Lung cancer is one of the malignant tumors with the highest mortality and the fastest growing incidence,which seriously threatens human life and health.With the popularization of low-dose spiral CT and the enhancement of public awareness of physical examination,more and more ground-glass nodules have been detected.Accumulating studies have shown that for patients with nodules diameter≤2 cm and ground-glass opacity≥50% ,under the condition of ensuring the cutting edge,thoracoscopic sublobectomy or subsegmentectomy can more effectively preserve the lung function of patients,and has gradually become the recommended surgical method.In recent years,with the continuous improvement of thoracoscopic surgery technology,thoracoscopic subsegmentectomy and combined subsegmentectomy have been gradually carried out.Compared with lobectomy and segmentectomy,subsegmental resection can retain more normal lung tissue and reduce the loss of lung function under the condition of ensuring the safe cutting edge.However,thoracoscopic subsegmental resection requires a higher level of surgical technique and anatomical knowledge for the operator,and is rarely reported in relevant literature.Therefore,this article reviews the progress of anatomical subsegmentectomy and combined subsegmentectomy in the treatment of early non-small cell lung cancer.

Primary liver cancer (PLC) is one of the most common malignant tumors with characteristics of strong invasiveness and poor prognosis. The morbidity and mortality of PLC rank among the top malignant tumors in the world. More than half of the world′s liver cancer occurs in China, which seriously threatens the health and life of Chinese people. Due to the imperceptible initial symptoms, most patients are not diagnosed until their tumors have progressed to be in advanced stage, and lose the chance for curative hepatectomy. At present, non-surgical treatment options, including interventional embolization, ablation, radiotherapy, chemotherapy, and systemic chemotherapy, play an increasingly prominent role in the comprehensive treatment of liver cancer. The authors briefly review the current status and research progress of the non-surgical treatment for liver cancer.

Objective:To investigate the effect of optimizing perioperative measures on reducing postoperative gastric emptying disorder in gastrointestinal reconstruction after pancreaticoduodenectomy.Methods:The clinical data of 146 patients who underwent pancreaticoduodenectomy from Jan 2019 to Dec 2020 at the Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital ,Anhui Medical University were analyzed retrospectively. Among them, 78 cases underwent traditional Billroth Ⅱ gastrojejunal anastomosis for gastrointestinal reconstruction, and 68 cases in the improvement group took optimization measures. The time to first postoperative flatus, time to oral intake, postoperative hospital stay and complications were observed.Results:The operation time in the control group was (351.4±71.6) min, less than that in the improved group (368.8±97.6) min, while the time [(9.9±6.5)d vs. (7.6±6.0)d] to first oral take and postoperative hospital stay [(20.7±8.6)d vs. (17.9±7.0)d] were significantly longer than those in the improved group. The incidence of postoperative gastric emptying disorder (19.2% vs. 7.4%) was significantly higher than that in the improved group ( P<0.05). There was no significant difference in postoperative time to first flatus and postoperative gastrointestinal bleeding between the two groups (all P>0.05). Conclusions:The measures of optimizing gastrointestinal reconstruction in the perioperative period of pancreaticoduodenectomy have obvious advantages in reducing gastric emptying disorder, promoting the recovery of gastrointestinal function and shortening the length of hospital stay.

OBJECTIVE: To investigate the effect of thoraco-laparoscopic esophagectomy on postoperative immune function of patients with esophageal carcinoma. METHODS: Eighty-one patients undergoing radical esophagectomy in our hospital between January, 2017 and December, 2019 were enrolled in this study.According to the surgical approach, the patients were divided into endoscopic group (41 cases) and open surgery (3 incisions) group (40 cases).The immunological indicators (CD3 RESULTS: No death occurred in either of the group after the operation.On days 4 and 7 after the operation, CD3 CONCLUSIONS Thoraco-laparoscopic resection of esophageal cancer can reduce postoperative secretion of proinflammatory factors, alleviate inflammatory responses, and promote the recovery of immune functions to accelerate postoperative recovery of the patients.
Carcinoma, Squamous Cell/surgery* ; Esophageal Neoplasms/surgery* ; Esophagectomy ; Humans ; Laparoscopy ; Postoperative Complications ; Postoperative Period

Objective: To evaluate the immunogenicity and safety of concomitant administration of 23-valent pneumococcal polysaccharide vaccine (PPV23) and trivalent influenza vaccine (TIV) in preschoolers. Methods: A total of 1 035 children aged 3-7 years were enrolled in this study and randomly divided into three groups, inoculated PPV23, TIV and both, respectively. A one-year follow-up study was conducted for immunogenicity and safety analysis. Results: A total of 1 035 serological specimens were collected, including 327 in PPV23 group, 348 in TIV group and 360 in concomitant vaccination group. No significant differences in geometric mean concentrations (GMC) of seven pneumococcal serotypes were observed between the PPV23 group and the concomitant vaccination group. Compared with the TIV group, the concomitant vaccination group showed higher serological conversion rate of H3 type (88.75% vs 84.20%, P=0.01), but lower serological conversion rate of B type (92.84% vs 98.56%, P<0.001). There was no significant difference in the primary adverse reactions between the three groups (P=0.197). The rate of secondary adverse reactions occurred in the concomitant vaccination group was 3.61%, which was higher than that of the other two groups (both P<0.001). All adverse reactions were mild or moderate, and cured after treatment. Conclusions Concomitant immunization with PPV23 and TIV is safe and have good immunogenicity, thus a viable immune strategy for susceptible children.

Objective To investigate the clinical characteristics,early diagnosis,and rational treatments of traumatic renal artery thrombosis or other traumatic emboli.Methods We summarized the clinical data of 10 patients with traumatic renal artery thrombosis or other traumatic emboli.Results Six of ten patients had left renal artery thrombosis,while four of the ten patients had right renal artery thrombosis.Ultrasonography reported a reduced blood flow signal in one patient,and then renal artery embolism was confirmed by enhanced CT.The other nine patients were directly definitely diagnosed as renal artery embolism by enhanced CT.Four patients were treated with low molecular weight heparin calcium,in whom the CT follow-up showed no obvious blood reperfusion in injured kidneys,but the renal function was in normal range.Renal hypertension occurred in two patients,and one of them received nephrectomy because of poorly controlled hypertension with medication.Conclusions Clinical symptoms,signs and laboratory examinations show no specific findings for diagnosis of traumatic renal artery thrombosis.The color Doppler ultrasound is a preliminary screening method for,and an enhanced CT scan is an effective method for,diagnosis of renal artery thrombosis.The early recovery of renal blood circulation is an evidence of effective treatment.Major concerns are supposed to focus on renal function and blood pressure during followup.

Objective To evaluate the effectiveness and safety of varicella attenuated live vaccine ( VarV) produced by A Co. Ltd. Methods We selected 3 provinces in China and enrolled 15 002 children aged 3-<11 in this random, multicenter study. Participants were randomly divided into two groups: the ex-perimental group and the control group. Every varicella case was collected and recorded to calculate the vac-cine efficacy. Vaccine safety was assessed by means of spontaneous report and regular follow-up visits. Re-sults During the observation period, the incidence of varicella was 0. 147% in the experimental group and 1. 155% in the control group (P<0. 001). The vaccine efficacy was 87. 27%. The adverse reaction rate af-ter vaccination was lower than the rates reported in other literatures. Conclusion The VarV produced by A Co. , Ltd. in China was effective and safe in preventing varicella.

BACKGROUND/AIMS: Previous studies reported that integrated information in the brain ultimately determines the subjective experience of patients with chronic pain, but how the information is integrated in the brain connectome of functional dyspepsia (FD) patients remains largely unclear. The study aimed to quantify the topological changes of the brain network in FD patients. METHODS: Small-world properties, network efficiency and nodal centrality were utilized to measure the changes in topological architecture in 25 FD patients and 25 healthy controls based on functional magnetic resonance imaging. Pearson's correlation assessed the relationship of each topological property with clinical symptoms. RESULTS: FD patients showed an increase of clustering coefficients and local efficiency relative to controls from the perspective of a whole network as well as elevated nodal centrality in the right orbital part of the inferior frontal gyrus, left anterior cingulate gyrus and left hippocampus, and decreased nodal centrality in the right posterior cingulate gyrus, left cuneus, right putamen, left middle occipital gyrus and right inferior occipital gyrus. Moreover, the centrality in the anterior cingulate gyrus was significantly associated with symptom severity and duration in FD patients. Nevertheless, the inclusion of anxiety and depression scores as covariates erased the group differences in nodal centralities in the orbital part of the inferior frontal gyrus and hippocampus. CONCLUSIONS: The results suggest topological disruption of the functional brain networks in FD patients, presumably in response to disturbances of sensory information integrated with emotion, memory, pain modulation, and selective attention in patients.
Anxiety ; Brain* ; Chronic Pain ; Connectome ; Depression ; Dyspepsia* ; Gyrus Cinguli ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Memory ; Orbit ; Putamen

Deficient activity of endo-1,4-beta-glucanase II (Cel5A) secreted by Trichoderma reesei is one of the challenges involved in effective cellulase saccharification of cellulosic substrates. Therefore, we expressed Cel5A in Pichia pastoris by constructing a recombinant strain. With the gene optimization based on codon bias, and the construction of expression vector pPIC9K-eg2, the optimized gene was electro-transformed into P. pastoris GS115 to form transformants. Then, a high Cel5A activity producing recombinant, namely P. pastoris GS115-EG Ⅱ, was selected on G-418 resistant plates, followed by shake-flask cultivation. Enzyme characterization showed that the recombinant Cel5A reacted optimally at pH 4.5 and 60 ℃, with 50 kDa of molecular weight, preferentially degrading amorphous cellulose. Recombinant Cel5A was not significantly different from the native T. reesei Cel5A. Moreover, a shake-flask fermentation of the recombinant strain was optimized as below: incubation temperature 28 ℃, initial pH 5.0, inoculum volume 2%, methanol addition (per 24 h) 1.5% (V/V), sorbitol addition (per 24 h) 4 g/L and Tween 80 4 g/L. Under above optimized condition, the recombinant produced 24.0 U/mL of the Cel5A after 192 h fermentation. When incubated in a 5 L fermentation, Cel5A enzyme activity reached 270.9 U/mL at 180 h, with 4.16 g/L of the total protein. The study indicates that the recombinant strain P. pastoris GS115-EG Ⅱ is extremely suitable for heterologous expression of T. reesei cellulase Cel5A. And the recombinant Cel5A can be used as an alternative to the native T. reesei Cel5A in development of a commercially relevant enzyme based biorefinery process.

The expensive production of bioethanol is because it has not yet reached the 'THREE-HIGH' (High-titer, high-conversion and high-productivity) technical levels of starchy ethanol production. To cope with it, it is necessary to implement a high-gravity mash bioethanol production (HMBP), in which sugar hydrolysates are thick and fermentation-inhibitive compounds are negligible. In this work, HMBP from an atmospheric glycerol autocatalytic organosolv pretreated wheat straw was carried out with different fermentation strategies. Under an optimized condition (15% substrate concentration, 10 g/L (NH4)2SO4, 30 FPU/g dry matter, 10% (V/V) inoculum ratio), HMBP was at 31.2 g/L with a shaking simultaneous saccharification and fermentation (SSF) at 37 degrees C for 72 h, and achieved with a conversion of 73% and a productivity of 0.43 g/(L x h). Further by a semi-SFF with pre-hydrolysis time of 24 h, HMBP reached 33.7 g/L, the conversion and productivity of which was 79% and 0.47 g/(L x h), respectively. During the SSF and semi-SSF, more than 90% of the cellulose in both substrates were hydrolyzed into fermentable sugars. Finally, a fed-batch semi-SFF was developed with an initial substrate concentration of 15%, in which dried substrate (= the weight of the initial substrate) was divided into three portions and added into the conical flask once each 8 h during the first 24 h. HMBP achieved at 51.2 g/L for 72 h with a high productivity of 0.71 g/(L x h) while a low cellulose conversion of 62%. Interestingly, the fermentation inhibitive compound was mainly acetic acid, less than 3.0 g/L, and there were no other inhibitors detected, commonly furfural and hydroxymethyl furfural existing in the slurry. The data indicate that the lignocellulosic substrate subjected to the atmospheric glycerol autocatalytic organosolv pretreatment is very applicable for HMBP. The fed-batch semi-SFF is effective and desirable to realize an HMBP.
Biofuels ; Carbohydrates ; chemistry ; Cellulose ; chemistry ; Ethanol ; metabolism ; Fermentation ; Furaldehyde ; chemistry ; Glycerol ; chemistry ; Hydrolysis ; Triticum