Objective To investigate the effect of extracorporeal diaphragmatic pacing(EDP)on wea-ning patients undergoing mechanical ventilation after acute Stanford type A aortic dissection(ATAAD)sur-gery.Methods A total of 80 patients who underwent ATAAD surgery and required mechanical ventilation in the cardiac intensive care unit(CCU)of our hospital from October 2023 to October 2024 were selected as the study subjects.They were randomly divided into a control group and an intervention group using a random number table method,with 40 patients in each group.Both groups of patients received conventional clinical drug therapy,mechanical ventilation support,and rehabilitation exercises after surgery.The intervention group additionally underwent EDP therapy on this basis.The clinical data,mechanical ventilation time,weaning out-comes,oxygenation index,tidal volume,and changes in diaphragm function parameters were compared be-tween two groups of patients.Results Compared with the control group,the intervention group had a shorter mechanical ventilation time[77.00(59.00,133.63)h]vs.54.50(49.00,105.25)h],offline success rate(72.5％vs.90.0％),oxygenation index[202.90(178.63,240.05)mmHg vs.236.50(196.00,293.75)mm-Hg],higher tidal volume[(496.00±111.95)mL vs.(563.23±133.98)mL],with a statistically significant difference(P＜0.05).Compared with the control group,diaphragmatic excursion(DE)of both sides[11.90(8.50,16.50)mm vs.15.30(12.20,19.80)mm;12.60(10.80,14.90)mm vs.14.70(11.43,19.20)mm]and diaphragmatic thickening fraction(DTF)of left and right side[21.75％(17.53％,27.13％)vs.26.30％(21.10％,32.40％);24.00％(17.68％,29.35％)vs.28.30％(22.43％,33.40％)]of the intervention group were higher,and the differences were statistically significant(P＜0.05).Conclusion EDP can enhance the function of the diaphragm in patients,shorten the duration of mechanical ventilation,improve the success rate of wea-ning,and improve the weaning outcomes of mechanically ventilated patients after ATAAD surgery.

Objective:To evaluate the safety and effectiveness of pecto-intercostal fascial plane (PIFP) block and erector spinae plane (ESP) block for postoperative analgesia in median open heart surgery.Methods:A total of 158 patients who underwent elective midline open heart surgery at the Nanjing First Hospital, Nanjing Medical University from October 2022 to October 2023 were randomly divided into a PIFP block group (P group) and ESP block group (E group) using a random number table method, with 79 patients in each group. Before anesthesia surgery, the group P underwent ultrasound-guided bilateral PIFP block, while the group E underwent ultrasound-guided bilateral ESP block. Both groups received sufentanil intravenous patient-controlled analgesia after surgery. The resting and activity Visual Analog Scale (VAS) scores of two groups of patients at 6, 12, 18, and 24 hours after surgery were recorded; The first press time of the patient′s postoperative patient-controlled analgesia pump, the cumulative dose of sufentanil within 24 hours, the number of effective presses, and the rate of salvage analgesia were recorded; and extubation time, intensive care unit (ICU) stay, and adverse reactions; the time of nerve block operation, clarity score of puncture needle imaging under ultrasound, and patient satisfaction with nerve block were also recorded.Results:There was no statistically significant difference in resting VAS scores and activity VAS scores between the two groups at 6, 12, 18, and 24 hours after surgery (all P>0.05). The activity VAS scores of the group P were lower than those of the group E at 6 and 12 hours after surgery (all P<0.05); Compared with the group E, patients in the group P had significantly longer first press time of postoperative analgesia pump (all P<0.05), lower salvage analgesia rate, cumulative dose of sufentanil 24 hours after surgery, and fewer effective presses of analgesia pump (all P<0.05); There was no statistically significant difference in extubation time, ICU stay, and incidence rate of nausea between the two groups of patients (all P>0.05); Compared with the group E, the group P had shorter nerve block operation time, higher clarity score of puncture needle imaging under ultrasound, and higher patient satisfaction (all P<0.05). Conclusions:Compared with ESP block, PIFP block can provide better perioperative analgesia for cardiac surgery patients, reduce the use of opioid drugs, and the operation of PIFP block is simpler, with good safety and effectiveness.

ObjectiveIn the treatment of acute gouty arthritis （AGA）， western medicine is mostly used for anti-inflammatory and analgesic purposes to control the blood uric acid level， but some patients are still at risk of poor control and recurrent attacks. Chinese medicinal prescriptions， potent in resisting inflammation and relieving pain， are able to stabilize the blood uric acid level， reduce acute attacks， and improve the clinical efficacy of western medicine. However， there is a lack of evidence to support their use as evidence-based medicine. This study employed network Meta-analysis （NMA） to evaluate the efficacy and safety of common Chinese medicinal prescriptions in the treatment of AGA， aiming to provide evidence-based medical evidence for the clinical use of Chinese medicinal prescriptions in the treatment of AGA. MethodChinese and English databases were searched for prospective cohort studies and randomized controlled trials （RCTs） on Chinese medicinal prescriptions against AGA from database inception to December 1， 2022. Stata software and Review Manager were used for statistical analysis. ResultForty-four papers with 3 564 cases involved were included in the current NMA. In terms of reducing blood uric acid， the cumulative probability results showed that Mahuang Lianyao Chixiaodou Tang showed optimal efficacy （87.60%）. In terms of relieving joint pain， Danggui Niantongtang and Guizhi Shaoyao Zhimutang showed optimal efficacy （92.00% and 82.30%）. In terms of improving erythrocyte sedimentation rate （ESR）， Simiaowan was superior to other prescriptions （87.00%）. In terms of reducing C-reactive protein （CRP）， Simiaowan and Baihutang modified with Guizhitang showed superior efficacy （76.00% and 66.10%）. In terms of safety， except for the basic treatment group， Mahuang Lianyao Chixiaodou Tang had the lowest probability of adverse events， and Danggui Niantongtang had the highest probability of adverse reactions during treatment. According to the results of cluster analysis， Mahuang Lianyao Chixiaodou Tang and Simiaowan are effective and safe. ConclusionAccording to the results of NMA， Chinese medicinal prescriptions can assist in the treatment of AGA and improve the effectiveness of western medicine. For patients with AGA， clinicians can choose Mahuang Lianyao Chixiaodou Tang or Simiaowan as an auxiliary drug for routine western medicine treatment.

C1 gases including CO, CO₂ and CH₄, are mainly derived from terrestrial biological activities, industrial waste gas and gasification syngas. Particularly, CO₂ and CH₄ are two of the most important greenhouse gases contributing to climate change. Bioconversion of C1 gases is not only a promising solution to addressing the problem of waste gases emission, but also a novel route to produce fuels or chemicals. In the past few years, C1-gas-utilizing microorganisms have drawn much attention and a variety of gene-editing technologies have been applied to improve their product yields or to expand product portfolios. This article reviewed the biological characteristics, aerobic or anaerobic metabolic pathways as well as the metabolic products of methanotrophs, autotrophic acetogens, and carboxydotrophic bacteria. In addition, gene-editing technologies (e.g. gene interruption technology using homologous recombination, group Ⅱ intron ClosTron technology, CRISPR/Cas gene editing and phage recombinase-mediated efficient integration of large DNA fragments) and their application in these C1-gas-utilizing microorganisms were also summarized.
Gene Editing ; Gases ; Carbon Dioxide ; Genetic Engineering ; Cloning, Molecular

Abstract: Objective To compare the application value of metagenomic next generation sequencing (mNGS) with traditional culture in diagnosis of pulmonary infection pathogens. Methods　The clinical documents of 310 patients with suspected pulmonary infection admitted to the General Hospital of Center Theater Command from February 2021 to September 2022 were retrospectively analyzed. The results of mNGS and traditional culture were analyzed, followed by comparison on the positive rate, sensitivity, specificity, accuracy (ACC), positive predictive value (PPV) and negative predictive value (NPV) between the two methods. Results　 The study revealed that mNGS can simultaneously detect multiple pathogens, with the highest efficiency of detection for bacteria and the lowest for fungi. And the sequencing numbers of bacteria, fungi and viruses shown by mNGS were significantly different (H=70.361, P<0.001). In comparison, mNGS displayed a higher positive detection rate (88.40%) than traditional culture (29.70%) (χ2=162.373, P<0.001), but the consistency between the two methods was not significant (Kappa = -0.003, P=0.902). The sensitivity, specificity, ACC, PPV and NPV of mNGS were 91.29%, 28.26%, 81.94%, 87.96%, and 36.11% respectively, compared to corresponding 30.30%, 73.91%, 36.77%, 86.96% and 15.60% of traditional culture respectively. Through analysis, it is confirmed that the sensitivity and specificity between the two methods were statistically significant (91.29% vs 30.30%, χ2=148.120, P<0.001 and 28.26% vs 73.91, χ2=13.793, P<0.001). Conclusions　mNGS can significantly improve the detection rate of pathogens in pulmonary infections and provide a complementary tool besides to traditional culture method for accurate anti-infection therapy. Furthermore, both traditional culture and mNGS pathogen detection methods are highly dependent on sample quality and detection quality control. mNGS requires the correct interpretation of comprehensive, non-destructive pathogenic genetic information to accurately identify pathogens.

OBJECTIVE: To investigate the therapeutic mechanism of resveratrol (RES) for Alzheimer's disease (AD) in light of network pharmacology. METHODS: We searched PubChem, BATMAN-TCM, Genecards, AD, TTD, String 11.0, AlzData, SwissTargetPrediction, Metascape and other databases for the therapeutic targets of RES and human AD-related targets. The intersection was determined using Venny 2.1 to obtain the therapeutic targets of RES for AD. The protein-protein interaction (PPI) network was constructed, the gene ontology (GO) was enriched and the Kyoto Encyclopedia of Genes and Genomes pathway (KEGG pathway) were analyzed. Cytoscape 3.7.1 software was used to construct a target-signaling pathway network of RES in the treatment of AD. Molecular docking verification was carried out on SwissDock (http://www.swissdock.ch/docking). We examined a 293Tau cell model of AD for changes in protein levels of pS396, pS199, Tau5, CDK5, glycogen synthase kinase 3β (GSK3β) and p-GSK3β in response to RES treatment using Western blotting. RESULTS: We obtained 182 targets of RES, 525 targets related to AD, and 36 targets of RES for AD treatment, among which 34.6% of the targets were protein-modifying enzymes, 27.7% were metabolite invertase, 13.8% were gene-specific transcriptional regulators, and 10.3% were transporters. The core key targets of RES in the treatment of AD included INS, APP, ESR1, MMP9, IGF1R, CACNA1C, MAPT (microtubule- associated protein Tau), MMP2, TGFB1 and GSK3B. Enrichment analysis of GO biological process suggested that the biological function of RES in AD treatment mainly involved the response to β-amyloid protein, positive regulation of transferase activity, the transmembrane receptor protein tyrosine kinase signaling pathway, regulation of behavior, learning or memory, aging, and transmembrane transport. KEGG pathway enrichment analysis showed that the most significantly enriched signaling pathways were AD pathway, PI3K-AKT signaling pathway, cGMP-PKG signaling pathway, and MAPK signaling pathway. Molecular docking results showed that RES had strong binding with ESR1, GSK3B, MMP9, IGF1R, APP and INS. In the cell model of AD, treatment with 50 μmol/L RES for 12 h significantly reduced the levels of pS396 and pS199 by regulating CDK5 and GSK3β activity ( CONCLUSIONS RES produces therapeutic effects on AD by acting on multiple targets and affecting multiple signaling pathways and improves AD-associated pathologies
Alzheimer Disease/genetics* ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Molecular Docking Simulation ; Phosphatidylinositol 3-Kinases ; Resveratrol/pharmacology*

Objective To explore the effect of using cluster nursing measures on expectoration in mechanical ventilation patients after craniocerebral operation. Methods Convenient sampling and controlled trials at not the same period were used. Sixty-seven mechanical ventilation patients after craniocerebral operation were selected as the research objects in Department of Neurosurgery Intensive Care Unit (ICU) of the First Hospital Affiliated to Wenzhou Medical College. Thirty-two patients treated from June 2015 to June 2016 were assigned in the control group, and they were given routine respiratory nursing care; 35 patients admitted and treated from July 2006 to July 2017 were included in the intervention group, and they were given evidence-based cluster nursing intervention measures on the basis of routine care. The differences in expectoration effect, arterial blood gas analysis index, incidence of pulmonary infection and prognosis of patients in two groups were compared. Results Compared with control group, the amount of expectoration in the intervention group was significantly increased (mL/d: 49.69±9.45 vs. 33.72±10.63, P < 0.05), while the daily number of sputum suction (times: 21.57±2.31 vs. 28.76±22.66), the time needed for each sputum suction(s: 6.81±1.74 vs. 9.28±2.52), respiratory frequency (bpm: 26.26±1.83 vs. 28.58±1.36), incidence of pulmonary infection [0 vs. 12.5% (4/32)], time of mechanical ventilation (days: 6.37±2.51 vs. 8.92±3.32), time of ICU stay (days: 7.49±3.87 vs. 10.33±2.12), time of hospital stay (days: 10.31±1.99 vs. 14.56±3.57), fatality rate [8.6% (3/35) vs. 21.9% (7/32)] in the intervention group were significantly decreased (all P < 0.05); after treatment the arterial partial pressure of oxygen (PaO2) and pulse oxygen saturation degree (SpO2) were significantly increased than those before treatment, and the arterial partial pressure of carbon dioxide (PaCO2) was significantly decreased than that before treatment, and the degrees of improvement in the intervention group on 5 days were significantly better than those in the control group [PaO2(mmHg, 1 mmHg = 0.133 kPa): 60.89±3.44 vs. 57.34±2.49, PaCO2(mmHg): 41.06±4.32 vs. 45.22±4.78, SpO2: 0.986±0.030 vs. 0.963±0.023, all P < 0.05]. Conclusion The cluster nursing measures can effectively improve the expectoration effect for mechanical ventilation patients after craniocerebral surgery, reduce the mortality and incidence of pulmonary infection, shorten the stay in ICU and improve the prognosis, suggesting that the measures be worthy to be applied widely in clinics.

OBJECTIVETo study the dynamics of the reinfection of Schistosoma japonicum and related risk factors among the people in schistosomiasis endemic areas in China.

METHODSLiterature retrieval was conducted by using databases of PubMed, CNKI,VIP and Wanfang to collected all the data about the human re-infection of Schistosoma japonicum and related risk factors in the endemic areas in China. And a Mata-analysis was conducted on the literatures met the inclusion standards.

RESULTSEighteen studies involving 12 604 people for infection survey and 3 128 people for re-infection survey were included in the analysis. The overall infection rate was 20.8%, and the overall re-infection rate was 21.0% . The difference had no statistical significance (Z = 1.12, P = 0.26). The re-infection related factors included baseline infection intensity (OR = 3.58, 95% CI: 1.56-8.22); the index of contaminated water OR = 2.37, 95% CI: 1.08-5.22); distance from house to river-side (OR = 1.72, 95% CI: 0.41-7.30) and age (OR = 0.48, 95% CI: 0.19-1.23).

CONCLUSIONThe baseline infection intensity, the index of contaminated water and distance from house to river-side were the risk factors related to the re-infection of Schistosoma japonicum and age was a protective factor.

ObjectiveTo observe the effect of transcutaneous acupoint electrical stimulation (TAES) on the ovariangranulosa cell apoptosis-related proteins, Bcl-2 and Bax, as well as the oocyte quality in theolder women with kidney deficiency receiving in vitro fertilization-embryo transfer (IVF-ET).MethodSixty-six older women with kidney deficiency who were receiving IVF-ET because of the fallopian tube factor were randomized into a treatment group (intervened by TAES) and a control group (intervened by sham acupuncture), 33 in each group. The kidney-deficiency syndrome score, HCG E2/follicle count per day, excellent follicle rate, excellent embryo rate, and clinical pregnancy rate were observed and compared between the two groups; Western blot was used to detect the expression of protein Bcl-2 and Bax.ResultCompared to the control group, the treatment group had significant improvement in kidney-deficiencysymptoms (P<0.01), significant increases in theHCG E2/follicle count per day, excellent follicle rate, and excellent embryo rate (P<0.05), enhanced expression of Bcl-2 protein (P<0.01), and decreased expression of Bax protein (P<0.01); while there were no significant differences in comparing theretrievedoocyte number and clinical pregnancy rate (P>0.05). The expression of Bcl-2 and Bax proteins were markedlycorrelatedwith IVF-related indexes (P<0.05).ConclusionTAES can improve the kidney-deficiency symptoms and the quality of oocyte and embryo inolder women; this action is possibly related to the regulation of expression of the cell apoptosis-related protein Bcl-2 and Bax, as well as the decrease ofgranulosecell apoptosis.

Cellulose takes nearly 10% (W/W) dry weight of cassava tubers. In this study, the cellulase cost of different ethanol fermentation from cassava cellulose was evaluated. The processes include the direct saccharification and fermentation of original cassava cellulose residues, the direct saccharification and fermentation of pretreated cassava cellulose residues, and the simultaneous co-saccharification and fermentation of cassava starch and cassava cellulose. The results show that the cassava cellulose utilization in the first two processes were low with the enzyme cost of 13 602 and 11 659 RMB Yuan per tone of ethanol, respectively. In the third process, the final ethanol concentration increased from 101.5 g/L to 107.0 g/L when cassava cellulose and cassava starch were saccharified simultaneously. Comparing to the first two processes, the third one demonstrated the lowest enzyme cost at 3 589 RMB Yuan per ton of ethanol, which was less than the ethanol price and no additional equipment and operation cost input were added. The conclusion provided a practical way of cassava cellulose utilization in cassava ethanol industry.
Biotechnology ; economics ; methods ; Cellulase ; economics ; Cellulose ; metabolism ; Cost-Benefit Analysis ; Ethanol ; economics ; metabolism ; Fermentation ; Manihot ; metabolism ; Saccharomyces cerevisiae ; metabolism