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@#Abstract: Objective To analyze the epidemic characteristics of hand, foot and mouth disease (HFMD) in Nanping City, Fujian province and to provide the basis for formulating effective prevention and control measures as well as evaluating the efficacy of prevention and treatment. Methods Descriptive epidemiological method was used to analyze the incidence data of HFMD in Nanping City from 2012 to 2021. Results A total of 49 231 cases of HFMD were reported in Nanping City from 2012 to 2021. The incidence fluctuated greatly over the 10-year period, ranging from 76.10/100 000 to 308.93/100 000, with an average incidence of 184.99/100 000 per year. The overall incidence and the number of cases showed a fluctuating downward trend over time, but the incidence was high in the next year, and there were statistically significant differences in the incidence rates between different years(χ2=8 169.176, P<0.001). There were significant regional differences in the incidence, the top three average annual incidence rates were: Guanze County (370.76/100 000), Zhenghe County (295.31/100 000) and Wuyishan City (250.31/100 000). There were two peaks of HFMD incidence each year, with the first occurring in May and June and the second occurring in September and October. The incidence rate was higher among males (215.86/100 000) than females (152.93/100 000), and males were more susceptible than females (RR=1.412, 95%CI=1.387-1.438). The cases were mainly aged 0-4 years, accounting for 86.25% (42 461/49 231) of all cases, and the incidence rate gradually decreased with increasing age (χ2trend=570,105.801, P<0.001). The majority of cases (85.22%, 41 953/49 231) occurred in children living in scattered areas, followed by children in kindergartens (12.39%, 6 101/49 231). The etiological results showed a total of 3 476 laboratory-confirmed cases, and the proportion of three (classes) of enterovirus positivity varied each year, with different pathogen compositions showing statistical significance (χ2=584.613, P<0.001). In addition to the years 2015-2017, during which Cox A16 and EV71 were the dominant strains, other years were dominated by other enteroviruses, with EV71 being the main type in severe and fatal cases of HFMD in Nanping City. Conclusion Nanping City should strengthen health education for children living in the diaspora and in day-care centers, enhance surveillance of epidemics and pathogenology, improve vaccination rates against EV71, focus on the detection and typing of other enteroviruses, and implement effective prevention and control measures for HFMD.
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@#Objective To analyze the perioperative outcome of consecutive 1 000 patients undergoing robotic lung resection and summarize surgical experience. Methods We retrospectively reviewed the clinical data of 1 000 patients undergoing robotic lung resection between May 2009 and June 2018 in Shanghai Lung Tumor Clinical Medical Center. Robotic lobectomy was compared with traditional VATS over the same period using a propensity-matched analysis. There were 327 males and 673 females at average age of 56.21±11.33 years. Lobectomy was performed in 866 patients (11 bilobectomy included), sublobar resection was performed in 129 patients, sleeve lobectomy was performed in the remaining 5 patients. Pathology was as follows: adenocarcinoma in 875 patients, squamous carcinoma in 52 patients, benign tumors in 73 patients. 90.5% of the primary lung cancer were in stage Ⅰ. Results The mean operative time was 90.31±19.70 min; 95.70% of patients’ estimated blood loss was less than 100 ml. Conversion rate to thoracotomy was 0.90% (9 patients) . The average lymph node station and count harvested was 5.59±1.36 and 9.60±3.21 respectively. The mean volume of chest tube drainage on the first postoperative day was 229.19±131.67 ml. Median chest tube time was 3.85±1.43 d. There was 1 in-hospital death due to pulmonary embolism. A total of 189 patients had postoperative complications (18.90%) whose majority was postoperative air leak more than 5 days. The mean overall hospital costs was 92 710.53±12 367.23 Yuan. Compared with VATS, RATS was associated with significant reduction in intraoperative blood loss, time to chest tube removal and postoperative hospital stay. The operative time, conversion rate, lymph nodes removed, morbidity and mortality were similar between the two groups. Conclusion Robotic-assisted lung resection is safe and effective with low conversion rate and less complications, and it can overcome many disadvantages of traditional VATS.
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@#Objective To investigate the perioperative outcome of robot-assisted pulmonary lobectomy in treating pathological stage Ⅰ non-small cell lung cancer (NSCLC). Methods We retrospectively analyzed the clinical data of 333 consecutive p-T1 NSCLC patients who underwent robotic-assisted pulmonary lobectomy in our hospital between May 2013 and April 2016. There were 231 females (69.4%) and 102 males (30.6%) aged from 20–76 (55.01±10.46) years. Cancer was located in the left upper lobectomy in 37 (11.1%) patients, left lower lobectomy in 71 (21.3%) patients, right upper lobectomy in 105 (31.5%) patients, right middle lobectomy in 32 (9.6%) patients, right lower lobectomy in 88 (26.4%) patients. Adenocarcinoma was confirmed in 330 (99.1%) patients and squamous cell cancer was confirmed in 3 (0.9%) patients. Results Total operative time was 46–300 (91.51±30.80) min. Estimated intraoperative blood loss was 0–100 ml in 319 patients (95.8%), 101–400 ml in 12 patients (3.6%), >400 ml in 2 patients (0.6%). Four patients were converted to thoracotomy, including 2 patients due to pulmonary artery branch bleeding and 2 due to pleural adhesion.No patient died within 30 days after surgery. And no perioperative blood transfusion occurred. Postoperative day 1 drain was 0–960 (231.39±141.87) ml. Chest drain time was 2–12 (3.96±1.52) d. And no patient was discharged with chest tube. Length of hospital stay after surgery was 2–12 (4.96±1.51) d. Persistent air leak was in 12 patients over 7 days. No readmission happened within 30 days. All patients underwent lymph node sampling or dissection with 2–9 (5.69±1.46) groups and 3–21 (9.80±3.43) lymph nodes harvested. Total intraoperative cost was 60 389.66–134 401.65 (93 809.23±13 371.26) yuan. Conclusion Robot-assisted pulmonary lobectomy is safe and effective in treating p-Stage Ⅰ NSCLC, and could be an important supplement to conventional VATS. Regarding to cost, it is relatively more expensive compared with conventional VATS. RATS will be widely used and make a great change in pulmonary surgery with the progressive development of surgical robot.
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Lysophosphatidyl acyltransferase (LPAT) is the important enzyme responsible for the acylation of lysophosphatidic acid (LPA), leading to the generation of phosphatidic acid (PA) in plant. Its encoding gene is an essential candidate for oil crops to improve oil composition and increase seed oil content through genetic engineering. In this study, a fulllength AhLPAT4 gene was isolated via cDNA library screening and rapid amplification of cDNA ends (RACE); our data demonstrated that AhLPAT4 had 1631 nucleotides, encoding a putative 43.8 kDa protein with 383 amino acid residues. The deduced protein included a conserved acyltransferase domain and four motifs (I–IV) with putative LPA and acyl-CoA catalytic and binding sites. Bioinformatic analysis indicated that AhLPAT4 contained four transmembrane domains (TMDs), localized to the endoplasmic reticulum (ER) membrane; detailed analysis indicated that motif I and motifs II–III in AhLPAT4 were separated by the third TMD, which located on cytosolic and ER luminal side respectively, and hydrophobic residues on the surface of AhLPAT4 protein fold to form a hydrophobic tunnel to accommodate the acyl chain. Subcellular localization analysis confirmed that AhLPAT4 was a cytoplasm protein. Phylogenetic analysis revealed that AhLPAT4 had a high homology (63.7–78.3%) with putative LPAT4 proteins from Glycine max, Arabidopsis thaliana and Ricinus communis. AhLPAT4 was ubiquitously expressed in diverse tissues except in flower, which is almost undetectable. The expression analysis in different developmental stages in peanut seeds indicated that AhLPAT4 did not coincide with oil accumulation.
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Introduction: Impact Factor is a proxy for the significance of a journal in its field. This study aims to examine the perceptions of Impact Factor and journal reading preferences among gastrointestinal researchers. Methods: A world wide online survey was conducted among 764 gastrointestinal researchers in 2004. Basic characteristics, job nature and number of publications were reported. Moreover, opinions towards the applications of Impact Factor, reading preferences of gastrointestinal and general medical journals were assessed. Results: Majority of the respondents believed that Impact Factor could reflect the journal quality (68.1%) and should be a major factor in selecting journals for publications (78.6%). Only about 40% of them agreed that use of Impact Factor should be extended to appraisals of institutes, departments, and faculty members. North American and European researchers tended to read the journals in their own regions. Gastrointestinal and general medical journals with relative higher Impact Factor were the most popular and highly ranked. Conclusions: In general, assessment of journal quality was a more acceptable application of Impact Factor than other uses to gastrointestinal researchers. Reading preferences of both general medical and specialty journals may be related to the geographic locations of the readers and the Impact Factor values.
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The genotype of Orientia tsutsugamushi DNA from mites in the Xisa archipelago of China were identified. A natural focus of tsutsugamushi disease in the archipelago was found. The DNA sequence that codes for the 56 kDa protein of O. tsutsugamushi was amplified by nested polymerase chain reaction (N-PCR). The purified positive products were cloned into a pGEM-T vector and sequenced. The DNA sequence was compared with various sequences on the internet for sequence homology. A 507 bp DNA fragment encoding the 56 kDa protein was amplified from the samples. The sequence homology was 85% (Karp strain), 68% (Gilliam strain), 65% (Kato strain), and 67% (Yonchon strain). Orientia tsutsugamushi is carried by the mites of the Xisa archipelago; the main genotype is the Karp strain.