The cyclic GMP-AMP synthase(cGAS)-stimulator of interferon genes signaling pathway plays a central role in cells'ability to sense the presence of abnormal double-stranded DNA within the cytoplasm.Modulation of the function of the cytoplasmic DNA recognition receptor cGAS allows regulation of this signaling pathway.In recent years,research has identified protein post-translational modifications(PTMs),including phosphorylation,acetylation,ubiquitination,methylation,and SUMOylation,as having significant roles in regulating innate immune signaling pathways.This paper reviews how PTMs influence the function of cGAS and its downstream signaling pathways through various mechanisms.

Objective:To evaluate the application of layered harvesting technique for thin anterolateral thigh flap (ALTF) based on preoperative perforator mapping by colour Doppler ultrasound (CDU) and digital subtraction angiography (DSA).Methods:From April 2023 to November 2023, 13 patients (14 flaps) with forearm and hand wounds. were treated in the Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, In this study, they were 8 males and 5 females; aged from 19 to 58 years old, with a mean of 37 years old. Body Mass Index (BMI) was 17.30 - 31.87 kg/m 2 with an average of 23.64 kg/m 2. The flap area was 9 cm×6 cm-20 cm×13 cm; the flap thickness was 4-6 mm with an average of 5.2 mm. Before surgery, CDU was applied to determine the entrance of the perforator vessel and made skin marking. DSA technology was further used to relocate the position of the perforator vessel and the branches of the superficial fascia layer at the flap tangential position. Based on the precise perforator positioning, the thin ALTF was harvested between the deep and superficial layers of the superficial fascia. Regular outpatient follow-ups were conducted after surgery. Results:The 14 flaps had 1 to 2 perforators and 2 to 4 superficial fascia branches, and the preoperative positioning coincided with the intraoperative perforator entrance, and the distance was less than 1 cm. All patients were included in the follow-up from 1 to 7 months with a mean of 3.2 months. Only 1 patient had the complication delayed healing at the donor site. All flaps survived successfully and had a good appearance without secondary trimming.Conclusion:Preoperative CDU and DSA accurately locate the entrance of the perforator and the distribution of superficial fascial branches, and the layered harvesting technique for thin ALTF, effectively reduces the difficulty at harvesting of the thin flap and reduces damage to the donor site.

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.

Objective:To validate the role of color Doppler ultrasound in an animal model to detect early heterotopic ossification (HO) after brain-traumatic/burn/tenotomy.Methods:Forty-four rats were randomly divided into two groups. Rats in experimental group ( n=22) were operated to build brain-traumatic/burn/tenotomy model and others in control group ( n=22) underwent only skin incision injury. Color Doppler ultrasound, X-ray film examination at 2, 3, 4, 6, 8 and 10 weeks post-injury were performed to follow up the progression of HO in both groups respectively. Histology was used to confirm bone formation. Results:In the experimental group, disorder structure with a hypoechoiccore in treated Achilles tendon was visualized using color Doppler ultrasound in the 2nd week. Additional tiny hyperechoic foci were observed in the 3rd week, which increased in the fourth week and fused into a mineralized island in the sixth week. No obvious abnormality was found in control group at the aforementioned time point. X-ray could detect heterotopic bone tissue in the sixth week in the experimental group but not in the control group. X-ray and HE stainning had confirmed bone formation in the tenth week in the experimental group.Conclusions:Color Doppler ultrasound can detect early HO and continuously follow up the progression of HO.

[Abstract] Objective: To investigate the effect of alantolactone (ALT) on proliferation, migration, invasion and apoptosis of human osteosarcoma 143B cells and the underlying mechanism. Methods: Osteosarcoma 143B cells were treated with different concentrations of ALT (0, 4, 6, 8, 10 µmol/L). Then, the cell proliferation ability was detected by crystal violet staining and MTT assay, cell migration was determined by Wound-healing test, cell invasion was analyzed by Transwell assay and cell apoptosis rate was detected by Hoechst33258 staining. The mRNA and protein expressions of E-cadherin, N-cadherin, caspase-3, cleaved caspase-3 (c-caspase-3), poly ADP-ribose polymerase (PARP) and cleaved PARP (c-PARP) in 143B cells were detected by qPCR and Western blotting (WB), respectively. TCF/LEF (T cell lymphocyte factor/lymphoid enhancer factor) transcriptional activity was examined with Luciferase reporter gene assay. The mRNA and protein expressions of β-catenin as well as MMP-7 and c-Myc were detected by qPCR and WB, respectively. Results: ALT inhibited proliferation, migration and invasion of osteosarcoma143B cells and promoted apoptosis(P<0.05or P<0.01). After the treatment with ALT at 8, 10 µmol/L, the mRNA and protein expressions of E-cadherin and PARP, as well as the protein expressions of c-caspase-3 and c-PARP were up-regulated, while the mRNA and protein expressions of N-cadherin were downregulated (P<0.05 or P<0.01);At the sametime, theTCF/LEF transcriptional activity and the mRNA and protein expressions of β-catenin, MMP-7 and c-Myc were significantly down-regulated (P<0.05 or P<0.01). Conclusion:ALT may inhibit the proliferation, migration and invasion and promote cell apoptosis possibly through suppressing Wnt/β-catenin signaling pathway in osteosarcoma 143B cells.

Background Neovascular glaucoma (NVG) often occurs secondary to ocular ischemic diseases.Intravitreal injection of bevacizumab or ranibizumab as an adjunct therapy or NVG is safe and efficient.However,the efficacy of intravitreal injection of conbercept for NVG is still under exploration.Objective This study was to evaluate the efficacy and safety of intravitreal conbercept combined with trabeculectomy and panretinal photocoagulation for NVG.Methods A prospective,interventional case series study was performed.Twenty-six patients (27 eyes) who were diagnosed with NVG in Tianjin Eye Hospital were included.Twenty-five eyes were initially injected with conbercept into vitreous,then trabeculectomy and panretinal photocoagulation were performed,the best corrected visual acuity (LogMAR),intraocular pressure and treatment-related indexes were examined before and after treatment,the intraoperative and postoperative complications were evaluated.Light microscopy and transmission electron microscopy were used to observe the surgically excised trabecular tissue.Enucleation was performed on 2 eyes,and the surgically excised tissue was taken as the histopathological controls.Results At six monthes after surgery,the intraocular pressure of the 25 patients with intravitreal injection of conbercept were decreased from (48.8 ± 10.2) mmHg to (18.0±4.3) mmHg,the number of anti-glaucoma medications were decreased from 3.0 (3.0,4.0) to 0.0 (0.0,1.0) (both at P＜0.05).Best corrected visual acuity (LogMAR) was increased from 2.0± 0.9 to 1.5 ± 1.4 (P＞0.05).Twenty-one eyes displayed controlled intraocular pressure (≤ 21 mmHg) after treatment.Regression of neovasculariztion in the surface of iris and thin-walled vessels in the iris stroma in specimens with intravitreal injection of conbercept were revealed by light microscopy.New vessels decreased,endothelial cell degeneration and vascular occlusion or cavity in the iris stroma in the conbercept-treatment specimens were revealed by transmission electron microscopy.Conclusions A comprehensive therapy for NVG can regress iris neovascularization,reduce postoperative complication,effectively control intraocular pressure and preserve visual function by intravitreal injection of conbercept,anti-glaucoma surgery and panretinal photocoagulation.

Objective To compare the outcome of combined and staged approach on concomitant carotid and coronary severe stenosis.Methods From March 2013 to May 2015,27 patients with concomitant carotid and coronary severe stenosis were treated by carotid endarterectomy and coronary artery bypass grafting,15 cases received one-stage operation and 12 staged.The basic characteristics,details during surgery,complications,quality of life score,hospital stay and cost were compared.Results 27 patients received carotid endarterectomy and off-pump coronary artery bypass grafting under general anesthesia.Revascularization were performed on 27 carotid and 82 coronary artery.The characteristics of patients were similar between two groups,reflected with WIC,combined approach subgroup was (5.27 ± 0.88) and staged subgroup was (4.92 ± 1.24).The operation time was significantly decreased in the synchronous group [(295.33 ± 49.73)min vs (390.83 ± 73.45) min,P ＜ 0.001].Hospital stay days was also reduced [(30.20 ± 12.91) days vs(44.67 ± 6.34) days,P =0.002],the medical cost was lower in combined approach group,but no significant statistical difference.The complications including 1 case TIA,1 recurrent nerve injury in one-stage group and 1 case myocardial infarction,1 mediastinal bleeding post-operation and 1 pulmonary infection in stage group.No cerebral infarction and death.Quality of life scores(SF-36) of the two groups was 5.53 ± 1.30 and 5.75 ± 1.36 respectively,no significant difference.Conclusion The efficacy and safety of treatment for concomitant carotid and coronary severe stenosis patients with combined or staged approach was similar.But the combined approach program can reduce the hospital stay time and cost in some degree.

Objective: To clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients survived more than 10 years after radical hepatectomy. Methods: Two hundreds and fifty-two patients who underwent curative resection for HCC between January 1999 and March 2006 at Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qingdao University were included.There were 217 male cases and 35 female cases aging from 17 to 82 years with median age of (53.8±10.5)years. Followed by March 31 2016, clinicopathologic factors in 10-year survivors and patients who died within 10 years were compared by χ² test, Kaplan-Meier survival analysis and Cox proportional hazards model and the prognostic factors affecting survival were identified. Results: All patients were followed-up for 4.0 to 205.7 months with median time of 53.4 months. The 10-year overall survival rate was 26%, there were 62 cases(26.2%) who survived for more than 10 years after initial hepatectomy. In survival >10-year group, the paitents with ALT<40 U/L, gamma-glutamyl transpeptidase<64 U/L, albumin≥35 g/L, without liver cirrhosis and portal hypertension, Child-Pugh grade A, no blood transfusion, AFP≤20 μg/L, tumor size ≤5.0 cm, single tumor, high differentiation, TNM stage Ⅰ and TACE negative after resection were more than the patients in survival <10-year group (P<0.05). In multivariate analysis, Child-Pugh grade A, the tumor size ≤5.0 cm and TACE negative after resection were favorable independent factors associated with 10-year survival (P<0.05). Conclusion Based on the results of the study, Child-Pugh grade A, tumor size ≤5.0 cm and TACE negative after resection at initial hepatectomy might be biologically favorable conditions for patients surviving more than 10 years.

OBJECTIVETo understand the molecular characteristics of a dengue virus outbreak in China-Myanmar border region, Yunnan province, 2015 and provide etiological evidence for the disease control and prevention.

METHODSSemi-nested RTPCR was conducted to detect the capsid premembrane (CprM) gene of RNA of dengue virus by using dengue virus NS1 positive serum samples collected in Mengdin township, Gengma county, Yunnan province in July, 2015. Some positive samples were then detected by using PCR with specific primers to amplify the full E gene. The positive PCR products were directly sequenced. Then sequences generated in this study were BLAST in NCBI website and aligned in Megalign in DNAstar program. Multiple sequence alignments were carried out by using Mega 5.05 software based on the sequences generated in this study and sequences downloaded from GenBank, including the representative strains from different countries and regions. Phylogenetic trees were constructed by using Neighbor-Joining tree methods with Mega 5.05 software.

RESULTSTwenty one of 25 local cases and 10 of 14 imported cases from Myanmar were positive for DENV-1. Eight serum samples were negative for dengue virus. A total of 13 strains with E gene (1485 bp), including 8 local strains and 5 imported strains, were sequenced, which shared 100% nucleotide sequence identities. Twelve strains with CprM gene (406 bp) from 9 local cases and 3 imported cases shared 100% nucleotide sequence identities. Phylogenetic analyses based on E gene showed that the new 13 strains clustered in genotype I of dengue virus and formed a distinct lineage.

CONCLUSIONSThis outbreak was caused by genotype I of DENV-1, which had the closest phylogenetic relationships with dengue virus from neighboring Burma area. Comprehensive measures of prevention and control of dengue fever should be strengthened to prevent the spread of dengue virus.

Capsid Proteins ; China ; epidemiology ; DNA Primers ; Databases, Nucleic Acid ; Dengue ; epidemiology ; virology ; Dengue Virus ; genetics ; Disease Outbreaks ; Genotype ; Humans ; Myanmar ; epidemiology ; Phylogeny ; Polymerase Chain Reaction ; Sequence Alignment ; Software

Aim To determine the effective compo-nents of Semen Ziziphi Spinosae for sedative-hypnotic and its mechanism. Methods The extraction of Se-men Ziziphi Spinosae and the rat brain homogenates were prepared. High concentrations of Diazepam com-petitively replaced the ligand compounds of Semen Ziz-iphi Spinosae combining BDZ receptor in brain tissue, and all the compounds with sedative and hypnotic effects were collected and identified by HPLC and LC-MS technique, as the compounds extracted from the brain tissue were administered with Semen Ziziphi Spi-nosae. The brain tissue was administered with Diaze-pam, and with Semen Ziziphi Spinosae and Diazepam. Results The HPLC chromatograms show that the peak time of BDZ receptor ligand compounds was 2. 71 min and 46. 87min, when compared with Diazepam. And the LC-MS chromatograms display the relative molecu-lar weight of the ligand compounds was 274. 28 m/z, 453. 34 m/z,496. 34 m/z and 608. 38 m/z respective-ly. According to the fingerprint of Semen Ziziphi Spi-nosae, these compounds may be fatty acid substances and lupine pill triterpene compounds. Conclusions On the basis of the principle of receptor ligand bind-ing, we established a way to quickly analyze and iden-tify the role of natural products in the same drug target compounds. The method not only can clearly define the effective components of natural products, but also clar-ify the mechanism of action of the compounds. The ac-tive ingredient of calm hypnosis in Semen Ziziphi Spi-nosae may be fatty acid substances Palmitic acid ( C16 H32 O2 ) and lupine pill triterpene compounds Alphitolic acid( C30 H48 O4 ) and Spinosin( C28 H32 O15 ) . They exert their sedative and hypnotic effects by combining with BDZ receptor, and the research has laid a theoretical foundation for the further study about mechanism of Se-men Ziziphi Spinosae.