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The initiating etiologic factor in Crohn's disease (CD) remains unclear. SAMP1/YitFc (SAMP) mice develop chronic ileitis similar to human CD. We used bone marrow chimeras to determine if SAMP ileitis results from a primary immunological defect or from dysregulated mucosal immunity secondary to intrinsic, nonhematopoietic (e.g., epithelial) dysfunction. SAMP mice receiving wild-type (AKR) BM developed severe ileitis, whereas SAMP BM did not confer ileitis to WT recipients. WT lymphocytes from reconstituted SAMP mice resembled native SAMP populations in regard to surface phenotype and cytokine production. Ilea from native SAMP mice and SAMP recipients of wild-type BM displayed decreased epithelial barrier resistance ex vivo and increased epithelial permeability in vivo compared to native WT mice and AKR recipients of SAMP BM. This permeability defect preceded the development of ileal inflammation, was present in the absence of commensal bacteria, and was accompanied by altered ileal mRNA expression of the tight junction proteins claudin-2 and occludin. Our results provide evidence that the primary defect conferring ileitis in SAMP mice originates from a nonhematopoietic source. Generation of pathogenic lymphocytes is a consequence of this defect and does not reflect intrinsic proinflammatory leukocyte properties. Decreased barrier function suggests that defects in the epithelium may represent the primary source of SAMP ileitis susceptibility. [ABSTRACT FROM AUTHOR]

Aim: To perform a site-specific conjugation of Fab′ fragments of a mouse monoclonal antibody(MoAb) B43(of IgG1 subtype) to a bifunctional chelator 6-[ p- (bromoacetamido) benzyl]-1,4,8,11-tetraazacyclotetradecane- N,N′,N″,N′″-tetraacetic acid (BAT) via the thiol groups in the hinge distal to the antigenbinding site of the Fab′. Methods: B43 was cleaved using a simple 2-step method. First, stable F(ab′)2 was produced by pepsin treatment. Fab′ with free thiol in the hinge region was then obtained by cysteine reduction of F(ab′)2. Second, a sitespecific conjugation of Fab′ to thiol-specific BAT was performed in a one-step reaction. Results: The Fab′ fragment had approximately 1.8 free thiol groups per molecule after cysteine reduction. The conjugation efficiency and the chemical yield were approximately 1.28 moles chelator/Fab′ and 74% of the initial concentration of Fab′, respectively. The F(ab′)2, Fab′ and Fab′-BAT all maintained reasonable antigen-binding properties. 67Cu labeling of the conjugate under standard conditions did not impair the immunoreactivity of Fab′-BAT. Conclusion: This is a simple and efficient method for producing immunoreactive conjugates of Fab′- BAT, which can be used to make radiometal-labeled conjugates for further diagnostic and therapeutic applications. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of αz-zearalenol on angiotensin II-induced β3 integrin mRNA expression in human umbilical vein endothelial cells (HUVECs). Methods The mRNA level in integrin β3 was determined by reverse transcription-polymerase chain reaction. Endothelial NF-κB activity was determined by the luciferase activity assay of plasmid NF-κB-LUC. Results The angiotensin II- induced β3 integrin mRNA expression was inhibited by α-zearalenol and 17β-estradiol (10nmol/L-1 μmol/L), but not influenced by ICI 182, 780, a pure competitive antagonist for estrogen receptor or a nitric oxide inhibitor Nω -Nitro-L-arginine methyl ester hydrochloride. Alpha-zearalenol and 1 7β-estradiol suppressed the angiotensin II-induced activation of NF-κB in endothelial cells. Conclusion Alpha-zearalenol inhibits angiotensin II-induced integrin β3 mRNA expression by suppressing NF-κB activation in endothelial cells. [ABSTRACT FROM AUTHOR]

The authors establish the approximations to the distribution of M-estimates in a linear model by the bootstrap and the linear representation of bootstrap M-estimation, and prove that the approximation is valid in probability 1. A simulation is made to show the effects of bootstrap approximation, randomly weighted approximation and normal approximation. [ABSTRACT FROM AUTHOR]

Presents the results of a 1997 survey on the status of Pseudois schaeferi or dwarf blue sheep in Sichuan Province, China. Overview of previous studies; Description of Batang County in Sichuan Province, China; Morphology and behavior of dwarf blue sheep.

We have investigated the photon-assisted shot noise properties in the magnetic field tunable heterostructures. Transport properties of the model structure are strongly dependent on the oscillatory field and the magnetic field. In this structure, electrons can absorb or emit one or multi-photons to reach the quasi-bound state. As a result, the transmission properties are affected considerably by photon-assisted tunneling and these features cause the nontrivial variations in the shot noise and Fano factor. It is found that the shot noise becomes spin-dependent and can be modulated not only by the magnetic field, but also by the oscillatory field. Both the spin-up and spin-down components of the shot noise can be greatly suppressed by the magnetic field, and can also be drastically enhanced by the harmonically driven field. Furthermore, with increasing external magnetic field, it is important to note that the enhanced intensity is decreased, even suppressed. These results suggest another method to suppress the shot noise via modulating the oscillatory field at a diluted-magnetic semiconductors/semiconductor structure. [ABSTRACT FROM AUTHOR]

Objective: To determine the correlation and clinical significance of musculoskeletal ultrasound semi-quantitative grading with bone salt metabolism, rheumatoid factor and erythrocyte sedimentation rate (ESR) in patients with rheumatoid arthritis. Methods: This is a clinical comparative study. A total of 240 patients with rheumatoid arthritis admitted to Baoding NO.1 Central Hospital were selected according to the DAS28 score of rheumatoid arthritis, and were divided into four groups, with 60 cases in each group from May 2020 to May 2022. The differences and correlation of musculoskeletal ultrasound semi-quantitative grading, bone metabolism indicators, erythrocyte sedimentation rate and rheumatoid factor among the four groups were statistically analyzed. Results: The scores of bone erosion, synovial hyperplasia, joint effusion and intrasynovial blood flow in Group-H were significantly higher than those in Group-R, L and M, with statistically significant differences(p=0.00). The procollagen Type-1 N-terminal propeptide(P1NP), bone-specific alkaline phosphatase(BALP) and osteoprotegerin(OPG) in Group-H were significantly lower than those in Group-R, L and M, with statistically significant differences(p=0.00); The tartrateresistant acid phosphatase(TRAC) in Group-H was significantly higher than that in Group-R, L and M, with a statistically significant difference(p=0.00). The levels of RF and ESR in Group-H were significantly higher than those in Group-R, L and M, with statistically significant differences(p=0.00). Conclusion: Musculoskeletal ultrasound semi-quantitative grading is correlated with the level of bone salt metabolism, rheumatoid factor and ESR in patients with rheumatoid arthritis. It can be combined with laboratory examination to objectively judge the severity of the course of rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Abstract Background The prognostic value of cytokeratin 19 fragment (CYFRA 21 − 1) and Ki67 in advanced non-small cell lung cancer (NSCLC) patients with wild-type epidermal growth factor receptor (EGFR) remains to be explored. Methods In this study, 983 primary NSCLC patients from January 2016 to December 2019 were retrospectively reviewed. Finally, 117 advanced NSCLC patients with wild-type EGFR and 37 patients with EGFR mutation were included and prognostic value of CYFRA 21 − 1 and Ki67 were also identified. Results The patients age, smoking history and the Eastern Corporative Oncology Group (ECOG) performance scores were significantly different between CYFRA21-1 positive and negative groups (p

Precipitable water vapour (PWV) over a ground station can be estimated from the global navigation satellite systems (GNSS) signal's zenith wet delays (ZWD) multiplying by a conversion factor that is a function of weighted-mean temperature (Tm). The commonly used Bevis Tm model (BTM) may not perform well in some regions due to its use of data from North America in the model development. In this study, radiosonde observations in 2012 from three stations - Changsha, Huaihua, Chenzhou in Hunan province, China - were used to establish a new regional Tm model (RTM) based on a numerical integration and the least squares estimation methods. Four seasonal RTMs were also established and assessed for 2012. The RTM-derived Tm at the three stations from 2012 - 2014 were validated by comparing it with radiosondederived Tm. Results showed that the accuracy of the yearly RTM was improved by 29% over the BTM, and the bias and root mean square (RMS) of all the four seasonal RTMs were slightly smaller than the yearly RTM, and the accuracy of spring, summer, autumn and winter Tm models is improved by 5, 13, 4, and 5% respectively. In addition, the bias and RMS of the differences between the GNSS-PWV resulting from the RTM-derived Tm and the radiosonde-PWV were 1.13 and 3.21 mm respectively, which are reduced by 34 and 10% respectively. Thus the seasonal RTMs are recommended for GNSS meteorology for Hunan Province. [ABSTRACT FROM AUTHOR]

With the rapid progress of technology, the popularity of tablet computers and the development of e-book applications have brought the use of e-books as a learning tool under the spotlight. In the meantime, the aim of school education lies not only in providing students with knowledge but also in encouraging them to construct knowledge actively. Consequently, in this study, an approach of integrating the guided peerfeedback strategy into e-book design was proposed. An experiment was conducted on an elementary school natural science course to explore its effectiveness in comparison with the conventional e-book development activity. It was expected that the guided peer-feedback approach could engage students in knowledge organizing and in-depth thinking while stimulating more innovative ideas. To assess the impacts of this approach, a quasi-experimental design method was adopted. The students were divided into two groups: the experimental group, in which the students learned with the guided peer-feedback strategy together with the e-book development approach, and the control group, in which the students learned with the conventional ebook development approach. The experimental results indicated that the integrated guided peer-feedback and e-book development strategy had significant impacts on the students' learning achievements and ebook project outcomes while reducing their cognitive load and increasing their innovative thinking tendency in the design process. [ABSTRACT FROM AUTHOR]

Abstract To study the soil consolidation effect of shrub plant roots on tailings soil and to explore the frictional characteristics of plant roots on tailings soil, three experimental conditions of the root–soil interface were established by using a modified indoor direct shear instrument with binders such as liquid sodium silicate and cyanoacrylate to conduct direct shear frictional tests at the root–soil interface using the roots of the typical slope protection plant Amorpha fruticosa. The Gompertz improved curve model was established by using the relationship between shear stress and shear displacement and the trend of the root–soil interface parameter index. The results were compared between the improved Gompertz curve model and the Clough–Duncan hyperbolic model, and a two-factor coupled improved Gompertz interfacial intrinsic structure model with normal stress and cohesive strength factor was established. The results showed that the interface shear stress and shear displacement showed strain hardening characteristics at different normal pressures for cohesive strength ratios of 1.5 and 1.7 at the root–tailing soil interface. At a cohesive strength ratio of 1.6, strain-softening was observed from 100 to 300 kPa and strain hardening was observed at 400 kPa. The improved Gompertz curve model predicts the shear stress and shear displacement curves at the root–soil interface with different cohesive strengths more reasonably than the Clough–Duncan hyperbolic model, and the maximum accuracy can be improved by nearly 40%. The two-factor coupled improved Gompertz curve model can fit the shear stress versus shear displacement relationship at the A. fruticosa root–tailing soil interface.

Examines the disruption of adhC gene of Mycobacterium smegmatis in the standard gene replacement methods. Revelation of gene duplication of the m. smegmatis genome; Characterization and comparison in the mutants of m. smegmatis; Indication of the chromosomal duplication process in m. smegmatis a potential source of genome dynamics.

We investigated the transmission probability of a single electron transmission through a quantum ring device based on the single-band effective mass approximation method and transfer matrix theory. The time-dependent Schrödinger equation is applied on a Gaussian wave packet passing through the quantum ring system. The electron tunneling resonance peaks split when the electron transmits through a double quantum ring. The splitting energy increases as the distance between the two quantum rings decreases. We studied the tunneling time through the single electron transmission quantum ring from the temporal evolution of the Gaussian wave packet. The electron probability density is sensitive to the thickness of the barrier between the two quantum rings. [ABSTRACT FROM AUTHOR]

PknD is one of the eleven eukaryotic-like serine/threonine protein kinases (STPKs) of Mycobacterium tuberculosis (Mtb). In vitro phosphorylation assays with the active recombinant PknD showed that the intracellular protein NAD+-dependent malate dehydrogenase (MDH) is a substrate of this kinase. MDH, an energy-supplying enzyme, catalyzes the interconversion of malate and oxaloacetate and plays crucial roles in several metabolic pathways including the citric acid cycle. The phosphorylation site was identified on threonine residues and the phosphorylation inhibited the MDH activity. In vitro, the recombinant MDH could also be phosphorylated by at least five other STPKs, PknA, PknE, PknH, PknJ, and PknG. Immunoprecipitation analysis revealed that MDH was hyperphosphorylated in the bacteria at the beginning of the stationary and under oxygen-limited conditions by STPKs other than PknD. On the contrary, when PknD-deficient mutant mycobacteria were grown in a phosphate-depleted medium, MDH was not detectably phosphorylated. These results suggest that although the MDH is a substrate of several mycobacterial STPKs, the activity of these kinases can depend on the environment, as we identified PknD as a key element in the MDH phosphorylation assay under phosphate-poor conditions.

Treatment regimens for acute myeloid leukemia (AML) continue to offer weak clinical outcomes. Through a high-throughput cell-based screen, we identified avocatin B, a lipid derived from avocado fruit, as a novel compound with cytotoxic activity in AML. Avocatin B reduced human primary AML cell viability without effect on normal peripheral blood stem cells. Functional stem cell assays demonstrated selectivity toward AML progenitor and stem cells without effects on normal hematopoietic stem cells. Mechanistic investigations indicated that cytotoxicity relied on mitochondrial localization, as cells lacking functional mitochondria or CPT1, the enzyme that facilitates mitochondria lipid transport, were insensitive to avocatin B. Furthermore, avocatin B inhibited fatty acid oxidation and decreased NADPH levels, resulting in ROS-dependent leukemia cell death characterized by the release of mitochondrial proteins, apoptosis-inducing factor, and cytochrome c. This study reveals a novel strategy for selective leukemia cell eradication based on a specific difference in mitochondrial function. [ABSTRACT FROM AUTHOR]

Background: Creatine transporter (CRTR) deficiency is the most common creatine deficiency syndrome, of which the final diagnosis relies on mutation in the X-linked CRTR gene. To date, more than 90 mutations in the SLC6A8 gene have been reported. This paper discusses a novel mutation detected via the thorough sequencing of all the X-chromosome-specific exons investigated in a four and a half year old boy with an intellectual disability, speech and language delay and motor disturbance. Methods: A brain magnetic resonance imaging (MRI) and a proton magnetic resonance spectroscopy (MRS) were carried out, the creatine and creatinine concentrations in the urine were checked and all exons were sequenced. Results: A detailed clinical investigation revealed a reduction in the cerebral creatine levels in the brain by the MRS, elevated creatine and creatinine concentrations in the urine and signal abnormalities in the left frontal cortex of the brain by the MRI. A novel change was identified in the heterozygosity of the exon 10: c.1395-c.1401 deletion. Conclusion: The use of a combination of powerful new technologies, such as thorough exome-nextgeneration sequencing and a brain MRS, should be considered, in order to determine any neurometabolic diseases, especially when the signal abnormalities in the brain MRI cannot be explained by any other factors. This mutation results most likely in a dysfunction of the creatine transport and synthesis, hence causing central nervous system symptoms. [ABSTRACT FROM AUTHOR]

Alcohol intake is associated with myocardial contractile dysfunction and apoptosis although the precise mechanism is unclear. This study was designed to examine the effect of the cytochrome P450 enzyme CYP2E1 inhibition on ethanol-induced cardiac dysfunction. Adult male mice were fed a 4% ethanol liquid or pair-fed control diet for 6weeks. Following 2weeks of diet feeding, a cohort of mice started to receive the CYP2E1 inhibitor diallyl sulfide (100 mg/kg/d, i.p.) for the remaining feeding duration. Cardiac function was assessed using echocardiographic and IonOptix systems. Western blot analysis was used to evaluate CYP2E1, heme oxygenase-1 (HO-1), iNOS, the intracellular Ca2+ regulatory proteins sarco(endo)plasmic reticulum Ca2+-ATPase, Na+ㅡCa2+ exchanger and phospholamban, pro-apoptotic protein cleaved caspase-3, Bax, c-Jun-NH2-terminal kinase (JNK) and apoptosis signal-regulating kinase (ASK-1). Ethanol led to elevated levels of CYP2E1, iNOS and phospholamban, decreased levels of HO-1 and Na+ㅡCa2+ exchanger, cardiac contractile and intracellular Ca2+ defects, cardiac fibrosis, overt O2− production, and apoptosis accompanied with increased phosphorylation of JNK and ASK-1, the effects were significantly attenuated or ablated by diallyl sulfide. Inhibitors of JNK and ASK-1 but not HO-1 inducer or iNOS inhibitor obliterated ethanol-induced cardiomyocyte contractile dysfunction, substantiating a role for JNK and ASK-1 signaling in ethanol-induced myocardial injury. Taken together, these findings suggest that ethanol metabolism through CYP2E1 may contribute to the pathogenesis of alcoholic cardiomyopathy including myocardial contractile dysfunction, oxidative stress and apoptosis, possibly through activation of JNK and ASK-1 signaling. [ABSTRACT FROM AUTHOR]

Objective To test whether in the absence of actin, actin-binding proteins such as caldesmon, calponin, and tropomyosin interact with the myosin of unphosphorylation, Ca2+-dependent phosphorylation (CDP), and C2+- independent phosphorylation (CIP) and stimulate myosin Mg2+-ATPase activities. Methods MC-ATPase activities were measured to evaluate the effects of caldesmon, calponin, and tropomyosin on the myosin in unphosphorylation, CDP by myosin light chain kinase (MLCK), and CIP by MLCK. Results (1) At different incubation-time, i.e., 5, 10, 20, 40, and 60 minutes, the highest Mg2+-ATPase activity was observed when myosin was in the state of CDP, the medium was CIP of myosin, and the lowest was the unphosphorylated myosin. (2) In the absence of caldesmon, calponin, and tropomyosin, the Mt-ATPase activities from high to low were in the following order: CDP, C1P, and unphosphorylated myosin. However, in the presence of caldesmon, calponin, and tropomyosin, the order of relative value of Mg2+-ATPase activities from high to low was unphosphorylated, CIP, and CDP of myosin respectively compared to the corresponding controls. Conclusions The results propose that caldesmon, calponin, and tropomyosin are capable of stimulating Mg2+-ATPase activity of smooth muscle myosin in Ca2+-independent manner, since Ca2+ is not obligating for the stimulating effects of the three proteins. The common characteristic of the three proteins is that when myosin activities are low, theft activations are relatively strong and this property might be involved in smooth muscle tension keeping. [ABSTRACT FROM AUTHOR]

Accurate identification of deer-derived components is significant in food and drug authenticity. Over the years, several methods have been developed to authenticate these products; however, identifying whether female deer products are hybrids is challenging. In this study, the zinc finger protein X-linked (ZFX) gene sequences of sika deer (Cervus nippon), red deer (Cervus elaphus) and their hybrid offspring were amplified and sequenced, the X221 and X428 species-specific single nucleotide polymorphisms (SNP) loci were verified, and a tetra-primer amplification refractory mutation system (T-ARMS-PCR) assay was developed to identify the parent-of-origin of female sika deer, red deer, and their hybrid deer. The T-ARMS-PCR developed based on the X221 locus could identify sika deer, red deer, and their hybrid offspring according to the presence or absence of PCR product sizes of 486 bp, 352 bp, and 179 bp, respectively, just as X428 locus could identify sika deer, red deer, and their hybrid offspring according to the presence or absence of PCR product sizes of 549 bp, 213 bp, and 383 bp, respectively. Forty products labeled deer-derived ingredients randomly purchased were tested using this assay, and the results showed that the identification results based on the two SNP loci were utterly consistent with the actual sources. In addition, this method was found to be accurate, simple, convenient, and with high specificity, thus providing an essential technical reference for deer product species identification. It is also an important supplement to the identification methods of the original ingredients of existing deer products., (© 2023. The Author(s).)

Objective: To determine the correlation and clinical significance of musculoskeletal ultrasound semi-quantitative grading with bone salt metabolism, rheumatoid factor and erythrocyte sedimentation rate (ESR) in patients with rheumatoid arthritis., Methods: This is a clinical comparative study. A total of 240 patients with rheumatoid arthritis admitted to Baoding NO.1 Central Hospital were selected according to the DAS28 score of rheumatoid arthritis, and were divided into four groups, with 60 cases in each group from May 2020 to May 2022. The differences and correlation of musculoskeletal ultrasound semi-quantitative grading, bone metabolism indicators, erythrocyte sedimentation rate and rheumatoid factor among the four groups were statistically analyzed., Results: The scores of bone erosion, synovial hyperplasia, joint effusion and intrasynovial blood flow in Group-H were significantly higher than those in Group-R, L and M, with statistically significant differences(p=0.00). The procollagen Type-1 N-terminal propeptide(P1NP), bone-specific alkaline phosphatase(BALP) and osteoprotegerin(OPG) in Group-H were significantly lower than those in Group-R, L and M, with statistically significant differences(p=0.00); The tartrate-resistant acid phosphatase(TRAC) in Group-H was significantly higher than that in Group-R, L and M, with a statistically significant difference(p=0.00). The levels of RF and ESR in Group-H were significantly higher than those in Group-R, L and M, with statistically significant differences(p=0.00)., Conclusion: Musculoskeletal ultrasound semi-quantitative grading is correlated with the level of bone salt metabolism, rheumatoid factor and ESR in patients with rheumatoid arthritis. It can be combined with laboratory examination to objectively judge the severity of the course of rheumatoid arthritis., Competing Interests: Declaration of conflicting interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Enhanced external counterpulsation (EECP) is a non-invasive assisted circulation technique and a rich pool of evidence has accumulated for its clinical application in the prevention and management of multiple comorbidities in the elderly population, including angina, heart failure, ischemic cerebrovascular diseases, neurodegenerative diseases, sleep disorder, diabetes and its complications, ischemic eye diseases, sudden hearing loss and erectile dysfunction, as well as various psychological and psychiatric conditions. When applying EECP to elderly patients, emphasis should be placed on issues such as safety assessment, risk management and protocol individualization, as well as the monitoring of efficacy during and after treatment., Competing Interests: Nothing to disclose., (© 2020 The Authors. Aging Medicine published by Beijing Hospital and John Wiley & Sons Australia, Ltd.)

Objective: To investigate the seroprevalence of Toxoplasma gondii infection in patients with gynecological malignant tumors, so as to provide the evidence for the control of T. gondii infections in the patients with gynecological malignant tumors., Methods: A total of 327 patients with gynecological malignant tumors were recruited, and 200 women with normal healthy examinations were served as controls. The serum anti- T. gondii IgG and IgM antibodies were detected by using ELISA, and the seroprevalence was compared between the patients and controls, and among various types of cancers., Results: The overall seroprevalence of T. gondii was 26.91% (88/327) in the patients with gynecological malignant tumors, which was significantly higher than that (5.00%) in the healthy volunteers ( χ 2 = 39.36, P <0.01) . The prevalence of anti- T. gondii IgG antibody in the cancer patients was significantly higher than that in the controls (26.30% vs. 5.00%; χ 2 = 37.79, P <0.01), while the prevalence of anti- T. gondii IgM antibody in the cancer patients was not significantly different from that in the controls (0.92% vs . 0; corrected χ 2 = 0.58, P > 0.01) . The positive rates of anti- T. gondii IgG antibody were 27.68%, 25.47% and 25.69% in ovarian cancer, cervical cancer, and breast cancer patients respectively, which were all significantly higher than those in the controls ( χ 2 = 32.35, 27.32 and 28.00; all P values<0.01); however, there was no significant difference among the various types of cancer patients in the positive rates of anti- T. gondii IgG antibody ( χ 2 = 0.17, P > 0.05) . In addition, the positive rates of anti- T. gondii IgM antibody were 1.79%, 0 and 0.92% in ovarian cancer, cervical cancer and breast cancer patients respectively, which was not significantly different from those in the controls (all P values > 0.05)., Conclusions: The seroprevalence of T. gondii infection is high in the patients with gynecological malignant tumors. It is suggested that the prevention and control of T. gondii infection should be strengthened in these patients.

Background: The loss of muscle mass, strength and function associated with increasing age has various health ramifications, including the elevated risk for falls, fractures, frailty, poor quality of life, and mortality. Several studies have confirmed the effects of protein supplementation and RT (resistance training) for this age-related change independently, but whether a combination of the two produces a stronger effect remains controversial., Objective: This study aims to explore whether a combination of protein supplementation and RT leads to reduction of muscle mass, strength and function in the elderly., Methods: We retrieved RCTs (randomized controlled trials) reporting the effects of protein supplementation combined with RT on muscle mass, strength and function in the elderly, published before May 2018 through PubMed, MEDLINE, Embase, and manual searches., Results: Twenty-one RCTs were included, involving 1,249 participants. The results showed that protein supplementation combine with RT significantly enhances the muscle mass and strength of the older adults, where FFM (fat-free mass) increased by 0.23 kg (95% CI: 0.09, 0.38; P=0.002), ASMM (appendicular skeletal muscle mass) by 0.39 kg (95% CI: 0.14, 0.64; P=0.002), handgrip strength by 0.29 kg (95% CI: 0.08, 0.50; P=0.008), knee extension strength by 0.27 kg (95% CI: 0.06, 0.47; P=0.013), leg press strength by 0.33 kg (95% CI: 0.01, 0.64; P=0.04), but no significant effects were seen on muscle function., Conclusion: Compared to simple RT, protein supplementation combine with RT is more effective in enhancing the muscle mass and strength in the elderly, and the findings do not support the benefit of combination treatment for muscle function., Competing Interests: None

Aim: To investigate the advantages of inferoposterior duodenal approach (IPDA) for laparoscopic pancreaticoduodenectomy (LPD)., Methods: A total of 36 patients subjected to LPD were admitted to the Affiliated Yijishan Hospital of Wannan Medical College from December 2009 to February 2015. These patients were diagnosed with an ampullary tumour or a pancreatic head tumour through computed tomography, magnetic resonance imaging or endoscopic retrograde cholangiopancreatography preoperatively. The cases were selected on the basis of the following criteria: tumour diameter < 4 cm; no signs of peripheral vascular invasion; evident lymph node swelling; and distant metastasis. Of the 36 cases, 20 were subjected to anterior approach (AA; AA group) and 16 were subjected to IPDA (IPDA group). Specimen removal time, intraoperative blood loss and postoperative complications in the two groups were observed, and their differences were compared., Results: During the operation, 2 cases in the AA group and 2 cases in the IPDA group were converted to laparotomy; these cases were excluded from statistical analysis. The remaining 32 cases successfully completed the surgery. The AA group and IPDA group exhibited the specimen removal time of 205 ± 52 and 160 ± 35 min, respectively, and the difference was significant (P < 0.01). The AA group and IPDA group revealed the intraoperative blood loss of 360 ± 210 mL and 310 ± 180 mL, respectively, but these values were not significantly different. Postoperative pathological results revealed 4 cases of inferior common bile duct cancer, 8 cases of duodenal papillary cancer, 6 cases of ampullary cancer, 13 cases of pancreatic cancer, 3 cases of chronic pancreatitis accompanied with cyst formation or duct expansion, and 2 cases of mucinous cystic tumour in the pancreatic head. The postoperative complications were pulmonary Staphylococcus aureus infection, incision faulty union, ascites induced poor drainage accompanied with infection, bile leakage, pancreatic leakage and delayed abdominal bleeding., Conclusion: In IPDA, probing for important steps can be performed in early stages, surgical procedures can be optimised and operation time can be shortened.

Objective: To examine whether the polymorphisms of endothelial nitric oxide synthase (eNOS) gene are associated with the susceptibility to high altitude pulmonary edema (HAPE) in Chinese railway construction workers at Qinghai-Tibet where the altitude is over 4 500 m above sea level., Methods: A case-control study was conducted including 149 HAPE patients in the construction workers and 160 healthy controls randomly recruited from their co-workers, matching the patients in ethnicity, age, sex, lifestyle, and working conditions. Three polymorphisms of eNOS gene, T-786C in promoter, 894G/T in exon 7, and 27bp variable number tandem repeat (VNTR) in intron 4, were genotyped using polymerase chain reaction (PCR) and confirmed with DNA sequencing., Results: The frequencies of 894T allele and heterozygous G/T of the 894G/T variant were significantly higher in HAPE patients group than in the control group (P=0.0028 and P=0.0047, respectively). However, the frequencies of the T-786C in promoter and the 27bp VNTR in intron 4 were not significantly different between the two groups. Haplotypic analysis revealed that the frequencies of two haplotypes (H3,T-T-b, b indicates 5 repeats of 27 bp VNTR; H6, C-G-a, a indicates 4 repeats of 27 bp VNTR) were significantly higher in HAPE patients (both Pü0.0001). On the contrary, the frequencies of H1 (T-G-b) and H2 (T-G-a) were lower in HAPE patients than in healthy controls (both Pü0.001)., Conclusions: Two haplotypes (T-T-b and C-G-a) may be strongly associated with susceptibility to HAPE. Compared with the individual alleles of eNOS gene, the interaction of multiple genetic markers within a haplotype may be a major determinant for the susceptibility to HAPE.