Objective:To explore clinical value of multi-phase scan of spiral computed tomography(CT)combined with tumor markers in the diagnosis of gastric cancer.Methods:A total of 80 patients with highly suspected gastric cancer admitted to hospital from September 2019 to September 2023 were selected.All patients underwent multi-phase(arterial phase,venous phase,delayed phase)scan of spiral CT,and the tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724)and carbohydrate antigen 199(CA199)]of them were detected,as well as pathological examination.Based on the results of pathological examination,the CT values of multi-phase scan of spiral CT and tumor marker levels between patients with malignant tumor and patients with benign tumor were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic cut-off values of various parameters,and also analyze the diagnostic value of multi-phase scans of spiral CT combined with tumor markers for gastric cancer.Results:In 80 patients with highly suspected gastric cancer,62 cases were confirmed as malignant tumor by pathological examination.The CT values of arterial phase,venous phase and delayed phase,CEA,CA724 and CA199 levels in patients with malignant tumor were higher than those in patients with benign tumor(P＜0.05),respectively,and the differences of them were significant(t=10.322,15.195,19.123,17.115,14.494,14.041,P＜0.05).The results of ROC curve indicated that the area under curve(AUC)values of the CT values of arterial phase,venous phase and delayed phase of spiral CT examination,single CEA,single CA724,single CA199 and combination of them were all greater than 0.70 in diagnosing gastric cancer,and all of them had diagnostic value but the diagnostic value of combined detection was highest.The optimal diagnostic value could be obtained when the cut-off values of above indicators were respectively 82.275 HU,74.975 HU,50.445 HU,5.970ng/ml,8.385μg/l and 41.315U/ml.According to the results of pathological examination,the sensitivity,specificity and accuracy of multi-phase scan of spiral CT combined with tumor markers were respectively 96.77％,94.44％and 96.25％in diagnosing gastric cancer,and the consistency between the combined examination and the pathological examination was favorable(Kappa=0.895).Conclusion:The combination of multi-phase scan of spiral CT and tumor markers has higher diagnostic value for gastric cancer,which can be used as important auxiliary scheme for the diagnosis of gastric cancer.

Objective To investigate the incidence and risk factors of recurrence of renal calculi after intracavitary lithotripsy. Methods The clinical data of 190 patients with renal stones who underwent endoluminal lithotripsy in our hospital were retrospectively collected. Based on the results of CT, B-ultrasound, or X-ray examination of the urinary system during the 2-year follow-up period, therecurrence of renal calculi was analyzed. Univariate and multivariate Logistic regression were used to analyze the risk factors of stone recurrence. Results of 190 patients, 49 patients experienced stone recurrence within 2 years after surgery, with a recurrence rate of 25.79%. Univariate Logistic regression analysis showed that body mass index(BMI), diabetes, smoking, older age and hypertension were protective factors for stone recurrence. Multivariate Logistic regression analysis showed that diabetes and smoking were risk factors for stone recurrence, while age and hypertension were protective factors for stone recurrence. Conclusion The recurrence of renal stone after intracavitary lithotripsy is common. Diabetes and smoking are risk factors for the recurrence of renal stone, while older age and hypertension are protective factors.

Objective:To explore the predictive value of pre-biopsy serum inflammatory markers on positive prostate biopsy results, establish a nomogram model based on pre-biopsy inflammatory markers combined with other parameters, and evaluate its predictive ability for prostate biopsy results.Methods:The clinical data of 601 patients undergoing transperineal prostate biopsy who were admitted to the Second Hospital of Tianjin Medical University from August 2019 to August 2021 were retrospectively analyzed. The median age was 68(35, 89)years, and the median tPSA was 9.56(4.01, 19.95)ng/ml. The median fPSA was 1.36(0.88, 2.02)ng/ml, the median PSAD was 0.16(0.11, 0.26)ng/ml 2, and the median platelet-to-lymphocyte ratio(PLR)was 129.90(98.95, 169.89). PI-RADS v2.1 score<3 points in 189 cases(31.45%), 3 points in 174 cases(28.95%), 4 points in 190 cases(31.61%), and 5 points in 48 cases(7.99%). A simple randomization method was used to obtain 421 cases(70.00%)in the modeling group and 180 cases(30%)in the validation group.There was no significant difference in the clinical data between the two groups ( P>0.05). Univariate and multivariate logistic regression analysis were performed in the modeling group to screen independent influencing factors for the prediction of positive prostate biopsy results. A nomogram model was established and internal verification was conducted. External validation of the model was performed in the validation group. Receiver operating characteristic(ROC)curve was used to verify model discrimination, Hosmer-Lemeshow goodness-of-fit test was used to verify model calibration, and decision curve analysis (DCA) was used to evaluate the net benefit and clinical utility of the predictive model. Results:The results of univariate analysis showed that the age( OR=1.060, P<0.01), histological inflammation( OR=0.312, P<0.01), the number of biopsy needles( OR=0.949, P=0.009), f/tPSA( OR=0.954, P=0.003), PV( OR=0.973, P<0.01), PSAD( OR=29.260, P<0.01), PI-RADS v2.1 score(3-point OR=3.766, P=0.001; 4-point OR=11.800, P<0.01; 5-point OR=57.033, P<0.01), lymphocyte count( OR=1.535, P=0.013), NLR( OR=0.848, P=0.044), PLR( OR=0.994, P=0.005)and SII( OR=0.999, P=0.009)were statistically different between the prostate patients and non-prostate cancer patients in the modeling group; Multivariate analysis showed that age( OR=1.094, P<0.001), fPSA( OR=0.605, P=0.002), histological inflammation ( OR=0.241, P<0.001), PSAD ( OR=7.57, P=0.013), PLR ( OR=0.994, P=0.005) and PI-RADS v2.1 Score(3-point OR=2.737, P=0.016; 4-point OR=8.621, P<0.001; 5-point OR=47.65, P<0.001) was an independent influencing factor for prostate cancer at initial biopsy; a nomogram model based on age, fPSA, PSAD, PLR and PI-RADS v2.1 scores was established. The AUC of the modeling group was 0.849(95% CI 0.810-0.888), and the sensitivity was 80.9%, and the specificity was 76.1%; the AUC of the validation group was 0.862(95% CI 0.809-0.915), and the sensitivity was 91.9%, and the specificity was 67.8%, suggesting that the diagnostic prediction model had a good discrimination. The calibration curve showed that the prediction model was well calibrated ( χ2=6.137, P=0.632). The decision curve analysis (DCA) of the modeling and validation groups indicated a larger net benefit of the predictive model. Conclusions:The nomogram model established in this study based on age, fPSA, PSAD, PLR and PI-RADS v2.1 score showed good predictive efficacy for prostate biopsy in patients with PSA between 4-20 ng/ml.

Prostate cancer in patients with dwarfism is rarely reported. One case was reported in this article. The patient was admitted to the hospital due to the PSA elevation for more than 4 years. Due to the dwarf disease, the patient could not accommodate the transrectal ultrasound probe, and was highly suspected of prostate cancer.The prostate needle biopsy was not performed. Combined with the medical history, PSA level, preoperative MRI and PSMA-PET/CT examination, the patient was clinically diagnosed with localized prostate cancer, and radical surgical treatment was performed.

Drug target discovery is the basis of drug screening.It elucidates the cause of disease and the mechanism of drug action,which is the essential of drug innovation.Target discovery performed in biological sys-tems is complicated as proteins are in low abundance and endogenous compounds may interfere with drug binding.Therefore,methods to track drug-target interactions in biological matrices are urgently required.In this work,a Fe3O4 nanoparticle-based approach was developed for drug-target screening in biofluids.A known ligand-protein complex was selected as a principle-to-proof example to validate the feasibility.After incubation in cell lysates,ligand-modified Fe3O4 nanoparticles bound to the target protein and formed complexes that were separated from the lysates by a magnet for further analysis.The large surface-to-volume ratio of the nanoparticles provides more active sites for the modification of chemical drugs.It enhances the opportunity for ligand-protein interactions,which is beneficial for capturing target proteins,especially for those with low abundance.Additionally,a one-step magnetic separation simplifies the pre-processing of ligand-protein complexes,so it effectively reduces the endogenous interference.Therefore,the present nanoparticle-based approach has the potential to be used for drug target screening in biological systems.

Stearoyl-ACP Δ⁹ desaturase (SAD) catalyzes the synthesis of monounsaturated oleic acid or palmitoleic acid in plastids. SAD is the key enzyme to control the ratio of saturated fatty acids to unsaturated fatty acids in plant cells. In order to analyze the regulation mechanism of soybean oleic acid synthesis, soybean (Glycine max) GmSAD family members were genome-wide identified, and their conserved functional domains and physicochemical properties were also analyzed by bioinformatics tools. The spatiotemporal expression profile of each member of GmSADs was detected by qRT-PCR. The expression vectors of GmSAD5 were constructed. The enzyme activity and biological function of GmSAD5 were examined by Agrobacterium-mediated transient expression in Nicotiana tabacum leaves and genetic transformation of oleic acid-deficient yeast (Saccharomyces cerevisiae) mutant BY4389. Results show that the soybean genome contains five GmSAD family members, all encoding an enzyme protein with diiron center and two conservative histidine enrichment motifs (EENRHG and DEKRHE) specific to SAD enzymes. The active enzyme protein was predicted as a homodimer. Phylogenetic analysis indicated that five GmSADs were divided into two subgroups, which were closely related to AtSSI2 and AtSAD6, respectively. The expression profiles of GmSAD members were significantly different in soybean roots, stems, leaves, flowers, and seeds at different developmental stages. Among them, GmSAD5 expressed highly in the middle and late stages of developmental seeds, which coincided with the oil accumulation period. Transient expression of GmSAD5 in tobacco leaves increased the oleic acid and total oil content in leaf tissue by 5.56% and 2.73%, respectively, while stearic acid content was reduced by 2.46%. Functional complementation assay in defective yeast strain BY4389 demonstrated that overexpression of GmSAD5 was able to restore the synthesis of monounsaturated oleic acid, resulting in high oil accumulation. Taken together, soybean GmSAD5 has strong selectivity to stearic acid substrates and can efficiently catalyze the biosynthesis of monounsaturated oleic acid. It lays the foundation for the study of soybean seed oleic acid and total oil accumulation mechanism, providing an excellent target for genetic improvement of oil quality in soybean.
Fatty Acid Desaturases ; genetics ; metabolism ; Gene Expression Profiling ; Oleic Acid ; biosynthesis ; Phylogeny ; Plant Proteins ; genetics ; Seeds ; chemistry ; Soybeans ; classification ; enzymology ; genetics

Establishing fever clinic was an important achievement of the fight against severe acute respiratory syndrome (SARS) in 2003, and played an important role in the subsequent outbreaks of H1N1, H7N9 and Middle East respiratory syndrome (MERS). Fever clinics have significant emergency characteristics, but there are no rescue conditions in the fever clinics. Consequently, the problem of establishment and management of fever clinics is still outstanding. Based on the development of fever clinics, this paper analyzes the operational dilemma of fever clinics, explores the measures of establishment and management of fever clinics, and constructs the operational mechanism of fever clinics in order to provide the basis for the emergency management system of public health emergencies, which is suitable for Chinese health system.

Objective To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. Methods A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled. The patients were divided into three groups according to the random number table method, high-intensity group and low-intensity group were injected Novolin R (high-intensity group 2/3 dosage, low-intensity group 1/3 dosage) to modulate stress hyperglycemia by simulated artificial pancreas. Simulated artificial pancreas consisted of Guardian real time glucose monitoring system (GRT system), close-circle control algorithm and micro-pump;subcutaneous injection of Humulin 70/30 was applied to modulate stress hyperglycemia in humulin group. Real-time glucose levels of interstitial fluid in abdominal wall, equivalent to blood glucose levels, 10 minutes each time, were monitored by using of GRT system for all patients in three groups. Fasting serum levels of stress hormones including epinephrine and cortisol and insulin resistance index (IRI) were recorded within 24 hours after inclusion. Mean blood glucose, blood glucose variation coefficient, blood glucose target-reaching rate, blood glucose target-reaching time, hypoglycemia rate and 6-month mortality were measured. Twenty healthy adults from health administration department of the hospital were recruited as healthy control group. Results A total of 60 eligible critically ill patients were included in this study, each group with 20 patients. There was no significant difference in gender, age, APACHE Ⅱ scores among three groups. The levels of serum epinephrine, cortisol and IRI within 24 hours after inclusion in the three groups were significantly higher than those in healthy control group. The mean blood glucose levels of humulin group, low-intensity group, high-intensity group were decreased (mmol/L: 10.2±3.2, 8.4±2.6, 8.1±2.2), the blood glucose target-reaching rate were increased [40.2% (3 295/8 196), 71.1% (5 393/7 585), 80.4% (6 286/7 818)], the blood glucose target-reaching time were shortened (hours: 49.1±5.8, 24.6±4.6, 17.5±4.2), the hypoglycemia rates were increased respectively [1.3% (108/8 196), 2.8% (211/7 585), 4.0% (313/7 818)], with statistically significant differences (all 1 = 0.000). There was no significant difference in blood glucose variation coefficient and 6-month mortality among three groups [blood glucose variation coefficient: (29.4±3.7)%, (28.5±5.3)%, (26.1±4.6)%, 6-month mortality: 55.0%, 45.0%, 40.0%, all 1 > 0.05]. Conclusions Simulated artificial pancreas could effectively and safely modulate stress hyperglycemia in critically ill patients, high-intensity modulation could bring about better efficacy in the regulation of hyperglycemia. High-frequency blood glucose monitoring by using GRT system could promptly identify hypoglycemia and help it to be corrected.

Enhancing soybean (Glycine max) oil production is crucial to meet the market demand of vegetable oil. Diacylglycerol acyltransferase (DGAT) catalyzes the final acylation reaction of triacylglycerol (TAG) synthesis, acting as one of the rate-limiting enzymes for oil biosynthesis in plant seeds. Here, a cDNA clone VgDGAT1A encoding the DGAT1 protein was isolated from the high oil plant Vernonia galamensis. VgDGAT1A was specifically overexpressed in soybean seeds, and several high-generation transgenic lines (T7) were obtained by continuous selection. qPCR analysis showed that VgDGAT1A was highly expressed in the mid-development stage (30-45 DAF) of the transgenic seeds. Accordingly, the DGAT enzyme activity in the transgenic seeds was increased by 7.8 folds in comparison with the wild-type controls. Seed oil and starch contents were, respectively, increased by 5.1% (Dry weight) and reduced by 2%-3% in the transgenic soybeans. Importantly, protein content was not significantly different between transgenic and control seeds. Seed weight and germination rate of the transgenic lines exhibited no negative effect. Fatty acid profiling demonstrated that antioxidant oleic acid (C18:1Δ9) content in the transgenic seed oil was elevated by 8.2% compared to the control, and correspondingly, easily-oxidized linoleic acid (C18:2Δ9,12) and linolenic acid (C18:3Δ9,12,15) were decreased by 6% and 2% respectively. Taken together, seed-specific overexpression of an exogenous VgDGAT1A gene can break the negative linkage of oil and protein contents in soybean seeds, indicating that engineering of this highly-active DGAT enzyme is an effective strategy to improve oil yield and nutritional value in oilseeds.

Objective To investigate the effect of various concentration of inhaled oxygen during exercise on reactive oxygen species (ROS) production in chronic obstructive pulmonary disease (COPD) rats and the possible mechanism. Methods Eighty COPD Wistar rats were divided into low oxygen (LO, n=20), normal oxygen (NO, n=20) and inhaled oxygen (IO, n=20) exercising groups, which ran on tread-mill in the conditions of 13.6%, 21%, 25%oxygen, respectively, and non-exercising normal oxygen group (C, n=20), which stood on still treadmill in the condition of 21%oxygen. Their apoptosis percentage of neutrophils and ROS content were measured with flow cytometry, glutathione (GSH) in lung with immunohistochemistry and cytochrome C oxidase IV (COXIV) in skeletal muscle with Western blotting, as one and four weeks of exercising. Results For one week of exercise, the ROS was more in LO and NO groups than in C group (P<0.05), while the neutrophils apoptosis percentage was less (P<0.05);and there was no difference among C, LO, NO, IO groups in expression of GSH and COXIV (P>0.05). For four weeks of exercise, the ROS was more in LO group but less in NO and IO groups than in C group (P<0.05);while the expression of GSH and COXIV increased in NO and IO groups compared with those in C group (P<0.05). Conclusion A long term exercise in non-hypoxic state may inhibit ROS production for COPD patients, by promoting neutrophils apoptosis and antioxidant expression.