Doxorubicin(DOX)is a commonly administered chemotherapy drug for treating hematological malignancies and solid tumors;however,its clinical application is limited by significant cardiotoxicity.Cynaroside(Cyn)is a flavonoid glycoside distributed in honeysuckle,with confirmed potential biological functions in regulating inflammation,pyroptosis,and oxidative stress.Herein,the effects of Cyn were evaluated in a DOX-induced cardiotoxicity(DIC)mouse model,which was established by intraperitoneal injections of DOX(5 mg/kg)once a week for three weeks.The mice in the treatment group received dexrazoxane,MCC950,and Cyn every two days.Blood biochemistry,histopathology,immunohistochemistry,reverse transcription-quantitative polymerase chain reaction(RT-qPCR),and western blotting were conducted to investigate the cardioprotective effects and potential mechanisms of Cyn treatment.The results demonstrated the significant benefits of Cyn treatment in mitigating DIC;it could effectively alleviate oxidative stress to a certain extent,maintain the equilibrium of cell apoptosis,and enhance the cardiac function of mice.These effects were realized via regulating the transcription levels of pyroptosis-related genes,such as nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),caspase-1,and gasdermin D(GSDMD).Mechanistically,for DOX-induced myocardial injury,Cyn could significantly modulate the expression of pivotal genes,including adenosine monophosphate-activated protein kinase(AMPK),peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α),sirtuin 3(SIRT3),and nuclear factor erythroid 2-related factor 2(Nrf2).We attribute it to the mediation of AMPK/SIRT3/Nrf2 pathway,which plays a central role in preventing DOX-induced cardiomyocyte injury.In conclusion,the present study confirms the therapeutic potential of Cyn in DIC by regulating the AMPK/SIRT3/Nrf2 pathway.

Objective:To investigate the relationship between the virulence and the carbapenem resistance phenotype of Klebsiella pneumoniae from blood infection,and to identify carbapenem-resistant and hypervirulent Klebsiella pneumoniae(CR-HVKP)strains.Methods:A total of 192 Klebsiella pneumoniae strains were isolated from blood culture of patients with bloodstream infections from 2016 to 2019,of which 96 isolates were carbapenem-resistant Klebsiella pneumoniae(CRKP)and 96 were carbapenem-sensitive Klebsiella pneumoniae(CSKP).The drug susceptibility was detected by VITEK-2 automatic microbial analyzer;carbapenemase genes,virulence genes and capsule typing were detected by polymerase chain reaction;the high viscosity phenotype of strains was detected by string test,and the genome characteristics of CR-HVKP were detected by whole genome sequencing.Serum killing and biofilm formation test were used to further verify the virulence of CR-HVKP.Results:There were significant differences in drug resistance to common antibiotics,except for minocycline between CSKP and CRKP isolates(all P<0.05).92 out of 96 CRKP isolates carried carbapenemase genes,mainly blaKPC-2.The string tests were positive in 4 isolates of CRKP and 36 isolates of CSKP(P<0.05).The detection rates of virulence genes Kfu,aerobictin,iutA,ybtS,rmpA,magA,allS,and capsule antigen K1 and K2 in CSKP group were significantly higher than those in CRKP group(all P<0.05).One HVKP strain was detected in the CRKP group(CR-HVKP)and 36 HVKP was detected in the CSKP group(P<0.05).The CR-HVKP strain belonged to the MLST412,serotype K57,expressed iutA,entB,mrkD,fimH,and rmpA virulence genes,and showed strong biofilm formation and significantly increased serum resistance.Whole genome sequencing results showed that this CR-HVKP isolate carried blaSHV-145,blaTEM-1,blaCTX-M-3,fosA6,oqxA5,oqxB26,and aac(3)-Ⅱd resistance genes,accompanied by abnormalities in outer membrane protein K(OmpK)35 and OmpK36.Conclusions:The drug resistance of CRKP is significantly higher than that of CSKP,while CRKP carrying fewer virulence genes in both number and types compared to CSKP.A new MLST type of carbapenem-resistant and hypervirulent Klebsiella pneumoniae strain has been detected,which requires clinical awareness and epidemiological monitoring.

Along with the increasingly serious environmental pollution, dealing with the "white pollution" issue, which is caused by the worldwide use of not readily-degradable or non-degradable synthetic plastics, has become a great challenge. It is an environmentally friendly strategy to degrade synthetic plastics using microorganisms that exist in nature or evolved under selection pressure. Based on the NSFC-EU International Cooperation and Exchanges Project "Bio Innovation of a Circular Economy for Plastics", this review summarized the screening of bacteria, fungi and microbial consortia capable of degrading synthetic plastics such as polyethylene (PE), polypropylene (PP), polystyrene (PS), polyvinyl chloride (PVC), polyurethane (PUR), and polyethylene terephthalate (PET). We also analyzed the role of various microorganisms played in the degradation of petroleum-based plastics. Moreover, we discussed the pros and cons of using microorganisms and enzymes for degradation of synthetic plastics.
Biodegradation, Environmental ; Microbial Consortia ; Petroleum ; Plastics ; Polyurethanes

Objective:To investigate the clinical characteristics and pregnancy outcomes of fetal umbilical artery embolism.Methods:This retrospective case series recruited 18 cases of fetal umbilical artery embolism delivered at Xiamen Maternal and Child Healthcare Hospital from January 2018 to February 2020. Maternal age, complications, umbilical artery condition revealed by prenatal ultrasound, delivery mode, perinatal outcomes, and placental pathological examinations were analyzed using descriptive statistical methods.Results:(1) The total prenatal detection rate of umbilical artery embolism was 0.062% (18/29 130). The average maternal age was (30.1±6.1) years old. Four of the 18 cases aged other 35 and one was younger than 18 years old; 17 cases were singleton pregnancy, and the other one was a dichorionic diamniotic twin pregnancy. The mean gestational age was (35.1±2.6) weeks when an abnormal umbilical artery was first indicated by ultrasound, including 16 with a single umbilical artery shown in the third trimester and two with suspected umbilical artery embolism. The main complications were followed as gestational diabetes mellitus (8/18), fetal growth restriction (4/18), and abnormal umbilical cord insertion (3/18). (2) Cesarean section was performed for 16 cases, resulting in live births, while the other two cases had intrauterine death. Among the 16 neonates, nine were premature infants, and seven were full-term infants, with an average birth weight of (2 434±816) g; four were small for gestational age, and neonatal asphyxia occurred in three cases. Eleven were admitted to the neonatal intensive care unit, including five with brain injury. (3) Placental pathological examinations showed embolism in one of the two umbilical arteries in 17 cases and the umbilical vein in one case. Excessive torsion of the umbilical cord was observed in 11 cases and the umbilical cord's abnormal insertion in three cases. One case refused placental pathological examination.Conclusions:Umbilical artery embolism should be considered when a single umbilical artery is indicated by ultrasound in the third trimester. The time of delivery should be based on the risk of premature birth and unexpected adverse events. A cesarean section is suggested.

Objective To evaluate the clinical effect of Tissue-Link combined with Cusa and Pringle in hepatectomy for primary hepatocellular carcinoma. Methods From January 2013 to January 2017,the clinical data of ninety-six primary hepatocellular carcinoma patients who had received hepatectomy were collected. 45 cases of hepatectomy (control group) were performed by Pringle. The other 51 cases (observation group) were treated with Tissue-Link combined with Cusa. The indexes and survival rates were compared between the two groups during and after operation. Results Compared with the control group, the operation time of the observation group was prolonged ((189. 2±45. 8) min vs. (151. 6±34. 7) min,t = -5. 101),the intraoperative blood loss ((273. 5±141. 6) ml vs. (371. 3±127. 2) ml,t = 7. 396),total bilirubin at seventh days after the operation (( 15. 7 ± 8. 9 ) μmol/ L vs. ( 26. 5 ± 10. 8 ) μmol/ L, t = 5. 320 ) and postoperative albumin supplementation((61. 0±9. 7) g vs. (84. 6±9. 3) g,t = 7. 698) of the observation group decreased. The tumor recurrence rate ( 0 vs. 8. 9% ( 4/ 45)), intrahepatic metastasis rate ( 7. 8% ( 4/ 51) vs. 20% ( 9/ 45)), extrahepatic metastasis rate (3. 9% (2/ 51) vs. 17. 8% (8/ 45)) (χ2 =. 031,6. 315,6. 746) decreased and the differences were statistically significant (P< 0. 05) . The 2 year and 3 year tumor free survival rate (88. 2%, 76. 5%) of the observation group was higher than those of the control group (64. 4%,44. 4%,χ2 = 5. 468, 8. 902),and the total survival rate of 3 year after operation (80. 4%) in the observation group was significantly, higher than that of the control group (51. 1%,χ2 = 4. 896),the difference was statistically significant (P<0. 05) . Conclusion Tissue-Link combined with Cusa is superior to Tissue-Link combined with Pringle in hepatectomy for primary hepatocellular carolnoma. It has less intraoperative blood loss, less damage to liver function and a lower relapse rate of ineisional margin,and the disease-free survival rate and overall survival rate are improved significantly.

Objective To investigate the influence of difference ileocecal junction length on the efficacy of laparoscopic subtotal colectomy combined with antiperistaltic cecorectal anastomosis (LSCACRA) in treatment of slow transit constipation (STC). Methods Ninety- two STC patients undergoing LSCACRA were divided into 2 groups by random digits table method:10-15 cm group (10-15 cm ascending colon preserved above ileocecal junction, 46 cases) and 2-3 cm group (2-3 cm ascending colon preserved above ileocecal junction ,46 cases). All the patients were followed up for 24 months, and the Wexner incontinence score (WIS), ileocecal junction emptying time of barium enema, Wexner constipation score (WCS), abdominal pain intensity score (NRS), gastrointestinal quality of life index (GIQLI), abdominal pain frequency score and abdominal bloating frequency score were compared between 2 groups. Results All the patients successfully completed LSCACRA, with no conversion to open surgery and death occurred. There were no statistical differences in amount of bleeding, operative time, hospitalization time, exhaust time, incidences of postoperative intestinal obstruction and pulmonary infection, defecation time, WIS and abdominal bloating frequency score between 2 groups (P>0.05). The WCS, GIQLI, NRS and abdominal pain frequency scores 6, 12 and 24 months after operation in 2-3 cm group were significantly better than those in 10 - 15 cm group, WCS: (1.7 ± 1.3) scores vs. (4.2 ± 2.3) scores, (1.7 ± 1.1) scores vs. (4.1 ± 1.9) scores, (1.2 ± 0.5) scores vs. (3.9 ± 2.5) scores;GIQLI:(116.8 ± 6.2) scores vs. (98.5 ± 14.7) scores, (122.9 ± 7.5) scores vs. (104.7 ± 16.5) scores, (124.3 ± 5.9) scores vs. (108.3 ± 15.1) scores; NRS: (1.3 ± 0.5) scores vs. (2.5 ± 1.7) scores, (0.9 ± 0.3) scores vs. (2.3 ± 1.4) scores, (0.8 ± 0.3) scores vs. (2.2 ± 1.5) scores;abdominal pain frequency score:(0.9 ± 0.3) scores vs. (1.6 ± 1.2) scores, (0.7 ± 0.3) scores vs. (1.4 ± 1.1) scores, (0.7 ± 0.2) scores vs. (1.2 ± 1.0) scores, and there were statistical differences (P<0.05). The ileocecal junction emptying time of barium enema 24 months after operation in 2-3 cm group was significantly shorter than that in 10-15 cm group: (17.6 ± 8.4) h vs. (21.3 ± 10.8) h, and there was statistical difference (P<0.05). Conclusions STC patients with LSCACRA is safe and effective. The shorter length of ascending colon preserved above ileocecal junction can improve the efficacy of LSCACRA in the treatment of STC and the prognosis of patients. The 2-3 cm length of ascending colon preserved above the ileocecal junction should be recommended.

Background and purpose:The gastric cancer is the highest incidence of malignant tumors in the world. The main treatment methods for gastric cancer are operation and chemotherapy. But the effect is not good. With the rapid development of economy and molecular biology, early diagnosis and molecular targeted therapy for gastric cancer has become a research hotspot. The oncogene overexpression and the anti-oncogene lower expression are closely related with gastric cancer.CDC4/FBXW7 is an anti-oncogene, butc-Myc is an oncogene. The previous research showed that CDC4 affected the expression of many oncogenes, such as Cyclin E. This study aimed to investigate the expression of CDC4 and c-Myc in gastric cancer and to elucidate the potential relationship between their expressions and clinical pathological characteristics.Methods:Semi-quantitative reverse transcription polymerase chain reaction (sRT-PCR), immunohistochemistry and Western blot method were used to determine the mRNA and protein expressions of CDC4 and c-Myc in 40 specimens of gastric carcinoma tissues, corresponding adjacent tissues and normal mucosal tissues. The expressions of CDC4 and c-Myc and the clinical pathological characteristics were analyzed.Results:The protein expressions of CDC4 in gastric cancer tissues were signiifcantly lower than those in adjacent tissues and normal mucosal tissues (P<0.05), whereas the protein expression of c-Myc in gastric cancer tissues was signiifcantly higher than that in adjacent tissues and normal mucosal tissues (P<0.05). The protein and mRNA expression of CDC4 and c-Myc were correlated with differentiation, TNM stage, lymph node metastasis, inifltration, but not with patients’ gender, age and site of cancer (P<0.05). There was a signiifcant negative correlation between CDC4 and c-Myc at the mRNA and protein expression levels (P<0.05).Conclusion:The lower expression of CDC4 is correlated with differentiation, TNM stage, lymph node metastasis and inifltration. c-Myc overexpression is likely to be the CDC4 loss. It suggests that the loss of CDC4 may be a valuable marker for assessing the diagnosis and treatment and the prognosis of gastric cancer.

Objective To discuss the safety and effectiveness of laparoendoscopic single -site surgery (LESS)in cholecystectomy.Methods LESS and conventional laparoscopic(LC)effect were compared and analyzed in cholecystectomy.48 cases were divided into the two groups,24 cases(group LESS)were cheated by laparoendo-scopic single-site surgery;24 cases(group LC)were cheated by laparoscopic cholecystectomy.Contrasted in their operation time,intraoperative amount of bleeding,intraoperative laparotomy rate,body temperature after operation, complications,intestinal recovery time (postoperative exhaust),hospitalization time after operation,postoperative pain index,cosmetic effect,white blood cell (WBC),serum cortisol (Cortisol,Cor),immunoglobulin A (IgA)and comple-ment (C3 ).Results All cases were successful,no cases converted to laparotomy,no postoperative complications.The operation time of group LESS and group LC were (110.2 ±29.3)min and (77.8 ±31.2)min,respectively,the differ-ence was ststictically significant (t=5.07,P<0.05).The intestinal recovery time and hospitalization time after oper-ation in group LESS were less than that in gruoup LC (P<0.05 ).The cosmetic effect in group LESS (3.5 ± 0.5)was higher than that in group LC(2.1 ±0.5)(P<0.05).Cor and C3 in group LESS were higher than those in group LC(P<0.05 ).Conclusion Laparoendoscopic single -site surgery in cholecystectomy is safe and feasible, compared with traditional laparoscopic operation,operation time in LESS is long,but arapid postoperative recovery, beauty effect is obvious.

Objective To explore the effect of pathogenesis,diagnosis,therapy and prevention of portal vein thrombosis(PVT) after devascularization.Methods Data of 86 patients who underwent devascularization because of cirrhotic portal hypertension between January 2009 and December 2014 were retrospectively analyzed.Patients were divided into preventive anticoagulant treatment group (46 cases) and nonpreventive anticoagulant treatment group (40 cases) according to whether or not to receive prophylactic anticoagulant therapy.Compared the causes of PVT and clinical characters.Results The occurrence of PVT was 10.9％ (5/ 46) in preventive anticoagulant treatment group,PVT Ⅰ , Ⅱ, Ⅲ, Ⅳdegree were 2,3,0,0 cases,and that was 32.5％ (13/40) in nonpreventive anticoagulant treatment group, PVT Ⅰ , Ⅱ , Ⅲ, Ⅳ degree were 4,7,2,0 cases, the incidence rate of treatment group was lower than control group (x2 =9.735, P ＜ 0.05).There was no relationship in PVT with sex, age, and intraoperative ligation of splenic artery beforehand (P＞0.05).There were apparent correlation in PVT with centrifugal-flow of portal vein and peak value of platelet count(P＜0.05).All patients discharged uneventfully after anticoagulant treatment, including 2 cases of thrombolytic and 4 cases of blood supply recanalization, no case died from PVT.Conclusion The definite cause of PVT after devascularization is centrifugal-flow of portal vein and the peak value of platelet count (300-499) × 109/L is a pivotal risk factor.The key point of therapy is early diagnosis and early anticoagulant treatment.

Objective To evaluate the effect of integrated control measures on soil-transmitted nematodiasis so as to provide the evidence for formulating the appropriate control strategies and measures in Jinhu County,Jiangsu Province. Methods Since 1995,the comprehensive control measures were carried out for soil-transmitted nematodiasis,and the measures included deworm-ing,health education,safe water,sanitation and environmental remediation. The effects of the comprehensive control measures were evaluated by the investigations of the prevalence of soil-transmitted nematodiasis,awareness of health knowledge,and behav-iors of residents. Results From 1995 to 2012,646 437 person-times were administrated in deworming medication with 2.48 times per capita;the benefit rate of safe water was 97.90%;the popularity rate of harmless toilets was 86.89%. The awareness rate of health knowledge increased from 54.05%in 1996 to 95.60%in 2012,the difference between them were statistically significant (χ2=230.92,P<0.01);the rate of correct health behaviors increased from 59.07%in 1996 to 96.40%in 2012,the difference between them had statistical significance(χ2=202.69,P<0.01). The prevalence of soil-transmitted nematodiasis decreased from 62.57%in 1989 to 1.21%in 2012,the difference had statistical significance(χ2=1 016.92,P<0.01). The infection rates of Asca-ris lumbricodes,hookworm and Trichuris trichiura were 0.58%,1.12%and 0,respectively in 2012,and compared with the rates of those infections in 1989,the decline rates were 94.96%,97.28%and 100%respectively,the differences between them were sta-tistically significant(χ2A sc aris =129.50,χ2hookworm=544.62,χ2Tri ch uris =254.19,all P<0.01). Conclusion The comprehensive control strategies and measures are effective and soil-transmitted nematodiasis has been controlled in Jinhu County.