Ultraviolet (UV) radiation and reactive oxygen species (ROS) impair the physiological functions of retinal pigment epithelium (RPE) cells by inducing cell apoptosis, which is the main cause of age-related macular degeneration (AMD). The mechanism by which UV/ROS induces RPE cell death is not fully addressed. Here, we observed the activation of a ceramide-endoplasmic reticulum (ER) stress-AMP activated protein kinase (AMPK) signaling axis in UV and hydrogen peroxide (H2O2)-treated RPE cells. UV and H2O2 induced an early ceramide production, profound ER stress and AMPK activation. Pharmacological inhibitors against ER stress (salubrinal), ceramide production (fumonisin B1) and AMPK activation (compound C) suppressed UV- and H2O2-induced RPE cell apoptosis. Conversely, cell permeable short-chain C6 ceramide and AMPK activator AICAR (5-amino-1-β-D-ribofuranosyl-imidazole-4-carboxamide) mimicked UV and H2O2’s effects and promoted RPE cell apoptosis. Together, these results suggest that UV/H2O2 activates the ceramide-ER stress-AMPK signaling axis to promote RPE cell apoptosis.

To explore the clinical effects of less invasive surfactant administration (LISA) via a gastric tube on the treatment of respiratory distress syndrome (RDS) in premature infants aged 32 to 36 weeks. A total of 97 premature infants with RDS admitted to the Children's Hospital of Shanxi from February 2017 to January 2018 were randomly divided into LISA (47 cases) and (intubation-surfactant-extubation,) INSURE groups (50 cases). In the LISA group, 6F gastric tubes were inserted into the trachea through direct laryngoscopy under nasal continuous positive airway pressure (NCPAP), and pulmonary surfactant (PS) was injected. In the INSURE group, PS was injected via tracheal intubation and NCPAP was performed after extubation. The incidence of technical-related adverse events and various complications in the two groups were observed. PS was successfully injected through gastric tube in the LISA group. There were no significant differences in reflux, asphyxia, bradycardia (<100 beats/min), apnea, FiO 2 , changes in PaO 2 and PaCO 2 at 1 hour post-treatment between the groups. During the course of administration, blood pressure and SpO 2 in the LISA group were more stable, and significant differences between the 2 groups were observed. However, no significant differences in the complications and outcomes between the 2 groups occurred. The LISA technique can be used to treat premature infants with RDS aged 32 to 36 weeks with stronger spontaneous breathing ability. Further clinical studies are required to determine the optimal strategy of LISA administration and the most profitable patient population.

Our results imply that GSC has a wide range of LN metastases, including LN within jejunal mesentery in B-II reconstruction cases, and curable resection may obtain better results. Therefore, we suggest that radical operation for B-I patients needs removal of gastroduodenectomy anastomosis and the above LNs, and that B-II patients need removal of 10 cm of jejunum besides gastrojejunostomy anastomosis, and clearance of LN within its mesentery, in addition to B-I GSC.

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BackgroundThis study was conducted to investigate the risk factors of anastomotic fistula after the radical resection of esophageal‐cardiac cancer.MethodsFive hundred and forty‐four esophageal‐cardiac cancer patients who underwent surgery and had complete clinical data were included in the study. Fifty patients diagnosed with postoperative anastomotic fistula were considered the case group and the remaining 494 subjects who did not develop postoperative anastomotic fistula were considered the control. The potential risk factors for anastomotic fistula, such as age, gender, diabetes history, smoking history, were collected and compared between the groups. Statistically significant variables were substituted into logistic regression to further evaluate the independent risk factors for postoperative anastomotic fistulas in esophageal‐cardiac cancer.ResultsThe incidence of anastomotic fistulas was 9.2% (50/544). Logistic regression analysis revealed that female gender (P < 0.05), laparoscopic surgery (P < 0.05), decreased postoperative albumin (P < 0.05), and postoperative renal dysfunction (P < 0.05) were independent risk factors for anastomotic fistulas in patients who received surgery for esophageal‐cardiac cancer. Of the 50 anastomotic fistulas, 16 cases were small fistulas, which were only discovered by conventional imaging examination and not presenting clinical symptoms. All of the anastomotic fistulas occurred within seven days after surgery. Five of the patients with anastomotic fistulas underwent a second surgery and three died.ConclusionFemale patients with esophageal‐cardiac cancer treated with endoscopic surgery and suffering from postoperative hypoproteinemia and renal dysfunction were susceptible to postoperative anastomotic fistula.

The diagnosis of postdural disc herniations is very difficult and mainly based on intraoperative and histopathological results. Early surgical intervention is important to relieve symptoms and prevent severe neurological deficits.

Knowledge of the gas adsorption rate and diffusion characteristics in shale are very important to evaluate the gas transport properties. However, research on methane adsorption rate characteristics and diffusion behavior in shale is not well established. In this study, high-pressure methane adsorption isotherms and methane adsorption rate data from four marine shale samples were obtained by recording the pressure changes against time at 1-s intervals for 12 pressure steps. Seven pressure steps were selected for modelling, and three pressure steps of low (~0.4 MPa), medium (~4.0 MPa), and high (~7.0 MPa) were selected for display. According to the results of study, the methane adsorption under low pressure attained equilibrium much more quickly than that under medium and high pressure, and the adsorption rate behavior varied between different pressure steps. By fitting the diffusion models to the methane adsorption rate data, the unipore diffusion model based upon unimodal pore size distribution failed to describe the methane adsorption rate, while the bidisperse diffusion model could reasonably describe most of the experimental adsorption rate data, with the exception of sample YY2-1 at high pressure steps. This phenomenon may be related to the restricted assumption on pore size distribution and linear adsorption isotherm. The diffusion parameters α and β/α obtained from the bidisperse model indicated that both macro-and micropore diffusion controlled the methane adsorption rate in shale samples, as well as the relative importance and influence of micropore diffusion and adsorption to adsorption rate and total adsorption increased with increasing pressure. This made the inflection points, or two-stage process, at higher pressure steps not as evident as at low pressure steps, and the adsorption rate curves became less steep with increasing pressure. This conclusion was also supported by the decreasing difference values with increasing pressures between macro-and micropore diffusivities obtained using the bidisperse model, which is roughly from 10 −3 to 10 0 , and 10 −3 to 10 −1 , respectively. Additionally, an evident negative correlation between macropore diffusivities and pressure lower than 3-4 MPa was observed, while the micropore diffusivities only showed a gentle decreasing trend with pressure. A mirror image relationship between the variation in the value of macropore diffusivity and adsorption isotherms was observed, indicating the negative correlation between surface coverage and gas diffusivity. The negative correlation of methane diffusivity with pressure and surface coverage may be related to the increasing degree of pore blockage and the decreasing concentration gradient of methane adsorption. Finally, due to the significant deviation between the unipore model and experimental adsorption rate data, a new estimation method based upon the bidisperse model is proposed here.