Objective To study the seasonal distribution characteristics of polycyclic aromatic hydrocarbons (PAHs) in PM_2.5 in Lianyungang City, and analyze the sources of PAHs pollution, and to evaluate the health risks of PAHs in different seasons. Methods PM2.5 samples were collected regularly from January 2019 to December 2023, and 16 types of PAHs were determined by HPLC. Kruskal-Wallis H test was used to compare the concentrations of PM2.5 and PAHs in different years and seasons. The source of PAHs was analyzed by characteristic ratio and principal component analysis (PCA). Health risks were assessed using the BaP equivalent method and the incremental lifetime cancer risk (ILCR) model. Results The annual exceedance rates of PM_2.5 and BaP in Lianyungang showed a decreasing trend from 2019 to 2023. PM_2.5, total PAHs and PAHs monomers (except Ace, Flu and Acy) all showed significant seasonal differences, with the highest concentration in winter (P<0.001). The average proportion of 4-ring PAHs was the highest and the average proportion of 2-ring PAHs was the lowest. The proportion of 5-6 ring PAHs was relatively high in winter and spring. PM2.5and PAHs were negatively correlated with temperature, relative humidity and precipitation, and were positively correlated with atmospheric pressure. PM_2.5 was negatively correlated with wind speed, while some PAHs monomers were positively correlated with wind speed. The characteristic ratio and PCA results showed that the main sources of PAHs in Lianyungang City were mixed sources of road dust and vehicle emissions, oil pollution sources and biomass combustion sources. The results of ILCR showed that the highest risk was found in adults, with males slightly higher than females. In Lianyungang, the maximum value of ILCR in winter was more than 10-6 in people over 9 years old. Conclusion The main sources of PAHs in PM_2.5 in Lianyungang City are mixed sources of road dust and vehicle emissions, oil pollution sources, and biomass combustion sources. Under the current exposure level of PAHs in PM_2.5, residents have a certain potential carcinogenic risk.

Objective:To investigate the clinical value of endoscopic ultrasound elastography versus contrast-enhanced computed tomography in the risk stratification of gastrointestinal stromal tumors (GISTs). Methods:Clinical and imaging data were obtained from 77 patients who were confirmed to have GISTs and underwent endoscopic or surgical treatment at Wenzhou Central Hospital between May 2019 and April 2021. Endoscopic ultrasound elastography based on a five-point scoring system and hypotonic gastrointestinal contrast-enhanced computed tomography were performed for preoperative risk stratification of GISTs. The two techniques were compared in terms of the accuracy of preoperative risk stratification of GISTs. The imaging features of the two techniques were summarized.Results:According to the postoperative pathological results, 13 patients were at high risk, 13 patients were at medium risk, 35 patients were at low risk, and 16 patients were at extremely low risk. These patients were divided into two groups according to postoperative pathological results: a low-risk group (low risk + extremely low risk) and a medium- and high-risk group (high + medium risk). In the low-risk group ( n = 51), 42 patients were identified by endoscopic ultrasound elastography to have low-risk GISTs and were recommended to receive endoscopic treatment, while the rest 9 patients were identified to have medium-risk GISTs. Contrast-enhanced computed tomography findings revealed that 30 patients had low-risk GISTs and were recommended to receive endoscopic treatment, and 21 patients had medium-risk GISTs. In the medium- and high-risk group ( n = 26), 4 patients were identified by endoscopic ultrasound elastography to have low-risk GISTs, and 22 patients had medium- or high-risk GISTs. Contrast-enhanced computed tomography findings revealed that 9 patients were identified to have low-risk GISTs, and 17 patients had medium- or high-risk GISTs. Endoscopic ultrasound elastography yielded an overall diagnostic accuracy of 83.11% (64/77), while contrast-enhanced computed tomography had an overall diagnostic accuracy of 61.04% (47/77). Endoscopic ultrasound elastography outperformed contrast-enhanced computed tomography in accurate risk stratification of GISTs ( χ2 = 4.66, P < 0.05). In terms of predicting high-risk GISTs, endoscopic ultrasound elastography had a sensitivity of 84.62% and a specificity of 82.35%, both were higher than those of contrast-enhanced computed tomography (sensitivity: 65.38%; specificity: 58.82%), but the differences in sensitivity and specificity between the two techniques were not significant (sensitivity: Fisher's exact test P = 0.590, specificity: χ2 = 0.93, P > 0.05). Conclusion:Endoscopic ultrasound elastography appears to have a better overall diagnostic accuracy in the risk stratification of GISTs compared with contrast-enhanced computed tomography. The combined use of these two techniques may offer a better comprehensive understanding of the perilesional structure and organ involvements and distant metastasis than a single technique, thereby providing a reliable reference for the choice of treatment for GISTs.

Organ transplantation is the main treatment for organ failure.Functional protection of donor organs during ex vivo transportation is critical for the success of organ transplantation.How to protect the functions of donor organs during in vitro transportation is an important issue in the field of organ transplantation research.In a hypoxic environment,transcriptional activity of a series of genes in cells is activated.These genes are mainly involved in angiogenesis,iron metabolism,glucose metabolism,and cell proliferation/survival.In aerobic organisms,hypoxia-inducible factor-1α(HIF-1α)is involved in the regulation of the expression of various genes to maintain homeostasis of tissues and cells under hypoxic conditions,thereby adapting to the hypoxia.Many studies have shown that the HIF-1α pathway plays an important role in protecting isolated organs from cold ischemic injury during cold storage.HIF-1α has been a hot topic in research on the protective mechanism of cold ischemic injury of isolated organs.Regulating the HIF-1α-related signaling pathway is expected to be a new strategy to maintain organ functions during cold storage of isolated organs.

Objective To evaluate the efficacy and safety of prostatic arterial embolization (PAE) and transurethral resection of prostate (TURP) in treatment of benign prostatic hyperplasia (BPH).Methods Totally 40 patients with BPH from Jan 2016 to Oct 2016 were selected.All patients were divided into PAE (n=20) and TURP (n=20) group by random number table method.The curative effect indexes (international prostate symptom score [IPSS],quality of life score [QOL],prostate volume [PV],postvoid residual [PVR],maximum urinary flow rate [Qmax] and prostate-specific antigen [PSA]),the complications and side effects,as well as the incidence of sexual dysfunction were analyzed and compared between the two groups.Results No statistical difference of IPSS,QOL,PV,PVR,Qmax nor PSA was found between the two groups before operation (all P＞0.05).IPSS,QOL,PV,PVR and PSA were significantly lower than those before operation 3,6 and 12 months after operation (all P＜0.05),while Qmax was obviously higher than that before operation (P＜0.05).Three months after operation,the curative effect indexes were statistically different between the two groups (all P＜0.05),while no statistical difference was found 6 and 12 months after operation (P＞0.05).The incidence of postoperative complications in TURP group was higher than that in PAE group (x2 =4.329,P=0.037).There was no statistical difference in the incidence of sexual dysfunction between the two groups (x2=2.105,P=0.147).Conclusion PAE and TURP can significantly alleviate clinical symptoms of patients with BPH.Three months after operation,the efficacy of TURP is better than PAE,but PAE is more minimally invasive and has fewer complications.

OBJECTIVETo demonstrate the clinical applicability of three-dimensional CT angiography by evaluating the anatomic features and variation of inferior mesenteric artery(IMA) and left colic artery(LCA) in order to provide reference to vessel ligation strategy in laparoscopic rectal cancer surgery.

METHODSClinical and image data of 123 patients receiving abdominal multislice CT at The Sixth Affiliated Hospital from 2014 to 2015 were retrospectively analyzed. The images were 3D-reconstructed with computer 3D CT angiography and arterial enhancement phase images were chosen for analysis. Linear distances from IMA root to abdominal aortic bifurcation and from LCA at IMA root level to IMA root were measured. Branch types of IMA, coursing pattern of LCA, and association between LCA and inferior mesenteric vein (IMV) site were summarized.

RESULTSOf 123 cases, 80 were males and 43 were females, mean age was (46.8±16.6) years, body weight was (57.7±10.4) kg, and BMI was (21.3±3.6) kg/m. The average distance from IMA root to abdominal aortic bifurcation was (42.5±7.9) mm, and this distance was closely associated with body weight (OR=4.771, 95%CI: 1.398 to 16.283, P=0.013). Longer distance tended to appear in the heavier patients. LCA and sigmoid artery (SA) originating from same single IMA was found in 61(49.6%) cases; LCA and SA forking at same point in 35(28.5%) cases; LCA and SA coursing together and forking afterwards in 24(19.5%) cases, and LCA disappearing in 3(2.4%) cases. In 71(57.7%) patients, LCA ascended medial to the lateral border of left kidney, while in 16(13.0%) patients, LCA arranged below the inferior border of left kidney. When the LCA site was higher and the distance from LCA to IMA root was closer [distance from LCA to IMA root level was (24.2±9.9) mm, (30.0±15.2) mm and (66.6±12.3) mm, F=83.2, P<0.001]. At the level of IMA root, LCA located medial to IMV in 21(17.1%) cases, located just lateral to IMV in 54(43.9%) cases, and located lateral and ascended far away from IMV in 48(39.0%) cases.

CONCLUSION3D-CT angiography is non-invasive, efficient and accurate in evaluating coursing features and variation of IMA and its branches, which can provide important reference to the surgeons, promising laparoscopic surgery smooth and safe.

Although most microbes are not readily cultured in the lab, microbial DNA can be extracted directly from an environmental sample and be functionally expressed in a suitable host for natural products discovery, and this approach has been termed "metagenomics". An E'mei Mountain soil metagenomic library was constructed using an Escherichia coli-Streptomyces shuttle vector for functional based screening of anti-bacterial clones in Streptomyces albus host. Two active clones were obtained and their fermentation broths were studied for the inhibitory effect on Staphylococcus aureus biofilm. Their fermentation products have a good inhibitory effect on the formation of S. aureus biofilm, and the inhibitory effect could exceed 90% when the concentration of sample was 2 MIC (Minimum Inhibitory Concentration). In addition, two samples had significantly effect on S. aureus biofilm dispersal, and the clearance rate of EM110 was higher than EM123. In conclusion, substances with strong bioactivities on biofilm formation and dispersal of S. aureus could be discovered by using metagenomics technology.

Objective To evaluate the effect of oral mesalazine combined with metronidazole enema in the treatment of patients with ulcerative colitis and the impact on interferon-γ (IFN-γ),interleukin-4 (IL-4),interleukin-8 (IL-8).Methods A total of 80 patients with ulcerative colitis were selected and randomly divided into control group and observation group,40 cases in each group.The control group was treated with oral mesalazine.The observation group was treated with oral mesalazine and metronidazole retention enema.4 weeks as a course of treatment,the patients were treated for 2 courses.The clinical efficacy,disease activity index(DAI) score before and after treatment,as well as peripheral blood erythrocyte sedimentation rate (ESR),levels of IFN-γ,IL-4,IL-8 changes was compared between the two groups.Results The total effective rate was 90.00％ in the control group,which was significantly higher than 75.00％ in the control group,the difference was statistically significant (x2 =23.52,P ＜ 0.05).Before treatment,there were no significant changes in diarrhea,colonic mucosal inflammation,bloody stool and DAI scores (t =0.32,0.08,0.03,0.05,all P ＞ 0.05).After treatment,there were significant decline in each integral of the two groups,the integral of the observation group declined more than those in the control group,the differences were statistically significant(t =15.35,5.8,11.25,14.12,all P ＜0.05).Before treatment,there were no significant changes in ESR,IL-4,IL-8,IFN-γ of peripheral blood in the two groups (t =0.60,-0.95,0.03,-0.06,all P ＞ 0.05).After treatment,ESR,IL-8,IFN-γ of peripheral blood declined in the two groups,IL-4 was increased,and the changes were more significantly in the control group than those in the control group(t =10.02,4.70,10.23,22.82,all P ＜ 0.05).Conclusion Oral mesalazine enema combined with metronidazole enema has significant clinical effect in patients with ulcerative colitis,it is better than treating with oral mesalazine only,and can effectively improve the clinical symptoms and possibly plays a role by regulating IL-8,IFN-γ,IL-4,and it deserves further clinical application.

Objective This study explored the expression of polyclonal protein SUZ12 in patients with intrahepatic cholangiocarcinoma(ICC),and its role in predicting the survival and treatment of ICC patients.Methods The expression of SUZ12 and p16INK4a was detected by immunohistochemical assay in 207 liver tissue samples including ICC patients,BilIN-1,-2,-3 and non-tumor-like cholangiocarcinoma.The expression of these proteins was assessed to be related to the pathological characteristics of the ICC patients receiving chemotherapy and the outcome of survival as well as the subsequent chemotherapy response.Results The expression level of SUZ12 was gradually increased from non-neoplastic bile duct tissue to BilIN-1,-2,-3 and ICC.The expression of p16INK4a protein was expressed in non-neoplastic-like cholangiocarcinoma,but it decreased gradually in BilIN-1,-2,-3 and ICC tissues.SUZ12 expression was associated with undifferentiated ICC,lymph node metastasis and advanced cancer.Kaplan-Meier curve analysis showed that ICC patients with high expression of SUZ12 had a significant reduction in overall survival and disease-free survival in comparison with ICC patients with the low expression of SUZ12.SUZ12 expression was significantly associated with overall survival of patients receiving adjuvant gemcitabine-based chemotherapy(AGC).Conclusion SUZ12 expression is able to predict the overall survival and disease-free survival of ICC patients with adjuvant gemcitabine-based chemotherapy.

Objective: To establish a rapid and sensitive isothermal amplification assay for the detection of human Adenovirus. Methods: Primers and probe used for recombinase polymerase amplification(RPA)were designed based on the conserved region of the adenoviruses hexon gene. After optimizing the reaction temperature and times, the products of RPA were detected by capillary electrophoresis and lateral flow dipstick(LFD). Sensitivity and specicity of the assay were evaluated. The diagnostic value of the RPA-LFD assay was verified using clinical samples which were simultaneously tested by real time PCR assay. Results: The analytical sensitivity of RPA-LFD assay was 2 copies DNA molecules per reaction and no cross reaction with other pathogens was observed. Compared with real-time PCR assay, the sensitivity, and specificity of the present assay were all 100%. Conclusions The RPA-LFD assay developed in this study has the characteristics of high specificity, sensitivity, rapid and no requirement of expensive equipment which provided a new tool for rapid detection of human adenovirus.

Objective To investigate the condition of defecation function,psychological health and quality of life about patients who underwent low rectal cancer anus preservation operation.Methods We randomly selected 40 cases from patients who went to do rectal cancer anus preservation operation as observation group,who received e-valuation with bowel habit questionnaire (the result using Zhong-fa Xu anal function evaluation method which widely used for subjective evaluation),SF-36 scoring systems at 2 weeks before surgery,postoperative 3 months,6 months, 1 year,and the anorectal manometry postoperative 3 months,6 months,1 year.The normal controls were 40 healthy people without anus-rectal disease and disordered defecation,investigated and detected at the same time point.Results Compared with the control group,the ARP,MSP,RAIA,MTV of the observation group significantly decreased(P <0.05)within 3 months and 6 months after operation[postoperative 3 months:(22.2 ±3.8)mL,(30.3 ±4.1)mL and (4.1 ±15.8)mL,(83.5 ±17.3)mL,32.5%,t or χ2:6.34,8.21,5.34,8.94,4.34;after 6 months,those were (26.3 ±3.5)mL,(37.3 ±4.7)mL and (4.7 ±16.1)mL,(106.2 ±18.2)mL,40%,t or χ2:7.34,7.99,4.75, 7.99,4.75],and 1 year the margin contract (P >0.05).Compared with the control group,in the preoperation,the results of anal function evaluation method and SF-36 scoring systems had no significant differences.Based on the Zhong-fa Xu anal function evaluation,we could draw the following conclusions:anal function was impaired obviously in postoperative 3 months (fine rate was 62.5%,χ2 =16.08,P <0.01 ),and recovered gradually in postoperative 6 months to 1 year,but the impaired performance was still exists in postoperative 1 year.Compared with the control group,3 months,6 months after surgery,the SF-36 life quality comprehensive score of the observation group had no significant difference (P >0.05),but the scores of PF and RF dimension were lower than those of the healthy con-trols:postoperative PF dimension[3 months:(80.12 ±15.12),6 months:(82.19 ±17.01),and 1 year:(83.13 ± 17.12),compared with the control group,t =4.5,3.1,2.5 respectively],postoperative RP dimension [3 months:(58.29 ±40.15),6 months:(59.48 ±41.07),1 year:(60.17 ±42.15),compared with the control group,t =4.1, 2.9,2.7 respectively];there were statistically significant differences (P <0.05).Conclusion For patients who underwent low rectal cancer anus preservation operation,postoperative anal function and life quality were affected,and is significant in a short period of time,part of the quality of life for long-term survival in patients decreased obviously, and it is necessary to assess sufficiently preoperation,do defecation function exercise or biological feedback therapy postoperation.