Objective To explore the relationship between serum Visfatin,pentraxin 3(PTX3),and carbo-hydrate antigen 19-9(CA19-9)levels and prognosis in patients with acute cholecystitis.Methods A total of 228 patients with acute cholecystitis admitted to a hospital from September 2020 to September 2023 were se-lected as the study objects.According to the severity of the patients,228 patients were divided into mild group(n=81),moderate group(n=102)and severe group(n=45).The patients were divided into good prognosis group(n=186)and bad prognosis group(n=42).General data of patients were collected,serum Visfatin and PTX3 levels were detected by enzyme linked immunosorbent assay,and serum CA19-9 levels were determined by chemiluminescence immunoassay.Univariate and multivariate analysis of prognostic factors in patients with acute cholecystitis was performed,and the diagnostic value of serum Visfatin,PTX3 and CA19-9 levels in patients with acute cholecystitis was analyzed by drawing receiver operating characteristic curve.Results Ser-um Visfatin,PTX3 and CA19-9 in moderate and severe groups were significantly different from those in mild group(P＜0.05).There were significant differences in serum Visfatin,PTX3 and CA19-9 between severe group and moderate group(P＜0.05).Gallbladder thickness,long diameter and short diameter of gallbladder,serum Visfatin,PTX3 and CA19-9 levels in the poor prognosis group were significantly different from those in the good prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that serum Visfatin,PTX3 and CA19-9 levels were the influential factors for poor prognosis of patients(P＜0.05).The area under the curve of serum Visfatin,PTX3 and CA19-9 combined diagnosis was significantly larger than that of Visfa-tin alone diagnosis(Z=4.577,P＜0.001)and PTX3 alone diagnosis(Z=3.132,P=0.002)and the area un-der the curve of CA19-9 diagnosis alone(Z=2.766,P=0.006).Conclusion Serum Visfatin,PTX3 and CA19-9 are elevated in patients with acute cholecystitis,which is related to the patient's condition.The combi-nation of the three is of better value in the diagnosis of poor prognosis.

Objective:To investigate the spectrum, drug resistance and risk factors of multidrug resistant organism (MDRO) in chronic osteomyelitis.Methods:A retrospective study was conducted by cluster sampling to analyze the 414 patients with chronic osteomyelitis who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Shanxi Medical University, Department of Orthopaedics, The People's Hospital of Shanxi Province, Department of Traumatology, Yuncheng City Hospital, and Department of Orthopaedics, Linfen City Hospital from January 2016 to December 2021. The patients were assigned into 2 groups according to whether MDRO had been detected or not. In the MDRO infection group of 150 cases, there were 118 males and 32 females with an age of (48.8±16.2) years; in the non-MDRO infection group of 264 cases, there were 194 males and 70 females with an age of (46.0±17.8) years. The characteristics of bacterial spectrum and drug resistance in MDRO infection were described and analyzed. The 2 groups were compared in terms of clinical data like gender, age, course of disease, body mass index, history of antibiotic use before admission, combined internal diseases, combined trauma, and length of hospital stay. The items with P<0.05 were included in a multivariate logistic regression model to explore the risk factors for MDRO infection. Results:Pathogenic bacteria (331 strains) were detected in 286 of the 414 patients with chronic osteomyelitis, and infection with 168 strains of MDRO was detected in 150 of the 286 patients, yielding a detection rate of 50.8% (168/331). Of the 168 strains of MDR, 129 (76.8%, 129/168) were Gram-positive and 39 (23.2%, 39/168) Gram-negative. Staphylococcus aureus was the most frequently detected species of Gram-positive bacteria (58.1%, 75/129) and the most frequently detected pathogen (44.6%, 75/168) in this study. The resistance of Gram-positive bacteria to peptides and oxazolidinones was low (less than 10%). Multivariate logistic regression analysis showed that age ≥45 years ( OR=6.991, 95% CI: 3.525 to 13.865, P<0.001), essential hypertension ( OR=4.191, 95% CI: 2.070 to 8.485, P<0.001), trauma ( OR=4.232, 95% CI: 2.409 to 7.435, P<0.001) and length of hospital stay ( OR=1.015, 95% CI: 1.001 to 1.029, P=0.030) were the risk factors for MDRO infection in patients with chronic osteomyelitis. Conclusions:The detection rate of MDRO is at a medium to high level. Gram positive bacteria are the main pathogens and resistant to most antibiotics. Antibiotic therapy guided by bacterial culture is of great significance for patients with chronic osteomyelitis. Age≥45 years, essential hypertension, trauma, and long hospital stay are risk factors for MDRO infection in patients with chronic osteomyelitis.

Objective:To study the independent risk factors of tumor recurrence after radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC), and to establish a preoperative prediction score.Methods:A retrospective study was conducted on 168 HCC patients treated with RFA at Zhongshan Hospital affiliated to Sun Yat-sen University from June 2016 to September 2019. The X-tile software was used to determine the optimal cut-off value of preoperative circulating tumor cells (CTC) which was then used to analyze the relationship between different CTCs values with various clinical factors. The Cox regression model was used to analyze independent risk factors of recurrence after RFA, and each independent risk factor was assigned a score of 1 to compose the prediction score. The patients were divided into the low-risk group (0-2 scores), intermediate-risk group (3 scores) and high-risk group (4-5 scores). The Kaplan-Meier method was used to draw cumulative recurrence curves in calculating the cumulative recurrence rates of the 3 different groups.Results:Of 168 patients, there were 151 males and 17 females. Their age (Mean±SD) was 58.33±9.53 years. CTC≥1/3.2 ml was detected in 131 patients (77.98%) (range 0-20/3.2 ml). The X-tile software determined the preoperative CTC cut-off value of HCC patients to be 2/3.2ml which separated a CTC-negative group with 93 patients, and a positive group of 75 patients. On analyses, the relationship between preoperative CTC and various preoperative clinical parameters were related to number of tumor nodules, tumor maximum diameter and alpha-fetoprotein (AFP) levels ( P<0.05). Multivariate analysis showed that CTC positivity[ HR(95% CI): 1.990(1.332-2.974)], AFP>20 ng/ml[ HR(95% CI): 1.659(1.111-2.477)], PIVKA-II>40 mAU/ml[ HR(95% CI): 1.580 (1.022-2.443)], number of tumor nodules ≥2[ HR(95% CI): 1.568 (1.057-2.326)], and tumor diameter>30 mm[ HR (95% CI): 1.544 (1.007-2.369)] were independent risk factors of recurrence ( P<0.05) after RFA in HCC patients. The cumulative recurrence rates of patients at 6 months, 12 months, and 18 months were 14.9%, 35.6%, and 56.4% in the low-risk group, 38.9%, 70.5%, and 85.0% in the intermediate-risk group, and 64.5%, 84.5% and 100% in the high-risk group. The differences were significant ( P<0.05). Conclusion:Preoperative CTC positivity, AFP>20 ng/ml, PIVKA-II>40 mAU/ml, tumor nodules ≥2, and tumor diameter>30 mm were independent risk factors of recurrence after RFA in HCC patients. This preoperative predictive score could be used to guide clinical treatment strategies.

Objective:To analyze the risk factors of hepatocellular carcinoma microvascular invasion (MVI) and to construct a preoperative prediction clinical scoring system.Methods:A retrospective analysis was made on 113 patients with hepatocellular carcinoma undergoing hepatectomy at Zhongshan Hospital from March 2018 to Jun 2019.Postoperative pathology confirmed 35 cases with microvascular invasion.Results:The multivariate logistic regression model showed that the maximum tumor diameter( OR: 1.028, 95% CI: 1.001-1.005), the smoothness of the capsule edge( OR: 0.208, 95% CI: 0.062-0.699), the positive circulating tumor cells (CTC)( OR: 3.728, 95% CI: 1.029-13.501) and abnormal prothrombin(PIVKA-Ⅱ)( OR: 1.001, 95% CI: 1.000-1.002) were risk factors for MVI. The area, sensitivity and specificity of the clinical score constructed by assigning 1 point to each risk factor were 0.906, 74.29% and 92.31%, respectively. Clinical scores of 0, 1, 2, 3, and 4 predict MVI positive rates of 0 (0/26), 9.09% (3/33), 28.57% (6/21), 77.78% (14/ 18), 85.71% (12/14). Conclusions:Tumor maximum diameter>62 mm, PIVKA-Ⅱ>115 mAU/ml, unsmooth tumor capsule and CTC in peripheral blood are independent high risk factors in patients with MVI.

Objective:To explore the application value of detecting circulating tumor cells (CTC) before liver transplantation for predicting the recurrence and survival of hepatocellular carcinoma (HCC).Methods:From October 2015 to October 2019, 62 HCC patients at Affiliated Zhongshan Hospital were collected and analyzed by Cyttel method before liver transplantation. CTC was determined by X-tile software and Kaplan-Meier method for determining the optimal cutoff value of CTC before liver transplantation and the relationship between CTC and clinical factors was analyzed. Univariate and multivariate COX regression analyses were performed for determining the independent risk factors affecting the prognosis. Kaplan Meier method was employed for describing the survival curve of tumor-free survival and overall survival after transplantation.Results:The optimal preoperative critical value of CTC was 3.2 ml. CTC ≥3/3.2 mL was set as CTC positive group while CTC <3/3.2 mL CTC negative group. The positive/negative CTC before transplantation was significantly correlated with preoperative Alpha-fetoprotein(AFP) level, maximal tumor diameter, lymph node metastasis, liver transplantation criteria and degree of differentiation ( P<0.05). Univariate and multivariate COX regression models indicated that the number of preoperative CTC (HR: 1.262, 95%CI: 1.069-1.489, P=0.006) and microvascular invasion (HR: 2.657, 95%CI: 1.120-6.305, P=0.027) were independent risk factors for tumor-free survival after transplantation while microvascular invasion (HR: 3.738, 95%CI: 1.219-11.459, P=0.027) was the sole independent risk factor affecting the overall survival of HCC after transplantation. Statistically significant difference existed between preoperative CTC positive/negative and tumor recurrence or metastasis (no recurrence, intrahepatic recurrence, and distant metastasis)( χ2=7.790, P=0.020). The disease-free survival rates of 1/2/3-year CTC-negative/positive patients were 82.90%, 68.70%, 58.90% and 49.00%, 29.40%, 22.10%; the 1/2/3-year overall survival rates of preoperative CTC-negative/positive patients were 85.50%, 77.10%, 69.79% and 64.90%, 47.20%, 40.50% respectively. The disease-free survival curve of CTC-negative patients was significantly higher than that of CTC-positive counterparts ( P<0.001) and the overall survival curve of CTC-negative patients was significantly higher than that of CTC-positive counterparts ( P<0.005). Conclusions:Preoperative CTC detection has certain application value in evaluating the prognosis of liver cancer after liver transplantation, which has important clinical significance and application prospects.

Objective:To investigate the correlation between preoperative circulating tumor cells (CTC) and microvascular invasion (MVI) in patients with hepatocellular carcinoma.Methods:The data of 227 patients who underwent hepatocellular carcinoma resection in Zhongshan Hospital Affiliated to Sun Yat-sen University from January 2018 to March 2020 were retrospectively analyzed. The peripheral blood CTC was detected by Cyttel detection before operation. The relationship between preoperative peripheral blood CTC and clinical characteristics of patients was analyzed; the multivariate logistic regression model was used to analyze the independent risk factors for MVI; the receiver operating characteristic (ROC) curve was used to compare the efficacy of each independent risk factor in predicting the occurrence of MVI, and the relationship between CTC and MVI was clarified.Results:According to the ROC curve, the cut-off values for predicting MVI of CTC, alpha-fetoprotein (AFP), protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), and tumor long-axis diameter were 3 CTC/3.2 ml, 158 μg/L, 178 AU/L and 59 mm. CTC-positive group had ≥3 CTC/3.2 ml in peripheral blood, and CTC-negative group had <3 CTC/3.2 ml, and there were 117 and 110 cases in the two groups. The median AFP levels of preoperative CTC-positive group and CTC-negative group were 123.0 μg/L (0-20 000.0 μg/L) and 9.6 μg/L (0-18 676.0 μg/L), and the median tumor long-axis diameter was 50.0 mm (5.0-200.0 mm) and 36.0 mm (2.0-150.0 mm), the differences between the two groups were statistically significant (both P < 0.05). Before operation, AFP≥158 μg/L ( OR = 3.551, 95% CI 1.426-8.843, P = 0.006), PIVKA-Ⅱ≥178 AU/L ( OR = 12.250, 95% CI 4.384-34.231, P < 0.01), peripheral blood CTC ≥ 3 CTC/3.2 ml ( OR = 8.913, 95% CI 3.561-22.306, P < 0.01) and tumor long-axis diameter ≥59 mm ( OR = 3.250, 95% CI 1.339-7.885, P = 0.009) were independent risk factors for the occurrence of MVI; the area under the ROC curve (AUC) of these factors for predicting MVI was 0.752, 0.777, 0.857 and 0.743. CTC was more effective in predicting MVI than AFP and tumor long-axis diameter, and the differences were statistically significant (both P < 0.05). The efficacy of CTC in predicting MVI was slightly better than that of PIVKA-Ⅱ, but the difference was not statistically significant ( P > 0.05). Conclusion:CTC may be one of the important indicators of hepatocellular carcinoma MVI in clinical practice.

A novel β-glucosidase BglD2 with glucose and ethanol tolerant properties was screened and cloned from the deep-sea bacterium Bacillus sp. D1. The application potential of BglD2 toward polydatin-hydrolyzing was also evaluated. BglD2 exhibited the maximal β-glucosidase activity at 45 °C and pH 6.5. BglD2 maintained approximately 50% of its origin activity after incubation at 30 °C and pH 6.5 for 20 h. BglD2 could hydrolyze a variety of substrates containing β (1→3), β (1→4), and β (1→6) bonds. The activity of β-glucosidase was enhanced to 2.0 fold and 2.3 fold by 100 mmol/L glucose and 150 mmol/L xylose, respectively. BglD2 possessed ethanol-stimulated and -tolerant properties. At 30 °C, the activity of BglD2 enhanced to 1.2 fold in the presence of 10% ethanol and even remained 60% in 25% ethanol. BglD2 could hydrolyze polydatin to produce resveratrol. At 35 °C, BglD2 hydrolyzed 86% polydatin after incubation for 2 h. Thus, BglD2 possessed glucose and ethanol tolerant properties and can be used as the potential candidate of catalyst for the production of resveratrol from polydatin.
Enzyme Stability ; Glucose ; Glucosides/pharmacology* ; Hydrogen-Ion Concentration ; Stilbenes/pharmacology* ; Substrate Specificity ; Temperature ; Xylose ; beta-Glucosidase/genetics*

Single-cell RNA sequencing (scRNA-seq) is generally used for profiling transcriptome of individual cells.The droplet-based 10X Genomics Chromium (10X) approach and the plate-based Smart-seq2 full-length method are two frequently used scRNA-seq platforms,yet there are only a few thorough and systematic comparisons of their advantages and limitations.Here,by directly comparing the scRNA-seq data generated by these two platforms from the same samples of CD45-cells,we systematically evaluated their features using a wide spectrum of analyses.Smart-seq2 detected more genes in a cell,especially low abundance transcripts as well as alterna-tively spliced transcripts,but captured higher proportion of mitochondrial genes.The composite of Smart-seq2 data also resembled bulk RNA-seq data more.For 10X-based data,we observed higher noise for mRNAs with low expression levels.Approximately 10％-30％ of all detected tran-scripts by both platforms were from non-coding genes,with long non-coding RNAs (lncRNAs)accounting for a higher proportion in 10X.10X-based data displayed more severe dropout prob-lem,especially for genes with lower expression levels.However,10X-data can detect rare cell types given its ability to cover a large number of cells.In addition,each platform detected distinct groups of differentially expressed genes between cell clusters,indicating the different characteristics of these technologies.Our study promotes better understanding of these two platforms and offers the basis for an informed choice of these widely used technologies.

Objective To investigate the characteristics and risk factors of infection after liver transplantation from donor liver of donation after citizen's death. Methods Clinical data of 68 recipients after liver transplantation from donor liver of donation after citizen's death were analyzed retrospectively. The recipients were divided into infection group (33 cases) and non-infection group (35 cases) according to the presence of infection after operation. Major infection characteristics of the 68 recipients after liver transplantation were summarized. Univariate analysis was conducted on the possible risk factors of infection after liver transplantation, and multivariate analysis was further conducted on the risk factors with statistical significance, so as to find out the independent risk factors. In addition, accuracy of predicting infection after liver transplantation was analyzed using receiver operating characteristic (ROC) curves. Results Thirty-three recipients were infected after liver transplantation, accounting for 49% of the total recipients with bacterial infection and fungal infection mainly. These recipients mainly presented pulmonary infection and abdominal cavity infection. Univariate analysis results showed that a total of 8 factors contributed to infection after liver transplantation from donor liver of organ donation, including the donors' open injury, recipients' preoperative hemoglobin level, platelet count, Child-Pugh classification of liver function, model for end-stage liver disease (MELD) score, intraoperative erythrocyte infusion, gamma-glutamyl transpeptidase (GGT) on day 1 after operation and postoperative stay time of intensive care unit (ICU) (all P<0.05). Multivariate Logistic regression results analysis showed that preoperative hemoglobin level <120 g/L and postoperative stay time of ICU >96 h were the independent risk factors of infection after liver transplantation from donor liver of organ donation (both P<0.05). Analysis results of ROC curves showed that preoperative hemoglobin level<114 g/L and postoperative stay time of ICU >102 h resulted in higher accuracy for predicting postoperative infection. Conclusions Infection after liver transplantation from donation after citizen's death presents high incidence, dominated by bacterial infection and fungal infection in lung and abdominal cavity. Low preoperative hemoglobin level and long postoperative stay time of ICU of recipients can increase the risk of infection after liver transplantation.

STUDY DESIGN: A prospective cross-sectional study. PURPOSE: To evaluate the risk factors associated with the severity of pain intensity in patients with non-specific low back pain (NSLBP) in Southern China. OVERVIEW OF LITERATURE: Low back pain (LBP) is the leading cause of activity limitation and work absence throughout the world, so a firm understanding of the risk factor associated with NSLBP can provide early and prompt interventions that are aimed at attaining long-term results. METHODS: Participants were recruited from January 2014 to January 2016 and were surveyed using a self-designed questionnaire. Anonymous assessments included Short Form 36-Item Health Survey (SF-36) and Visual Analogue Scale (VAS). The association between the severity of NSLBP and these potential risk factors were evaluated. RESULTS: A total of 1,046 NSLBP patients were enrolled. The patients with primary school education, high body mass index (BMI), those exposed to sustained durations of driving and sitting, smoking, recurrent LBP had increased VAS and Oswestry Disability Index (ODI) scores with lower SF-36 scores (p<0.01). Workers and drivers compared with waiters and patients who lifted >10 kg objects in a quarter of their work time for >10 years had higher VAS and ODI scores with lower SF-36 scores (p<0.01). Multiple logistic regression showed lower levels of education, LBP for 1–7 days, long-lasting LBP in last year, smoking, long duration driving, and higher BMI were associated with more severe VAS score. CONCLUSIONS: The severity of NSLBP is associated with lower levels of education, poor standards of living, heavy physical labor, long duration driving, and sedentary lifestyle. Patients with recurrent NSLBP have more severe pain. Reducing rates of obesity, the duration of heavy physical work, driving or riding, and attenuating the prevalence of sedentary lifestyles and smoking may reduce the prevalence of NSLBP.
Anonyms and Pseudonyms ; Body Mass Index ; China ; Cross-Sectional Studies ; Education ; Health Surveys ; Humans ; Logistic Models ; Low Back Pain ; Obesity ; Prevalence ; Prospective Studies ; Risk Factors ; Sedentary Lifestyle ; Smoke ; Smoking