Objective To explore the role and mechanism of warm malate ringer's solution(MR)in resuscitation of the lethal triad caused by severe trauma.Methods A rat model of severe trauma was established in SPF-grade SD rats(half male and half female,weighing 200～220 g)using combined multiple injuries and hemorrhagic shock,and the rats were randomly divided into 8 groups(n=8):Sham group,only arterial and venous catheterization;Trauma(Tra)groups with different time points(10,30,60,90,120,180 min)and a Trauma group that were observed without any treatment for 180 min after model establishment.The changes of activated clotting time(ACT),reaction time(R),maximum amplitude(MA),and rate of blood clot formation(Angle)at different time points were detected by using thromboelastography,and tail bleeding,core body temperature and arterial blood gas parameters,were also observed and detected.The plasma von Willebrand Factor(vWF)level,mitochondrial respiratory control ratio in pulmonary venous endothelium,and expression levels of vascular endothelial cadherin(VE-Cadherin),peroxisome proliferator activating receptor gamma coactivator 1α(PGC1α),dynamin-related protein 1(Drp1),p-Drp1,and mitofusin 2(Mfn2)were detected to evaluate the vascular endothelial injury and mitochondrial dysfunction.Another group of SD rats were randomly divided into severe trauma group(no treatment for 180 min after injury),and MR solution at room temperature and at 37 ℃ groups.MR solution at room temperature or at 37 ℃ was given to the rats using a medical blood transfusion apparatus at 60 min post-trauma.Above indicators were observed and detected to investigate the resuscitation effect of the MR solution.Results Compared with the Sham group,the severely traumatic rats at 180 min after injury had significantly prolonged ACT and R values(P＜0.05),shortened MA and decreased Angle values(P＜0.05),extended tail bleeding time(P＜0.05),lower partial pressure of carbon dioxide(PCO2)and HCO3-and base excess(BE)levels(P＜0.05),and continuously increasing K+(P＜0.05)and decreasing Na+(P＜0.05)and Ca2+levels(P＜0.05).Additionally,plasma vWF level(P＜0.05)and protein levels of VE-cadherin,PGC1α and Mfn2 in pulmonary vein endothelium were significantly reduced(P＜0.05),the expression of p-Drp1 was enhanced and the mitochondrial respiration control rate was declined in the rats at 180 min after injury(P＜0.05).MR solution resuscitation shortened tail bleeding time(P＜0.05),increased core body temperature(P＜0.05),elevated plasma vWF level(P＜0.05),increased protein levels of VE-cadherin,PGC1α and Mfn2(P＜0.05),and decreased that of p-Drp1 protein expression(P＜0.05)when compared with the rats at 180 min after severe traumatic injury.The above effects were more significant in the rats infused with the solution at 37 ℃ than those at room temperature.Conclusion Warm MR solution significantly improves the lethal triad in rats after severe trauma,which may be associated with its improving mitochondrial function and attenuating vascular endothelial damage.

Objective To precisely knock out MCT1in humancolorectalcancercellline RKO by using CRISPR/Cas9 gene editingtechnique,and to detect its biological function. Methods CRISPRv2-MCT1-KO # 1 and CRISPRv2-MCT1-KO # 2 plasmids weretransfected into RKO cells. The monoclonal cells were selected by the medium containing puromycin after 48 h. The expression of MCT1 was detected by Western blotting and DNA sequencing. The change of expression and distribution of MCT1 protein were detected by immunofluorescence.Intracellular lactic acid level was detected by lactic acid detection kits. Colonyformation assayand CCK-8 assay were performed to detect cell proliferation ability. The potential signaling pathways of MCT1 in colorectal cancer were explored by GSEA software. Results CRISPRv2-MCT1-KO plasmid was well constructed. Western blottingand DNAsequencingresults showedthat MCT1 was successfully knocked outinthe humancolorectal cancer RKOcells. Compared withthecontrol group, MCT1 protein was notobserved onthecell membraneof MCT1-nockoutcells,andtheintracellularlactatelevel was significantlyreduced(P <0.05). The proliferation ability of RKO cells was significantly decreased after MCT1 knockout(P <0.05). GSEA analysis showedthat MCT1 may promotethe occurrence and development ofcolorectal cancerthrough oxidative phosphorylation and MYC signaling pathway. Conclusion The stable MCT1-knockout human colorectal cancer RKO cell line was successfully constructed by applying CRISPR/Cas9 technology, which might become an ffectivetoolforstudyingtherole of MCT1 inthe occurrence and development ofcolorectal cancer.

Background and objective China is a high-incidence area of lung cancer,and its morbidity and mortality were the highest in malignant tumors.At present,the popularization of low-dose computed tomography (CT) examination has significantly improved the detection rate of early lung cancer,anatomical segmentectomy is currently widely used early in non-small cell lung cancer (NSCLC) and those who cannot tolerate lobectomy in patients with lung cancer.However,the anatomical structure of segment and its surgical operation is relatively complex,lead to segmentectomy has a high risk and difficulty.We performed anatomical segmentectomy by use of combining three-dimensional computed tomography bronchography and angiography (3D-CTBA) and three-dimensional video-assisted thoracic surgery (3D-VATS) single-operationhole minimally invasive surgery in the treatment of NSCLC to investigate its clinical effect,and evaluate its clinical relevant feasibility and theoretical basis.Methods We carried out a retrospective review of the 57 cases by use of combining 3D-CTA in preoperative and 3D-VATS single-operation-hole anatomical segmentectomy in intraoperative in the treatment of NSCLC performed in Department of Thoracic Surgery,the First Affiliated Hospital of Soochow University from October 2015 to April 2017.Results The whole group was successfully performed by use of VATS without anyone conversion to thoracotomy.The mean operation time was (142.2±28.3) min,and the mean blood loss was (93.8±46.5) mL.The mean number of lymph node dissection was (9.1±2.2),and the mean postoperative thoracic drainage was (429.8±181.2) mL.The postoperative retention of chest tube time was (2.8±1.1) d.The mean hospitalization time was (5.2±1.3) d.The postoperative pathology showed 9 cases with benign lesions,accounting for 15.7％,48 cases with malignant lesions,accounting for 84.2％.Postoperative complications:pulmonary infection in 3 cases (5.2％),atelectasis in 1 case (1.9％),small amount of hemoptysis in 1 case (1.9％),lung leakage ＞3 d in 2 cases (3.5％).Arrhythmia in 4 cases (7.0％).The patients were followed up for 10 months.No complications occurred such as bronchial pleural fistula,chylothorax,encapsulated pleural effusion and those patients were followed up without recurrence and distant metastasis.Conclusion The use of combining 3D-CTBA and 3D-VATS single-operation-hole to anatomical segmentectomy is safe and effective in the treatment of NSCLC and is suitable for early non-small cell lung cancer,especially those can not tolerate lobectomy.

Objective To explore a new approach that is better than coronal scalp incision and facial percutaneous small incision in surgical treatment of zygomatic bone and zygomatic arch fracture.Methods The modified auriculotemporal incision was applied in 43 patients with zygomatic bone and zygomatic arch fracture that needed open reposition,and the exposure degree,bleeding,postoperative elasticity and texture of skin,facial nerve function and satisfactory degree were evaluated after operation.Results In present study,the upper part of zygomatic arch and lateral orbital margin could be greatly explored for operation of zygomatic bone and zygomatic arch fracture in all 43 patients by application of this approach.Less bleeding was observed during operation.All patients had primary healing and none of them presented with temporal numbness and facial palsy.After 6 months follow-up,41 cases (95.3％) and 43 cases (100％) showed fine elasticity of operative skin and satisfactory degree,respectively.Conclusions The modified auriculotemporal incision is better than conventional approach in surgical treatment of zygomatic bone and zygomaticarch fracture.