Objective:To analyze the causal relationship between gut microbiota and gestational diabetes,and to clarify its mechanism.Methods:Two-sample Mendelian randomization(MR)analysis was conducted by using summary data from genome-wide association study(GWAS)for gut microbiota and gestational diabetes.The GWAS data of gut microbiota were obtained from a GWAS study from the MiBioGen consortium;the GWAS data on gestational diabetes were sourced from the FinnGen consortium's publicly available R8 dataset;inverse variance weighted(IVW)method was used as the primary method to detect the causal association between the gut microbiota and the gestational diabetes.Sensitivity analysis was performed by Weighted Median and MR Egger methods;heterogeneity and pleiotropy were detected by Cochran's Q,MR-PRESSO,Egger intercept tests and Leave-One-Out analysis;multivariable MR was used to adjust for the effect of body mass index(BMI);reverse MR was used to explore the presence of reverse causal associations;Gene Ontology(GO)fuctional and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling enrichment analyses were used to explore the potential pathways through which gut microbiota may have impact on gestational diabetes.Results:Four gut microbes were found to be causally associated with gestational diabetes:the genus Methanobrevibacter and the phylum Euryarchaeota displayed negative causal relationships with the risk of gestational diabetes,while the genus Olsenella and genus Lachnoclostridium exhibited positive causal associations.No significant heterogeneity or horizontal pleiotropy was detected in the analysis.The reverse MR analysis did not reveal any causal relationship.After adjusting for BMI,the multivariable MR analysis results showed there were the causal associations between the genus Olsenella and the phylum Euryarchaeota with the risk of gestational diabetes.The GO fuctional and KEGG signaling pathway enrichment analyses results showed that axon development,axon production,insulin secretion and other pathways were significantly enriched.Conclusion:There are causal associations between four gut microbes and gestational diabetes.Among them,the significant correlations with gestational diabetes are still observed in phylum Euryarchaeota and genus Olsenella after adjusting for BMI.

Objective To explore the clinical value of neurography and nerve root sealing in treatment of multilevel lumbar spinal stenosis with lumbar instability using Endo-P/TLIF.Methods A total of 60 patients with multi-segment lumbar spinal stenosis and lumbar instability hospitalized in our hospital were included in this study From January 1,2022 to June 21,2022.All patients underwent nerve root closure angiography before surgery to confirm the responsible segments,and then the responsible segments were treated with Endo-P/TLIF.The patients were followed up for 6 months.The basic information on the age,gender,course of disease,surgical time,intraop-erative bleeding,hospitalization time,and off-bed ambulation time was collected.Then the data on VAS score,ODI score,JOA score,lumbar lordosis angle,intervertebral height,dural cross-sectional area,sacral inclination angle,pelvic projection angle,and pelvic inclination angle before,right after,3 months and 6 months after the operation were calculated.The number of responsible segments indicated by MRI and confirmed by nerve root closure angiography and the number of the single segment,double segments,3 segments,and above finally decompressed were statisti-cally analyzed.Results All patients went through the surgery safely.During the 6-month follow-up,one patient did not return to the hospital for consultation on time,and one patient was out of contact.Finally,the follow-up data of 58 patients were completely collected for statistical analysis.Fifty-five cases were remarkably improved,2 better,and 1 moderately,6 months after the operation,with a total effectiveness rate of 100%.The number of unilateral and bilateral single responsible segments confirmed by nerve root angiography and sealing was significantly larger than by MRI(P<0.05),but the number of unilateral and unilateral double,or multiple responsible segments was signifi-cantly smaller(P<0.05).There were statistically significant differences in terms of postoperative VAS score,ODI score,JOA score,VAS score,ODI score,JOA score,lumbar lordosis angle,intervertebral height,dural cross-sectional area,sacral inclination angle,pelvic inclination angle as compared to the preoperative data(P＜0.05).The pelvic projection angle was insignificantly improved as compared to the preoperative condition(P ? 0.05).Conclusion The accurate diagnosis with selective neurography and nerve root sealing improves the confirmation of responsible nerve segments before operation.Base on the accurate diagnosis,multi-segment lumbar spinal canal stenosis with lumbar instability can be effectively treated with Endo-P/TLIF,the responsible segment decompressed,trauma and bleeding reduced,hospital stay shortened,spinal physiological curvature well recovered,and clinical efficacy improved.Therefore,the method is worthy of extensive application in clinical practice.

Aim To explore the feasibility of the micro- dynamic chromogenic method for quantitative detection of bacterial endotoxin in recombinant novel coronavirus vaccine ( CHO cell).Methods The micro-dynamic color method of Limulus reagent was used to establish a bacterial endotoxin standard curve.The dilution factor was determined through interference pre -experiment, the recoverv rate of the endotoxin added to the test so- J lution was determined, and the interference test to complete the quantitative detection test of the bacterial endotoxin content in the test product was performed, and the results were compared with those of the gel-clot method.Results Hie linear range of the concentration of the standard curve was 0.02 to 2.0 EU • mL 1 , and the regression equation of the standard curve was lgT =-0.302 7 lgC +2.858 7( r = 0.998 9).When recombinant novel coronavirus vaccine ( CHO cell) was cliluted 40 times or below, the micro -dynamic chromogenic reagent did not interfere with the bacterial endotoxin agglutination reaction, and the recovery rate was 50% to 200%.The test results were consistent with the gel- clot method.Conclusions The micro-dynamic chromogenic method can be used for the quantitative detection of bacterial endotoxins in recombinant novel coronavirus vaccine ( CHO cell) with accurate results, high sensitivity, and process monitoring.

Objective:To understand the characteristics and differences of diarrhea-related symptoms caused by different pathogens, and the clinical features of various pathogens causing diarrhea.Methods:Etiology surveillance program was conducted among 20 provinces of China from 2010 to 2016. The acute diarrhea outpatients were collected from clinics or hospitals. A questionnaire was used to survey demographics and clinical features. VFeces samples were taken for laboratory detection of 22 common diarrhea pathogens, to detect and analyze the clinical symptom pattern characteristics of the patient’s.Results:A total of 38 950 outpatients were enrolled from 20 provinces of China. The positive rates of Rotavirus and Norovirus were the highest among the five diarrhea-causing viruses (Rotavirus: 18.29%, Norovirus: 13.06%). In the isolation and culture of 17 diarrhea-causing bacterial, Escherichia coli showed the highest positive rates (6.25%). The clinical features of bacterial diarrhea and viral diarrhea were mainly reflected in the results of fecal traits and routine examination, but pathogenic Vibrio infection was similar to viral diarrhea. Conclusion:Infectious diarrhea presents different characteristics due to various symptoms which can provide a basis for clinical diagnosis.

BACKGROUND:It is convenient to fabricate porcelain veeners using chairside computer aided design/computer aided manufacture (CAD/CAM) system. However, the color of the restorations is not ideal when the veener is cemented immediately, so different surface treatments are needed. OBJECTIVE:To investigate the influence of different surface treatments on the color of chairside porcelain veneers made of CEREC Blocs and the color match between the porcelain veneers and teeth. METHODS:Five fresh extracted maxillary central incisors were selected and prepared. Twenty-five 0.6 mm porcelain veneer specimens were fabricated with Sirona CEREC Blocs by chairside CAD/CAM system, and then randomized into five groups. Untreated specimens served as control group. The other four groups were treated respectively by polishing, glazing, glazing after polishing or staining. The color parameters of specimens and the teeth were measured with ShadeEye NCC on the middle 1/3 region of labial surfaces, and color differences (ΔE) between the specimens and teeth were calculated. Data were analyzed by SPSS 19.0 software. RESULTS AND CONCLUSION:Compared with the control group, the L* value of the glazing, glazing after polishing and staining groups were significantly decreased (P<0.05). The L* value of the staining group was the lowest. The a* and b* values had no significant differences between groups (P>0.05). Compared with the control group, the ΔE values of glazing, glazing after polishing and staining groups were significantly decreased (P<0.05), and the ΔE value of the staining group was the lowest. The ΔL* values of glazing, glazing after polishing and staining groups were significantly lower than those of the control group (P<0.05), and the ΔL* value of the staining group was the lowest. Compared with the control group, only the Δb* value of staining group was decreased significantly (P<0.05). The Δa* values did not differ significantly between groups (P>0.05). These results suggest that the chairside porcelain veneers made of CEREC Blocs can obtain satisfactory aesthetic appearance by glazing and staining.

BACKGROUND:Hip arthroplasty is an effective means currently in repair of femoral neck fractures. With the increased in the amount of surgery, surgery failure rate also has increased. In particular, prosthesis loosening and fracture are very common after replacement.Qiangguyin can promote the formation of osteoblasts, resist osteoporosis, inhibit osteoclast activity, and increase bone density. Drynaria invigorates the kidney, strengthens the bone and tendon and relieves pain, and has bidirectional regulatory effects on promoting bone formation and inhibiting bone resorption.
OBJECTIVE:To investigate effects ofQiangguyin on periprosthetic bone density in patients with femoral neck fracture after hip arthroplasty.
METHODS:96 patients with femoral neck fracture were equaly divided into observation group and control group based on the random number table. Both groups were given selective joint replacement. Patients were implanted with femoral head made by US Stryker Corporation, and fixed with bone cement. After replacement, patients in the control group were treated with calcium D3 tablets and capsules alfacalcidol. On this basis, the treatment group was given theQiangguyin oral drug intervention for a month. Bone density surrounding the prosthesis was observed in both groups. Alkaline phosphatase and tartrate-resistant hydrochloric acid phosphatase activities were detected. Repair effects were compared.
RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. No infection or loosening of the prosthesis occurred. Ambulation time and healing time were significantly less in the observation group than in the control group (P < 0.05). No significant difference in bone density surrounding the prosthesis was detected between the two groups before medication, and an obvious increased trend was found after medication (P < 0.05). Bone density was significantly higher in the observation group than in the control group after medication (P < 0.05). Serum alkaline phosphatase activity was significantly higher in the two groups after medication, but tartrate-resistant hydrochloric acid phosphatase activity was significantly decreased, which showed significant differences as compared with that before medication (P < 0.05). Simultaneously, significant differences in serum alkaline phosphatase activity and tartrate-resistant hydrochloric acid phosphatase activity were detected between the observation and control groups after medication (P < 0.05). At 6 months after replacement, the excelent and good rate of joint function was significantly higher in the observation group than in the control group (94%, 79%,P < 0.05). These results indicate that Qiangguyin could resist bone resorption and suppress excessive bone turnover, improve bone density around the prosthesis, and restore joint function after hip arthroplasty.

Objective To investigate the role of mitochondrial apoptotic pathway in intrathecal doxepin?induced apoptosis in rat neurons. Methods Twenty?four adult male Wistar rats, weighing 250-300 g, in which intrathecal catheters were successfully implanted without complications, were randomly divided into 4 groups ( n=6 each) using a random number table: control group ( group C) and different concentrations of doxepin groups (D5, D10 and D20 groups). In D5, D10 and D20 groups, 5, 10, and 20 mmol∕L doxepin 0. 2 μl∕g were injected intrathecally, respectively. In group C, the equal volume of normal saline was given instead. At 6 h after intrathecal administration, the animals were sacrificed, and the lumbar segments of the spinal cords were obtained for detection of the cell apoptosis ( by TUNEL assay) , expression of Bax and Bcl?2 ( by immunohistochemistry) , release of cytochrome c ( Cyt c) , and expression of caspase?3, caspase?8 and caspase?9 mRNA ( using real?time reverse transcriptase polymerase chain reaction) . Apoptosis rate and Bcl?2∕Bax ratio were calculated. Results Compared with group C, the expression of Bax was significantly up?regulated, the expression of Bcl?2 was down?regulated, Bcl?2∕Bax ratio was decreased, the release of Cyt c and apoptosis rate were increased, and the expression of caspase?3 and caspase?9 mRNA was up?regulated in D10 and D20 groups, the expression of Bcl?2 was down?regulated in group D20 ( P<0.05 or 0.01) , and no significant change was found in the parameters mentioned above in group D5 (P>0.05). The expression of Bax was significantly up?regulated, Bcl?2∕Bax ratio was decreased, the release of Cyt c and apoptosis rate were increased, and the expression of caspase?3 and caspase?9 mRNA was up?regulated in D10 and D20 groups, and the expression of Bcl?2 was down?regulated in group D20 as compared with group D5 ( P<0.05 or 0.01) , and in group D20 as compared with group D10 ( P<0.05) . There was no significant difference in the expression of caspase?8 mRNA among the four groups ( P>0.05) . Conclusion Mitochondrial apoptotic pathways, but not death receptor pathway, is involved in intrathecal doxepin?induced apoptosis in rat neurons.

OBJECTIVETo investigate the feasibility of immediate breast and nipple-areola reconstruction after skin-sparing mastectomy.

METHODS24 patients who received skin-sparing mastectomy underwent immediate breast reconstruction with or without breast implants. The nipple-areola complex is also reconstructed with the skin paddle of the latissimus dorsi flap in one stage.

RESULTSAll the latissimus dorsi myocutaneous flaps survived completely. Partial necrosis happened in two reconstructed nipples which healed after dress changing. The follow-up period ranged from 6 to 12 months. 3 patients presented with capsular contracture (Baker I), with no necessary of surgical revision. The retraction rate of reconstructed nipples projection is 35.4% at 6 months postoperatively and 38.6% at 12 months postoperatively. 91.7% of patients were satisfied or very satisfied with the breast shape, while 83.3% were satisfied or very satisfied with the breast volume. All the patients considered the reconstructed nipple very good, while 91.6% were satisfied with the nipple projection. 91.7% considered immediate nipple reconstruction to be very important, and 8.3% considered it to be important. 66.7% considered the new breast could replace the breast they had lost, and 8.3% considered that it could not.

CONCLUSIONFor skin-sparing mastectomy, immediate breast and nipple reconstruction can achieve good aesthetic results.

Breast Neoplasms ; surgery ; Esthetics ; Female ; Humans ; Mammaplasty ; methods ; psychology ; Myocutaneous Flap ; transplantation ; Nipples ; surgery ; Superficial Back Muscles ; transplantation

Objective:Esophageal cancer has high morbidity in China, and surgery is the main treatment for this disease. Postop-erative nutrition is also important for the patients. In this article, we discuss the possibility of retrosternal route gastrostomy feeding (RGF). Methods: The data of 127 esophageal cancer patients between 2011 and 2013 were retrospectively analyzed. RGF was per-formed in all the patients, and post-operation complications were studied. Results: Bowel obstruction, catheter displacement, and wound infection did not occur. Conclusion:RGF is a safe and effective nutrition method for patients who underwent retrosternal recon-struction.

OBJECTlVE To expIore the intervention effect of Iosartan on the Iung oxidative injury in-duced by paraquat(PQ). METHODS AduIt maIe SD rats were randomIy divided into 4 groups:normaI controI group,PQ intoxication group(rats were treated with singIe ig PQ 40 mg·kg-1 ),Iosartan inter-vention for 7 and 14 d groups(rats were ig given Iosartan 10 mg·kg-1 daiIy for 7 and 14 consecutive days after PQ was given). AII rats were sacrificed on the 16th day to obtain Iung tissues. HE staining was used to observe the Iung pathoIogicaI changes. The activities of superoxide dismutase(SOD),cataIase (CAT)and totaI antioxidant capacity(T-AOC)and content of Iipid peroxide(LPO)were detected by spectrophotometry. ReaI-time quantitative PCR was used to investigate the NF-κB mRNA expression in Iung tissue. RESULTS PathoIogicaI examination showed that acute Iung injury and significant Iung fibro-sis appeared in PQ intoxication group but were reversed by Iosartan. The IeveIs of SOD,CAT and T-AOC decreased whiIe the content of LPO in PQ intoxication group increased significantIy compared with controI group(P﹤0.05). Compared with PQ intoxication group,the IeveIs of SOD,CAT and T-AOC in-creased and the content of LPO decreased in Iosartan intervention for 7 and 14 d groups(P﹤0.05),and the IeveIs of T-AOC and LPO in Iosartan intervention for 7 and 14 d groups and the activities of SOD and CAT in Iosartan intervention for 14 d group nearIy returned to normaI. The mRNA expression of NF-κB was upreguIated after rats were exposed to PQ,downreguIated in Iosartan intervention for 7 and 14 d groups in rat Iung tissues( P﹤0.05),but nearIy returned to normaI. CONCLUSlON Oxidative stress may be invoIved in the acute PQ poisoning process and Iosartan might have intervention effect on acute PQ Iung damage by improving the antioxidant capacity and downreguIating the mRNA expression of NF-κB.