Genomic Characteristics and the Potential Clinical Implications in Oligometastatic Non–Small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Oligometastatic non–small cell lung cancer (NSCLC) patients have been increasingly regarded as a distinct group that could benefit from local treatment to achieve a better clinical outcome. However, current definitions of oligometastasis are solely numerical, which are imprecise because of ignoring the biological heterogeneity caused by genomic characteristics. Our study aimed to profile the molecular alterations of oligometastatic NSCLC and elucidate its potential difference from polymetastasis. @*Materials and Methods@#We performed next-generation sequencing to analyze tumors and paired peripheral blood from 77 oligometastatic and 21 polymetastatic NSCLC patients to reveal their genomic characteristics and assess the genetic heterogeneity. @*Results@#We found ERBB2, ALK, MLL4, PIK3CB, and TOP2A were mutated at a significantly lower frequency in oligometastasis compared with polymetastasis. EGFR and KEAP1 alterations were mutually exclusive in oligometastatic group. More importantly, oligometastasis has a unique significant enrichment of apoptosis signaling pathway. In contrast to polymetastasis, a highly enriched COSMIC signature 4 and a special mutational process, COSMIC signature 14, were observed in the oligometastatic cohort. According to OncoKB database, 74.03% of oligometastatic NSCLC patients harbored at least one actionable alteration. The median tumor mutation burden of oligometastasis was 5.00 mutations/Mb, which was significantly associated with smoking, DNA damage repair genes, TP53 mutation, SMARCA4 mutation, LRP1B mutation, ABL1 mutation. @*Conclusion@#Our results shall help redefine oligometastasis beyond simple lesion enumeration that will ultimately improve the selection of patients with real oligometastatic state and optimize personalized cancer therapy for oligometastatic NSCLC.

Genomic and Transcriptomic Characterization Revealed the High Sensitivity of Targeted Therapy and Immunotherapy in a Subset of Endometrial Stromal Sarcoma / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The unique chromosomal rearrangements of endometrial stromal sarcoma (ESS) make it possible to distinguish high-grade ESS (HGESS) and low-grade ESS (LGESS) from the molecular perspective. Analysis of ESS at the genomic and transcriptomic levels can help us achieve accurate diagnosis of ESS and provide potential therapy options for ESS patients. @*Materials and Methods@#A total of 36 ESS patients who conducted DNA- and/or RNA-based next-generation sequencing were retrospectively enrolled in this study. The molecular characteristics of ESS at genomic and transcriptomic levels, including mutational spectrum, fusion profiles, gene expression and pathway enrichment analysis and features about immune microenvironment were comprehensively explored. @*Results@#TP53 and DNMT3A mutations were the most frequent mutations. The classical fusions frequently found in HGESS (ZC3H7B-BCOR and NUTM2B-YWHAE) and LGESS (JAZF1-SUZ12) were detected in our cohort. CCND1 was significantly up-regulated in HGESS, while the expression of GPER1 and PGR encoding estrogen receptor (ER) and progesterone receptor (PR) did not differ significantly between HGESS and LGESS. Actionable mutations enriched in homologous recombination repair, cell cycle, and phosphoinositide 3-kinase/AKT/mammalian target of rapamycin pathways were detected in 60% of HGESS patients. Genes with up-regulated expression in HGESS were significantly enriched in five immune-related pathways. Most HGESS patients (85.7%) had positive predictors of immunotherapy efficacy. Moreover, immune microenvironment analysis showed that HGESS had relatively high immune infiltration. The degree of immune infiltration in HGESS patients with ZC3H7B-BCOR fusion was relatively higher than that of those with NUTM2B-YWHAE fusion. @*Conclusion@#This study investigated the molecular characteristics of ESS patients at the genomic and transcriptomic levels and revealed the potentially high sensitivity of targeted therapy and immunotherapy in a subset of HGESS with specific molecular features, providing a basis for guiding decision-making of treatment and the design of future clinical trials on precision therapy.

Effects of breast milk intake ratio during hospitalization on antibiotic therapy duration in preterm infants less than 34 gestational weeks: a multicenter retrospective cohort study / 中华围产医学杂志

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d<DOT≤15.0 d), Q 3 (15.0 d<DOT≤27.0 d) and Q 4 (DOT>27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%<breast milk intake ratio≤50%), medium-ratio breastfeeding group (50%<breast milk intake ratio≤75%) and high-ratio breastfeeding group (breast milk intake ratio>75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.

Investigation and analysis of appetite status in patients with lymphoma during chemotherapy / 白血病·淋巴瘤

Objective:To investigate the appetite of patients with lymphoma during chemotherapy and its influencing factors.Methods:A total of 103 patients with lymphoma who underwent chemotherapy were sequentially selected in Fujian Medical University Union Hospital from December 2020 to August 2021. The questionnaire survey was carried out by using general information and Karnofsky score was performed. Appetite score was calculated according to Chinese version of the appetite symptom questionnaire for cancer patients. Multiple linear regression analysis was used to analyze the influencing factors of appetite status of lymphoma patients during chemotherapy, and Pearson correlation analysis was used to explore the relationship between Karnofsky score and appetite score of patients.Results:For patients with lymphoma during chemotherapy, Karnofsky score was (75±18) scores and the appetite score was (25.0±5.0) scores. Univariate analysis showed that age, body mass index (BMI), nausea and vomiting, oral mucosa rupture, gum infection, fever, throat infection were influencing factors of appetite score of patients (all P < 0.05). Multivariate analysis showed that patients ' age ( B = -1.118, β = -0.187, P = 0.016), BMI ( B = -2.047, β = -0.271, P = 0.001), nausea and vomiting ( B = -4.352, β = -0.411, P < 0.001) were the independent influencing factors of appetite score. Correlation analysis showed that the Karnofsky score was positively correlated with appetite score ( r = 0.361, P < 0.05). Conclusions:Special attention should be paid to the appetite of elder lymphoma patients with lower BMI during chemotherapy, and nausea and vomiting should be paid more attention; targeted measures of increasing the patients' appetite could improve their nutritional level and prognosis.

Efficacy and safety evaluation of intra-articular injection of platelet rich plasma and hyaluronic acid in the treatment of knee osteoarthritis / 中华风湿病学杂志

Objective:To compare the clinical efficacy and safety of intra-articular injection of platelet rich plasma and hyaluronic acid in the treatment of knee osteoarthritis.Methods:The relevant literatures including the randomized control study of intra-articular injection of platelet rich plasma and hyaluronic acid in the treatment of knee osteoarthritis published from January 2010 to December 2021 were searched. The bias risk of the included literatures was evaluated by Revman 5.3 software, and the data were processed and analyzed by Stata 16.0 software. The weighted mean difference ( WMD) was calculated for the difference ofefficacy indexes, and the difference was compared by t-test. The odds ratio ( OR) was calculated for the difference of safety index, and the difference was compared by t-test. Results:① A total of 10 literatures were included, all of which were in English. ② A total of 921 patients were included in the study, of which 479 patients were treated with intra-articular injection of platelet rich plasma and 442 patients were treated with intra-articular injection of hyaluronic acid. ③ Comparing the VAS scores of platelet rich plasma injection and hyaluronic acid injection, the visual analogue scale (VAS) scores of platelet rich plasma injection patients were significantly lower than those of hyaluronic acid injection patients after 6 and 12 months of injection treatment, and the difference was statistically significant [ WMD(95% CI)=-0.66(-1.25, -0.77), P=0.029; WMD(95% CI)= -0.90(-1.51, -0.29), P=0.004]. ④ The specific performance was that the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score of patients injected with platelet rich plasma after 6 and 12 months of injection treatment was significantly lower than that of patients injected with hyaluronic acid [ WMD(95% CI)=-0.76(-1.06, 0.45), P<0.001; WMD(95% CI)=-1.35(-2.05, -0.65), P<0.01]; After 3, 6 and 12 months of injection treatment, the WOMAC stiffness score of patients injected with platelet rich plasma was significantly lower than that of patients injected with hyaluronic acid [( WMD(95% CI)=-0.37(-0.66, -0.08), P=0.011; WMD(95% CI)=-0.30(-0.57, -0.04), P=0.023; WMD(95% CI)=-0.62(-0.92, -0.33), P<0.001]; After 3, 6 and 12 months of injection treatment, the WOMAC function score of patients injected with platelet rich plasma was significantly lower than that of patients injected with hyaluronic acid [ WMD(95% CI)=-1.90 (-2.53, -1.27), P<0.001; WMD(95% CI)=-5.77(-9.20, -2.34), P=0.001; WMD(95% CI)=-5.72(-8.62, -2.82), P<0.001]. ⑤There was no significant difference in the incidence of adverse events between the two intra-articular injection methods [ OR(95% CI)=1.28(0.68, 2.42), P=0.440]. Conclusion:Compared with intra-articular injection of hyaluronic acid, the short-term clinical efficacy of injection of platelet rich plasma is equivalent to that of injection of hyaluronic acid, but the long-term clinical efficacy is better, and the safety of the two methods is similiar.

Efficacy and safety of curcumin in the treatment of knee osteoarthritis: a systematic review / 中华风湿病学杂志

Objective:To analyze the efficacy and safety of curcumin in the treatment of knee osteoarthritis.Methods:The randomized controlled trials of curcumin in the treatment of knee osteoarthritis published from January 2011 to August 2021 were retrieved. The bias risk of the included literatures was evaluated by Revman 5.3 software, and the efficacy related indexes and the incidence of adverse events were analyzed by Stata 16.0 software. The weighted mean difference ( WMD) was calculated for the difference of efficacy indexes, the odds ratio ( OR) was calculated for the difference of safety indexes, the difference was compared by t test. Results:① A total of 9 relevant literatures were included, all of which were in English. ② A total of 724 patients were included in the study, of which 383 were treated with curcumin capsules and 341 were treated with placebo. ③ The visual analogue scale/score (VAS) of patients treated with oral curcumin at 3-4, 6 and 8 weeks were significantly lower than those of patients treated with oral placebo, the differences were statistically significant [weighted mean difference ( WMD)=-1.09, 95% CI (-1.44, -0.73), P<0.001; WMD=-1.52, 95% CI (-2.35, -0.69), P<0.001; WMD=-1.20, 95% CI(-1.71, -0.69), P<0.001]. ④ The western Ontario and McMaster universities osteoarthritis index (WOMAC) scores of patients treated with oral curcumin for 3-4 and 6-8 weeks were significantly lower than those of patients treated with oral placebo, and the differences were statistically significant [ WMD=-7.96, 95% CI(-14.89, -1.04), P=0.020; WMD=-15.34, 95% CI(-20.51, -10.18), P<0.001]. Specifically, the WOMAC pain and stiffness scores of patients treated with oral curcumin for 6-8 weeks were significantly lower than those of patients treated with oral placebo, and the differences were statistically significant [ WMD=-2.16, 95% CI(-3.69, -0.63), P=0.010; WMD=-1.00, 95% CI (-1.54, -0.46), P<0.001]. The WOMAC joint function scores of patients treated with oral curcumin for 3-4 and 6-8 weeks were significantly lower than those of patients treated with oral placebo, the difference was statistically significant [ WMD=-3.21, 95% CI(-4.51, -1.92), P<0.001; WMD=-7.07, 95% CI(-11.19, -2.94), P<0.001]. ⑤ There was no significant difference in the incidence of adverse events between oral curcumin and placebo [ OR=1.19, 95% P(0.74, 1.90), P=0.478]. Conclusion:Compared with placebo, oral curcumin can significantly alleviate the pain, stiffness and joint function of patients with knee osteoarthritis, and its safety is similar to placebo.

The effect of high flow humidification oxygen inhalation on hypoxemia in patients undergoing cardiac surgery and the effect of postoperative weaning time / 中国实用护理杂志

Objective:To study the effect of high flow humidification oxygen inhalation on hypoxemia in patients undergoing cardiac surgery and the effect of postoperative weaning time.Methods:A total of 80 patients with hypoxemia after cardiac surgery from January 2018 to January 2020 were selected for the study, according to the random number table, they were divided into the observation group and the control group, 40 cases each.The control group was treated with noninvasive positive pressure ventilation, while the observation group was treated with high flow humidification and oxygen absorption. The weaning time, the changes of the arterial oxygen partial pressure (PaO 2), partial pressure of carbon dioxide (PaCO 2), oxygenation index (PaO 2/FiO 2), pH value, spontaneous breathing frequency (RR), heart rate before and after treatment 2 h, 6 h, 24 h, and the incidence of complications were compared between the two groups. Results:The weaning time in the observation group was (35.51±4.61) h, and that in the control group was (44.04±3.85) h, the difference was statistically significant( t value was 8.982, P<0.01). The PaO 2 in the observation group at 2, 6, 24 h after treatment were (73.96±4.32), (79.82±3.61), (94.82±2.71) mmHg(1 mmHg=0.133 kPa), and those in the control group were (70.72±3.10), (75.63±3.88), (90.27±3.55) mmHg, the differences were statistically significant( t values were 3.854, 5.000, 6.443, P<0.01). The PaO 2/FiO 2 in the observation group at 2, 6, 24 h after treatment were (239.45±18.74), (269.85±20.09), (291.83±17.30) mmHg, and those in the control group were (226.74±20.72), (251.12±16.74), (279.65±19.40) mmHg, the differences were statistically significant( t values were 2.877, 4.530, 2.964, P<0.01). The RR in the observation group at 2, 6, 24 h after treatment were (24.74±2.03), (22.61±1.86), (18.63±2.05) times/min, and those in the control group were (26.07±1.89), (24.24±1.73), (20.11±1.87) times/min, the differences were statistically significant( t values were 3.033, 4.058, 3.373, P<0.01). The heart rate in the observation group at 2, 6, 24 h after treatment were (83.32±4.88), (76.06±4.71), (70.34±3.82) times/min, and those in the control group were (86.06±3.29), (80.91±4.31), (75.71±6.22) times/min, the differences were statistically significant( t values were 2.944, 4.805, 4.653, P<0.01). The total incidence of complications in the observation group was 7.50%(3/40), and that in the control group was 25.00%(10/40), the difference was statistically significant( χ 2 value was 4.501, P<0.05). Conclusions:High flow humidification and oxygen absorption is well for patients with hypoxemia after cardiac surgery, which effectively improve the blood gas index, shorten the weaning time, reduce the incidence of complications, and have good safety, which is worth popularizing.

CD7 expression and its prognostic significance in acute myeloid leukemia patients with wild-type or mutant CEBPA / 中华血液学杂志

Objective@#To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7+ in AML patients with wild-type (WT) or mutant-type (MT) CEBPA.@*Methods@#The clinical data of 298 newly diagnosed non-M3 AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7+ and CD7- patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7+ group by Kaplan-Meier method.@*Results@#In CD7+ group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7- group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7+ group comparing to those of CD7- group in AML patients with wild type CEBPA. There were no statistical difference between CD7+ group and CD7- group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7+ group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7+-CEBPA MT group, CD7- and CD7+-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) .@*Conclusion@#The CEBPA mutation rate was higher in CD7+ AML patients then that of CD7- patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.

Comparison of diagnostic efficacy of fine needle aspirate cytology, fine needle aspirate-thyroglobulin and BRAF gene in cervical metastatic lymph nodes of papillary thyroid carcinoma / 中国医学影像技术

Objective: To compare the diagnostic efficacy of fine needle aspirate cytology (FNAC), fine needle aspirate-thyroglobulin (FNA-Tg) and BRAF genetic testing in diagnosis of suspected cervical metastatic lymph nodes of PTC. Methods: A retrospective analysis was performed on 95 patients who received modified radical thyroidectomy and confirmed as PTC by pathology. Totally 118 suspected cervical metastatic lymph nodes found with ultrasound examination before or after modified radical thyroidectomy were all detected with FNAC, FNA-Tg and BRAF genetic testing. Taken postoperative pathology as gold standard, the sensitivity specificity, positive predictive value, negative predictive value and accuracy of three methods were obtained, and ROC curves were constructed to compare the diagnostic efficacy of three methods. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC was 63.95% (55/86), 100% (32/32), 100% (55/55), 50.79% (32/63) and 73.73% (87/118), respectively, of FNA-Tg was 91.86% (79/86), 100% (32/32), 100% (79/79), 82.05% (32/39) and 94.07% (111/118), respectively, while of BRAF genetic testing was 80.23% (69/86), 100% (32/32), 100% (69/69), 65.31% (32/49), 85.59% (101/118), respectively. AUC of FNAC, FNA-Tg and BRAF genetic testing was 0.820, 0.991 and 0.874, respectively. The differences of AUC between FNAC and FNA-Tg, BRAF genetic testing and FNA-Tg were statistically significant (P<0.001), whereas between FNAC and BRAF genetic testing was not statistically significant (P=0.099). Conclusion: FNA-Tg is more effective than FNAC and BRAF genetic testing in diagnosis of cervical suspected lymph node metastasis of PTC.

Organ Donation from Factors to Explore the Effect of Soft Culture System / 中国医学伦理学

Objectives:To find out factors that influence the public's organ donation willingness,and explore the effect on organ donation of soft culture system.Methods:We conducted a survey towards people from typical cities and counties of Zhejiang Province by using self-made questionnaire.We adopt some data processing methods such like entropy weight method.Results:Factors like education,age,traditional concept all can affect the degree of organ donation willingness.Soft culture system has favorable social effects.It is directive in reality.Conclusions:In the humanistic perspective,the construction of organ-donation soft culture system plays an obvious role in improving the degree of social organ donation willingness.It includes education training,humanitarian assistance model radiation,and incentive method.

X-linked dominant protoporphyria:report of a pedigree and detection of ALAS2 gene mutations / 中华皮肤科杂志

Objective To report a pedigree with X?linked dominant protoporphyria(XLDPP), and to detect 5?aminolevulinic acid synthetase 2(ALAS2)gene mutations in this pedigree. Methods A clinical investigation was performed in a pedigree with XLDPP, and relevant data were collected from family members. A next?generation sequencing method was applied to screen possible mutation sites, and Sanger sequencing was performed to determine pathogenic gene mutations. Dermoscopy was conducted to observe skin lesions in the patients with XLDPP, and the Fotofinder system and very high frequency (VHF) ultrasound system were utilized to assess the severity of photodamage. Liver and gallbladder ultrasonography as well as blood examination were performed for all the family members. Results A deletion mutation, c.1706?1709ΔAGTG, was detected in the ALAS2 gene on the X chromosomes of all the patients in this family, which led to replacement or loss of 19-20 C?terminal residues through transcriptional frameshifting, and eventually caused an increase in ALAS2 activity. In the patients with XLDPP, skin photodamage was relatively severe;protoporphyrin?induced hepatobiliary damage was observed and aggravated with age;anemia and iron deficiency occurred sometimes. Conclusion The deletion mutation c.1706?1709ΔAGTG of the ALAS2 gene may be the underlying cause of XLDPP in this pedigree.

Vaginal tightening surgery by strengthening the pelvic floor support / 中华医学美学美容杂志

Objective To explore the related pelvic floor anatomy to the pathological vaginal relaxation and key points of the vaginal tightening surgery.Methods The vaginal tightening surgery was performed in 24 cases of vaginal relaxation.The key points of this operation included levator ani muscle suturation and perineal body reconstruction,and anal sphincter reconstruction as in case of the muscle injury grade Ⅲ.Results The degree of levator ani muscle separation was positively correlated with that of vaginal relaxation in all the 24 cases.18 cases were followed up from 6 months to 2 years,and had no complications of rectovaginal fistula and infections.The average level of perineal body was increased from 2.3 cm to 3.5 cm.Vaginal length of 6 cm from vaginal orifice was proper with good tightness.The patients felt strong anal contraction,enhanced ability of vaginal tightening and improved quality of sex life.There were no more infections of genitourinary tract.Conclusions Through levator ani muscle suturation and perineal body reconstruction,it can get the vaginal tightening effect.

Overexpressing 3-ketosteroid-Δ1-dehydrogenase for degrading phytosterols into androst-1,4-diene-3,17-dione / 生物工程学报

We constructed plasmid pMTac to overexpress 3-ketosteroid-Δ1-dehydrogenase (KSDD) in Mycobacterium neoaurum JC-12 for improving androst-1,4-diene-3,17-dione (ADD) production. To construct pMTac, pACE promoter on pMF41 was replaced by tac promoter, and then four recombinants were constructed, which were M. neoaurum JC-12/pMF41-gfp, M. neoaurum JC-12/pMTac-gfp, M. neoaurum JC-12/pMF41-ksdd and M. neoaurum JC-12/pMTac-ksdd. Fluorescence detection results show that much more green fluorescent protein (GFP) was expressed in M. neoaurum JC-12/pMTac-ksdd than M. neoaurum JC-12/pMF41-ksdd. The activity of KSDD was 2.41 U/mg in M. neoaurum JC-12/pMTac-ksdd, 6.53-fold as that of M. neoaurum JC-12 and 4.36-fold as that of M. neoaurum JC-12/pMF41-ksdd. In shake flask fermentation, ADD production of M. neoaurum JC-12/pMTac-ksdd was 5.94 g/L, increased about 22.2% compared to the original strain M. neoaurum JC-12 and 12.7% to M. neoaurum JC-12/pMF41-ksdd. AD (4-androstene-3,17-dione) production of JC-12/pMTac-ksdd was 0.17 g/L, decreased 81.5% compared to M. neoaurum JC-12 and 71.2% to M neoaurum JC-12/pMF41-ksdd. In the 5 L fermenter, 20 g/L phytosterols was used as substrate, ADD production of M. neoaurum JC-12/pMTac-ksdd was improved to 10.28 g/L. pMTac is favorable for expressing KSDD in M. neoaurum JC-12, and overexpression of KSDD has beneficial effect on ADD producing, and it is the highest level ever reported using fermentation method in M. neoaurum.

Rapid Analysis of Volatile Fatty Acids in Feces by Headspace Gas Chromatography Tandem Mass Spectrometry / 分析化学

A rapid headspace gas chromatography tandem mass spectrometric ( HS-GC/MS ) method was established for the analysis of volatile fatty acids ( VFAs ) in the feces. Feces were suspended by 6%phosphoric acid aqueous solution (1:2 m/V) and sealed in the headspace bottle for HS-GC/MS analysis. The HS-GC/MS method was optimized as follows: agitator temperature ( temp. ):80 ℃, syringe temp.:80 ℃, sample incubation time: 30 min, injection: 1 mL without split-flow. The chromatographic separation was performed on a DB-FFAP capillary column (30m×0. 25 mm×0. 25 μm) with injection port temp.:250 ℃. The temperature program ( initial temp. at 50 ℃ within first 1 min, and raised to 200 ℃ by 10 ℃/min) was employed by fixing the flow of carrier gas (high purity helium) at 1. 0 mL/min. The electron energy at -70 eV for electron impact ( EI ) ionization, ion source temp.: 250 ℃, transfer line temp.:280 ℃, the voltage of electron multiplier at 0. 95 kV. The spectra were recorded in the range of m/z 33-200 for full scan. The established HS-GC/MS method could be applied to analyze VGAs in the feces from human and rat appropriately. There are nine VFAs identified in the feces from human, and eight VFAs detected in the feces from rat by retrieving the NIST library, comparing with the standards and analyzing the MS data. Furthermore, the relative percentage contents of acetic acid, propionic acid and butyric acid accounted for roughly 85% of all VFAs by area normalization. The method is simple and sensitive, and it can be used to rapidly detect VFAs in the feces from human and rat.

Atticotomy with canaloplasty and tympanoplasty for limited epitympanic cholesteatoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the surgical results of atticotomy with canalopalsty and tympanoplasty for limited cholesteatoma.@*METHOD@#Thirty-one cases of limited epitympanic cholesteatoma and retraction pocket received atticotomy. The surgical procedure consisted of eliminating cholesteatoma and pocket, reconstructing lateral epitympanic wall and tympanoplasty with cartilage/perichondrium island flap.@*RESULT@#The anatomic pattern of external ear canal appeared near normal, and the hearing level improved or remained normal during 2-year follow up except for 2 cases with tympanosclerosis. No epitympanic retraction pocket or cholesteatoma relapsed. 1 case appeared tympanic perforation.@*CONCLUSION@#Atticotomy, contemporaneous reconstruction of lateral epitympanic wall and tympanoplasty with cartilage/perichondrium, indicated to be a reliable treatment and prevention technique for epitympanic cholesteatoma. It can achieve good morphological and functional results.

Study on relation between the fetal abdominal great vessels anormalities and heterotaxy / 中华超声影像学杂志

Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases (0.7%) of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant( P＜ 0.001). The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ (P＜0.001). There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant (P＜ 0.001). Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.

Study on relationship between the abnormalities in the area behind the heart and fetal defects / 中华超声影像学杂志

Objective To investigate the relationship between the abnormalities in the area behind the heart in the four-chamber view and fetal defects, the clinical significance of assessment of area behind the heart in fetal screening.Methods 7062 fetuses were scanned.Area behind the heart in the four-chamber view and anatomical survey were detected.Results Fifty-three cases (0.8％, 53/7062) with abnormal sonographic findings in the area behind the heart in the four-chamber view were detected prenatally.Thirtyseven cases were confirmed by autopsy postnatally.Among these cases, 73.0％ (27/37) had heterotaxy syndrome,8.1％(3/37) had situs inversus totalis,18.9％ (7/37) had heart defects.Conclusions There is close relationship between the abnormalities in the area behind the heart and the fetal defects.This can be used as an effective and simple indicator in screening situs inversus and cardiovascular abnomalities.