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[Objective] In the inaugural switching operation between Pipelines Q1 and Q2, which were originally used for heated and normaltemperature transmission of crude oil respectively in China, the approach of “transformation while operation” was employed, posing challenges such as complex process flows, demanding engineering implementation, and engagement of numerous offload and injection users. [Methods] To ensure a rational transformation and switching mode with minimal impact on normal production and operation, a comprehensive study was conducted on the hydraulic and thermal systems of these transmission pipelines. This study aimed to evaluate various factors influencing preheating and temperature dropping during commissioning, as well as the pros and cons of different switching modes. Simulation accuracy was checked for the preheating process after transforming Pipeline Q2, originally designed for normaltemperature transmission, into a heated transmission system. These simulation results were then verified with actual engineering data to ensure alignment with the practical requirements. Additionally, valuable field experience was gained from the transformation of Pipeline Q1, originally intended for heated transmission, into a normal-temperature transmission system. Based on these study findings, reasonable suggestions and recommendations were presented for key nodes in switching operations. [Results] The selection of the preheating method should be based on site-specific conditions when transforming in-service normal-temperature oil transmission pipelines into heated transmission systems. For instance, Pipeline Q2 should be treated by heating Russian oil to be transmitted in advance combined with preheating the pipeline with high-temperature Russian oil, aligning the commissioning process with the transmission requirements of Daqing oil.Likewise,appropriate measures should be taken to gradually reduce the temperature of oil products between stations during the transition from the heated to normal-temperature mode.This can be achieved through the quantitative transmission of oil products with a gradually decreasing temperature by batch.To facilitate this,heating stations along the route can be utilized to ensure a gradual temperature drop of the oil products between stations. [Conclusion] The study findings offer valuable insights for commissioning under switching operations of inservice crude oil pipelines.

D-p-hydroxyphenylglycine (D-HPG) is an important intermediate for the synthesis of sweeteners and drugs. An innovative continuous chromatographic process was developed to recover D-HPG from crystallization mother liquor, with the aim of reducing the process cost and improving the quality of D-HPG. The thickening properties of different nanofiltration membranes on mother liquor were investigated by pre-treatment test, and the Applexion NF200 nanofiltration membrane was selected to enrich D-HPG. The separation properties of different resins were analyzed by single column experiment, and the separation degree of Applexion XA945 resin to D-HPG and ammonium sulfate could reach 16. Based on the results, the way of sequential simulated moving bed separation was further studied. The results showed that after separation by the sequential simulated moving bed, the average purity of D-HPG in feeding was increased from 42.2% to 96.3%, and the average yield was 91%. The continuous chromatographic system is a promising method for the recovery of D-HPG from crystallization mother liquor. Compared with the traditional process, the new process not only ensures the total yield of D-HPG, but also greatly reduces the process cost and improves the product quality.

[Purpose/Significance] The online interaction of participatory websites improves the efficiency of information transmission and communication, and improves users' perception and experience. Through the study of bullet screen under participatory website, it complements the relevant research on user experience theory, and provides practical guidance for short video disseminators and relevant participatory websites. [Method/Process] This paper selected Bilibili, a typical participatory website, as the research object, took the short video bullet screen data and aggregated hotness indicator data of Bilibili as the research samples to study its user interaction experience, used python to crawl bullet screen popularity and content information of short videos, and studied its users’ aggregated hotness indicators and user generated contents of participatory websites through correlation analysis and text emotion analysis. [Result/Conclusion] The results show that there is a correlation between the number of bullet screen, the number of comments and the number of the video playback of participatory websites; Real time bullet screen interaction enhances the audience's cognitive sharing, emotional experience and onlooker experience.

The 6- DOF joint robot with offset wrist can’t satisfy the Pieper rule,thus there are no closed- form inverse kinematics solutions for them. Compared with non- offset robot,a numerical iterative algorithm that integrates the closed- form inverse solutions of non- offset robot with the modified Newton iteration method is obtained,and the inverse method is utilized to obtain the closed- form inverse solutions of the non- offset robot with the same configurations,and the solutions are considered as the initial values of the subsequent iteration. According to the forward kinematics,by combining the three components of position vector with the three independent elements of attitude matrix,a non- liner equation set which contains all joint variables can be obtained,and then the numerical inverse kinematics solutions for the robot with offset wrist can be searched with the modified Newton iteration method. A large number of tests indicate that the algorithm can meet the requirements of real- time control.

To investigate the preparation of radioiodinated Chlorpyrifos and its biodistribution in mice, Chlorpyrifos was labeled with 131I using the Iodogen method. Biodistribution studies were carried out in KM mice. At different times after radiopharmaceutical i.v. administration (185 kBq 131I-Chlorpyrifos/mouse, n=5), the animals were sacrificed. Blood samples and the tissues of interested were collected, weighted and counted. The percentage of injected does per gram (%ID/g) was calculated for each sample. The labeling yield of 131I-Chlorpyrifos was 93.5%, The radiochemical purity (RCP) was 96.9%. Biodistribution in mice demonstrated that 131I-Chlorpyrifos was extensive, and the uptakes mainly occur in lung, stomach, small-intestine, colon, musle, and submaxillay gland, as indicated by their amount of 37.12%ID/g, 6.18%ID/g, 8.12%ID/g, 8.15%ID/g, 7.04%ID/g, and 7.02%ID/g at 10 min, respectively. And it was metabolized in liver and kidney, as indicated by their uptake of 4.34%ID/g and 8.50%ID/g at 5 min, and 0.22%ID/g and 0.69%ID/g at 4 h, respectively. In addition, 131I-Chlorpyrifos was cleared out from blood quickly, and the uptake of 131I-Chlorpyrifos in blood was 37.27%ID/g at 5 min, and decreased to 1.35%ID/g at 4 h post injection. In conclusion, 131I-Chlorpyrifos was stable in vitro and it was absorbed in lung and digestive tract, and it was metabolized mainly in liver and kidney, worthy of further investigation to trace the compound in vivo and in vitro.

The Monte Carlo method is a simple and common way to analyze workspace for robot,and workspace boundary extraction is the key part of Monte Carlo workspace analysis. By using an improved algorithm to extract the workspace boundary of a robot with 7 degrees of freedom,the extraction efficiency and the result both meet the requirement of the following work. The efficiency and accuracy of the improved algorithm are analyzed through experiment,and the result shows the improved algorithm is effective.

In view of problem of single-point failure in hardware and software running environment of gas disaster early-warning system of coal mine, a gas disaster early-warning system based on hot-standby was proposed, and its hot-standby solution, hardware and software design and implementation were introduced. The system employs high-reliability hot-standby cluster for mutual backup and hot-standby solution based on RoseHA and shared disc array, greatly improves its reliability. The application result shows that availability of the gas disaster early-warning system based on hot-standby is greatly improved with longer mean time between failures and shorter mean time for fixing failure, compared with the early-warning system based on single server.

Since 1949, modern Chinese language has, in the course of its development in Mainland China, twice witnessed large-scale transfers in its word emotive overtones. The first began in 1949 and went on all the way till the end of the Cultural Revolution in 1977. Derogation manifested itself in that period, during which the derogatory words enjoyed their greatest number, widest usages and highest frequency in the history of the Chinese language. The second began from the Reform and Opening Up Policy in 1978 and lasted untill now. De-derogation has manifested itself in this period, during which the derogatory words have had the smallest number, least usages and lowest frequency in the history of the Chinese language. The two large-scale transfers result from their specific social backgrounds and the development of the Chinese language itself.

Objective: To compare the efficacy of remimazolam and propofol on hemodynamics and quality of early postoperative recovery in elderly patients with frailty undergoing endoscopic retrograde cholangiopancreatography (ERCP). Methods: A total of 108 elderly patients with frailty (aged≥75 years) undergoing elective ERCP in the General Hospital of Northern Theater Command were prospectively enrolled from November 2022 to May 2023. According to the different anesthetic drugs used, the patients were divided into two groups by random number table method: remimazolam group (group R) and propofol group (group P). The group R was given remimazolam 0.15-0.20 mg/kg and alfentanil 5.0 μg/kg for anesthesia onset, and then was pumped remimazolam 0.4-0.8 mg·kg -1 ·h -1 and alfentanil 0.5 μg·kg -1 ·min -1 to maintain sedation. The group P was given propofol 1.0-1.5 mg/kg and alfentanil 5.0 μg/kg, and was pumped propofol 2.0-6.0 mg·kg -1 ·h -1 and alfentanil 0.5 μg·kg -1 ·min -1 . The primary outcome was the incidence of intraoperative hypotension [mean arterial pressure (MAP)<65 mmHg (1 mmHg=0.133 kPa) or MAP>20% decrease from baseline value] and severe hypotension (MAP<55 mmHg) in both groups, and other outcomes included: MAP, heart rate, pulse oxygen saturation (SpO 2 ) and bispectral index (BIS) values of patients at each time of before anesthesia induction (T 0 ), 1 min after anesthesia induction (T 1 ), endoscope through the oropharynx (T 2 ), immediate lithotomy (T 3 ), endoscope withdrawal from the oropharynx (T 4 ), and patients awake (T 5 ); the use of vasoactive drug during operation; the incidence of bradycardia, hypoxemia and injection pain; and the postoperative 15-item Quality of Recovery (QoR-15) score. Results: Group R included 33 males and 20 females, aged (81.5±4.9) years. Group P included 26 males and 29 females, aged (82.3±6.0) years. The incidence of intraoperative hypotension in group R was 24.5% (13/53), which was lower than 43.6% (24/55) in group P ( P =0.036), there was no significant difference of the incidence of severe hypotension which was 0 (0/53) and 5.5% (3/55) ( P =0.225). Compared with T 0 , MAP and BIS decreased at T 1 -T 4 (both P <0.05); heart rate and SpO 2 decreased at T 1 -T 2 in both groups (both P <0.05). Compared with group P, MAP increased at T 1 -T 4 ; heart rate, SpO 2 and BIS increased in group R (all P <0.05). The use of intraoperative vasoactive drug in group R was (93.9±21.4) μg, lower than (123.3±29.7) μg in group P ( P <0.001), and the incidence of bradycardia, hypoxemia and injection pain in group R was 5.7% (3/53), 13.2% (7/53), and 3.8% (2/53), lower than 18.2% (10/55), 30.9% (17/55), and 16.4% (9/55) in group P (all P <0.05). There was no significant difference in the incidence of bucking or involuntary body movement and hiccuping in both groups (both P >0.05). The awakening time in group R was (11.8±3.0) min, longer than (10.3±3.3) min in group P ( P =0.016), and the incidence of emergence agitation was 3.8% (2/53), lower than 16.4% (9/55) ( P =0.031). There was no significant difference in postanesthesia care unit (PACU) stay duration and the incidence of postoperative nausea and vomiting in both groups (all P >0.05). The postoperative QoR-15 scores at 1 d were (131.9±4.7) and (129.3±5.7) with statistically significant difference ( P =0.010), and QoR-15 scores at 3 d were (134.8±3.3) and (133.6±5.0) with no significant difference ( P =0.205). Conclusions: Compared with propofol, remimazolam reduces the incidence of intraoperative hypotension, bradycardia, injection pain and the use of intraoperative vasoactive drug on elderly patients with frailty undergoing ERCP. Remimazolam has relatively stable hemodynamics, it prolongs the recovery time but does not significantly affect the quality of early postoperative recovery.

Objective: To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease. Methods: In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed. Results: There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) ( P <0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased ( P <0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased ( P <0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group ( P <0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis ( P <0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI : 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection ( P <0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95% CI : 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion: The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

Objective: To explore the effect of high-flow nasal catheter oxygen inhalation in preventing hypoxemia during endoscopic retrograde cholangiopancreatography (ERCP) surgery in elderly patients. Methods: From September 2021 to September 2022, 116 elderly patients (aged ≥ 70 years) who underwent elective ERCP in the Northern Theater General Hospital were prospectively selected, then divided into general nasal catheter oxygen inhalation group [group C, 31 males and 27 females, aged (79.8±6.4) years] and high-flow nasal catheter oxygen inhalation group [group H, 33 males and 25 females, aged (81.4±6.7) years], with 58 patients in each group. All patients were monitored for anesthesia by target-controlled infusion of propofol and remifentanil. The main outcome index was the incidence of intraoperative subclinical hypoxemia (90% ≤ SpO 2 < 95%, duration >5 s), hypoxemia (75% < SpO 2 < 90%, 5 s < duration ≤ 60 s) and severe hypoxemia (SpO 2 < 75% or SpO 2 < 90%, duration > 60 s). Secondary observation measures were SpO 2 from T 0 to T 5 (T 0 , before anesthesia induction; T 1 , immediately after anesthesia induction; T 2 , endoscopic introduction; T 3 , duodenal papula intubation; T 4 , endoscopic withdrawal; T 5 , postoperative awakening), the arterial oxygen partial pressure (PaO 2 ), carbon dioxide partial pressure (PaCO 2 ) and pH at T 0 , 15 min after the induction and T 5 . Results: The incidence of intraoperative subclinical hypoxemia in group C and group H was 12.0% (7/58) and 3.4% (2/58) respectively, which showed no significant statistical difference ( P =0.165) from each other. The incidence of intraoperative hypoxemia in group H was 8.6% (5/58), which was significantly lower than 31.0% (18/58) of group C ( P =0.003). Neither group had intraoperative severe hypoxemia. SpO 2 of group H were (98.2±0.9)%, (98.2±0.9)%, (97.8±1.7)% and (97.7±1.7)% at T 1 , T 2 , T 3, T 4 , which were higher than (96.8±2.1)%, (96.4±3.0)%, (96.1±2.9)% and (96.4±3.4)% in group C (all P <0.05). PaO 2 at 15 min after induction in group H was (240.5±46.7) mmHg (1 mmHg=0.133 kPa), which was higher than that of group C (170.6±33.4) mmHg ( P <0.001). There was no statistically significant difference in pH and PaCO 2 between the two groups of patients at each timepoint. Conclusion: High flow nasal catheter oxygen can effectively reduce the incidence of hypoxemia in ERCP in elderly patients.

Objective: To evaluate the learning curve of the "Double Grooves-Double Rings" (DGDR) technique of transurethral Thulium laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH) by a single surgeon. From June 2021 to July 2022, 84 patients mean age (69.0±8.0) years,preoperative prostate volume (90.9±40.3)ml with BPH underwent ThuLEP in the Department of Urology, Peking University First Hospital.Performed by a single surgeon who had no experience of transurethral resection of prostate (TURP) and any laser surgeries. The case scatter plots with the best fitting line were drawn to analyze the learning curve. According to the date of the surgeries, the patients were equally divided into three learning stages (28 patients for each group). The T-PSA,prostate volume,operative time,enucleation time, enucleation efficiency,catheter indwelling time, hemoglobin drop and perioperative complications (including re-TURP, blood transfusion, stress incontinence≥3 months and urethral stricture) were compared among the groups. The learning curve was divided into three stages, and the cutting point was shown on the 14 th case. Except the prostate volume [stage1 (75.7±30.7) ml, stage2 (93.40±39.6)ml, stage3 (103.5±46.2) ml, P <0.05], there was no significant difference of the baseline data between three groups ( P >0.05). Compared with those of stage 1(100.6±24.7) min,(0.55±0.22) g/min, a statistically significant improvement was observed in both of the operative time and the enucleation efficiency among stage 2[(84.5±36.6) min, (0.87±0.33) g/min and stage 3 (71.2±26.3) min, (1.27±0.45) g/min, P <0.05]. The learning curve of the DGDR technique for ThuLEP can be divided into three stages. A ThuLEP beginner can preliminarily master this technique after completing 14 cases.

Objective: To explore the mechanism of nerve growth factor (NGF) in the skeletal muscle fiber remodeling in ischemic limbs during therapeutic angiogenesis. Methods: Eighteen female mice with SPF grade, 6 weeks old and 25-30 g weighed were randomly allocated to sham-operated group ( n =6), blank control group ( n =6) and NGF gene transfection group ( n =6). The left hindlimb ischemia models were established by ligating the femoral artery in blank control group and NGF gene transfection group. Seven days after the operation, mice in the three groups were separately injected with normal saline, empty plasmids, and NGF plasmids. Gastrocnemius of left hindlimbs was harvested after the blood perfusion assessment of the ischemic limb on the 21st postoperative day. The gastrocnemius muscle specimens were stained with HE, CD31 and proliferating cell nuclear antigen (PCNA) immunohistochemistry staining, the mRNA expressions of myosin heavy chain-Ⅰ(MHC-Ⅰ), MHC-Ⅱa and MHC-Ⅱb were measured by real-time PCR, and the protein level of NGF and peroxisome proliferator-activated receptors-β/δ (PPAR β/δ) were detected by Western blot. The expression of cytochrome C oxidase (COX), isocitrate dehydrogenase (IDH) and adenosine triphosphate (ATP) were examined by enzyme-linked immunosorbent assay (ELISA). Results: On the 21st day after operation, the blood perfusion of the ischemic limb in NGF gene transfection group was (195.70±9.99)PU, which was lower than that in sham-operated group (312.15±17.32)PU ( P =0.001), while it was higher than that in blank control group (82.11±8.55)PU ( P =0.001). The degree of muscle atrophy in the NGF gene transfection group was lower than that in the blank control group. The capillary density of NGF gene transfection group (0.34±0.05) was higher than that of sham-operated group (0.11±0.03) and blank control group (0.27±0.04) ( P <0.05). The endothelial cell proliferation index in NGF gene transfection group (0.39±0.19) was significantly higher than that in sham-operated group (0.18±0.01) and blank control group (0.25±0.14) ( P <0.05). The expression of NGF, PPAR β/δ, COX, IDH, ATP, and MHC-Ⅰ mRNA in NGF gene transfection group were significantly higher than those in sham-operated group and blank control group ( P <0.05). Conclusions: NGF gene transfection can promote angiogenesis in the ischemic limbs of mice, increase the blood perfusion, and thus induce the remodeling of skeletal muscle fibers to type Ⅰ. This process may be related to NGF-induced PPAR β/δ expression and promote the cellular aerobic metabolism in skeletal muscle.

Objective: To explore the changes of γ-GCS mRNA expression and GSH-PX in serum of workers exposed to manganese in order to provide scientific basis for early diagnosis of manganese poisoning. Methods: In June 2017, a total of 180 workers from a motorcycle manufacturer were selected by stratified random sampling, including 115 welders as the exposure group and 65 administrative office workers as the Control Group, the exposure group was divided into high exposure group (43 persons) and low exposure group (72 persons) according to whether the exposure group exceeded the standard limit. The levels of γ-gcs Mrna expression and GSH-Px activity in serum were determined by Occupational Health Survey, and the differences of γ-gcs Mrna expression and GSH-Px activity among different groups were analyzed. Results: Compared with the control group, the serum GSH-Px activity was lower and the serum γ-GCS mRNA expression level was higher in the exposed group ( F =370.52, 275.95, P <0.01) . Compared with the control group, there was significant difference in γ-GCS mRNA expression level and GSH-Px activity ( F =0.475、1.06, P <0.01; F =48.53、111.70, P <0.01) . The concentrations of manganese in air, welding dust and urine were positively correlated with the level of γ-GCS mRNA ( r =0.71, 0.50, 0.31, P <0.01) The serum GSH-Px activity was negatively correlated with the concentrations of manganese in air, welding dust and urine ( r =-0.80, -0.52, -0.30, P < 0.01) , There was no correlation between Serum γ-GSH-Px activity and age and years of exposure ( P >0.05) . Conclusion: Serum γ-GCS mRNA expression level and GSH-Px activity level can be used as early biomarkers of manganese poisoning. The concentrations of manganese in workplace air, welding dust and urine manganese in workers are the influencing factors.

Objective: To observe the incidence of Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia and to explore the risk factors for its occurrence. Methods: The data of patients suffered from Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia from June 2018 to May 2021 were retrospectively reviewed. The type of procedure, surgeon, age and gender were selected as matching factors, 4 patients without Tapia syndrome were selected as control group for each case. The radiological parameters including mandibular-vertebral distance, thyroid-vertebral distance, thyroid cartilage-vertebral distance, and C 2 -C 7 lordotic Cobb angle were measured on lateral radiographs of the cervical spine. The above parameters were measured on neutral, over-flexion and over-extension radiographs. The difference between the Tapia group and the control group were analyzed. Results: There were 9 patients (0.37%) suffered from Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia in 2 431 patients, and it happened in 0.67 days (0-2 days) after the operation. There were 3 males and 6 females with a mean age of (61±5) years. The clinical manifestations was tongue extension deviation in 8 cases (88.9%), dysarthria in 6 cases (66.7%), dysphagia in 3 cases (33.3%), tongue stiffness in 3 cases (33.3%), hoarseness in voice and pharyngeal discomfort in 1 case (11.1%). All of the symptoms were relieved in all patients at 3 months postoperative follow-up. In neutral position, the mandibular-vertebral distance was (7.19±3.96) mm in the control group and it was (3.98±3.01) mm in Tapia group ( P <0.05). From neutral position to hyperflexion position, the distance between mandible and vertebral body was reduced from 3.98 mm to 1.95 mm in the Tapia group and decreased for 51.0%, and it decreased from 7.19 mm for 31.8% to 4.90 mm in the control group. Conclusions: The incidence of Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia is low. A smaller mandibular-vertebral distance on pre-operative cervical spine lateral view radiograph maybe a risk factor for Tapia syndrome after posterior cervical surgery under oral tracheal intubation general anesthesia.

Objective: To investigate the correlation between the severity of uncovertebral joints degeneration and heterotopic ossification (HO) after single-level artificial cervical disc replacement (ACDR). Methods: From January 2005 to January 2016, 70 patients who had undergone single-level ACDR in Peking University Third Hospital and had at least 5 years follow-up were included in this study. There were 35 males and 35 females with an average age of (42±8) years (range, 25-62 years). Cervical spine A-P X-rays were taken to assess the degeneration of uncovertebral joints and lateral X-rays were taken to assess the degeneration of intervertebral space. Cervical spine lateral and the flexion-extension X-rays at 5 years follow up were taken to assess HO. Degeneration of uncovertebral joints were evaluated by the classification system set-up in Peking University Third Hospital. Kellgren&Lawrence grading system was used to evaluate the degeneration of intervertebral space. HO was evaluated by the McAfee grading standards. The data were collected before surgery and at 5-years follow-up, then the correlation between degeneration of uncovertebral joints, degeneration of intervertebral space and HO was analyzed with Spearman non-parametric test. Results: The average follow-up time of 70 patients was (62.7±4.8) years (range, 52-74 months). There was a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR ( r= 0.585, P< 0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and HO ( r= 0.557, P< 0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and preoperative uncovertebral joints degeneration ( r= 0.727, P< 0.01). Conclusion: There is a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR.

Background: Lung cancer is currently the leading malignant tumor in both domestic and foreign morbidity and mortality. Surgical treatment is the main treatment option for lung cancer. The aim of this study is to explore the effects of enhanced recovery after surgery (ERAS) combined with respiratory function exercise combined with single-hole thoracoscopic surgery on lung cancer patients with postoperative pulmonary complications, postoperative pain, time to get out of bed, time to extubation and length of hospital stay., Methods: A total of 240 patients who underwent endoscopic lung cancer surgery at the Affiliated Hospital of Yangzhou University and the Yancheng First People's Hospital from October 2017 to October 2019 were randomly divided into 4 groups, with 60 patients in each group. Patients in group A underwent single-hole thoracoscopic surgery, and preoperatively performed ERAS concept education and respiratory function training; group B used conventional 3-hole thoracoscopic surgery, and performed ERAS concept education and respiratory function training before operation; group C used conventional 3-hole thoracoscopic operation surgery, routine hospitalization education and nursing guidance, routine respiratory function training, no preoperative ERAS concept education; group D used single-hole thoracoscopic surgery, routine hospitalization education and nursing guidance, routine respiratory function training, no preoperative ERAS concept mission. The number of postoperative pulmonary complications, postoperative pain, time to get out of bed, extubation time, and hospital stay were recorded in the four groups., Results: Compared with the groups B, C, and D, the incidence of pulmonary complications was significantly reduced, and the time to get out of bed, extubation time, and hospital stay were significantly shortened in group A. Compared with groups B, C, the postoperative pain was significantly reduced in group A. Compared with group C, the pulmonary complications were significantly reduced, and the time to get out of bed, extubation time and hospital stay were significantly shortened in group B. The differences were statistically significant (P<0.05). There was no significant difference in postoperative pain between group A and group D, group B and group C (P>0.05)., Conclusions: For patients with single-hole thoracoscopic lung cancer surgery, the ERAS concept guidance can effectively reduce the incidence of pulmonary complications and postoperative pain, shorten the time to get out of bed, the time to extubate, and the length of hospital stay.

Objective: To compare the biomechanical properties of two ultra-strong sutures and suturing methods in panda rope bridge technique (PRBT) application, and provide guidance for clinical selection of suture threads and suture methods., Methods: Forty Achilles tendons from bulls were randomly divided into 4 groups ( n =10) and transected at the 4 cm proximal to the tendon insertion. Groups A and B used Ethibond sutures (USP 5), the proximal end was fixed at the myotendious junction with Krackow sutures and the distal end was fixed through a calcaneus canal. Groups A and B had 4 and 8 threads through the stump plane, respectively. Groups C and D used Ultrabraid sutures (USP 2), the proximal end was fixed at the myotendious junction with Krackow sutures and the distal end was fixed in the calcaneus with two anchors. Groups C and D had 4 and 8 threads through the stump plane, respectively. The dynamic tensile forces of 20-100, 20-200, 20-300, and 20-400 N were tested respectively by using a dynamic tensile testing machine at 0.5 Hz for 250 cycles. After each stage of testing, the gap between stumps was measured with a caliper and the type of suture failure was recorded., Results: After dynamic tensile forces of 20-100 N and 20-200 N, the gaps of the four groups arranged from small to large were groups D, B, C, and A. The differences between groups A and B and groups C and D were significant ( P <0.05). But after dynamic tensile forces of 20-300 N and 20-400 N, the gaps were more than 5 mm in all groups. The suture retention rates of the four groups after dynamic tensile forces of 20-100 N and 20-200 N were all 100%. The suture retention rates of groups A, B, C, and D were 0, 80%, 60%, and 100%, respectively after dynamic tensile forces of 20-300 N. The differences of suture retention rates between group A and groups B and D were significant ( P <0.05). There was no significant difference between groups B, C, and D ( P >0.05). After dynamic tensile forces of 20-400 N, the suture retention rates of groups A, B, C, and D were 0, 50%, 0, and 70%, respectively. There were significant differences between groups A and B and groups C and D ( P <0.05)., Conclusion: Repairing Achilles tendon rupture via PRBT with 8 ultra-strong sutures through the stump plane can meet the mechanical requirements for walking by using ankle boots and heel pads in the early accelerated rehabilitation after operation.

Objective: To investigate the surgical treatment of severe congenital cervical kyphosis. Methods: The clinical data of patients with severe congenital cervical kyphosis (Cobb>40°) treated in Peking University Third Hospital from March 2004 to March 2018 were retrospectively summarized. In this series, 8 cases were enrolled, included 4 males and 4 females; the patients were 5-45 years old. According to the etiology, 4 patients were diagnosed with vertebral body underdevelopment, 2 with vertebral insufficiency, 1 with cervical spine congenital fusion and 1 with C(2) spinous process mecism. Five cases were treated with traction before final surgical correction. The surgical strategy was anterior correction or posterior correction or combined procedure in regards to different situation. The curvature of cervical angle was measured by two-line Cobb method, and the cervical kyphosis angle was measured on lateral radiographs in the neutral and extended position at the pre-operation and post-operation in each patient. The correction rate and evaluated Japanese Orthopedic Association (JOA) scoring for the function of spinal cord were also measured. The data before and after the operation were compared with t test. Results: In this series, the average kyphotic Cobb angle was 67°±18° and 8°±8° before and after surgical correction, respectively ( t= 8.471, P< 0.05).The final correction rate was 87%±13%.The JOA score improved from 11.1±2.7 to 14.0±1.5 ( t= -2.656, P< 0.05) at the end of follow up. Conclusions: The pre-correction by cervical spine traction and final surgical correction by anterior, posterior or combined approaches of internal fixation and fusion can achieve good results and reduce risk and difficulty in operation for severe congenital cervical spine kyphosis with vertebral body underdevelopment without vertebral insufficiency and cervical spine congenital fusion. The final surgical correction by one-stage anterior, posterior or combined approaches of internal fixation and fusion can achieve good results for severe congenital cervical spine kyphosis with vertebral insufficiency and/or cervical spine congenital fusion.

In the past two decades,the United States made an impressed progress in the prevention and control of cancer that the overall morbidity and mortality of cancer had shown a downward trend, while China had seen an opposite trend. Cancer, one of the major public health concerns in China, has imposed an enormous burden onthe society and individuals. Therefore,in order to scientifically formulate cancer prevention and control policies, it is essential to make a comprehensive understanding of the practical experience in the field of cancer prevention and control from the United States. This article reviews the relevant literature on cancer trends as well as the prevention and control strategies in the United States,depictsthe cancer epidemic situation in the United States in the past 30 years, and summarizes the influencing factors, strategies and intervention experiences that lead to the improvement of cancer epidemic. It highlights the policy support, surveillance and intervention adopted by the United States for the cancer prevention and control. This article is expected to provide some implications and reference for the cancer prevention and control in China.

Background: Thoracoscopic lobectomy combined with mediastinal lymph node dissection has been considered as one of the standard surgical procedures for early lung cancer. After 20 years of development, thoracoscopic lobectomy has reached a consensus on reliability and minimally invasive. At present, thoracoscopic lobectomy has a variety of incisions, which gradually evolve into four holes based on three holes, and two or one hole as the operative approach. The aim of this study was to evaluate the clinical value of four-hole unilateral dissecting lobectomy and mediastinal lymph node dissection in the treatment of non-small cell lung cancer (NSCLC). The aim of this study was to investigate the clinical value of anatomical lobectomy with mediastinal lymphadenectomy under four-hole completely video-assisted thoracoscopic surgery (C-VATS) in the treatment of non-small cell lung cancer., Methods: The patients undergoing lobectomy with mediastinal lymphadenectomy for NSCLC were identified in the Department of Thoracic Surgery, Yangzhou First People's Hospital, Yangzhou University from March 2015 to July 2016. Preoperative clinical diagnosis of peripheral-type early NSCLC. The patients were randomly divided into four-hole monophasic group (experimental group) and three-hole group (control group) according to the number of hospitalization before surgery. According to inclusion and exclusion criteria, the 39 cases assign in experimental group and 34 cases in the control group, including 36 males and 37 females; aged 38 to 84 years. The mean operation time, average blood loss, lymph node dissection group, average drainage, average extubation time and postoperative complications were compared between the two groups for statistical analysis., Results: The two groups of patients were successfully completed surgery, no death after surgery. Mean bleeding in the two groups, the number of lymph node dissection group, the average postoperative drainage, the average time of extubation, postoperative complications, with no significant difference. The average operation time of the four-hole unidirectional group was shorter than that of the three-hole group. The difference was statistically significant (P<0.05)., Conclusions: The safety and efficacy of a four-hole one-way operation under VATS are satisfactory. The operation is smooth during operation, which shortens the course of operation and deserves the clinical promotion.
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Objective: To assess the midterm clinical and radiological outcomes of internal fixation and fusion for the treatment of Hirayama disease and to evaluate the clinical significance and value of this procedure., Methods: In the study, 36 patients were treated with anterior cervical internal fixation and fusion. The clinical outcomes including muscle strength and atrophy were recorded. The radiological outcomes including range of motion of cervical spine and the cross-sectional area of spinal cord at each level on MRI scan were measured before and at 3 month, 1 year and 2 years follow-up time points after surgery., Results: (1) Clinical outcomes: all the patients showed no further progression of symptoms except one patient with mild progression of muscular weakness and atrophy. As the time passed by, the ratio of the patients with muscle strength and atrophy improvement increased. There were 26.5% of patients in 3 months, 36.0% in 1 year and 85.7% in 2 years who experienced muscle strength improvement. 8.8% of patients in 3 months, 24.0% in 1 year and 35.8% in 2 years felt muscle atrophy improvement. And 12 of the 14 patients showed improved muscle strength and atrophy at the end of 2 years period follow-up. (2) Radiological outcomes: the range of motion (ROM) of C2-C7 was significantly decreased after the operation. The ROM of preoperation was 62.25°±2.10° and that of 2 years postoperation was 13.67°±7.51°(P<0.01). The spinal cord was of no compression on flexion MRI. The cross-section area of spinal cord on MRI was significantly increased only at C6 level (P<0.05) at the end of three months follow-up. The level of increased cross-section area rose to C4-C5-C6 levels (P<0.01) in 1 year and to C4-C5-C6-C7 levels at the end of 2 years follow-up (P<0.05). The cross-section area increased 15.60% at C4, 19.08% at C5, 21.60% at C6 and 23.91% at C7 with significant difference (P<0.05) 2 years after the operation., Conclusion: Anterior cervical internal fixation and fusion is an effective surgical treatment for Hirayama disease and may provide preferable midterm clinical and radiological outcomes. This procedure has clinical significance and value in terms of control of the progression and outcome of this disease.

Objective: To evaluate the early and long-term outcomes of carotid endarterectomy for carotid artery stenosis and analyse the risk factors for the outcomes. Methods: A retrospective review of 369 patients underwent carotid endarterectomy(CEA) in Peking Union Medical College Hospital from Oct 2006 to Nov 2012 was conducted. Clinical data including general conditions, perioperative and follow-up outcomes were collected. Results: Three hundred sixty-nine patients underwent 407 CEAs. The long-term follow-up rate (≥30 d) was 89.9% and follow-up period was 11.8-48.3 months. Among 407 CEAs, patients with symptomatic carotid artery stenosis, carotid stenosis over 70% and contralateral severe carotid stenosis occupied 78.0%(317/407), 98.4%(400/407) and 12.04%(49/407) respectively. Total early complications (<30 d) of stroke, cardiac events and death was 3.93% (16/407). Univariate analysis showed no risk factor had significant effect on early complications ( P >0.05). Total long-term complications of stroke, cardiac events and death was 8.7% (32/366). Univariate analysis showed that total long-term complication rate of smoking group was higher than non-smoking group (12.1% vs 5.1%, P <0.05), contralateral carotid artery stenosis group was higher than opposite one (28.6% vs 8.0%, P <0.05). Multivariate Logistic regression showed the HR of long-term complications rate in patients aged over 65 years, smoking history, myocardial infarction and contralateral carotid stenosis were 2.59, 2.66, 2.48 and 6.06, respectively. Conclusions: CEA is safe method for the treatment of carotid stenosis. To CEA, age over 65 years, smoking history, myocardial infarction and contralateral carotid stenosis are risk factors for long-term adverse outcomes.

Objective: To explore the efficacy of over-the-scope clip (OTSC) in the treatment of gastrointestinal fistula., Methods: Clinical data of 12 gastrointestinal fistula patients, including 3 internal fistula and 9 external fistula treated with OTSC in our institute from March 2015 to May 2016 were retrospectively analyzed. OTSC was performed when pus was drained thoroughly and intra-abdominal infection around gastrointestinal fistula was controlled, and each patient received one clip to close fistula., Results: There were 6 female and 6 male patients with mean age of (50.1±12.6) years. The successful rate of endoscopic closure was 100% without complications including bleeding and intestinal obstruction during and after OTSC treatment. According to comprehensive evaluation, including drainage without digestive juices, no recurrence of intra-abdominal infection, no overflow of contrast medium during digestive tract radiography, and CT examination without intra-abdominal abscess, clinical gastrointestinal fistula closure was 91.7%(11/12). There was no recurrence of gastrointestinal fistula during 3 months of follow-up in 11 patients. In the remaining 1 case, the gastric fistula after laparoscopic sleeve gastrectomy recurred one week after OTSC treatment because of intra-abdominal infection surrounding fistula, and was cured by surgery finally., Conclusion: The endoscopic closure treatment of OTSC for gastrointestinal fistula is successful and effective, and control of intra-abdominal infection around fistula with adequate drainage is the key point.

The potential of cancer immunotherapy has been demonstrated recently using the chimeric antigen receptors-engineered (CAR) T cells, in which B cell haematological malignancies was successfully treated in clinical trials. However, challenges remain in the translation of the potential benefits into therapy of other types of cancer with similar efficacy and safety. Excessive activation of genetically-modified T cells may cause severe toxicities, such as cytokine storm, on-target toxicities, and tumor lysis syndrome. Genomic integration of viral vectors may cause genetic toxicities due to insertional mutagenesis of important genes. Strategies to overcome these toxicities are proposed and discussed, including the use of suicide genes, combinatorial antigen recognition, on-switch, non-viral vector and other innovative gene therapy strategies, to enhance safety of this promising immunotherapy.

This study was designed to evaluate the anti-inflammatory effect of recombinant human kallistatin (Kal) on ulcerative colitis (UC) in the mouse model. Acute colitis was induced by administration of 4% dextran sodium suffate (DSS) to KM mice for 7 days. The mice were then randomized into 5 groups: model control, Kal 0.2 mg·kg(-1)·d(-1), 1.0 mg·kg(-1)·d(-1) and 2.0 mg·kg-1·d(-1) group, salazosulfapyridine (SASP) group. Ten age-matched normal KM mouse were administered with saline in the normal control. The weight, colon length, inflammation factor (MPO/SOD/MDA) and TNF-α/IL-10 levels among the five groups of mice were determined. The results showed that histological index score and MPO/MDA/TNF-α levels of high-dose Kal treatment group and SASP group were significantly lower compared with the model group (P < 0.01), but the weight, colon length, IL-10 level and SOD activity were significant higher than the model group (P < 0.01), approaching the normal group. These parameters showed that Kal can significantly relieve the UC state in a dose-dependent manner. This study demonstrates that Kal significantly remits UC in mice, and participates in the regulation of inflammatory cytokines TNF-α/IL-10 levels and has some antioxidant activity.

Objective: To analyze the efficacy and safety of surgery and endovascular management in treating Takayasu arteritis., Methods: The data of 116 patients (24 males and 92 females; mean age (32±12) years) with Takayasu arteritis and underwent surgery or endovascular therapy was retrospective analyzed. According to the two different surgical procedures, the patients were divided into two groups: open repair group and endovascular repair group. One hundred and fifty-four surgical procedures were done including 69 cases of open repair and 85 cases of endovascular repair. A total of 211 arterial lesions were revascularized (open repair 114; endovascular repair 97)., Results: Among the 154 surgical procedures, 11(7.1%) presented a complication during perioperative period including 6(8.7%) of open repair and 5(5.9%) of endovascular repair. After a median follow-up of 38.5(0.5-142.0) months, three(4.3%) cases of stroke and death were observed in open repair group, two(2.3%) cases of stroke and 4(4.7%) cases of death were observed in endovascular repair group. At 1, 3, 5 and 10 years of follow-up, primary patency rate of open repair and endovascular repair were 95.0% and 89.3%, 84.3% and 69.8%, 73.3% and 56.3%, 53.4% and 48.1%, respectively; Primary assisted patency rate were 100% and 97.5%, 90.4% and 78.2%, 79.1% and 72.8%, 60.7% and 54.0%, respectively; Secondary patency rate were 100% and 98.8%, 95.6% and 92.7%, 85.8% and 78.1%, 74.8% and 58.0%, respectively. Cumulative survival rate were 97.0% and 100%, 97.0% and 97.6%, 97.0% and 90.6%, 91.3% and 84.5%, respectively (χ(2)=0.182, P=0.669)., Conclusions: Both of the surgical revascularization and endovascular management are safe and effective in the treatment of Takayasu arteritis. Although long-term patency of endovascular therapy is low, it can be performed repeatedly and can be used as a preferred approach in treating a short stenosis. Surgical repair shows excellent long-term durability, it seems to be more suitable for complex lesions and failure cases of endovascular management.

Objective: To investigate the clinical efficacy of cervical anterior internal fixation and bone grafting fusion by comparative analyzing hand dysfunction in Hirayama disease patients using Jebsen-Taylor Test (JTT)., Methods: From Feb 2010 to Jan 2014, 20 hirayama disease patients who underwent surgery were enrolled in Department of Orthopaedics, Peking University Third Hospital. JTT were evaluated for the 20 patients before and after surgery. Among them, 9 patients were evaluated before and at three months, one year and more than 2 years after surgery., Results: All sections of the JTT scale indicated that the patients with CSM exhibited a significant impairment compared with healthy adults. Each scale of JTT was improved after surgery in addition to picking up small objects and placing them in a can and simulated feeding. The whole time were improved from 72.3 s to 60.2 s., Conclusion: JJT is a valid efficacy evaluation in assessing the impairment of hand and upper extremities of patients with Hirayama disease and the surgery can improve patients' hand function.

In the past ten years, corneal endothelial keratoplasty has been widely and successfully performed in China. As an ideal surgical treatment for corneal endothelial diseases, Descemet's membrane endothelial keratoplastywas only tried out in few hospitals. This article summarized the development of Descemet's membrane endothelial keratoplasty in surgical indications, operation process and postoperative complications in China and abroad for providing references for clinical application.

Development of liver fibrosis is closely associated with angiogenesis and abnormal vascular remodeling. Recent studies have highlighted the importance of angiogenesis and vascular remodeling in fibrogenesis, the results that inhibition of angiogenesis is effective in suppression of liver fibrosis demonstrate that therapies with several molecular targets against angiogenesis, inflammation and fibrosis might be beneficial for the treatment of cirrhosis. However, there is some evidence that inhibition of angiogenesis can even worsen fibrosis. This article outlines recent advances regarding the interplay between inflammation, angiogenesis and fibrogenesis in terms of cellular and molecular mechanisms, and suggests a requirement of greater understanding to intervene in these key processes, such as liver sinusoidal endothelial cell fenestration and impact distinct chemokine actions driving monocyte migration and differentiation, for therapeutic benefit in the future.

Objective: To establish a murine model of hindlimb ischemia and denervation and evaluate the effects of neural factors on angiogenesis and skeletal muscle fiber remodeling., Methods: A total of 54 mice were randomly allocated into three groups of control (n = 6), hindlimb ischemia (n = 24), hindlimb ischemia and denervation (n = 24). The model of hindlimb ischemia was established by ligating femoral artery. And the model of hindlimb ischemia and denervation was established by transecting sciatic nerve on the basis of hindlimb ischemia modeling. Gastrocnemius of ischemic hindlimbs were harvested under the condition of peritoneal cavity anesthesia at Days 7, 14, 21 and 28 postoperation. And then the mice were sacrificed. The gastrocnemius of three groups were tested by hematoxylin-eosin staining, CD31 and PCNA immunohistochemical staining and myosin ATPase staining. The protein expressions of nerve growth factor (NGF) and vascular endothelial growth factor (VEGF) were detected by enzyme-linked immunosorbent assay., Results: At Day 7 postoperation, hindlimbs of two intervention groups showed ischemic manifestations as compared with controls. And semiquantitative assessment of ischemic damage showed the proportion level I-IV of hindlimb ischemia and denervation group was significantly higher than that of hindlimb ischemia group (33.4% vs. 16.6%, χ(2) = 7.94, P = 0.047). At Day 28 postoperation, the values of endothelial cell proliferation index [(2.4 ± 0.4)% vs. (5.7 ± 1.0)%, P = 0.000], capillary density [(0.44 ± 0.05) vs. (0.61 ± 0.07), P = 0.000], NGF protein expression [(6.71 ± 0.94) vs. (8.36 ± 0.77) pg/ml, P = 0.008] and VEGF protein expression [(11.32 ± 1.56) vs. (15.13 ± 2.93) pg/ml, P = 0.018] of hindlimb ischemia and denervation group significantly decreased as compared with hindlimb ischemia group. At Day 28 postoperation, the proportion of type II muscle fiber in gastrocnemius was significantly higher than that of hindlimb ischemia group [(84.9 ± 3.8)% vs. (78.8 ± 1.8)%, P = 0.008]., Conclusion: Neural factors play important roles in promoting angiogenesis and maintaining muscle fiber types in ischemic limbs. But its molecular regulatory mechanism requires further studies.

Connexin43 has been shown to play a pivotal role in wound healing process. Wound repair is enhanced by acute downregulation of connexin43, by increasing proliferation and migration of keratinocyte and fibroblast. Angiogenesis is also a central feature of wound repair, but little is known about the effects of connexin43 modulation on functions of endothelial cells. We used connexin43 specific small interference RNA (siRNA) to reduce the expression of connexin43 in human umbilical vein endothelial cell (HUVEC), and investigated the effects of connexin43 downregulation on intercellular communication, viability, proliferation, migration and angiogenic activity of HUVEC. Treatment of siRNA markedly reduced the expression of connexin43 by -80% in HUVEC (P < 0.05), and decreased the intercellular communication by -65% (P < 0.05). The viability, proliferation, migration and angiogenic activity of HUVEC decreased significantly (P < 0.05), compared with that of the normal cells. The results suggest that temporally downregulation of connexin43 expression at early stage of wound to inhibit the abnormal angiogenesis characterized with leaky and inflamed blood vessels, maybe a prerequisite for coordinated normal healing process.

Robust and efficient control of therapeutic gene expression is needed for timing and dosing of gene therapy drugs in clinical applications. Ribozyme riboswitch provides a promising building block for ligand-controlled gene-regulatory system, based on its property that exhibits tunable gene regulation, design modularity, and target specificity. Ribozyme riboswitch can be used in various gene delivery vectors. In recent years, there have been breakthroughs in extending ribozyme riboswitch's application from gene-expression control to cellular function and fate control. High throughput screening platforms were established, that allow not only rapid optimization of ribozyme riboswitch in a microbial host, but also straightforward transfer of selected devices exhibiting desired activities to mammalian cell lines in a predictable manner. Mathematical models were employed successfully to explore the performance of ribozyme riboswitch quantitively and its rational design predictably. However, to progress toward gene therapy relevant applications, both precision rational design of regulatory circuits and the biocompatibility of regulatory ligand are still of crucial importance.

Objectives: To investigate the effect of C(2-7) laminoplasty on postoperative anterior cord space (ACS) compared with C(3-7) laminoplasty, and to provide evidence for reasonable enlargement of decompression range cephalad., Methods: Fifty-seven Patients underwent cervical laminoplasty from February 2008 to October 2011 were studied retrospectively, which were divided into two groups by decompression range: Group C(3-7) and Group C(2-7). The pre-and post operative JOA scores,VAS scores of neek and shoulder pain, and cervical alignment were compared in each group. The postoperative ACS at each level from C(2-3) to C(7)-T(1) measured on MRI were compared between the two groups., Results: The postoperative JOA scores increased significantly in both groups. VAS scores and cervical alignment showed no significant difference. ACS at C(2-3) and C(3-4) was 6.13 mm (95%CI: 5.71-6.55) and 6.60 mm (95%CI: 6.10-7.11) respectively in Group C(3-7), which increased 2.5 mm and 2.1 mm respectively in Group C2-7 at the same segment, there was significant difference (P < 0.01). However, there was no significant difference of ACS at C(4-5) and any other caudal levels between the two groups., Conclusions: Compared with conventional C(3-7) laminoplasty, the extensive decompression cephalad to C(2) leads to larger ACS at C(2-3) and C(3-4). When the mid-sagittal diameter of anterior compression is more than 6.10 mm at C(3-4), C(3-7) laminoplasty may cause insufficient decompression, and enlargement of decompression range cephalad should be considered.

Follicle-stimulating hormone (FSH) is a pituitary glycoprotein hormone that is essential for the development of ovarian follicles and testicular seminiferous tubules. The relatively short half-life of FSH in vivo requires daily injections for more than 10 days that is inconvenient and possibly contribute to the stress perceived by the patients. The goal of the present study was to increase FSH glycosylation, in order to develop a long-acting recombinant FSH. The cDNA of native alpha and beta subunit of human FSH was linked by a sequence with two N-linked glycosylation sites, and the resulted DNA was inserted into pcDNA3.1 vector to generate a recombinant vector of pcDNA3.1-FSH. The pcDNA3.1-FSH was linearized and transfected into CHO-K1, positive transformants were selected by G418 and confirmed by PCR and Western blotting. A single chain recombinant FSH was expressed, with molecular weight of about 49 kDa. The recombinant FSH expression level in CHO-K1 cell strain in serum-free culture was 3 mg/L. Single injection of this recombinant FSH could induce folliculogenesis and ovulation in rats, the efficacy was similar with the commercially available FSH preparation (Folltropin-V) administrated 8 times consecutively. The results suggested a long-acting FSH was produced successfully.

Objective: To study the inhibitory effect of wogonin on the growth and proliferation of breast cancer cells MDA-MB-23, and observe its effect on the adhesion, migration and invasion of MDA-MB-23 cells, in order to further study its molecular mechanism., Method: MTT assay was used to detect the effect of wogonin on MDA-MB-23 cell growth. Ki-67 assay was adopted to test the effect of wogonin on cell proliferation. Scratch test, adherence test and invasion chamber assay were taken to detect the effect on the migration and invasion abilities of MDA-MB-231 cells. Proliferation and metastasis-related proteins and relevant signaling pathways were detected by Western blotting., Result: Wogonin could remarkably inhibit the growth and proliferation of MDA-MB-231 cells, significantly inhibit migration, adhesion and invasion abilities of breast cancer cells at a low concentration, and effectively inhibit the expression of Survivin, Bcl-2, ICAM-1, MMP-2, MMP-9 proteins of MDA-MB-231 cells., Conclusion: Wogonin could notably inhibit growth and proliferation of breast cancer cells, and inhibit migration, adhesion and invasion of MDA-MB-231 cells. Its invasive and adhesive effects on MDA-MB-231 cells may be related to the decrease in ICAM-1, MMP-2, MMP-9 expressions.

Objective: To analyze the diagnosis, treatment and prognosis of the malignant carotid body tumor., Methods: The data of pathology, diagnosis, therapy and follow-up of seven patients with malignant carotid body tumor in Peking Union Medical College Hospital from Dec 1949 to Dec 2012 were analyzed retrospectively., Results: 2 cases without the tumor resection. 5 cases were treated with surgical methods, 4 cases with tumor resection and external carotid artery ligation, 1 case with tumor resection and reconstruction of internal carotid artery with saphenous vein. Cranial nerve palsy occurred in 5 cases, of which 3 occurred hypoglossal nerve damage, 2 cases occurred vagus damage, 1 case with hypoglossal, vagus and sympathetic nerve damage. Follow-up was from 2 to 12 years. local tumor recurrence happened in 2-year postoperation and got remote bone and pancreas metastasis in 5-year postoperation in one case, and finally died in 7-year postoperation. 1 case had the internal carotid artery restenosis severely in 1-year postoperation, then performed the stent treatment. 2 cases without operation were still alive. Interestingly, the tumor after radiotherapy was steady in one case. The other received the tumor resection because of the severe syndrome after 8 years., Conclusion: the diagnosis of malignant carotid body tumor should base on occurring extensive invasion of adjacent organs, metastasis and pathology. Early stage surgical excision can reduce the recurrence and complication. Radiotherapy can effectively control local size and distant metastasis.

Purpose: To investigate the expression of gene DEK in oral squamous cell carcinoma, and explore the role of DEK in the development and metastasis of oral squamous cell carcinoma., Methods: Thirty-three specimens of oral squamous cell carcinoma (OSCC), 28 specimens of cervical lymph nodes metastasis, and 33 specimens of normal oral mucosal tissues adjacent to the cancerous lesions were examined. Polymerase chain reaction with reverse transcription (RT-PCR) and immunohistochemistry were used to detect mRNA and protein expression of DEK, respectively.The results were analysed with SPSS17.0 software package., Rusults: RT-PCR and immunohistochemistry showed that the expression of DEK mRNA and DEK protein in metastatic lymph nodes (82.1%, 82.1%) and cancerous tissues (81.2%, 76.8%) of OSCC were significantly higher than in the adjacent tissues (27.3%, 18.2%). The difference between cancerous tissues and adjacent tissues was significant (P<0.05)., Conclusion: DEK may play an important role in the occurrence and metastasis of OSCC.

Recombinant adenovirus-associated virus (rAAV) vectors mediated gene delivery system has been widely used in the treatments of cancer or other genetic diseases. It is considered to be one of the most promising vector owing to its non-pathogenicicity, low immune response, potential to integrate site-specif-ically, persistent and stable gene expression. However, it was limited in clinical applications because it is easy to be neutralized in serum and non-selection to the target site. Chemical modifications of rAAV have been studied to overcome those problems. This article reviewed the progress of chemical modifications of rAAV by various compounds and different modification methods, and predicted what the researches needed to do in the future.

Kallistatin (Kal) is a negative acute phase endogenous protein which can inhibit tumor angiogenesis, growth and metastasis effectively. To express and purify recombinant human kallistatin (rHKal), and characterize its biological activity, P. pastoris was transformed with pPIC9-Kal/GS115 (His4) to express rHKal. The fermentation was carried out in a 7.5 L bioreactor with high density cell culture. 1%-2% methanol was added to the medium to induce the expression of rHKal. The secretion was purified with phenyl sepharose, G-25 sepharose, heparin sepharose and Sephacryl S-100 chromatography. The biological activity of purified bulk rHKal on HUVEC was evaluated with MTT and tube formation assays. The final expression of rHKal in the supernatant reached 50 mg x L(-1), the purity of bulk rHKal after purification was above 98%. A dose-dependent inhibition of rHKal on HUVEC proliferation was observed, however, a U-shaped dose-response curve of rHKal on capillary formation of HUVEC was revealed. The described protocol provides an effective means for preparing rHKal that could be used for anti-angiogenesis therapy in the future.

This study is to investigate whether naked plasmid DNA can effectively transfect lung cancer related cells and express human kallistatin, an endogenous protein that inhibits angiogenesis and tumor growth, and to explore the biological activity of the low-level expressed kallistatin to lung cancer in vitro and in vivo. The plasmids were delivered with Lipofectamine 2000 to transfect various lung cancer related cells. Kal expression was determined by ELISA. The biological effects of Kal expression on proliferation, migration and apoptosis rate of the cells were examined. In subcutaneous NCI-H446 xenograft model, pKal was injected directly into tumors, the changes of CD34, Ki-67 and E-cadherin expression were detected with immunohistochemical assay, the tumor apoptosis was analyzed with TUNEL assay. Both the endothelial cell and lung cancer cells could express kallistatin after plasmid transfection. The proliferation and migration of human umbilical vein endothelial cells were inhibited, but the apoptosis rate was not affected. The proliferation rates of all the three tested lung cancer cells, such as NCI-H446, NCI-H460 and A549, were inhibited, and their apoptosis rates were enhanced, but different cells behaved differently. In subcutaneous NCI-H446 xenograft model, intratumor injection of pKal inhibited the growth of lung cancer by reducing angiogenesis and proliferation of tumor cells. In conclusion, this study demonstrated the efficacy of plasmid-mediated expression of kallistatin to lung cancer related cells, thus providing a basis for their clinical application in the treatment of lung cancer.

Recombinant adeno-associated virus (rAAV) has been widely used as vector for gene therapy. However, the effectiveness of gene therapy based on rAAV needs to be further improved. Enhancement of the transduction efficiency is one of the most important fields for rAAV-based gene therapy. Recent results have showed that the ubiquitin-proteasome system plays an important role in the trafficking of rAAV vector in cytoplasm, and regulation of its function may significantly improve the transduction efficiency of rAAV vector in various types of cells and tissues.

Cell adhesion mediated by cell adhesion molecules (CAMs) constitutes essential life phenomenon. In inflammation, immunity, infection, thrombosis, tumor metastasis and wound healing, cell adhesion comes into being the basic physiological and pathological process. Intervening with cell adhesion has been the important therapeutic and prophylactic strategies for diseases. Accumulated evidence has indicated that plant polysaccharides especially those exacted from Chinese traditional and herbal drugs displayed various pharmacological effects such as anti-inflammation, anti-cancer, anti-infection, immunomodulation, cardiovascular protective effects and so on. In this paper, the research progress of plant polysaccharides on cell adhesion is reviewed.

Recombinant adeno-associated virus (rAAV) is one of the most commonly used vectors for gene therapy. Despite the promising safety profile demonstrated in preclinical trials, the clinic efficacy of using rAAV was hampered by undesired response from the immune system. It is important to understand the mechanisms that lead to the induction of immune response against rAAV. Although a crucial role for innate immunity is shaping adaptive immune responses, the innate immune to rAAV was ignored in the past. Till now, at least three human cell types (dendritic cells, macrophages and endothelial cells) were discovered to be involved in sensing rAAV infection. The engagement of TLR9 by rAAV vector genomes triggers the activation of NF-kappaB signaling cascades, leading to the induction of pro-inflammatory cytokine genes. The viral capsid components are detected by TLR2, and this leads to the production of type I interferon mediated by interferon regulatory factors (IRFs) pathway. Self-complementary rAAV vectors induced higher TLR9 dependent innate immune response than single stranded rAAV. This review highlights the recent findings regarding the innate immune responses to rAAV vectors, the signaling pathways involved, and the impacts of innate immunity on the adaptive immune response to rAAV and its transgene expression.

Objective: To evaluate the efficiency between two treatments of sudden hearing loss., Method: All patients were divided into two groups randomly, basic drug group was treated with ganglioside and vinpocetine injection, combined therapy group was treated with intratympanic dexamethasone and what was used in basic drug group., Result: The effective rate of combined therapy group (73.53%) was significantly higher than that of basic drug group (37.78%) (P < 0.05)., Conclusion: The comprehensive therapy of intratympanic dexamethasone injection, ganglioside and vinpocetine injection have excellent efficiency for sudden hearing loss.

Follicle-stimulating hormone (FSH) is a glycoprotein which regulates the development, growth, pubertal maturation and reproductive processes of the body. Exogenous FSH has been used to promote ovarian follicular growth and maturation in female and spermatogenesis in male. The relative short elimination half life and rapid metabolic clearance of current versions of FSH require a daily or twice-daily scheduled subcutaneous injection to maintain stable FSH level being not below the threshold during ovarian stimulation. The development of recombinant long-acting FSH with enhanced biological activities may be helpful for less injection therefore to improve patient compliance, while reducing patient stress and error rates. A number of technological strategies have been explored to develop recombinant longer-acting FSH. For examples, attachment of the C-terminal peptide (CTP) of the human chorionic gonadotropin beta subunit or a sequence containing potential glycosylation sites to either subunit of FSH, creation of a single chain containing the alpha and beta subunits of FSH combined with CTP or N-linked glycosylation signal sequence as a linker, or fusion of the Fc domain of IgGi to FSH. Based on the modifiable molecular structure and pharmacokinetic and pharmacodynamic properties of recombinant FSH, it is hopeful that more FSH drugs with prolonged half-life and increased bioactivity will be developed to meet the modern clinical demands.

Various artificial riboswitches have been constructed by utilization of designed aptamers or by modification of natural riboswitch systems, because they can regulate gene expression in a highly efficient, precise and fast way, and promise to supply simple cis-acting, modular, and non-immunogenic system for use in future gene therapy applications. In this review, we present an overview of currently available technologies to design and select engineered riboswitches, and discuss some possible technologies that would allow them highly responsive to non-natural ligands, and dynamic control of gene expression in mammalian cells. Though how to bring custom-designed riboswitches as a novel and versatile tool box to gene control system is still a great challenge, the combination of structure-activity relationship information, computer based molecular design, in vitro selection, and high-through screening will serve as powerful tools for further development of riboswitch based gene regulatory systems.

The oral administration of bioactive macromolecular drugs such as proteins, peptides and nucleic acids represents unprecedented challenges from the drug delivery point of view. One key consideration is how to overcome the gastrointestinal tract absorption barrier. Recent studies suggest that microfold cell (M cell), a kind of specialized antigen-sampling epithelial cell which is characterized by a high endocytic rate and low degradation ability, may play an important role in macromolecule oral absorption. The development of an in vitro M cell coculture system and its modified models greatly advanced the study of M cells and the development of oral delivery system for macromolecular drugs. The special structure, function and formation characteristics, and biomarkers of M cell are summarized in this review. The applications of in vitro M cell models in developing oral delivery system ofbioactive macromolecular drugs are discussed.

High mobility group A2 protein (HMGA2), an architectural factor, is highly expressed in various cancer types including lung cancers. It is a candidate target for cancer therapy. RNAi is an effective gene silencing method with low cost and less time-consuming. It is possible to exploit this technology in therapy. Here, 5 siRNAs targeting Hmga2 gene (HMGA2 siRNA1-5) were designed and synthesized. MTT assay, colony formation assay, transwell assay and flow cytometry were used to evaluate the effects of these siRNAs on lung cancer cell lines (NCI-H446 and A549). Results from cell proliferation, clone formation, migration and apoptosis showed that HMGA2 siRNA1, 3, 5 could affect these aspects for both lung cancer cell lines. Among the five siRNAs, HMGA2 siRNA5 showed the greatest inhibition effects. The inhibition effects of HMGA2 siRNA5 are sequence specific and are not due to the induction of interferon response. Taken together, siRNAs targeting Hmga2 gene are potential candidates for lung cancer gene therapy.

The aim of this study was to reveal the protection role and the related mechanism of cytoglobin on the oxidation induced hepatic stellate cell damage. We applied siRNA to interfere the endogenous cytoglobin gene, used recombinant cytoglobin protein to treat the completely activated human hepatic stellate cell line LX-2 and the incompletely activated primary rat hepatic stellate cells, or over-expressed cytoglobin protein in LX-2 cells. We used two different oxidative-stress related models, the hydrogen peroxide model and the iron-overload model in our experiments and investigated the proliferation status and the intracellular superoxide level of the cells. The results showed that endogenous cytoglobin exerted significant protective effects on hydrogen peroxide or iron-overload induced LX-2 cell damage, confirming that upregulation of cytoglobin was the protective response of activated hepatic stellate cells to oxidative stress. Recombinant cytoglobin protein could protect LX-2 cells from oxidation induced damage, and prevent primary rat hepatic stellate cells from excessive proliferation and injury. The cytoplasmic reactive oxygen species (ROS) scavenging capacity of the recombinant cytoglobin protein was not as good as its capacity in scavenging ROS outside the cells, likely owing to the lack of active transporting mechanisms. Intracellular over-expression of cytoglobin protein could exert significant protective effect on LX-2 cells treated with hydrogen peroxide or iron-overload. Our results would accelerate the exploitation of new anti-fibrotic targets.