ObjectiveTo investigate the prevalence of overweight， obesity and fatty liver disease （FLD） in adult residents in a suburban area of Shanghai， and to explore the relationship between these conditions and eating out of home （EOH）. MethodsAdult residents from Zhongshan Street， Songjiang， Shanghai， were invited to report their frequency of EOH and undergo a physical examination using B-ultrasonography from May to September 2017. Binary logistic regression analyses were conducted to examine the relationship between EOH and conditions of overweight， obesity， and FLD. ResultsAmong the final sample size of 6 608 participants， the prevalence rates of overweight， obesity， and FLD were 41.65%， 14.71% and 38.29%， respectively. After adjusting for potential confounders， logistic analyses revealed that participants with an EOH frequency > once/week had a 1.44-fold higher prevalence of obesity （P=0.006）， a 1.35-fold higher prevalence of overweight/obesity （P=0.005）， and a 1.36-fold higher prevalence of FLD （P=0.008）. ConclusionThe prevalence of overweight， obesity， and FLD is relatively high in Songjiang， Shanghai. EOH may be a risk factor for these diseases， and residents are recommended to reduce the frequency of EOH.

Objective:To construct a classification and regression tree which can be used to guide the tracheostomy for traumatic cervical spinal cord injury (TCSCI) based on the identification of the risk factors for TCSCI.Methods:The 498 patients with TCSCI were retrospectively analyzed who had been treated at Department of Orthopedics, The Second Hospital Affiliated to Army Medical University from January 2009 to December 2018. There were 403 males and 86 females, with an age of (50.2±13.6) years. Of the patients, 69 received tracheostomy and 420 did not. The gender, age, smoking history, injury cause, neurological level of injury (NLI), American Spinal Cord Injury Association (ASIA) grade, injury severity score (ISS), thoracic injuries, prior pulmonary diseases, prior basic diseases, and operative approaches of the patients were statistically analyzed by single factor analysis. After the independent risk factors for tracheostomy were analyzed by binary logistic regression, the classification and regression tree was developed which could be used to guide the tracheostomy.Results:The logistic regression analysis showed age>50 years ( OR=4.744, 95% CI: 1.802 to 12.493, P=0.002), NLI at C 4 and above ( OR=23.662, 95% CI: 8.449 to 66.268, P<0.001), ASIA grade A ( OR=40.007, 95% CI: 12.992 to 123.193, P<0.001), and ISS score>16 ( OR=10.502, 95% CI: 3.909 to 28.211, P<0.001) were the independent risk factors for the tracheotomy. The classification and regression tree revealed that ASIA grade A and NLI at C 4 and above were the first and second decision nodes, which had a strong predictive effect on tracheostomy. 86.84% of the patients with ASIA grade A and NLI at C 4 and above underwent tracheostomy. Conclusion:Our classification and regression tree shows that NLI at C 4 and above and ASIA grade A have a strong guiding effect on tracheotomy for TCSCI.

As a type of prebiotics and dietary fiber, inulin performs plenty of significant physiological functions and is applied in food and pharmaceutical fields. Inulosucrase from microorganisms can use sucrose as the substrate to synthesize inulin possessing higher molecular weight than that from plants. In this work, a hypothetical gene coding inulosucrase was selected from the GenBank database. The catalytic domain was remained by N- and C- truncation strategies, constructing the recombinant plasmid. The recombinant plasmid was expressed in E. coli expression system, and after purifying the crude enzyme by Ni²⁺ affinity chromatography, a recombinant enzyme with a molecular weight of approximately 65 kDa was obtained. The optimal pH and temperature of the recombinant enzyme were 5.5 and 45 °C, respectively, when sucrose was used as the sole substrate. The activity of this enzyme was inhibited by various metal ions at different degrees. After purifying the produced polysaccharide, nuclear magnetic resonance analysis was used to determine that the polysaccharide was inulin connected by β-(2,1) linkages. Finally, the conditions for the production of inulin were optimized. The results showed that the inulin production reached the maximum, approximately 287 g/L after 7 h, when sucrose concentration and enzyme dosage were 700 g/L and 4 U/mL, respectively. The conversion rate from sucrose to inulin was approximately 41%.
Escherichia coli/genetics* ; Hexosyltransferases/genetics* ; Inulin ; Oligosaccharides ; Sucrose

Development of thoracolumbar vertebra (TLV) and rib primordium (RP) is a common evolutionary feature across vertebrates, although whole-organism analysis of the expression dynamics of TLV- and RP-related genes has been lacking. Here, we investigated the single-cell transcriptome landscape of thoracic vertebra (TV), lumbar vertebra (LV), and RP cells from a pig embryo at 27 days post-fertilization (dpf) and identified six cell types with distinct gene expression signatures. In-depth dissection of the gene expression dynamics and RNA velocity revealed a coupled process of osteogenesis and angiogenesis during TLV and RP development. Further analysis of cell type-specific and strand-specific expression uncovered the extremely high level of HOXA10 3'-UTR sequence specific to osteoblasts of LV cells, which may function as anti-HOXA10-antisense by counteracting the HOXA10-antisense effect to determine TLV transition. Thus, this work provides a valuable resource for understanding embryonic osteogenesis and angiogenesis underlying vertebrate TLV and RP development at the cell type-specific resolution, which serves as a comprehensive view on the transcriptional profile of animal embryo development.

The subaxial cervical facet dislocation is an important and common cause of cervical spinal cord injury, which often leads to the destruction of the three column structure of the cervical spine. At present, the treatment principle of the subaxial cervical facet dislocation is generally reduction as soon as possible, complete decompression, restoration of the intervertebral height and the normal sequence of the cervical spine and reconstruction of the stability of the cervical spine. Early reduction is particularly important for patients with spinal cord injury. Although there are many ways of reduction, the best way to achieve reduction and stability is still controversial. The authors review related literatures and summarize the reduction methods of the subaxial cervical facet dislocation, so as to provide reference for the clinical treatment of the subaxial cervical facet dislocation.

Objective:To explore the possible mechanism of Bcl-2/adenovirus E1B 19kDa-interacting protein 3-like (also known as NIX) mediating mitophagy in PC12 cells.Methods:The PC12 cells (rat adrenal pheochromocytoma cells) were cultured in a hypoxic incubator with a volume fraction of 1% O 2 to establish hypoxic injury models. The cells were divided into normoxia group and hypoxia groups at 6, 12, 24 and 48 hours after cells were exposed to hypoxic conditions. Afterwards, the expression levels of NIX, microtubule-associated protein 1 light chain 3 (LC3), translocase of outer mitochondrial membrane 20 (TOMM20), and cyclooxegenase 4 (COX4) were determined by Western blot analysis. Electron microscopy was used to observe the formation of autophagosomes after 24 hours of hypoxia. The mitochondria-NIX-LC3-autophagosome complexes were detected by confocal microscopy after the overexpression of NIX for 48 hours. The interaction between NIX and LC3 was verified by Co-immunoprecipitation (CoIP). After downregulation of NIX, the changes in mitochondria morphology were detected by confocal microscopy. The PC12 cells were divided into normoxia group, normoxia+ NIXshRNA group, hypoxia group and hypoxia+ NIXshRNA group, then the expression levels of NIX, LC3, TOMM20 and COX4 in each group were detected via Western blotting. Results:Compared to normoxia group, hypoxia group showed up-regulated expressions of NIX and LC3 [(0.44±0.03)∶(0.21±0.01), (1.04±0.03)∶(0.32±0.01)], and down-regulated expressions of TOMM20 and COX4 [(0.78±0.07)∶(1.46±0.08), (0.52±0.04)∶(0.98±0.06)] after 24 hours of hypoxia ( P<0.05). Autophagosomes containing mitochondria were detected by electron microscopy after 24 hours of hypoxia. The formation of the mitochondria-NIX-LC3-autophagosome complex were detected by confocal microscopy after the overexpression of NIX for 48 hours. CoIP demonstrated an interaction between NIX and LC3. Furthermore, inhibition of NIX preserved the integrity of the mitochondria compared with hypoxia group. Western blot analysis showed decreased expressions of NIX and LC3 in hypoxia+ NIXshRNA group [(0.90±0.04)∶ (1.30±0.19), (0.55±0.03)∶(0.75±0.03)] and increased expressions of TOMM20 and COX4 [(0.78±0.06)∶( 0.69±0.08), (0.81±0.07)∶( 0.81±0.07) in comparison to hypoxia group ( P<0.05). Conclusions:NIX can interact with LC3 to mediate mitophagy in PC12 cells. Therefore, the inhibition of NIX can preserve the integrity of the mitochondria and decrease the level of mitophagy, thus provide a protective effect.

Objective:To investigate the risk factors of tracheotomy after cervical spinal cord injury (CSCI) and the predictive role of key muscle strength in guiding bedside tracheotomy.Methods:A retrospective case-control study was used to analyze the clinical data of 294 patients with CSCI admitted to Xinqiao Hospital of Army Medical University from January 2009 to December 2013, including 243 males and 51 females, with the age range of 10-82 years [(48.9±14.7)years]. A total of 52 patients treated with tracheotomy (tracheotomy group), while 242 patients did receive tracheotomy (non-tracheotomy group). The indices were collected and compared between groups, including demographic data (gender, age, smoking history, cause of injury), injury severity data [level of injury, combined injury, cervical dislocation, American Spinal Cord Injury Association (ASIA) classification], and key muscle function strength [shrug (trapezius), shoulder abduction (deltoid) and elbow flexion (biceps)]. The risk factors affecting the tracheotomy were identified by the univariate logistic regression analysis and binary logistic regression analysis. The independent risk factor for tracheostomy and predictive role of key muscle strength was determined by the multiple logistic regression analysis.Results:Smoking history, falling injury, cervical dislocation, C 2-C 4 AISA scale A, shoulder-shrugging muscle strength, shoulder abduction muscle strength and elbow flexion strength were significantly different between groups ( P<0.05). Through the binary logistic regression analysis, it was preliminarily concluded that smoking history, traffic injury, falling injury, cervical dislocation, C 2-C 4 AISA scale A, and C 5-C 8 AISA scale A were statistically significant between groups ( P<0.05). The multiple logistic regression analysis showed smoking history( OR=2.27), cervical dislocation( OR=3.70) and C 2-C 4 AISA scale A ( OR=8.31) were significantly related to tracheostomy ( P<0.05). The multiple logistic regression analysis showed shoulder-shrugging muscle strength grade 3 and below and shoulder abduction muscle strength grade 2 and below had significant correlations with CSCI patients who required tracheotomy ( P<0.05). Conclusions:C 2-C 4 AISA scale A, cervical dislocation and smoking history are independent risk factors for determining whether the CSCI patients require tracheostomy. Shoulder-shrugging muscle strength grade 3 and below and shoulder abduction muscle strength grade 2 and below can be used to differentiate the bedside tracheotomy.

Objective To investigate the clinical outcomes of extraperitoneal pelvic packing combined with temporary occlusion of abdominal aorta in treatment of pelvic fractures with hemodynamic instability.Methods A retrospective case series study was made on 14 patients with pelvic fractures with hemodynamic instability managed by extraperitoneal pelvic packing plus temporary occlusion of abdominal aorta between December 2006 and December 2013.There were ten males and four females,with mean age of 38.2 years old (range,18-63 years).The fractures were classified according to the Tile classification,including two patients with type B1,two with type B2.2,one with type C1.1,two with type C1.2,two with type C1.3,three with type C2,and two with type C3.In addition,10 patients were with closed pelvic fractures and four with open pelvic fractures.All patients were diagnosed as hypovolemic shock once they were admitted.Every patient was given anti-shock treatment,temporary occlusion of abdominal aorta,and extraperitoneal pelvic packing instantly,in order to control hemorrhage of pelvic fracture after they were admitted.The operation time,red blood cell transfusion volume,preoperative and postoperative blood pressures,heart rates as well as other relevant parameters concerning death and survival were recorded and compared.Postoperative infection and wound healing status were recorded as well.Results The operation time was 50-70 minutes (mean,61 minutes).After surgery,the length of ICU stay was (10.9 ± 9.8) days and hospital stay was (23.1 ± 14.9) days.Red blood cell transfusion volume before and after surgery was (17.7 ± 2.2)U and (8.4± 1.7)U,respectively (P ＜ 0.05).The parameters of systolic pressures varied from preoperative (63.6 ± 2.1) mmHg to postoperative (90.9 ± 1.1) mmHg,and the parameters of heart rates declined from preoperative (106.2 ± 5.9) beats/min to postoperative (94.0 ± 6.2) beats/min,(P ＜ 0.05).Ten patients were available for follow-up of 8-24 months (mean,11.5 months).There were four deaths (29％) postoperatively,among which three were died from multisystem and organ failure,and one from severe brain injury.There were statistically significant differences between the survivors and the deaths in terms of time from injury to operation,average systolic pressures,and average heart rates (P ＜ 0.05).None had complications and wound was well healed.Conclusion For pelvic fractures with hemodynamic instability,extraperitoneal pelvic packing plus temporary occlusion of abdominal aorta has advantages of short manipulation time and effective outcomes,which can control the hemorrhage of pelvic fracture and ameliorate the hemodynamic status.

Objective To investigate the feasibility and efficacy of transurethral prostate enucleation with 2 μm laser in the treatment of benign prostatic hyperplasia (BPH). Methods One hundred and seven patients with BPH were treated by transurethral prostate enucleation with 2 μm laser under continuous epidural anesthesia or laryngeal mask anesthesia. The patient′s, average age was 67±9 yrs (52 to 85 yrs). Of whom, 10 patients had a history of urinary retention. The mean prostate volume was 72.5±17.6 ml (45 to 158 ml). Two deep trenches were cut at the 5 and 7 o, clock position from the bladder neck to the verumontanum. The incision continued to the urethral mucosa and submucosa along with the verumontanum bilaterally in an arc-shape and ended at the internal arc of urethral sphincter. Then the urethral mucosa at the level of the verumontanum was cut and the surgical capsule plane was identified. A retrograde blunt dissection was made along the surgical capsule plane with the resectoscope sheath front-end, and the sheath was swung from side to side to extend the capsule plane. The significantly enlarged middle lobe was treated with laser vaporization resection. In the same way, a trench was made at the 12 o, clock position, and the lateral lobe were removed by the sheath from the verumontanum level, finally only two cord-like pedicles were kept at the 1 and 11 o, clock position at the bladder neck, so that the removed gland tissue was fixed and hung in the gland fossa. For prostate volume less than 60 ml, the laser vaporization resection was carried out directly. If the prostate volume was greater than 60ml, transurethral resection would be performed instead of laser vaporization resection. With 4% mannitol irrigation, the enucleated prostate tissue was then cut into small pieces and washed out by a Braun plastic bottle through the resectoscope sheath. Intraoperative bleeding, operative time, catheterization time, postoperative voiding status, maximum urinary flow rate (Qmax) and length of hospital stay were recorded and analyzed. Results All patients successfully completed the transurethral prostate enucleation. The average operative time was 74±12 min (45-150 min). Five cases required blood transfusion. There was no recorded urethral stricture and no urinary incontinence except for one patient who recovered 1 mon after the operation. The follow-up time was 2-6 mon. The average Qmax was 6.3±0.6 ml/s before and increased to 17.5±1.5 ml/s after the operation. The international prostate symptom score (IPSS) and quality of life (QOL) were reduced from 26.4±5.5 and 4.6±0.5 to 9.3±2.1 and 2.8±0.3 after the operation, respectively, P<0.01. Postoperative secondary bleeding was not observed. Conclusions Transurethral prostate enucleation with 2 μm laser for BPH is a safe and effective minimally invasive treatment. Its efficacy is superior to open surgery, and even better than TURP.

Objective To observe the blood biochemical and histological changes before and after pancreas freezing, to provide evidence for cryosurgery for pancreatic cancer. Methods Fifteen healthy pigs were divided into deep frozen group (n = 5), shallow frozen group (n = 5), non-frozen group (n = 3) and normal group (n = 2). After anesthesia and Iaparotomy, a probe of the Argon-Helium Surgical System was inserted into the pancreas, 100% and 10% argon output power were used in deep and shallow frozen group, respectively;and the temperature were - 130 ～ - 140℃ and - 110 ～ - 120℃, respectively;which results in an ice-ball with 15 ～ 20 mm in diameter. Then helium gas was inputted to increase the temperature to 10 ～ 20℃ for three minutes;then the whole process was repeated. A probe was inserted into the pancreas in the non-frozen group only and only laparotomy was performed in non-grozen group normal group and normal group. Serum amylase, IL-6, CRP levels before and after the experiment was determined;the pigs were sacrificed at day 7 and the pancreas was harvested for light microscope and electron microscope examination. Results The frozen pancreatic tissue became pitchy necrosis zone, and it could be distinguished from non-frozen tissue;there were obvious tissue necrosis in the center and para-center of frozen area, and the ultra-structure were destroyed and disappeared, mitochondria degranulation and rough endoplasmic reticulum degrannlation were observed. Serum amylase was elevated in 13 (86.7%) pigs and most returned to normal at 6th day. Serum IL-6 was slightly elevated in 5 (33.3%) pigs. There was no significant difference among all the groups in term of serum CRP. All the pigs were alive until the time of sacrifice. Conclusions Cryosurgery has affirmative fatal ablative effects on pancreatic tissue, and it is safe with no serious complications.