Objective To evaluate the effect of donor gender on short-term survival rate of lung transplant recipients. Methods A retrospective analysis was conducted on the data of 1 066 lung transplant recipients. The log-rank test was used to evaluate the differences in short-term fatality among different donor gender groups and donor-recipient gender combination groups. Multivariate Cox regression, propensity score (PS) regression, and propensity score matching (PSM) were employed to control for confounding factors and further assess the differences in fatality. Subgroup analyses were also performed based on donor gender. Results Multivariate Cox regression analysis showed no statistically significant differences in fatality at 30 days, 1 year, 2 years and 3 years postoperatively between male and female donor groups (all P>0.05). After PS regression and PSM, univariate Cox regression analysis indicated that recipients from female donors had a higher fatality at 2 years postoperatively compared to those from male donors, with hazard ratios (95% confidence intervals) of 1.29 (1.01-1.65) and 1.36 (1.03-1.80) respectively. Multivariate Cox regression analysis also revealed no statistically significant differences in fatality at various follow-up time points among different donor-recipient gender combination groups (all P>0.05). Subgroup analyses based on donor sex showed no statistically significant differences in fatality among recipients of different gender within either male or female donor groups (all P>0.05). Conclusions Female donors may reduce the short-term postoperative survival rate of lung transplant recipients, but this negative impact is not sustainable in the long term. At present, there is no evidence to support the inclusion of sex as a factor in lung allocation rules.

Objective To investigate the expression of pepsin in vocal cord polyps and vocal cord cancer,and to compare the difference of pepsin expression.Methods From May 2020 to December 2021,27 patients with vocal cord polyp,27 patients with vocal cord cancer and 23 healthy volunteers were selected.RSI and RFS scoring scales were used for scoring,pepsin detection kit was used for saliva pepsin detection,and immunohistochemical methods were used to detect the expression of pepsin in vocal cord tissues of patients with vocal cord polyps and vocal cord cancer.Results The RSI score,RFS score and pepsin test kit results of vocal cord polyp group and vocal cord canc-er group were higher than those of non-vocal cord disease group,and the differences of the three indexes were statis-tically significant(P＜0.05).RSI score,pepsin detection kit results and pepsin immunohistochemistry results of vocal cord polyp group showed no significant difference compared with vocal cord cancer group(P＞0.05).The RFS score of vocal cord polyp group was significantly different from that of vocal cord cancer group(P＜0.05).Conclusion Pepsin may be an important pathogenic factor of vocal cord polyp and vocal cord cancer,and play an im-portant role in the occurrence of these two diseases.The difference of pepsin expression in vocal cord polyp and vo-cal cord cancer suggests that pepsin may have different pathogenesis.

Immune checkpoint inhibitors (ICIs) are currently used in the treatment of various tumors and play an important role in tumor treatment, resulting in many adverse reactions related to the immune system. Type 1 diabetes (T1DM) is a rare endocrine system complication, which is rarely reported at present. We report a case of T1DM after using ICIs to treat gastric cancer. The patient was a 34 year old male who developed diabetes ketoacidosis after 206 days of sintilimab monoclonal antibody use, with fasting blood glucose of 15.78 mmol/L and glycosylated hemoglobin of 8.6%. Islet related antibody: Glutamate decarboxylase antibody: 119.2 IU/mL; Insulin antibody:<2 IU/L. Fasting insulin: 0.21 mU/L; Fasting C-peptide: 0.12 μg/L. Through the analysis of patients' clinical data, it aims to improve clinicians' understanding of immune related type 1 diabetes and provide ideas for correct diagnosis and treatment.

Objective:In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups.Results:There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant ( t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ2=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences ( Z=0.406, P=0.685). Conclusions:Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.

Objective To investigate the correlation between tibial plateau varus and osteoporosis(OP)in postmenopausal women with knee osteoarthritis(KOA).Methods A retrospective analysis was conducted on 194 postmenopausal women with KOA who underwent unicompartmental knee arthroplasty.Various risk factors associated with tibial plateau varus[medial tibial plateau angle(MTPA)＜85°],including age,body mass index(BMI),Kellgren-Lawrence(K-L)grade,hip-knee-ankle angle(HKAA),lateral distal femur angle(LDFA),bone mineral density(BMD)were collected and analyzed.Multiple regression was employed to analyze the relationship of these factors with tibial plateau varus.Pearson's correlation coefficient was used to assess the association between MTPA and BMD.Results Multiple linear regression analysis revealed that BMD(β=0.381,P＜0.001)and HKAA(β=0.460,P＜0.001)were independent risk factors for tibial plateau varus.LDFA,age,BMI,K-L grade were not significantly associated with tibial plateau varus.A statistically significant association between BMD and tibial plateau varus was noted(r=0.817,P＜0.001).Further data stratification showed a significant association between BMD and tibial plateau varus in patients with knee varus(HKAA＜175°)(r=0.781,P＜0.001).There was no statistical significance association between BMD and tibial plateau varus in patients with normal lower extremity alignment(HKAA≥175°)(r=-0.035,P=0.063).Conclusion OP and knee varus emerge as the primary risk factors for tibial plateau varus in the knee in postmenopausal women with KOA.

Objective:To compare the postoperative tunnel enlargement and clinical outcomes of anterior cruciate ligament (ACL) reconstruction using the all-inside technique with the traditional outside-in graft introduction technique.Methods:A retrospective analysis was conducted on 47 patients with ACL injuries who were admitted to the First Hospital of the University of Science and Technology of China between December 2021 and July 2022. The patients were categorized into two groups based on the surgical approach used for ACL reconstruction. There were 25 cases in the all-inside group, 18 males and 7 females, aged 27.72±7.33 years, 17 cases on the left side and 8 cases on the right side; 22 cases in the traditional group, 11 males and 11 females, aged 27.82±7.12 years, 11 cases on the left side and 11 cases on the right side. Clinical parameters including the length of hospital stay, surgical duration, pain levels assessed via the visual analogue scale (VAS), Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner score were recorded and compared between the two groups. Additionally, femoral and tibial tunnel enlargement was evaluated using postoperative CT scans conducted one year after surgery.Results:All patients were followed up for 15.64±2.04 months (range, 12-21 months). The mean operation time was 178.60±42.90 min in the all-inside group and 133.60±28.77 min in the traditional group, indicating a statistically significant longer operation time in the all-inside group ( P<0.05). On postoperative days 1 and 15, the VAS scores were lower in the all-inside group (7.08±1.29 and 5.56±1.33 points) compared to the conventional group (7.96±1.29 and 6.32±1.13 points), with a statistically significant difference ( P<0.05). However, the differences in VAS scores between the two groups at postoperative months 1, 6, and 12 were not statistically significant ( P>0.05). The preoperative Lysholm, IKDC, and Tegner scores in the all-inside group and the conventional group were 34.00±18.63, 36.24±15.01, 1.20±1.12 points and 36.18±13.64, 38.23±14.94, 1.55±1.14 points, respectively, and at 6 months after surgery, respectively were 72.60±13.95, 74.12±12.03, 3.56±1.05 points, and 68.41±10.80, 66.59±17.93, 3.23±1.15 points, and at 12 months postoperatively were 92.32±5.23, 81.40±7.24, 5.28±1.62 points and 91.27±6.32, 82.18±7.26, 4.96±1.25 points. Both groups improved at 6 months postoperatively compared with preoperatively ( P<0.05), and further improved at 12 months postoperatively compared with 6 months postoperatively ( P<0.05), but the differences in each functional score between the two groups were not statistically significant at all time points ( P>0.05). At 1 year postoperatively, the values of femoral and tibial tunnel enlargement in the all-inside group (1.78±1.03 mm, 1.18±0.97 mm) were smaller than those in the conventional group (2.30±1.33 mm, 1.83±1.00 mm), and the differences were statistically significant ( P<0.05). The difference between the femoral side tunnel enlargement and tibial side enlargement in the traditional group was not statistically significant ( P>0.05), while the femoral side enlargement in the all-inside group was significantly larger than the tibial side ( P<0.05). The difference in Lysholm, IKDC and Tegner scores between grade 0 and grade 1 tunnel enlargement on the femoral side and tibial side was not statistically significant ( P>0.05). Conclusion:The short-term clinical outcomes following ACL reconstruction using the all-inside technique versus the traditional tunnel technique were comparable. However, early postoperative pain was less severe with the all-inside technique, and tunnel enlargement was smaller. The degree of bone tunnel enlargement did not significantly impact early clinical outcomes.

Objective To investigate the relationship between the paired like homeobox 2B(PHOX2B)protein and N-MYC oncogene(MYCN gene)status with the clinicopathological features and prognosis of pe-ripheral neuroblastic tumors(pNT).Methods The PHOX2B protein expression in pNT tissues of 41 children cases of pNT was detected by immunohistochemical staining,the MYCN gene expression status was detected by fluorescence in situ hybridization technique,and their relationship with clinicopathological features and prognosis was analyzed by continuous correction chi-square test and Kaplan-Meier method.Results The im-munohistochemical staining showed that PHOX2B protein was mainly localized in the cell nucleus,and the positive expression rate in pNT tissue was 82.9％.Its expression level was related to the onset age,differenti-ation degree and prognosis of pNT(P＜0.05),and the intensity of PHOX2B protein expression was not relat-ed to the MYCN gene status(P＞0.05).The survival stage in the children patients with MYCN gene amplification was shorter than that in the children patients with no MYCN gene amplification(P＜0.05).Conclusion PHOX2B protein has the diagnostic significance for pNT and could be used as a reliable diagnostic marker for pNT;MY-CN gene status is related to the survival period in the children patients,which can help to judge the prognosis of pNT children patients.

Objective:To study the epidemic characteristics of scrub typhus in Yantai City from 2006 to 2022, and provide a scientific basis for prevention and control of scrub typhus in Yantai City.Methods:In the subsystem "Infectious Disease Monitoring System" of the "China Disease Prevention and Control Information System", data on the outbreak of scrub typhus in Yantai City from January 1, 2006 to December 31, 2022 were collected and processed using software such as SPSS 23.0 for descriptive statistics.Results:A total of 599 scrub typhus cases were reported in Yantai City from 2006 to 2022, with an average annual reported incidence of 0.51/100 000. The reported incidence showed an upward trend year by year from 2006 to 2014 (χ 2trend = 144.72, P < 0.001), and reached a peak in 2014 (1.04/100 000). There was another small peak in 2019 (0.91/100 000). The incidence of scrub typhus showed a clear seasonal unimodal distribution, with October being the peak, accounting for 72.62% (435/599). In addition to Changdao County, other 12 cities (districts) reported scrub typhus cases. The top 3 cities with average annual reported incidence were Zhaoyuan City (1.58/100 000), Laizhou City (1.47/100 000) and Laiyang City (0.75/100 000). In all reported cases, the male to female ratio was 1.00∶1.07 (289∶310). The cases were mainly concentrated in the age range of 50 to 79, accounting for 74.46% (446/599). There was a statistically significant difference in the number of patients in different age groups in different years ( H = 38.71, P = 0.001). Farmers accounted for 88.65% (531/599) of the affected population. Conclusions:The incidence of scrub typhus in Yantai City shows an increasing trend and is widely distributed. It is recommended to strengthen the diagnosis, monitoring and infection management of scrub typhus.

Objective:In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups.Results:There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant ( t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ2=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences ( Z=0.406, P=0.685). Conclusions:Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.

Succinic acid is an important C4 platform chemical that is widely used in food, chemical, medicine sectors. The bottleneck of fermentative production of succinic acid by engineered Escherichia coli is the imbalance of intracellular cofactors, which often leads to accumulation of by-products, lower yield and low productivity. Stoichiometric analysis indicated that an efficient production of succinic acid by E. coli FMME-N-26 under micro-aeration conditions might be achieved when the TCA cycle provides enough ATP and NADH for the r-TCA pathway. In order to promote succinic acid production, a serial of metabolic engineering strategies include reducing ATP consumption, strengthening ATP synthesis, blocking NADH competitive pathway and constructing NADH complementary pathway were developed. As result, an engineered E. coli FW-17 capable of producing 139.52 g/L succinic acid and 1.40 g/L acetic acid in 5 L fermenter, which were 17.81% higher and 67.59% lower than that of the control strain, was developed. Further scale-up experiments were carried out in a 1 000 L fermenter, and the titer of succinic acid and acetic acid were 140.2 g/L and 1.38 g/L, respectively.
Escherichia coli/genetics* ; NAD ; Succinic Acid ; Acetic Acid ; Adenosine Triphosphate