[Clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns]

Objective: To explore the clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns. Methods: The retrospective case-control research approach was used. From January to December 2019, 109 patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) within 1 week after deep burn wound healing on the face and neck. Fifty-five patients who were admitted to the hospital from January to June and received comprehensive treatment and conventional nursing were included in conventional nursing group (27 males and 28 females, aged 21-65 (40±17) years), and fifty-four patients who were admitted to the hospital from July to December and received comprehensive treatment and sequential nursing were included in sequential nursing group (29 males and 25 females, aged 18-57 (37±11) years). The scores of pigmentation, vascularity, pliability, and thickness in Vancouver scar scale (VSS), the total score of VSS, the score of itch's impact on sleep in the four-item itch questionnaire (FIIQ), and the total score of FIIQ of patients were counted in the two groups before the first treatment (hereinafter referred to as treatment) and 3 months, 6 months, and 1 year after treatment. The treatment effective rate and the score of patients' satisfaction with the treatment effect in one year after treatment and the occurrence of adverse reaction during the treatment were counted. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test. Results: The scores of pigmentation, vascularity, pliability, and thickness in VSS and the total VSS score of patients between the two groups before treatment were close (P>0.05). The pliability score in VSS and total VSS score after 3 months of treatment, the score of vascularity in VSS and total VSS score after 6 months of treatment, and the scores of pigmentation, vascularity, pliability, and thickness in VSS and total VSS score of patients after 1 year of treatment in sequential nursing group were significantly lower than those in conventional nursing group (with Z values of -2.51, -3.37, -2.05, -3.28, -3.12, -5.86, -4.63, -5.56, -6.76, respectively, P<0.05 or P<0.01). The score of itch's impact on sleep in FIIQ after 3 months of treatment of patients in sequential nursing group was significantly lower than that in conventional nursing group (Z=-4.17, P<0.01), and the total scores of FIIQ after 3 months, 6 months, and 1 year of treatment of patients in sequential nursing group were significantly lower than those in conventional nursing group (with Z values of -6.56, -5.53, -5.84, respectively, P<0.01). After 1 year of treatment, the treatment effective rate of patients in sequential nursing group was 96.3% (52/54), which was significantly higher than 81.8% (45/55) in conventional nursing group (χ2=5.83, P<0.05), and the score of patients' satisfaction with the treatment effect in sequential nursing group was significantly higher than that in conventional nursing group (Z=-4.49, P<0.01). During the treatment period, there was no adverse reaction in patients in sequential nursing group, but there were 3 patients with pruritus and peripheral erythema on the wound in conventional nursing group, which were improved after dressing changes. Conclusions: Sequential nursing can effectively improve the prevention and management of new skin scars in patients after deep burns on the face and neck, improve the itching, the efficiency of treatment, and the satisfaction of patients with the treatment effect.

Inconsistent effects of a composite soil amendment on cadmium accumulation and consumption risk of 14 vegetables

Organic and inorganic mixtures can be developed as immobilizing agents that could reduce heavy metal accumulation in crops and contribute to food safety. Here, inorganic materials (lime, L; zeolite, Z; and sepiolite, S) and organic materials (biochar, B, and compost, C) were selectively mixed to produce six composite soil amendments (LZBC, LSBC, LZC, LZB, LSC, and LSB). Given the fact that LZBC showed the best performance in decreasing soil Cd availability in the incubation experiment, it was further applied in the field condition with 14 vegetables as the test crops to investigate its effects on crop safety production in polluted greenhouse. The results showed that LZBC addition elevated rhizosphere soil pH by 0.1-2.0 units and reduced soil Cd availability by 1.85-37.99%. Both the biomass and the yields of edible parts of all vegetables were improved by LZBC addition. However, LZBC addition differently affected Cd accumulation in edible parts of the experimental vegetables, with the observation that Cd contents were significantly reduced in Allium fistulosum L., Amaranthus tricolor L., and Coriandrum sativum Linn., but increased in the three species of Lactuca sativa. Further health risk assessment showed that LZBC application significantly decreased daily intake of metal (DIM), health risk index (HRI), and target hazard quotient (THQ) for Cd in Allium fistulosum L., Amaranthus tricolor L., and Coriandrum sativum Linn., whereas increased all the indexes in Lactuca sativa. Our results showed that the effect of a composite amendment on Cd accumulation in different vegetables could be divergent and species-dependent, which suggested that it is essential to conduct a pre-experiment to verify applicable species for a specific soil amendment designed for heavy metal immobilization.

Robust engraftment of fetal nonhuman primate CD34-positive cells in immune-deficient mice

Nonhuman primates (NHPs) represent one of the most important models for preclinical studies of novel biomedical interventions. In contrast with small animal models, however, widespread utilization of NHPs is restricted by cost, logistics, and availability. Therefore, we sought to develop a translational primatized mouse model, akin to a humanized mouse, to allow for high-throughput in vivo experimentation leveraged to inform large animal immunology-based studies. We found that adult rhesus macaque mobilized blood (AMb) CD34+-enriched hematopoietic stem and progenitor cells (HSPCs) engrafted at low but persistent levels in immune-deficient mice harboring transgenes for human (NHP cross-reactive) GM-CSF and IL3, but did not in mice with wild-type murine cytokines lacking NHP cross-reactivity. To enhance engraftment, fetal liver-derived HSPCs were selected as the infusion product based on an increased CD34hi fraction compared with AMb and bone marrow. Coupled with cotransplantation of rhesus fetal thymic fragments beneath the mouse kidney capsule, fetal liver-derived HSPC infusion in cytokine-transgenic mice yielded robust multilineage lymphohematopoietic engraftment. The emergent immune system recapitulated that of the fetal monkey, with similar relative frequencies of lymphocyte, granulocyte, and monocyte subsets within the thymic, secondary lymphoid, and peripheral compartments. Importantly, while exhibiting a predominantly naïve phenotype, in vitro functional assays demonstrated robust cellular activation in response to nonspecific and allogenic stimuli. This primatized mouse represents a viable and translatable model for the study of hematopoietic stem cell physiology, immune development, and functional immunology in NHPs. Summary Sentence: Engraftment of rhesus macaque hematopoietic tissues in immune-deficient mice yields a robust BLT/NeoThy-type primatized mouse model for studying nonhuman primate hematopoiesis and immune function in vivo.

A new Kirkpatrick-Baez-based scanning microscope for the Submicron Resolution X-ray Spectroscopy (SRX) beamline at NSLS-II

The development, construction, and first commissioning results of a new scanning microscope installed at the 5-ID Submicron Resolution X-ray Spectroscopy (SRX) beamline at NSLS-II are reported. The developed system utilizes Kirkpatrick-Baez mirrors for X-ray focusing. The instrument is designed to enable spectromicroscopy measurements in 2D and 3D with sub-200 nm spatial resolution. The present paper focuses on the design aspects, optical considerations, and specifics of the sample scanning stage, summarizing some of the initial commissioning results.

Effects of deoxynivalenol on the histomorphology of the liver and kidneys and the expression of MAPKs in weaned rabbits

Deoxynivalenol (DON) is widely present in grain-based feeds and food. It has attracted great attention due to its high contamination rate and strong toxicity. The objective of this study was to analyse the toxic effects of DON on the liver and kidneys of weaned rabbits. 45 weaned male rabbits were allocated into control, low DON dose (0.5 mg/kg body weight), and high DON dose (1.5 mg/kg body weight) groups. Saline or DON was administrated intragastrically in the empty stomach of rabbits every morning. After 24 days of treatment, liver and kidney samples were collected for histological, reverse transcription-quantitative polymerase chain reaction (qRT-PCR), and immunohistochemistry analyses. Haematoxylin eosin staining showed that 0.5 mg/kg BW DON caused mild damage to the liver and kidney morphology, while 1.5 mg/kg body weight DON resulted in hepatic vacuolation and necrosis, as well as tubular stenosis and lesions. Data from qRT-PCR, Western blot, and immunohistochemistry revealed that the mRNA and protein expression and the distribution range of extracellular signal-regulated kinase, p38, and c-Jun NH2-terminal kinase were increased in the liver and kidneys. In conclusion, DON at the tested concentrations damaged the liver and kidneys of rabbits by affecting the expression of key proteins from the mitogen-activated protein kinase signalling pathway. The damage extent was proportional to the amount of DON ingested.

SuperSonic shear imaging for the differentiation between benign and malignant thyroid nodules: a meta-analysis

PURPOSE

To assess the diagnostic value of SuperSonic shear imaging (SSI) for the differentiation between benign and malignant thyroid nodules through meta-analysis.

METHODS

Online database searches were performed on PubMed, EMBASE, the Cochrane Library, and the Web of Science until 31 July 2021. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. Three measures of diagnostic test performance were used to examine the value of SSI, including the summary area under the receiver operating characteristic curve (AUROC), the summary diagnostic odds ratio (DOR), and the summary sensitivity and specificity. Heterogeneity was explored using meta-regression and subgroup analyses.

RESULTS

Finally, 21 studies with 3376 patients were included in this study. There were a total of 4296 thyroid nodules, in which 1806 malignant nodules and 2490 benign ones were involved. Thyroid nodules exhibited a malignancy rate of 42.0% (range 5.6-79.8%), 95.1% of which were of papillary variant. SSI showed a summary sensitivity of 74% [95% confidence interval (CI) 67-79%], specificity of 82% (95% CI 77-87%) and AUROC of 0.85 (95% CI 0.82-0.88) for the differentiation between benign and malignant thyroid nodules. The summary positive likelihood ratio (LR), negative LR, and DOR were 4.2 (95% CI 3.3-5.3), 0.32 (95% CI 0.26-0.40), and 13 (95% CI 9-18), respectively.

CONCLUSIONS

SSI showed high accuracy in the diagnostic differentiation between benign and malignant thyroid nodules and can be served as a noninvasive and important adjunct for thyroid nodule evaluation.

Retention of Intrafibrillar Minerals Improves Resin-Dentin Bond Durability

The concept of extrafibrillar demineralization involves selective removal of apatite crystallites from the extrafibrillar spaces of mineralized dentin without disturbing the intrafibrillar minerals within collagen. This helps avoiding activation of endogenous proteases and enables air-drying of partially demineralized dentin without causing collapse of completely demineralized collagen matrix that adversely affects resin infiltration. The objective of the present study was to evaluate the potential of quaternized carboxymethyl chitosan (QCMC)-based extrafibrillar demineralization in improving resin-dentin bond durability. Isothermal titration calorimetry indicated that QCMC synthesized by quaternization of O-carboxymethyl chitosan had moderate affinity for Ca²⁺ (binding constant: 8.9 × 10⁴ M^-1). Wet and dry bonding with the QCMC-based demineralization produced tensile bond strengths equivalent to the phosphoric acid (H₃PO₄)-based etch-and-rinse technique. Those bond strengths were maintained after thermocycling. Amide I and PO₄^3- mappings of QCMC-conditioned dentin were performed with atomic force microscope-infrared spectroscopy (AFM-IR). Whereas H₃PO₄-etched dentin exhibited an extensive reduction in PO₄^3- signals corresponding to apatite depletion, QCMC-conditioned dentin showed scattered dark areas and bright PO₄^3- streak signals. The latter were consistent with areas identified as collagen fibrils in the amide I mapping and were suggestive of the presence of intrafibrillar minerals in QCMC-conditioned dentin. Young's modulus mapping of QCMC-demineralized dentin obtained by AFM-based amplitude modulation-frequency modulation recorded moduli that were the same order of magnitude as those in mineralized dentin and at least 1 order higher than H₃PO₄-etched dentin. In situ zymography of the gelatinolytic activity within hybrid layers created with QCMC conditioning revealed extremely low signals before and after thermocycling, compared with H₃PO₄-etched dentin for both wet and dry bonding. Confocal laser scanning microscopy identified the antibacterial potential of QCMC against Streptococcus mutans and Enterococcus faecalis biofilms. Taken together, the QCMC-based demineralization retains intrafibrillar minerals, preserves the elastic modulus of collagen fibrils, reduces endogenous proteolytic activity, and inhibits bacteria biofilms to extend dentin bond durability.

POS0978 LUMBAR FACET JOINTS ARTHRITIS RELATES TO ITS ADJACENT MRI INFLAMMATORY LESIONS IN AXIAL SPONDYLOARTHRITIS

Background

Facet joints are frequently impaired in patients with axial spondyloarthritis (axSpA), which raises high disease activity and poor physical function. However, insufficient attention is paid to the relationship between the feature of disease and facet joint arthritis (FJA) in magnetic resonance imaging (MRI) examination, because of lacking an ideal assessment tool. The Canada-Denmark (CANDEN) MRI scoring system is adopted in our study because it is a comprehensive method to assess the alteration of spine [1].

Objectives

We aimed to find relevant factors for lumbar FJA in axSpA patients.

Methods

This was a cross-sectional study that analyzed the lumbar MRI of axSpA patients using the CANDEN system. Demographic and clinical information was recorded. Univariate and multivariate linear mixed model (LMM) was used to screen related factors for lumbar FJA in MRI examinations.

Results

(1) Totally 108 axSpA patients were investigated in our study, while ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA) accounted for half respectively. Sixty-five (60.19%) participants were male and their median age was 35 years. (2) Twenty (37.10%) and 1 (1.80%) AS and nr-axSpA suffered lumbar FJA (P<0.05). (3) Univariate LMM found gender, vertebral body corner inflammation subscore (VBCIS), spondylodiscitis subscore (SDS), posterolateral elements inflammation subscore (PLEIS), fat posterior elements subscore (FPES), fat vertebral body subscore (FVBS), and AS disease activity score with C-reactive protein (ASDAS) related to lumbar FJA in AS patients. Besides, gender, the duration of symptom, peripheral arthritis, enthesitis, non-steroidal anti-inflammatory drugs, VCBIS, SDS, PLEIS, FPES, the ankylosis of sacroiliac joints, and bony erosion of hips were involved in the univariate LMM for nr-axSpA. (4) Multivariate LMM displayed that odd ratio (OR) and 95% confidence intervals (CI) of PLEIS, FPES, and ASDAS were 0.66 (0.40, 0.91), 0.45 (0.20, 0.71), and 0.23 (0.01, 0.44) (P<0.05). OR (95%CI) for VBCIS and PLEIS were 0.02 (0.00, 0.04) and 0.23 (0.16, 0.30) in nr-axSpA patients (P<0.05).

Conclusion

Prevalence of lumbar FJA is higher in AS patients than nr-axSpA. This lesion is mainly related to MRI changes of its neighborhood structure, especially inflammatory alterations, rather than demographic and clinical characteristics.

References

[1]Krabbe S, Østergaard M, Pedersen SJ, et al. Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis: updated definitions, scoring rules and inter-reader reliability in a multiple reader setting. RMD Open. 2019;5(2):e001057.

Disclosure of Interests

None declared

AB0228 THE CONNECTION BETWEEN NUTRITIONAL STATUS AND DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS

Background

Nutritional status is closely associated with a person’s physical condition. As for patients with autoimmune disease, nutritional status may affect the balance of immune system, which successively affects disease activity.

Objectives

The prognostic nutritional index (PNI), nutritional risk index (NRI), controlling nutritional status (CONUT) score and body mass index (BMI) are four widely used nutritional indices [1]. This study aimed to investigate the relationship between nutritional status and disease activity of rheumatoid arthritis (RA).

Methods

168 RA patients and 50 healthy volunteers were retrospectively enrolled. According to the disease activity score using 28 joint counts-erythrocyte sedimentation rate (DAS28-ESR), the cohort of RA patients was divided into the lower disease activity groups (DAS28-ESR≤3.2) and the higher disease activity groups (DAS28-ESR>3.2). We recorded clinical assessment and laboratory data for further analysis. Spearman’s correlation, receiver operation characteristic (ROC) curves, binary logistic regression analysis were carried out.

Results

Compared to the higher disease activity group, the lower disease activity group had low-level total protein (TP), ESR and CRP (all P<0.05), while high-level albumin and PNI (all P<0.05). PNI and NRI were negatively correlated with DAS28-ESR (r=-0.395, and r=-0.200, all P<0.05), while CONUT score was positively correlated with DAS28-ESR (r=0.324, P<0.05). ROC curve illustrated that area under the curve (AUC) of PNI for RA patients with higher disease activity was superior to NRI, CONUT score and BMI. The AUC of PNI was 0.693.

Figure 1.

The diagnostic value of variables for disease activity in rheumatoid arthritis using ROC curve

Table 1.

The correlation between nutritional indices and disease activity score using 28 joint counts-erythrocyte sedimentation rate (DAS28-ESR)

PNINRICONUT scoreBMIrP valuerP valuerP valuerP valueNeutrophil(×109/L)-0.0610.4340.0450.5680.0250.7570.0790.313Monocyte(×109/L)0.1830.1630.1450.064-0.1040.1930.1520.052Lymphocyte(×109/L)0.4720.0000.2010.010-0.4360.0000.2080.007ESR (mm/h)-0.5610.000-0.2580.0010.3930.000-0.1820.020CRP (mg/L)-0.5200.000-0.0770.3260.3910.0000.0030.967RF(IU/ml)-0.2240.004-0.1160.1510.2600.001-0.0820.306CCP(IU/ml)-0.1390.088-0.2010.0140.1950.018-0.1880.022DAS28-ESR-0.3950.000-0.2000.0110.3240.000-0.1420.072

Conclusion

PNI may become a manageable marker for detector disease activity of RA patients.

References

[1]Ahn, S.S., et al., Comparison of the Clinical Implications among Five Different Nutritional Indices in Patients with Lupus Nephritis. Nutrients, 2019. 11(7).

Disclosure of Interests

None declared

Cadmium phytoextraction through Brassica juncea L. under different consortia of plant growth-promoting bacteria from different ecological niches

Combined bioaugmentation inoculants composed of two or more plant growth-promoting bacteria (PGPB) were more effective than single inoculants for plant growth and cadmium (Cd) removal in contaminated soils. However, the principles of consortia construction still need to be discovered. Here, a pot experiment with Cd natural polluted soil was conducted and PGPB consortia with different ecological niches from hyperaccumulator Sedum alfredii Hance were used to compare their effects and mechanisms on plant growth condition, Cd phytoextraction efficiency, soil enzymatic activities, and rhizospheric bacterial community of Brassica juncea L. The results showed that both rhizospheric and endophytic PGPB consortia inoculants promoted plant growth (6.9%-22.1%), facilitated Cd uptake (230.0%-350.0%) of oilseed rape, increased Cd phytoextraction efficiency (343.0%-441.0%), and enhanced soil Cd removal rates (92.0%-144.0%). PGPB consortia inoculants also enhanced soil microbial carbon by 22.2%-50.5%, activated the activities of soil urease and sucrase by 74.7%-158.4% and 8.4%-61.3%, respectively. Simultaneously, PGPB consortia inoculants increased the relative abundance of Flavobacterium, Rhodanobacter, Kosakonia, Pseudomonas and Paraburkholderia at the genus level, which may be beneficial to plant growth promotion and bacterial phytopathogen biocontrol. Although the four PGPB consortia inoculants promoted oilseed growth, amplified Cd phytoextraction, and changed bacterial community structure in rhizosphere soil, their original ecological niches were not a decisive factor for the efficiency of PGPB consortia. therefore, the results enriched the present knowledge regarding the significant roles of PGPB consortia as bioaugmentation agents and preliminarily explored construction principles of effective bioaugmentation inoculants, which will provide insights into the microbial responses to combined inoculation in the Cd-contaminated soils.

Hydrogen sulphide regulates the growth of tomato root cells by affecting cell wall biosynthesis under CuO NPs stress

Copper oxide nanoparticles (CuO NPs) show strong nano-toxic effects on organisms. Hydrogen sulphide (H₂ S) plays a pivotal role in plant response to abiotic stress. In this study, we examine the crucial role of the cell wall as regulated by H₂ S in response to CuO NPs stress. The digestion method was employed to determine Cu content using atomic absorption spectrometry. The TraKine pro-tubulin staining kit was used to investigate the microtubule cytoskeleton using confocal laser-scanning microscopy. Cell wall component analysis utilized the ICS-3000 HPLC system. Application of H₂ S reduced growth inhibition caused by CuO NPs. Furthermore, most of the CuO NPs accumulates in roots, indicating a low transfer rate, and H₂ S significantly decreased CuO NPs content in roots, leaves and stems. Subcellular distribution analysis implied most Cu accumulated in root cell walls, and that H₂ S reduced the content of Cu in root cell walls. Cortical microtubules in the plasma membrane, guide cell wall biosynthesis. H₂ S obviously alleviated microtubule cytoskeleton disorders caused by CuO NPs. In addition, the content of cellulose, hemicellulose, pectin and other monosaccharides in root cell walls was reduced by CuO NPs treatment. H₂ S enhanced the monosaccharide and polysaccharide contents compared with that after CuO NPs treatment. In conclusion, H₂ S regulates cell wall development in response to CuO NPs stress by stabilizing microtubules. H₂ S affected Cu distribution and alleviated growth inhibition of tomato seedlings. The research results provide a theoretical basis for further study of nano-toxicity regulation in plants.

[Experience and thoughts on digestive tract reconstruction after radical resection of adenocarcinoma of the esophagogastric junction]

In the surgical treatment of adenocarcinoma of the esophagogastric junction (AEG), the scope of lymph node dissection, surgical approach selection, extent of tumor resection and digestive tract reconstruction have always been controversial, with the digestive tract reconstruction in AEG facing many challenges especially. The digestive tract reconstruction is related to the extent of resection. At present, the digestive tract reconstruction after total gastrectomy includes Roux-en-Y anastomosis, jejunum interposition and its derivatives. According to different reconstruction methods, they can be divided into tube anastomosis, linear anastomosis and manual anastomosis. Anti-reflux digestive tract reconstruction after proximal gastrectomy mainly includes esophagogastric anastomosis, interposition jejunum and double channel anastomosis. At present, double channel anastomosis is the most common reconstruction method in China. Based on the concept of interposition tubular stomach and reconstruction of gastric angle for anti-reflux, we propose "Giraffe" anastomosis, which moves artificial fundus and His angle downward to retain more residual stomach, showing good gastric emptying and anti-reflux effect. In this paper, combined with our clinical experience and understanding, we discuss the selection and technical key points of digestive tract reconstruction methods in AEG, and suggest that composite anti-reflux mechanism design may be the development trend of anti-reflux reconstruction in the future. The composite mechanism includes the retention of gastric electrical pacemaker in greater curvature of the middle part of gastric body to increase the emptying capacity of residual stomach, the reconstruction of gastric fundus and His angle anti-reflux barrier, and the establishment of an interposition tubular stomach acting as a buffer zone in Giraffe construction, and so on.

[Functional outcomes of 100 patients with adenocarcinoma of the esophagogastric junction undergoing Cheng's GIRAFFE(®) reconstruction after proximal gastrectomy]

Objective: To investigate the functional outcomes and postoperative complications of Cheng's GIRAFFE reconstruction after proximal gastrectomy. Methods: A descriptive case series study was conducted. Clinical data of 100 patients with adenocarcinoma of the esophagogastric junction who underwent Cheng's GIRAFFE reconstruction after proximal gastrectomy in Cancer Hospital of University of Chinese Academy of Sciences (64 cases), Zhejiang Provincial Hospital of Chinese Medicine (24 cases), Lishui Central Hospital (10 cases), Huzhou Central Hospital (1 case) and Ningbo Lihuili Hospital (1 case) from September 2017 to June 2021 were retrospectively analyzed. Of 100 patients, 64 were males and 36 were females; the mean age was (61.3 ± 11.1) years and the BMI was (22.7±11.1) kg/m(2). For TNM stage, 68 patients were stage IA, 24 were stage IIA and 8 were stage IIB. Postoperative functional results and postoperative complications of radical gastrectomy with Giraffe reconstruction were analyzed and summarized. Gastroesophageal reflux disease questionnaire (RDQ) score and postoperative endoscopy were used to evaluate the occurrence of reflux esophagitis and its grade (grade N, grade A, grade B, grade C, and grade D from mild to severe reflux). The continuous data conforming to normal distribution were expressed as (mean ± standard deviation), and those with skewed distribution were presented as median (Q1, Q3). Results: All the 100 patients successfully completed R0 resection, including 77 patients undergoing laparoscopic surgery and 23 patients undergoing laparotomy. The Giraffe anastomosis time was (38.6±14.0) min; the blood loss was (73.0±18.4) ml; the postoperative hospital stay was 9.5 (8.2, 13.0) d; the hospitalization cost was (6.0±0.3) ten thousand yuan. Fourteen cases developed perioperative complications (14.0%), including 7 cases of pleural effusion or pneumonia, 3 cases of anastomotic leakage, 2 cases of gastric emptying disorder, 1 case of gastrointestinal hemorrhage and 1 case of anastomotic stenosis, who were all improved and discharged after symptomatic management. Patients were followed up for (33.3±1.6) months. Eight patients were found to have reflux symptoms by RDQ scale six months after surgery, and 11 patients (11/100,11.0%) were found to have reflux esophagitis by gastroscopy, including 6 in grade A, 3 in grade B, and 2 in grade C. All the patients could control their reflux symptoms with behavioral guidance or oral PPIs. Conclusion: Cheng's GIRAFFE reconstruction has good anti-reflux efficacy and gastric emptying function; it can be one of the choices of reconstruction methods after proximal gastrectomy.

[Postoperative rehabilitation effect and influence factors of adult prelingual deafness with cochlear implant]

Objective: To investigate whether pre-lingual deafness adult caused by inadequate auditory compensation in childhood can benefit from cochlear implants and the related influencing factors. Methods: A total of 26 prelingual deafness as experimental group [11 males and 15 females, the age of operation was (24.5±5.7) years] and 13 postlingual deafness as control group [5 males and 8 females, the age at the time of operation was (42.2±11.4) years] were recruited. Objective assessment included hearing threshold and speech recognition rate tests while wearing cochlear implants. Subjective assessment used Nijmegen Cochlear Implant Questionnaire to assess hearing-related quality of life of subjects. The changes of hearing ability in the prelingual deafness group before and after operation and the differences with the postlingual deafness group were compared, and the correlation between speech recognition ability and the age diagnosed as severe or profound deafness, the age of hearing aid invalid, and duration of wearing cochlear implant were analyzed as factor indicators. All statistical results were analyzed by SAS 9.4 software. Results: In terms of objective indicators, the speech recognition rate of pre-lingual deafness was significantly lower than that of post-lingual deafness [(35.4±28.0)% vs (80.9±8.0)%,t=7.67, P<0.001], while there was no statistical difference in hearing threshold between the two groups [(34.8±4.0) dB HL vs (33.1±3.7) dB HL, t=1.30, P>0.05]. The indicators in the subjective questionnaire showed that the prelingual deafness group was only weaker in advanced sound perception, confidence and total mean score than the post-lingual deafness group (P<0.05), and there was no significant difference in other aspects(P>0.05), meanwhile, all indicators of the prelingual deafness group were significantly improved compared with the preoperative level (P<0.001). There was a moderate positive correlation between the hearing quality and the speech recognition rate in the prelingual deafness group(r=0.51, P=0.008). The regression analysis showed that the invalid age of hearing aid was the exact influencing factor of speech recognition rate. Conclusions: Certain prelingual deaf adults can adapt to cochlear implants and obtain different degrees of auditory assistance. Compared with the improvement of objective auditory ability assessment, the patient who received cochlear implantation gain more improvement in auditory related quality of life subjectively. The ineffective age of preoperative hearing aid is an important factor, which needs to be aroused sufficient preoperative attention.

[A case with severe neurocysticercosis]

This case report described the diagnosis and treatment of an ethnic Tibetan case with severe neurocysticercosis residing in agricultural areas of Sichuan province.

Positive effects of applying endophytic bacteria in eggplant-Sedum intercropping system on Cd phytoremediation and vegetable production in cadmium polluted greenhouse

The combination of intercropping and phytoremediation in the remediation of cadmium contaminated soil is an emerging model in recent years, but the results of previous studies are inconsistent. In the field experiment, eggplant was intercropped with hyperaccumulator Sedum alfredii Hance (inoculated or not inoculated with endophytic bacteria) to study the effects of intercropping on vegetable safety production, phytoremediation efficiency of hyperaccumulator and variation of soil available nutrients. The results showed that the intercropping treatment had a negative effect on the growth of eggplant and Sedum, but endophyte SaMR12 alleviated the inhibition of intercropping on plant growth. Intercropping treatment increases the Cd concentration in edible part of eggplant to 1.34 mg/kg compared with eggplant monoculture (1.19 mg/kg). While the application of SaMR12 reduces the Cd concentration of eggplant fruit to 0.95 mg/kg and significantly promotes the Cd uptake by Sedum. What's more surprising is that compared with eggplant monocropping, the content of soil available nitrogen, phosphorus and potassium in the treatment of intercropping with inoculated Sedum increased significantly. And according to the correlation analysis of various indexes of plants and soil, the Cd content of eggplant is negatively correlated with the available phosphorus and potassium in the soil, while the Cd content of Sedum is positively correlated with it, which suggested that the application of phosphorus and potassium fertilizers in this experimental site was beneficial to reduce Cd content in eggplant and improve Cd phytoextraction of Sedum. Therefore, in the daily production of moderately Cd-contaminated soil, intercropping eggplant with Sedum inoculated with endophytic bacteria is an excellent Phytoextraction Coupled with Agro-safe-production (PCA) pattern.