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ObjectiveTo systematically review the efficacy and safety of laparoscopic choledochoscopy combined with holmium laser lithotripsy through a meta－analysis. MethodsThis study was conducted based on PRISMA guidelines， with a PROSPERO registration number of CRD42023406221. Chinese databases including CNKI， Wanfang Data， and VIP and foreign language databases such as PubMed， Embase， the Cochrane Library， and Web of Science were searched for original articles on traditional laparotomy versus laparoscopic choledochoscopy combined with holmium laser lithotripsy in the treatment of bile duct stones. Dichotomous variables were assessed by odds ratio （OR） and 95% confidence interval （CI）， while continuous variables were assessed by weighted mean difference （WMD） and 95%CI， and a sensitivity analysis was performed for outcome measures with relatively high heterogeneity. The Begg test and Egger test were used to evaluate publication bias. Stata 15.0 and Review Manager 5.3 were used to perform the statistical analysis. ResultsA total of 26 retrospective studies from China were included in this study， with 2 238 patients in total. The meta－analysis showed that compared with traditional laparotomy for the treatment of bile duct stones， laparoscopic choledochoscopy combined with holmium laser lithotripsy had significantly shorter time of operation （WMD＝－1.26， 95%CI： －1.36 to －1.16， P<0.001）， length of hospital stay （WMD＝－1.93， 95%CI： －2.64 to －1.12， P <0.001）， and time to bowel function recovery （WMD＝－1.52， 95%CI： －1.68 to －1.35， P<0.001）， significantly less intraoperative blood loss （WMD＝－1.79， 95%CI： －1.93 to －1.66， P<0.001）， a significantly lower rate of intraoperative residual stone （OR＝0.15， 95%CI： 0.11－0.20， P<0.001）， and significantly fewer complications （OR＝0.17， 95%CI： 0.13－0.23， P<0.001）. ConclusionCompared with traditional laparotomy， laparoscopic choledochoscopy combined with holmium laser lithotripsy shows better efficacy in the treatment of bile duct stones.
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Objective:To explore the feasibility of using pulse oxygen saturation (SpO 2) to evaluate the condition of patients with acute respiratory distress syndrome (ARDS) in the Lijiang region. Methods:Patients with ARDS who visited the department of emergency of People's Hospital of Lijiang from August to December 2020 were selected as study subjects. Patients were divided by severity into mild ARDS group [200 mmHg (1mmHg = 0.133 kPa)≤oxygenation index (PaO 2/FiO 2, P/F)≤300 mmHg] and moderate to severe ARDS group (P/F≤200 mmHg). The general condition, clinical diagnosis, arterial blood gas analysis results of the patients were recorded, and the differences of the above indexes between the two groups of ARDS were compared. Spearman correlation analysis was used to analyze the correlation between SpO 2 and arterial oxygen saturation (SaO 2). SpO 2 was carried into the Ellis equation and the Rice equation to calculate the derived P/F and analyze the correlation between the derived P/F and the P/F measured in arterial blood gas analysis; receiver operator characteristic curve (ROC curves) were plotted, the sensitivity and specificity of SpO 2/fraction of inspiration oxygen (SpO 2/FiO 2, S/F) instead of P/F to assess oxygenation in patients with ARDS was calculated. To evaluate the feasibility of SpO 2 for the condition evaluation of patients with ARDS in the Lijiang region. Results:Compared with the mild ARDS group, the arterial partial pressure of oxygen (PaO 2), SaO 2 and hemoglobin (Hb) were significantly decreased in the moderate to severe ARDS group [PaO 2 (mmHg): 50.5 (39.3, 56.5) vs. 60.0 (55.0, 67.5), SaO 2: 0.86 (0.73, 0.91) vs. 0. 93 (0.90, 0.96), Hb (g/L): 142±27 vs. 156±24, respectively, all P < 0.05]. Correlation analysis revealed a significant positive correlation between SpO 2 and SaO 2 in ARDS patients residing at high altitude ( R = 0.650, P = 0.000). The P/F derived by the Rice formula was significantly and positively correlated with the P/F derived from arterial blood gas analysis ( R = 0.802, P = 0.000). The deduced P/F in mild and moderate to severe ARDS groups were all significantly correlated with the measured P/F ( R values were 0.562, 0.647, both P = 0.000). The P/F derived using the Ellis formula showed a significant positive correlation with the P/F derived from arterial blood gas analysis ( R = 0.822, P = 0.000). The deduced P/F of mild ARDS group and moderate to severe ARDS group were all positively correlated with the measured P/F ( R values were 0.556, 0.589, P values were 0.000, 0.010). There was a significant positive correlation between S/F and P/F in ARDS patients ( R = 0.828, P = 0.000), and the regression equation was S/F = 1.33 P/F+52.41. ROC curve analysis showed that S/F had some predictive value for patients with mild and moderate to severe ARDS, and area under ROC curve (AUC) and 95% confidence interval (95% CI) were 0.903 (0.829-0.977), 0.936 (0.870-1.000), both P = 0.000. When the cut-off value was 452 mmHg, S/F had a sensitivity of 100% and a specificity of 80.9% for predicting mild ARDS. When the cut-off value was 319 mmHg, S/F predicted moderate to severe ARDS with 95.1% sensitivity and 86.2% specificity. Conclusions:At high altitude, SpO 2 and SaO 2 have been correlated in patients with ARDS, and P/F derived using SpO 2 and measured P/F were significantly correlated in patients with ARDS, especially in those with moderate to severe ARDS. SpO 2 may be useful in the assessment of severity of illness in patients with ARDS at high altitude.
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Purpose To investigate the expression level and the role of TUSC7 in human cutaneous malignant melanoma (CMM).Methods Quantitative real time-PCR (qRT-PCR) assay was performed to detect the expression of TUSC7 in 60 cases of CMM tissues,20 cases of benign nevus,4 CMM cell lines,and one normal human epidermal melanocytes.Then overexpression of TUSC7 was performed and its role in tumor progression was explored.Results TUSC7 expression was significantly downregulated in primary CMM tissues (n =60) compared to benign nevi (n =20),which were significantly downregulated in all the four melanoma cell lines,especially in A375 cells,compared with the normal melanocytes cells (all P ＜ 0.05).In comparison with the A375 cells transfected with the empty plasmid,those transfected with pcDNA-TUSC7 showed an obvious decrease in the proliferation and colony formation activity,while increase in the apoptosis rate (all P ＜ 0.05).Conclusion Our results suggested that the dysregulation of TUSC7 may play an important role in the CMM progression.
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Objective To explore the effects of two-dimensional code on nursing instruments management.Methods Information regarding nursing instruments were edited and corresponding two-dimensional codes were generated which would be pasted on both the instruments and the registration book,and nurses were notified about the twodimensional codes.The effects of the application of two-dimensional code were assessed among 145 nurses using questionnaires,and 40 nurses were evaluated for theoretical and operational skills of the instrument.Results After applying two-dimensional code in management of nursing instruments,nurses' scores for utilizing,maintenance,addressing malfunction,storage and counting were higher than previous management method for instruments(P＜0.05),and the performance of theoretical and operational skills of 40 nurses were increased significantly(P＜0.05).Conclusion Two-dimensional code provides valuable benefits for information storage,instrument tracking,etc.,shows great convenience and efficiency to nursing instruments management,and helps to improve nurses' application skills of instruments.
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Objective To assess the activation of PI3K-AKT-mTOR signal pathway in Burkitt lymphoma.Methods The phosphorylation levels of AKT,mTOR and RPS6 were detected in the tissue sections by immunohistochemistry in 13 cases of Burkitt lymphomas and 14 cases of reactive hyperplasia of lymph nodes.Results The phosphorylation rates of AKT,mTOR and RPS6 were higher in Burkitt lymphoma than those in reactive hyperplasia of lymph nodes [84.6 ％(11/13) vs 64.2 ％(9/14),100.0 ％(13/13) vs 71.4 ％ (10/14),100.0 ％ (13/13) vs 78.6 ％ (11/14),all P ＜0.05].Conclusion PI3K-AKT-mTOR pathway is abnormally activated in Burkitt lymphoma.
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Objective To explore the clinicopathological features,immunohistochemical characteristics of gastrointestinal anaplastic large cell lymphoma (ALCL).Methods Clinical manifestations,histology and immunophenotype of three cases diagnosed with gastrointestinal ALCL were analyzed with the review of related literatures.Results The clinical manifestations of gastrointestinal ALCL were of no characteristical changes.The pathological features were pleomorphic in which some bizarre,horseshoed or kidney-shaped nuclei were seen.The characteristic of one of the three cases was shown as sarcomatoid.All cases expressed LCA,CD3,CD4,CDs,CD45Ro,CD30,two out of three cases expressed ALK protein,otherwise they were negative for B cell related antigens,CD15 and muscle,nerve,epithelium originated antigens.Conclusions ALCL of the gastrointestinal tract is extremely rare as one of the lymphatic hematopoietic system tumors.No definite clinical characteristic is seen in the gastrointestinal ALCL with high grade malignancy.It is easily misdiagnosed as carcinomas or other sarcomas.It is necessary to use biopsy to make a pathological diagnosis.
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Ethylene is the most widely used petrochemical feedstock globally. The development of bio-ethylene is essential due to limited fossil fuels and rising oil prices. Bio-ethylene is produced primarily by the dehydration of ethanol, but can alternatively be directly produced from ethylene biosynthesis pathways in plants, algae, or microorganisms by using cheap and renewable substrates. This review addressed the biosynthesis of ethylene in plants and microorganisms, the characterization of key enzymes, genetic engineering strategies for ethylene biosynthesis in microorganisms, and evaluated its perspective and successful cases toward the industrial application. The direct production of bio-ethylene from a biological process in situ is promising to supplement and even replace the petrochemical ethylene production.
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Ethylenes , Industrial Microbiology , Methods , Metabolic Engineering , Methods , Plants , Genetics , Metabolism , Saccharomyces cerevisiae , Metabolism , Synechocystis , Genetics , Metabolism , Trichoderma , MetabolismABSTRACT
Objective To analyze the distribution of T lymphocyte subsets in tumor microenvironment of papillary thyroid carcinoma (PTC). Methods The levels of CD3+ CD4+ CD8- ,CD3+ CD4- CD8+ ,CD3+ CD4+ CD8+ ,CD3+ CD4- CD8- T cell and CD4+/CD8+ ra- tio in tumor microenvironment of 35 cases PTC, 25 cases benign thyroid lesion and 15 healthy eases were detected by flow cytometry. Results Local tumor tissue of 35 cases PTC and 25 cases benign thyroid lesion, and blood of 15 healthy cases were collected. The ratio of CD4+/ CD8+ in blood, tumor microenvironment of benign thyroid lesions and PTCs decreased significantly ( P<0.01). The levels of CD3+ CD4+ CD8+ cell in tumor microenvironment of PTC and benign thyroid lesion were higher than that in peripheral blood( P<0.01). But the differ- ence of the level of CD3+ CD4+ CD8+ cell between PTC and benign thyroid lesion was not significant ( P>0.05). The levels of CD3+ CD4- CD8- cell in tumor microenvironment of benign thyroid lesion were higher than those in PTC and peripheral blood(P<0.01). The difference of the level of CD3+ CD4- CD8- cell between PTC and peripheral blood was not significant (P>0.05 ). The differences of CD4+/CD8+ ratio and the level of each of T lymphocyte subset such as CD3+ CD4+ CD8-, CD3+ CD4- CD8+, CD3+ CD4+ CD8+, CD3+ CD4- CD8- cell between 15 PTC cases with lymph node metastasis and 20 PTC cases without metastasis were not significant (P>0.05). Conclusions CD8+ T cell is the main immune cell in tumor microenvironment in PTC. The local cell-mediated immunity of PTC is in the status of obviously suppressed. But the obvious increase of CD3+ CD4+ CD8+ and CD3+ CD4- CD8- T cells in tumor microenvironment in thyroid benign lesion may be beneficial for creating the location for immune responding against tumor. The distribution of T lymphocyte sub- sets in tumor microenvironment in PTC is not associated with lymph node metastasis.
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0.05).Conclusions The local cell-mediated immunity of PTC is in the status of obviously suppressed.But the local impaired immune response against carcinoma is not associated with lymph node metastasis of PTC.
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Objective To study the expression of human platelet factor 4 (hPF4)mRNA and its relationship with angiogenesis and lymph node metastasis in papillary throid carcinoma(PTC). Methods RT-PCR was used to detect the expression of hPF4 mRNA in 40 cases of PTC and 10 cases of normal tissue surrounding carcinoma. Immunohistochemical stain was performed to detect microvessel density(MVD) whose endothelia were marked by antibody CD105. Results The positive-expression rate of hPF4 mRNA was 80 % respectively in normal tissue surrounding carcinoma. The positive-expression rate of hPF4 was 47.5 % in PTC cases. The MVD value of PTC cases with hPF4 mRNA positive expression was significantly lower than that of cases without hPF4 mRNA expression (P
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Objective To study the expression of thrombospondin(TSP) mRNA and its relationship with angiogenesis and lymph node metastasis in papillary thyroid carcinoma(PTC).Methods RT-PCT was utilized to detect the expression of TSP1 and TSP2 mRNA in 40 cases of PTC and 10 cases of normal tissue surrounding carcinoma.Immunohistochemical stain was performed to detect microvessel density(MVD) whose endothelia were marked by anti-CD105 McAb.Results The positive-expression rate of TSP1 mRNA,TSP2 mRNA was 80.0%,90.0% respectively in normal tissue surrounding carcinoma.The positive-expression rate of TSPI mRNA was 45.0%.The positive-expression rate of TSP2 mRNA was 47.5%.The MVD value of PTC cases with TSP1 and TSP2 mRNA positive expression was significantly lower than that of cases without TSP1 and TSP2 mRNA expression(P
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College of Stomatology of Wuhan University was the first dental school who introduced the Kavo head-simulator for clinical teaching.In this study,students of stomatology were investigated before and after head-simulator training and questionares were made.The results have showed that head-simulator teaching system not only raises the activity of student,consolidates the basic knowledge,develops the clinical thinking ability,but also increases the ability of clinical operational skill before clinical training.
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<p><b>OBJECTIVE</b>To make a thorough study on the clinicopathologic significance of the three-dimensional structural alteration of the p53 protein in papillary thyroid carcinomas and to provide an objective criterion for the evaluation of PTC prognosis.</p><p><b>METHODS</b>A total of 41 PTC cases were enrolled. Techniques including polymerase chain reaction with single strand conformational polymorphism (PCR-SSCP), DNA sequencing, computerized three-dimensional protein modeling by means of international shared resources and related software analysis were used.</p><p><b>RESULTS</b>15 cases with p53 gene mutation defined as Group I were detected in totally 41 PTC cases. No p53 gene mutation was found in the rest 26 cases which were classified as Group II. The differences in lymph node metastatic rate, distant metastatic rate, age, sex, size of the lesion between Group I and Group II were not significant (P > 0.05). The alterations of the amino acid residues of 9 PTC cases out of the 15 p53-gene mutated patients (Group I) were either located in the p53-protein domains, mainly the core domain and the non-specific DNA binding basic domain, or the severely defect cases with the formation of widely divergent structures. It was found that the alterations of the structure of the core domain could directly check the binding of p53 protein to its target DNA molecules. In addition, the alterations of the structure of the basic domain could indirectly prohibit the binding. The ones mentioned above were classified as Group Ib. The rest of six cases with their p53 protein amino acid residues mutated beyond the domains were grouped as Group Ia. The differences in lymph node metastatic rate, distant metastatic rate between Group Ib and Group Ia were statistically significant (P < 0.01, P < 0.05) respectively.</p><p><b>CONCLUSIONS</b>The alterations of the three-dimensional structure of p53-protein is considered as one of the morphological basis of the progression and heterogeneity of PTC. They render an authentic evidence for the selection of the clinical cases with a poor risk for metastasis.</p>
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Humans , Lymph Nodes , Metabolism , Mutation , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , Tumor Suppressor Protein p53 , MetabolismABSTRACT
The structure, karyotype and behavior of synaptonemal complex (SC) in the spermatocytes of hedgehog (Erinaceus euroaaus dealbatus (insectivora)) were analyzed by light and electron microscopy with a modified surface spread preparation which involves the use of sodium dodecyl-sulphate (SDS) and silver staining. The lateral elements of the synaptonemal complex have a constant width of about 50 nm, the distance between the two lateral elements is about 100 nm. The relative length and arm rationale constant for each autosomal SC. The relative length and arm ratio constant for ea of the autosomal SCs are very similar to that of mitotic autosome.The X and Y chromosome axes have a clear morphological distinction from the autosomal SC. The axes of X and Y chromosome pair and form a SC of certain length at pachytene stage. The axes of unpaired X and Y chromosome are heteropycnotic and display various morphological complexities. But these differentiations in hedgehog are primary than in other mammalians, such as human and mice. At pachytene stage the X and Y chromosome display an extensive side-by-side pairing segment with decreasing length as meiotic prophase progressed.