention,thereby reducing the risk of complications.

This paper focuses on the Party building work in public hospitals and deeply explores its practical status in dif-ferent work scenarios such as medical services,discipline construction,talent cultivation,and doctor-patient relationship han-dling.Through analysis,it is found that there are problems such as insufficient in-depth integration of Party building and busi-ness,formalized Party member education,and lack of innovation impetus in Party building work.Furthermore,a series of innova-tive development paths are proposed,including constructing a mechanism for the deep integration of Party building and business,using digital technology to innovate the Party member education mode,and creating an incentive Party building innovation cul-ture,aiming to provide a theoretical basis and practical reference for improving the quality of Party building work in public hospi-tals and promoting the sustainable development of public hospitals.

This paper focuses on the Party building work in public hospitals and deeply explores its practical status in dif-ferent work scenarios such as medical services,discipline construction,talent cultivation,and doctor-patient relationship han-dling.Through analysis,it is found that there are problems such as insufficient in-depth integration of Party building and busi-ness,formalized Party member education,and lack of innovation impetus in Party building work.Furthermore,a series of innova-tive development paths are proposed,including constructing a mechanism for the deep integration of Party building and business,using digital technology to innovate the Party member education mode,and creating an incentive Party building innovation cul-ture,aiming to provide a theoretical basis and practical reference for improving the quality of Party building work in public hospi-tals and promoting the sustainable development of public hospitals.

Inflammatory bowel disease(IBD)is a serious disorder,and exploration of active compounds to treat it is necessary.An acidic polysaccharide named SUSP-4 was purified from Selaginella uncinata(Desv.)Spring,which contained galacturonic acid,galactose,xylose,arabinose,and rhamnose with the main chain structure of →4)-α-D-GalAp-(1 → and →6)-β-D-Galp-(1 → and the branched structure of →5)-α-L-Araf-(1 →.Animal experiments showed that compared with Model group,SUSP-4 significantly improved body weight status,disease activity index(DAI),colonic shortening,and histopathological damage,and elevated occludin and zonula occludens protein 1(ZO-1)expression in mice induced by dextran sulfate sodium salt(DSS).16S ribosomal RNA(rRNA)sequencing indicated that SUSP-4 markedly downregulated the level of Akkermansia and Alistipes.Metabolomics results confirmed that SUSP-4 obviously elevated thiamine levels compared with Model mice by adjusting thiamine metabolism,which was further confirmed by a targeted metabolism study.Fecal transplantation experiments showed that SUSP-4 exerted an anti-IBD effect by altering the intestinal flora in mice.A mechanistic study showed that SUSP-4 markedly inhibited macrophage activation by decreasing the levels of phospho-nuclear factor kappa-B(p-NF-κB)and cyclooxygenase-2(COX-2)and elevating NF-E2-related factor 2(Nrf2)levels compared with Model group.In conclusion,SUSP-4 affected thiamine metabolism by regulating Akker-mania and inhibited macrophage activation to adjust NF-κB/Nrf2/COX-2-mediated inflammation and oxidative stress against IBD.This is the first time that plant polysaccharides have been shown to affect thiamine metabolism against IBD,showing great potential for in-depth research and development applications.

It is necessary to explore potent therapeutic agents via regulating gut microbiota and metabolism to combat Parkinson's disease(PD).Dioscin,a bioactive steroidal saponin,shows various activities.How-ever,its effects and mechanisms against PD are limited.In this study,dioscin dramatically alleviated neuroinflammation and oxidative stress,and restored the disorders of mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP).16 S rDNA sequencing assay demonstrated that dioscin reversed MPTP-induced gut dysbiosis to decrease Firmicutes-to-Bacteroidetes ratio and the abundances of Enterococcus,Streptococcus,Bacteroides and Lactobacillus genera,which further inhibited bile salt hy-drolase(BSH)activity and blocked bile acid(BA)deconjugation.Fecal microbiome transplantation test showed that the anti-PD effect of dioscin was gut microbiota-dependent.In addition,non-targeted fecal metabolomics assays revealed many differential metabolites in adjusting steroid biosynthesis and pri-mary bile acid biosynthesis.Moreover,targeted bile acid metabolomics assay indicated that dioscin increased the levels of ursodeoxycholic acid,tauroursodeoxycholic acid,taurodeoxycholic acid and β-muricholic acid in feces and serum.In addition,ursodeoxycholic acid administration markedly improved the protective effects of dioscin against PD in mice.Mechanistic test indicated that dioscin significantly up-regulated the levels of takeda G protein-coupled receptor 5(TGR5),glucagon-like peptide-1 receptor(GLP-1R),GLP-1,superoxide dismutase(SOD),and down-regulated NADPH oxidases 2(NOX2)and nu-clear factor-kappaB(NF-κB)levels.Our data indicated that dioscin ameliorated PD phenotype by restoring gut dysbiosis and regulating bile acid-mediated oxidative stress and neuroinflammation via targeting GLP-1 signal in MPTP-induced PD mice,suggesting that the compound should be considered as a prebiotic agent to treat PD in the future.

Objective:To explore the structure and function of recombination activating gene 1 (RAG1) related to severe combined immunodeficiency (SCID) before entering the preimplantation genetic testing for monogenic (PGT-M) cycle, and to predict the pathogenicity of its novel mutation sites.Methods:According to the whole exome sequencing reports of the probands in the Department of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University on August 2016, the chromosome karyotypes and Sanger sequencing of their parents from their peripheral blood, the structures and protein conserved domains of the novel mutation sites of RAG1 gene were analyzed by PROVEAN, PolyPhen-2 and Mutation Taster software, and the secondary and tertiary structures of the mutant and wild type RAG1 protein were reconstructed in three-dimensional structure to predict its pathogenicity. Results:The couple were carriers of RAG1 gene mutation, which were located on chromosome 11. The female was heterozygous missense mutation of c.946T>G (p.C316G) and the male was heterozygous integer mutation of c.1194_1196del (p.L399del). The amino acid of the RAG1 mutations mentioned above were highly conserved among human, chimpanzee, pig, cattle, rats and mice. The secondary and tertiary structure reconstruction showed that the RING-type zinc finger structure lost the ability to bind zinc ions due to c.946T>G mutation, and the deletion of leucine at position 399 caused by c.1194_1196del mutation reduced one hydrogen bond. Conclusion:It is speculated that the two novel mutation sites of RAG1 are pathogenic mutations, which expand the mutation spectrum of RAG1 gene and have important research value.

Objective:To explore the structure and function of recombination activating gene 1 (RAG1) related to severe combined immunodeficiency (SCID) before entering the preimplantation genetic testing for monogenic (PGT-M) cycle, and to predict the pathogenicity of its novel mutation sites.Methods:According to the whole exome sequencing reports of the probands in the Department of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University on August 2016, the chromosome karyotypes and Sanger sequencing of their parents from their peripheral blood, the structures and protein conserved domains of the novel mutation sites of RAG1 gene were analyzed by PROVEAN, PolyPhen-2 and Mutation Taster software, and the secondary and tertiary structures of the mutant and wild type RAG1 protein were reconstructed in three-dimensional structure to predict its pathogenicity. Results:The couple were carriers of RAG1 gene mutation, which were located on chromosome 11. The female was heterozygous missense mutation of c.946T>G (p.C316G) and the male was heterozygous integer mutation of c.1194_1196del (p.L399del). The amino acid of the RAG1 mutations mentioned above were highly conserved among human, chimpanzee, pig, cattle, rats and mice. The secondary and tertiary structure reconstruction showed that the RING-type zinc finger structure lost the ability to bind zinc ions due to c.946T>G mutation, and the deletion of leucine at position 399 caused by c.1194_1196del mutation reduced one hydrogen bond. Conclusion:It is speculated that the two novel mutation sites of RAG1 are pathogenic mutations, which expand the mutation spectrum of RAG1 gene and have important research value.

Baylisascaris schroederi,a roundworm(ascaridoid)parasite specific to the bamboo-feeding giant panda(Ailuropoda melanoleuca),represents a leading cause of mortality in wild giant panda populations.Here,we present a 293-megabase chromosome-level genome assembly of B.schroederi to infer its biology,including host adaptations.Comparative genomics revealed an evolutionary trajectory accompanied by host-shift events in ascaridoid parasite lineages after host separations,suggesting their potential for transmission and rapid adaptation to new hosts.Genomic and anatomical lines of evidence,including expansion and positive selection of genes related to the cuticle and basal metabolisms,indicate that B.schroederi undergoes specific adaptations to survive in the sharp-edged bamboo-enriched gut of giant pandas by structurally increasing its cuticle thickness and efficiently utilizing host nutrients through gut parasitism.Additionally,we characterized the secretome of B.schroederi and predicted potential drug and vaccine targets for new control strategies.Overall,this genome resource provides new insights into the host adaptation of B.schroederi to the giant panda as well as the host-shift events in ascaridoid parasite lineages.Our findings on the unique biology of B.schroederi will also aid in the development of prevention and treatment measures to protect giant panda populations from roundworm parasitism.

Objective: To assess the role of the arterial based complexity (ABC) scoring system in predicting clinically relevant outcomes of minimally invasive partial nephrectomy (MIPN). Methods: A retrospective review of 161 renal cell carcinoma patients who under-went MIPN at Tianjin Medical University Cancer Institute and Hospital from June 2016 to January 2018 was performed. The ABC score, including grades 1, 2, 3S, and 3H, were based on the patients'enhanced preoperative abdominal CT images. The reproducibility of the ABC scoring system was evaluated, and the relationship between the ABC score and patients'pathological features, surgery-related variables, postoperative complications, and renal function was analyzed. Results: Patients in grades 1, 2, 3S, and 3H in this study ac-counted for 20.5% (33/161), 60.2% (97/161), 11.8% (19/161), and 7.5% (12/161), respectively. The average Kappa value of the physi-cian's score was 0.523, and the average exact match percentage was 70.2%. The ABC score was significantly associated with operative time, warm ischemia time (WIT), estimated blood loss (EBL), and tumor size (P<0.001 for all) and was not associated with postopera-tive hospital stay, postoperative complications, preoperative estimated glomerular filtration rate (eGFR), and eGFR at 3 and 6 months postoperatively (P>0.05 for both). Conclusions: The ABC score is a scoring system with good repeatability and has certain predictive significance for the complexity of MIPN. However, further research is needed for its clinical application.

Echinococcus granulosus is the causative agent of cystic echinococcosis with medical and veterinary importance in China. Our main objective was to discuss the genotypes and genetic diversity of E. granulosus present in domestic animals and humans in western China. A total of 45 hydatid cyst samples were collected from sheep, humans, and a yak and subjected to an analysis of the sequences of mitochondrial cytochrome b (cytb) gene. The amplified PCR product for all samples was a 1,068 bp band. The phylogenetic analysis showed that all 45 samples were identified as E. granulosus (genotype G1). Ten haplotypes were detected among the samples, with the main haplotype being H1. The haplotype diversity was 0.626, while the nucleotide diversity was 0.001. These results suggested that genetic diversity was low among our samples collected from the west of China based on cytb gene analysis. These findings may provide more information on molecular characteristics of E. granulosus from this Chinese region.
Animals ; Animals, Domestic/parasitology ; Base Composition ; Base Sequence ; Cattle/*parasitology ; China ; Cytochromes b/*genetics ; DNA, Helminth/genetics ; Echinococcosis ; Echinococcus granulosus/classification/*genetics ; Genetic Variation ; Haplotypes/genetics ; Humans ; Mitochondria/genetics ; Molecular Sequence Data ; Phylogeny ; Polymerase Chain Reaction/*veterinary ; Sequence Alignment ; Sequence Analysis, DNA ; Sheep/*parasitology ; Tibet