Single-Cell Sequencing Reveals MYOF-Enriched Monocyte/Macrophage Subcluster as a Favorable Prognostic Factor in Sepsis

This research utilized single-cell RNA sequencing to map the immune cell landscape in sepsis, revealing 28 distinct cell clusters and categorizing them into nine major types. Delving into the monocyte/macrophage subclusters, 12 unique subclusters are identified and pathway enrichment analyses are conducted using KEGG and GO, discovering enriched pathways such as oxidative phosphorylation and antigen processing. Further GSVA and AUCell assessments show varied activation of interferon pathways, especially in subclusters 4 and 11. The clinical correlation analysis reveals genes significantly linked to survival outcomes. Additionally, cellular differentiation in these subclusters is explored. Building on these insights, the differential gene expression within these subclusters is specifically scrutinized, which reveal MYOF as a key gene with elevated expression levels in the survivor group. This finding is further supported by in-depth pathway enrichment analysis and the examination of cellular differentiation trajectories, where MYOF's role became evident in the context of immune response regulation and sepsis progression. Validating the role of the MYOF gene in sepsis, a dose-dependent response to LPS in THP-1 cells and C57 mice is observed. Finally, inter-cellular communications are analyzed, particularly focusing on the MYOF+Mono/Macro subcluster, which indicates a pivotal role in immune regulation and potential therapeutic targeting.

[Clinical effect of modified vertical rectus abdominis myocutaneous flap in repairing skin and soft tissue defects after abdominoperineal resection for rectal cancer]

Objective: To investigate the clinical effect of the modified vertical rectus abdominis myocutaneous flap in repairing the skin and soft tissue defect after abdominoperineal resection for rectal cancer. Methods: This study was a retrospective observational study. From June 2019 to July 2022, five male patients with low rectal cancer who were conformed to the inclusion criteria were admitted to the Department of Basic Surgery of Xiangya Hospital of Central South University, with ages ranging from 65 to 70 years and the sizes of the perianal skin ulcers ranging from 5 cm×4 cm to 11 cm×9 cm, and all of them underwent abdominoperineal resection. The secondary skin and soft tissue defects in the perineum with an area of 8 cm×6 cm-14 cm×12 cm (with the depth of pelvic floor dead space being 10-15 cm) were repaired intraoperatively with transplantation of modified vertical rectus abdominis myocutaneous flaps with the skin area being 9 cm×7 cm-16 cm×12 cm, the volume of the muscle being 18 cm×10 cm×5 cm-20 cm×12 cm×5 cm, and the vessel pedicle being 18-20 cm in length. During the operation, most of the anterior sheath of the rectus abdominis muscle was retained, the flap was transferred to the recipient area through the abdominal cavity, the remaining anterior sheaths of the rectus abdominis muscle on both sides of the donor area were repeatedly folded and sutured, the free edge of the transverse fascia of the abdomen was sutured with the anterior sheath of the rectus abdominis muscle, and the donor area skin was directly sutured. After the operation, the survival of the transplanted myocutaneous flap was observed. The occurrence of complications in the perineal recipient area was recorded within 2 weeks after the operation. The recovery of the perineal recipient area and the abdominal donor area was observed during follow-up, and the occurrence of complications in the donor area of the abdomen as well as the recurrence of tumors and metastasis were recorded. Results: All transplanted myocutaneous flaps in 5 patients survived after surgery. One patient had dehiscence of the incision in the perineal recipient area 2 days after surgery, which healed after 7 d with intermittent dressing changes and routine vacuum sealing drainage treatment. In the other 4 patients, no complications such as incisional rupture, incisional infection, or fat liquefaction occurred in the perineal recipient area within 2 weeks after surgery. Follow-up for 6-12 months after discharge showed that the skin of the perineal recipient area had good color, texture, and elasticity, and was not bloated in appearance; linear scars were left in the perineal recipient area and the abdominal donor area without obvious scar hyperplasia or hyperpigmentation; no complications such as incisional rupture, incisional infection, intestinal adhesion, intestinal obstruction, or weakening of the abdominal wall strength occurred in the abdominal donor area, and the abdominal appearance was good with no localized bulge or formation of abdominal hernia; there was no local recurrence of tumor or metastasis in any patient. Conclusions: The surgical approach of using the modified vertical rectus abdominis myocutaneous flap to repair the skin and soft tissue defects after abdominoperineal resection for rectal cancer is relatively simple in operation, can achieve good postoperative appearances of the donor and recipient areas with few complications, and is worthy of clinical promotion.

[Application effects of rehabilitation care decision-making scheme based on case management model in severe burn patients]

Objective: To explore the application effects of application of rehabilitation care decision-making scheme based on case management model in severe burn patients. Methods: The study was a non-randomized historical control study. Thirty patients who met the inclusion criteria and received routine rehabilitation nursing in the First Affiliated Hospital of Army Medical University (the Third Military Medical University, hereinafter referred to as the hospital) from April 2021 to March 2022 were included in routine rehabilitation nursing group (26 males and 4 females, aged 48.50 (31.75, 56.25) years), and 30 patients who met the inclusion criteria and received case management rehabilitation nursing in the hospital from April 2022 to March 2023 were included in case management rehabilitation nursing group (22 males and 8 females, aged 46.00 (36.75, 55.25) years). The length of intensive care unit (ICU) stay, total hospitalization day, and total hospitalization cost of the patients in two groups were recorded. At admission, convalescence, discharge, and 6 months after injury, the patients' life quality was evaluated by the concise burn specific health scale, the sleep quality was evaluated by the Pittsburgh sleep quality index, and the functional independence was evaluated by the functional independence rating scale. At convalescence, discharge, and 6 months after injury, the patients' scar status was evaluated by the Vancouver scar scale. At 6 months after injury, a third-party satisfaction questionnaire was used to investigate the efficacy satisfaction of patients. Results: The length of ICU stay and total hospitalization day of patients in case management rehabilitation nursing group were both significantly shorter than those in routine rehabilitation nursing group (with Z values of -1.97 and -1.99, respectively, P<0.05), and the total hospitalization cost was less than that in routine rehabilitation nursing group (Z=-1.99, P<0.05). At discharge and 6 months after injury, the life quality scores of patients in case management rehabilitation nursing group were significantly higher than those in routine rehabilitation nursing group (with t values of -3.19 and -4.43, respectively, P<0.05), while the sleep quality scores were significantly lower than those in routine rehabilitation nursing group (with Z values of -2.18 and -3.33, respectively, P<0.05). There were no statistically significant differences in cognitive function scores of functional independence of patients between the 2 groups at admission, convalescence, discharge, and 6 months after injury (P>0.05). The exercise function scores and total scores of functional independence of patients in case management rehabilitation nursing group at convalescence, discharge, and 6 months after injury were significantly higher than those in routine rehabilitation nursing group (with Z values of -4.37, -2.73, -4.10, -4.37, -2.64, and -4.06, respectively, P<0.05). The scar pigmentation scores of patients in case management rehabilitation nursing group at 6 months after injury were significantly lower than those in routine rehabilitation nursing group (Z=-2.05, P<0.05), and the scar vascularity scores of patients in case management rehabilitation nursing group at discharge and 6 months after injury in case management rehabilitation nursing group were significantly lower than those in routine rehabilitation nursing group (with Z values of -3.16 and -2.07, respectively, P<0.05). The scar pliability scores (with Z values of -3.16, -2.45, and -4.38, respectively, P<0.05), thickness scores (with Z values of -2.56, -2.35, and -4.70, respectively, P<0.05), and total scores (with Z values of -3.77, -3.04, and -3.13, respectively, P<0.05) of patients in case management rehabilitation nursing group at convalescence, discharge, and 6 months after injury were significantly lower than those in routine rehabilitation nursing group. At 6 months after injury, the efficacy satisfaction scores of patients in case management rehabilitation nursing group were 4.00 (3.00, 4.25), which were significantly higher than 3.00 (2.00, 4.00) in routine rehabilitation nursing group (Z=-2.72, P<0.05). Conclusions: The implementation of rehabilitation care decision-making scheme based on case management model can optimize the cost efficiency, improve the effectiveness of clinical treatment, and enhance the life quality and satisfaction of the curative effect of severe burn patients.

Integrative analysis of microbiota and metabolomics in chromium-exposed silkworm (Bombyx mori) midguts based on 16S rDNA sequencing and LC/MS metabolomics

The gut microbiota, a complex ecosystem integral to host wellbeing, is modulated by environmental triggers, including exposure to heavy metals such as chromium. This study aims to comprehensively explore chromium-induced gut microbiota and metabolomic shifts in the quintessential lepidopteran model organism, the silkworm (Bombyx mori). The research deployed 16S rDNA sequence analysis and LC/MS metabolomics in its experimental design, encompassing a control group alongside low (12 g/kg) and high (24 g/kg) feeding chromium dosing regimens. Considerable heterogeneity in microbial diversity resulted between groups. Weissella emerged as potentially resilient to chromium stress, while elevated Propionibacterium was noted in the high chromium treatment group. Differential analysis tools LEfSe and random forest estimation identified key species like like Cupriavidus and unspecified Myxococcales, offering potential avenues for bioremediation. An examination of gut functionality revealed alterations in the KEGG pathways correlated with biosynthesis and degradation, suggesting an adaptive metabolic response to chromium-mediated stress. Further results indicated consequential fallout in the context of metabolomic alterations. These included an uptick in histidine and dihydropyrimidine levels under moderate-dose exposure and a surge of gentisic acid with high-dose chromium exposure. These are critical players in diverse biological processes ranging from energy metabolism and stress response to immune regulation and antioxidative mechanisms. Correlative analyses between bacterial abundance and metabolites mapped noteworthy relationships between marker bacterial species, such as Weissella and Pelomonas, and specific metabolites, emphasizing their roles in enzyme regulation, synaptic processes, and lipid metabolism. Probiotic bacteria showed robust correlations with metabolites implicated in stress response, lipid metabolism, and antioxidant processes. Our study reaffirms the intricate ties between gut microbiota and metabolite profiles and decodes some systemic adaptations under heavy-metal stress. It provides valuable insights into ecological and toxicological aspects of chromium exposure that can potentially influence silkworm resilience.

[A cross-sectional survey and influencing factors analysis of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit]

Objective: To investigate the status of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit (BICU) and analyze its influencing factors. Methods: A multi-center cross-sectional survey research method was used. On May 8th, 2022, 107 BICU nurses who met the inclusion criteria were selected from the burn departments of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Guangdong Provincial People's Hospital, the First Affiliated Hospital of Guangxi Medical University, the Affiliated Hospital of Qinghai University, the Second Affiliated Hospital of Air Force Medical University, the Affiliated Hospital of Nantong University, Guiyang Steel Factory Staff Hospital, and the Second Affiliated Hospital of Kunming Medical University. The self-made nurses' enteral nutrition nursing knowledge-attitude-behavior questionnaire for severely burned patients was used to investigate the nurses' gender, age, working years, professional title, position, highest educational background, and whether they received systematic training in knowledge of enteral nutrition, the scores of each factor, and the total scores of knowledge, attitude, and behavior dimensions of enteral nutrition in nurses. The nurses were classified according to the general data, and the total scores of their knowledge, attitude, and behavior of enteral nutrition were calculated. Data were statistically analyzed with independent sample t test, one-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis H test. According to the results of univariate analysis and combined with clinical experience and significance, the generalized linear model analysis was carried out to screen the independent influencing factors of the total scores of knowledge, attitude, and behavior of enteral nutrition in BICU nurses. Results: A total of 107 nurses were surveyed, and 107 valid questionnaires were collected, with an effective recovery rate of 100%. In the BICU nurses' enteral nutrition knowledge-attitude-behavior questionnaire, the total scores of knowledge, attitude, and behavior were 44±13, 87±15, and 70±19, respectively. Most of the BICU nurses in this survey were female, aged 22-48 (31±6) years, and the number of nurses worked for 1-5, 6-10, and ≥11 years was evenly distributed. The majority of the professional titles of nurses were nurses, positions were responsible nurses, and the highest educational background was undergraduate. Forty-four nurses received systematic training in knowledge of enteral nutrition. There were statistically significant differences in the total scores of knowledge of enteral nutrition among BICU nurses with different ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (with H values of 27.36, 15.27, and 10.19, respectively, Z values of -3.33, -2.59, and -6.46, respectively, P<0.05). There were no statistically significant differences in the total scores of attitude and behavior of enteral nutrition among BICU nurses with different gender, ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (P>0.05). Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the total score of knowledge of enteral nutrition in BICU nurses (with 95% confidence intervals of 0.12-0.36, 0-0.30, 0.03-0.31, 0.01-0.32, and 0.19-0.40, respectively, standardized regression coefficients of 0.24, 0.15, 0.17, 0.17, and 0.29, respectively, P<0.05). There were no independent influencing factors for the total scores of enteral nutrition attitude and behavior of BICU nurses in different characteristics (P>0.05). Conclusions: The BICU nurses have low cognitive level in the implementation of enteral nutrition, their concept needs to be updated in time, and their behavior needs to be further standardized. Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the knowledge of enteral nutrition in BICU nurses.

[The cell nuclear damage probably induces chronic refractory diseases]

The cell nuclear damage is mainly caused by the radiation and various carcinogenic compounds, the essence of the damage is molecular adhesion fracture and chemical modification. After nuclear damage, the cells whose nuclei may be abnormal in morphology, structure and function, then become a kind of morbid cells or defective cells. The cell nuclear damage can affect gene expression and regulation, leading to dysfunctions or abnormalities of transcription and protein synthesis, which results in aging and induces various chronic refractory diseases, such as hypertension, atherosclerosis, diabetes, Alzheimer's disease, autoimmune diseases, and so on. The cell nuclear damage can also affect the state of cell differentiation and lead to restart of genes related to division and proliferation, thus inducing cancer. The cancer cells are derived from the cells with nuclear abnormalities, and the biological behavior or characteristics of cancer cells (shedding and metastasis, immune tolerance, uncontrolled, loss of contact inhibition, etc.) are derived from cells with nuclear abnormalities. This article reviewed the chronic refractory diseases caused by nuclear damage and their mechanisms, which provided a new idea for occupational health and toxicology research, as well as a new method and strategy for occupational disease prevention and treatment.

[Prospective study on application of mind mapping combined with scenario simulation training on the ability training of junior nurses in hospital transfer of patients with critical burns and trauma]

Objective: To explore the application effects of mind mapping combined with scenario simulation training on the ability training of junior nurses in hospital transfer of patients with critical burns and trauma. Methods: A prospective randomized controlled study was conducted. From December 2019 to December 2020, 55 female junior nurses from the Institute of Burn Research of the First Affiliated Hospital of Army Medical University (the Third Military Medical University) who met the inclusion criteria were enrolled in this study and divided into routine group (27 nurses, aged (24.0±0.9) years) and combined group (28 nurses, aged (24.2±0.8) years), according to the random number table. The nurses in routine group were trained with hospital transfer of patients with critical burns and trauma by theory combined with operational skill, and the nurses in combined group were trained with hospital transfer of patients with critical burns and trauma by mind mapping combined with scenario simulation training. Before and after the training, the self-made theoretical examination papers and skill assessment items were used for the examination and assessment to nurses, and their scores were calculated and compared. The self-made emergency ability scoring system was used to evaluate the emergency disposal ability of nurses from five dimensions, including team cooperation ability, emergency response ability, operative technique ability, specialized business ability, and nurse-patient communication ability, and their scores were calculated and compared. The non-standard implementation rates of transfer nursing measures, such as incomplete preparation of goods, poor communication effect of patients, inadequate pipeline nursing, unclear handover, and inadequate final treatment, were calculated and compared in the process of transporting highly simulated human (hereinafter referred to as simulated human) by nurses before and after training; and the rate of disease change and successful rate of transport of simulated human were calculated and compared after training. After assessment, self-made satisfaction questionnaire was used to compare nurses' satisfaction with the training mode, content, and effects. Data were statistically analyzed with independent sample t test, Pearson chi-square test, or Yates corrected chi-square test. Results: Fifty-five enrolled nurses were fully involved in the training, examination, assessment, and questionnaire filling. Before training, there were no statistically significant differences in theoretical examination and skill assessment scores between the 2 groups (P>0.05); After training, the theoretical examination and skill assessment scores of nurses in combined group were significantly higher than those in routine group (with t values of -3.89 and -4.24, respectively, P<0.05). Before training, there were no statistically significant differences in the scores of each item of emergency disposal ability between the 2 groups (P>0.05); after training, the scores in terms of team cooperation ability, emergency response ability, operative technique ability, specialized business ability, and nurse-patient communication ability of nurses in combined group were significantly higher than those in routine group (with t values of -6.49, -6.44, -2.21, -2.85, and -2.34, respectively, P<0.05). Before training, there were no statistically significant differences in the non-standard implementation rates of transfer nursing measures of nurses between the 2 groups (P>0.05); after training, the non-standard rates of incomplete preparation of goods, unclear handover, and inadequate final treatment of nurses in combined group were significantly lower than those in routine group (with t values of 3.87, 5.89, and 5.28, respectively, P<0.05). After training, the rate of disease change of simulated human of nurses in combined group was 7.14% (2/28), which was significantly lower than 33.33% (9/27) in routine group (χ2=5.89, P<0.05); the successful rate of transport was 96.43% (27/28), which was significantly higher than 74.07% (20/27) in routine group (χ2=3.87, P<0.05). After assessment, the total score of training satisfaction and scores of satisfaction with training mode and training effect of nurses in combined group were significantly higher than those in routine group (with t values of 5.22, 4.67, and 10.71, respectively, P<0.05). There was no statistically significant difference in the satisfaction score on training content between the two groups (P>0.05). Conclusions: Evidence-based mind mapping combined with scenario simulation training significantly improves the nursing skills and emergency handling capabilities of junior nurses in transferring patients with critical burns and trauma.

Identification through machine learning of potential immune- related gene biomarkers associated with immune cell infiltration in myocardial infarction

BACKGROUND

To investigate the potential role of immune-related genes (IRGs) and immune cells in myocardial infarction (MI) and establish a nomogram model for diagnosing myocardial infarction.

METHODS

Raw and processed gene expression profiling datasets were archived from the Gene Expression Omnibus (GEO) database. Differentially expressed immune-related genes (DIRGs), which were screened out by four machine learning algorithms-partial least squares (PLS), random forest model (RF), k-nearest neighbor (KNN), and support vector machine model (SVM) were used in the diagnosis of MI.

RESULTS

The six key DIRGs (PTGER2, LGR6, IL17B, IL13RA1, CCL4, and ADM) were identified by the intersection of the minimal root mean square error (RMSE) of four machine learning algorithms, which were screened out to establish the nomogram model to predict the incidence of MI by using the rms package. The nomogram model exhibited the highest predictive accuracy and better potential clinical utility. The relative distribution of 22 types of immune cells was evaluated using cell type identification, which was done by estimating relative subsets of RNA transcripts (CIBERSORT) algorithm. The distribution of four types of immune cells, such as plasma cells, T cells follicular helper, Mast cells resting, and neutrophils, was significantly upregulated in MI, while five types of immune cell dispersion, T cells CD4 naive, macrophages M1, macrophages M2, dendritic cells resting, and mast cells activated in MI patients, were significantly downregulated in MI.

CONCLUSION

This study demonstrated that IRGs were correlated with MI, suggesting that immune cells may be potential therapeutic targets of immunotherapy in MI.

[Correlation analysis of age and microbial characteristics in saliva and feces of high-risk population of upper gastrointestinal cancer]

Objective: To explore the correlation between age and diversity and microbial composition in saliva and feces microbiota in high-risk population of upper gastrointestinal cancer. Methods: Based on the national project on early diagnosis and early treatment of upper gastrointestinal cancer, 38 participants were enrolled in Linzhou in Henan province in August 2019. The participant information was collected by questionnaire. Saliva and feces specimens were collected from each participant for 16S rRNA sequencing and bioinformatics analysis. Spearman rank correlation was used to analyze the correlation between age and α diversity (Observed ASVs and Shannon index) and relative abundance of microbiota (phyla, genera, and species) in saliva and feces. Results: The median age (age range) of 38 participants was 54 (43-60) years old, and there were 16 males (42.1%). The Observed ASVs of saliva was negatively correlated with age (r_s=-0.35, P<0.05), but the observed ASVs of feces was not correlated with age. In saliva, the relative abundance of Treponema (r_s=‒0.44, P<0.05), Alloprevotella (r_s=‒0.42, P<0.05), and Porphyromonas (r_s=‒0.41,P<0.05) were significantly negatively correlated with age. At the species level, the relative abundance of Porphyromonas endodontalis, Alloprevotella tannerae, Haemophilus influenza, Moraxella bovoculi, Prevotella sp.oral clone ID019, and Prevotella sp.oral clone ASCG10 in saliva were significantly negatively correlated with age, and the r_s values were -0.50, -0.40, -0.38, -0.35, -0.33 and -0.33 (P<0.05), respectively. In feces, the relative abundance of Enterobacteria (r_s=-0.35, P<0.05), Escherichia (r_s=-0.33, P<0.05), and Bifidobacteria (r_s=0.33, P<0.05) were correlated with age. At the species level, the relative abundance of Romboutsia sedimentorum, Citrobacter murliniae, and bacteroides uniformis in feces were correlated with age, and the r_s values were -0.42, -0.37 and 0.36 (P<0.05), respectively. Conclusion: Age of the high-risk population of upper gastrointestinal cancer is correlated with the relative abundance of microbiota in saliva and feces.

Research on the emissions from industrial products exported from Guangdong Province-an input-output model analysis

This study uses an input-output model to analyze the wastewater, waste gas, and solid waste emissions in Guangdong’s industrial exports from 2004 to 2015; the Logarithmic Mean Divisia Index (LMDI) is used to analyze the factors influencing such pollution. The results reveal that embodied emissions of waste gas and solid waste in Guangdong’s export trade are increasing, while the increase in wastewater emissions is not apparent. The Logarithmic Mean Divisia Index (LMDI) is used to analyze the influencing factors of pollution, specifically, the structural, scale, and technical effects. We discovered that emissions of the top five industries account for about 80% of total emissions and the wastewater emissions’ technical effect has more impact; however, it is difficult for this technical effect in terms of embodied waste gas and solid waste to offset the scale and structural effects’ impacts. Moreover, the trends and factors influencing various industries’ pollution emissions differ. This study proposes that when the government carries out environmental pollution control measures, they should consider the embodied pollution caused by products from foreign trade and focus on treating industries with severe pollution. Simultaneously, the pollution controlling measures of different industries should also vary.

[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.

[Safety of an inactivated 2019-nCoV vaccine (Vero) in adults aged 60 years and older]

Objective: To analyze the safety of an inactivated 2019-nCoV vaccine (Vero cell) in adults aged 60 years and older. Methods: A randomized, double-blind, placebo-controlled clinical study was conducted in May 2020 The eligible residents aged 60 and above were recruited in Renqiu city, Hebei Province. A total of 422 subjects (phase Ⅰ/Ⅱ:72/350) were enrolled. Two doses of the trial vaccine or placebo were randomly administered according to a 0 and 28-day immunization schedule. Subjects were randomly divided into two groups in Phase Ⅰ. Within each group, participants received vaccine or placebo in a ratio of 2∶1. Subjects were randomly divided into four groups in phase Ⅱ to receive low-dose, medium-dose, high-dose vaccine and placebo, respectively, in a ratio of 2∶2∶2∶1. A combination of regular follow-up and active reporting was used to observe adverse reactions within 28 days after vaccination, and compare the incidence rate of adverse reactions in the trial and control groups. Results: 422 subjects were (66.45±4.70) years old, and 48.82% were male (206/422). There were 100, 124, 124 and 74 patients enrolled into the low-dose, medium-dose, high-dose vaccine groups and the placebo group, respectively. One person without the vaccination was removed, and 421 participants who received at least one dose of vaccine were included in the safety analysis. Within 28 days after the first or second dose, a total of 20.67% (87/421) subjects had adverse reactions (both solicitation and non-solicitation). About 76 patients suffered grade 1 adverse reactions [18.05% (76/421)] and 22 patients suffered grade 2 adverse reactions [5.23% (22/421)]. No grade 3 or above adverse reactions occurred. A total of 19.71% (83/421) subjects had solicited adverse reactions. The most common grade 1 adverse reaction was injection site pain, followed by fever and fatigue. The most common grade 2 adverse reactions were fever and fatigue, followed by muscle pain and injection site redness. A total of 2.61% (11/421) subjects had unsolicited adverse reactions. A total of 1.66% (7/421) subjects had serious adverse events after vaccination, and no serious vaccine-related adverse events were reported. Conclusions: The inactivated SARS-CoV-2 vaccine is safe for people aged 60 years and above.

Upregulation of CCNB2 and Its Perspective Mechanisms in Cerebral Ischemic Stroke and All Subtypes of Lung Cancer: A Comprehensive Study

Cyclin B2 (CCNB2) belongs to type B cell cycle family protein, which is located on chromosome 15q22, and it binds to cyclin-dependent kinases (CDKs) to regulate their activities. In this study, 103 high-throughput datasets related to all subtypes of lung cancer (LC) and cerebral ischemic stroke (CIS) with the data of CCNB2 expression were collected. The analysis of standard mean deviation (SMD) and summary receiver operating characteristic (SROC) reflecting expression status demonstrated significant up-regulation of CCNB2 in LC and CIS (Lung adenocarcinoma: SMD = 1.40, 95%CI [0.98–1.83], SROC = 0.92, 95%CI [0.89–0.94]. Lung squamous cell carcinoma: SMD = 2.56, 95%CI [1.64–3.48]. SROC = 0.97, 95%CI [0.95–0.98]. Lung small cell carcinoma: SMD = 3.01, 95%CI [2.01–4.01]. SROC = 0.98, 95%CI [0.97–0.99]. CIS: SMD = 0.29, 95%CI [0.05–0.53], SROC = 0.68, 95%CI [0.63–0.71]). Simultaneously, protein-protein interaction (PPI) analysis indicated that CCNB2 is the hub molecule of crossed high-expressed genes in CIS and LC. Through Multiscale embedded gene co-expression network analysis (MEGENA), a gene module of CIS including 76 genes was obtained and function enrichment analysis of the CCNB2 module genes implied that CCNB2 may participate in the processes in the formation of CIS and tissue damage caused by CIS, such as “cell cycle,” “protein kinase activity,” and “glycosphingolipid biosynthesis.” Afterward, via single-cell RNA-seq analysis, CCNB2 was found up-regulated on GABAergic neurons in brain organoids as well as T cells expressing proliferative molecules in LUAD. Concurrently, the expression of CCNB2 distributed similarly to TOP2A as a module marker of cell proliferation in cell cluster. These findings can help in the field of the pathogenesis of LC-related CIS and neuron repair after CIS damage.

Clinical assessment and molecular mechanism of the upregulation of Toll-like receptor 2 (TLR2) in myocardial infarction

Objective

The prevalence and mortality of cardiovascular diseases remain ranked first worldwide. Myocardial infarction (MI) is the central cause of death from cardiovascular diseases, seriously endangering human health. The clinical implication of toll-like receptor 2 (TLR2) remains contradictory, and its mechanism is still unknown. Hence, the objective of this study was to elucidate the clinical value and molecular mechanism of TLR2 in MI.

Methods

All high-throughput datasets and eligible literature were screened, and the expression levels of TLR2 were collected from the MI. The integrated expression level of TLR2 was displayed by calculating the standardized mean difference (SMD) and the area under the curve (AUC) of the summary receiver operating characteristic curve (sROC). The related TLR2 genes were sent for pathway analyses by gene ontology (GO), Kyoto encyclopedia of genes and genome (KEGG), and disease ontology (DO). Single-cell RNA-seq was applied to ascertain the molecular mechanism of TLR2 in MI.

Results

Nine microarrays and four reported data were available to calculate the comprehensive expression level of TLR2 in MI, including 325 cases of MI and 306 cases of controls. The SMD was 2.55 (95% CI = 1.35–3.75), and the AUC was 0.76 (95% CI = 0.72–0.79), indicating the upregulation of TLR2 in MI. The related TLR2 genes were primarily enriched in the pathways of atherosclerosis, arteriosclerotic cardiovascular disease, and arteriosclerosis, suggesting the clinical role of TLR2 in the progression of MI. Afterward, TLR2 was upregulated in myeloid cells in MI.

Conclusions

TLR2 may have a crucial role in progressing from coronary atherosclerosis to MI. The upregulation of TLR2 may have a favorable screening value for MI.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-022-02754-y.

Forensic Research Progress on Postural Asphyxia

In recent years, the increase in the number of cases of postural asphyxia has gradually attracted the attention and discussion of forensic scientists domestically and internationally, but a systematic, comprehensive and recognized expert consensus and identification standard has not been established at home and abroad. This paper reviews the case characteristics, occurrence, mechanism of death, and identification criteria of postural asphyxia, to provide reference for future research.

[Application effects of bundle nursing of citric acid extracorporeal anticoagulation on continuous renal replacement therapy of severe burn patients]

Objective: To explore the application effects of bundle nursing of citric acid extracorporeal anticoagulation on continuous renal replacement therapy (CRRT) of severe burn patients. Methods: A non-randomized controlled study was conducted. Forty-six patients who met the inclusion criteria and received regular nursing of citric acid extracorporeal anticoagulation during CRRT in the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January to December 2017 were included in regular nursing group (30 males and 16 females, aged 42.0 (38.7,47.0) years, with 201 times of CRRT performed), and 48 patients who met the inclusion criteria and received bundle nursing of citric acid extracorporeal anticoagulation during CRRT in the same hospital from January to December 2018 were included in bundle nursing group (32 males and 16 females, aged 41.0 (36.0,46.0) years, with 164 times of CRRT performed). The clinical data of all the patients in the two groups were recorded, including the length of intensive care unit (ICU) stay, total cost of treatment in ICU, cost of CRRT, unplanned ending of treatment, ending of treatment due to operation (with the rates of unplanned ending of treatment and ending of treatment due to operation calculated), times of disposable hemodialysis filter and supporting pipeline filter (hereinafter referred to as filter) with use time>24 h, times of CRRT, and lifetime of filter. For the patients in both groups who continuously received CRRT for 3 days or more from the first treatment, the prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), total calcium, ionic calcium (with the difference of total calcium or ionic calcium between before and after treatment calculated), creatinine, urea, β2 microglobulin, cystatin C, platelet count, mean arterial pressure, pH value, oxygenation index, bicarbonate radical, and lactic acid levels before the first treatment (hereinafter referred to as before treatment) and 3 days after the first treatment (hereinafter referred to as after 3 days of treatment). The treatment-related complications of all patients in the two groups were recorded during hospitalization. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test. Results: Compared with those in regular nursing group, the length of ICU stay was significantly shortened (Z=-4.71, P<0.01), the total cost of treatment in ICU was significantly reduced (t=-1.39, P<0.01), the cost of CRRT had no significant change (P>0.05), the rates of unplanned ending of treatment and ending of treatment due to operation were both significantly decreased (with χ2 values of 12.20 and 17.83, respectively, P<0.01), the times of filter service time>24 h was increased significantly (Z=-5.93, P<0.01), the times of CRRT were significantly reduced (Z=-4.75, P<0.01), and the filter service life was significantly prolonged (Z=-9.24, P<0.01) among patients in bundle nursing group. Thirty-one patients in bundle nursing group and 28 patients in regular nursing group continuously received CRRT for 3 days or more from the first treatment. Before treatment, PT, APTT, and INR of patients in bundle nursing group were 24.10 (16.08, 39.20) s, 38.81 (32.32, 45.50) s, and 1.17 (1.12, 1.19), respectively, similar to 31.75 (22.99, 40.96) s, 41.82 (35.05, 48.06) s, and 1.15 (1.11, 1.19) of patients in regular nursing group (P>0.05); the levels of total calcium and ionic calcium of patients in the two groups were similar (P>0.05). After 3 days of treatment, PT, APTT, and INR of patients in bundle nursing group and regular nursing group were 29.06 (20.11, 39.46) s, 35.25 (30.06, 40.28) s, 1.13 (1.09, 1.17) and 36.51 (26.64, 42.92) s, 39.89 (34.81, 46.62) s, 1.14 (1.10, 1.18), respectively, similar to those before treatment (P>0.05); the level of ionic calcium of patients in regular nursing group was significantly higher than that before treatment (Z=-2.08, P<0.05); the levels of total calcium and ionic calcium of patients in bundle nursing group were both significantly higher than those before treatment (with Z values of -3.55 and -3.69, respectively, P<0.01); compared with those in regular nursing group, APTT of patients was significantly shorter (Z=-2.29, P<0.05), while the total calcium level of patients was significantly higher in bundle nursing group (Z=-2.26, P<0.05). The difference of total calcium between before and after treatment of patients in bundle nursing group was significantly higher than that in regular nursing group (Z=-3.15, P<0.01). The differences of ionic calcium between before and after treatment of patients in the two groups were similar (P>0.05). Before treatment, the level of β2 microglobulin of patients in bundle nursing group was significantly higher than that in regular nursing group (Z=-2.84, P<0.01), the platelet count of patients in bundle nursing group was significantly lower than that in regular nursing group (Z=-2.44, P<0.05), while the levels of creatinine, urea, cystatin C, mean arterial pressure, pH value, oxygenation index, bicarbonate radical, and lactic acid of patients in the two groups were similar (P>0.05). After 3 days of treatment, the levels of creatinine, urea, β2 microglobulin, cystatin C, pH value, bicarbonate radical, and lactic acid of patients were all significantly lower than those before treatment (with Z values of -2.10, -2.90, -3.11, -2.02, -2.34, -2.63, and -2.84, respectively, P<0.05 or P<0.01), while the levels of platelet count, oxygenation index, and mean arterial pressure of patients were all significantly higher than those before treatment in bundle nursing group (with Z values of -6.65 and -2.40, respectively, t=-9.97, P<0.05 or P<0.01); the levels of creatinine, urea, β2 microglobulin, cystatin C, platelet count, pH value, bicarbonate radical, and lactic acid of patients were all significantly lower than those before treatment (with Z values of -5.32, -2.31, -2.41, -2.21, -3.68, -2.93, -2.20, and -2.31, respectively, P<0.05 or P<0.01), while the oxygenation index and mean arterial pressure of patients were both significantly higher than those before treatment in regular nursing group (Z=-5.59, t=-7.74, P<0.01). After 3 days of treatment, compared with those in regular nursing group, the levels of creatinine, cystatin C, platelet count, oxygenation index, bicarbonate radical, and mean arterial pressure of patients were all significantly higher (with Z values of -2.93, -1.99, -6.39, -2.09, and -2.52, respectively, t=-3.28, P<0.05 or P<0.01), while the levels of urea, β2 microglobulin, pH value, and lactic acid of patients were all significantly lower (with Z values of -3.87, -2.58, -4.24, and -2.75, respectively, P<0.05 or P<0.01) in bundle nursing group. During hospitalization, there were no treatment-related bleeding events or hypernatremia related to citric acid treatment of patients in the two groups. The ratio of total calcium to ionic calcium in one patient in bundle nursing group was >2.5, but there was no manifestation of citric acid accumulation poisoning; 1 patient had hypoionic calcemia, and 1 patient had severe metabolic alkalosis. Five patients had hypoionic calcemia and 2 patients had severe metabolic alkalosis in regular nursing group. Conclusions: The implementation of bundle nursing of citric acid extracorporeal anticoagulation during CRRT for severe burn patients shortens the length of ICU stay, reduces the total cost of treatment in ICU and the occurrence of treatment-related complications, relieves the economic burden of patients, and improves the continuity and quality of treatment.

[Application of a standard communication system-based continuous home remote visit mode in the management of visits to severely burned patients in the post-pandemic era of coronavirus disease 2019]

Objective: To observe the application effects of a standard communication system-based continuous home remote visit mode in the management of visits to severely burned patients in the post-pandemic era of coronavirus disease 2019 (hereinafter referred to as post-pandemic era). Methods: A retrospective cohort study was conducted. A total of 69 severely burned patients who met the inclusion criteria and were admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from February to December, 2020 and their 69 family members were recruited into this study. According to the difference of visit model, 33 severely burned patients who were admitted into burn intensive care unit (BICU) from February to June, 2020 and received completely restricted visits according to the requirements for epidemic prevention and control and their corresponding 33 family members were included into conventional visit group; 36 severely burned patients who were admitted into BICU from July to December, 2020 and received the standard communication system-based continuous home remote visits and their 36 corresponding family members were recruited into remote visit group. The family members in conventional visit group could only communicate with the primary nurses by telephone, while the patients and family members in remote visit group could communicate with the primary nurses, responsible doctors, rehabilitation therapists, and nutrition therapists through WeChat video call. The survey results of general information questionnaire and Hamilton Anxiety Scale (HAMA) scores of two groups of patients and their family members at BICU admission of patients, HAMA scores of the two groups of patients and their family members in the second week of BICU admission and at discharge from BICU of patients, the scores of the Visiting Effect Evaluation Scale of the two groups of patients and their family members and the scores of Chinese version of Critical Care Family Satisfaction Survey (C-CCFSS) of the two groups of family members at discharge from BICU, and the scores of Satisfaction Survey and Evaluation Scale During Hospitalization of patients within the first week after the discharge of patients from BICU were compared. Data were statistically analyzed with chi-square test, Fisher's exact probability test, and Mann-Whitney U test. Results: In remote visit group, there were 29 males and 7 females in patients, aged 48 (34, 53) years, and 15 males and 21 females in family members, aged 45 (30, 48) years. In conventional visit group, there were 24 males and 9 females in patients, aged 49 (38, 54) years, and 9 males and 24 females in family members, aged 44 (35, 48) years. At BICU admission of patients, the HAMA scores of the two groups of patients and family members were both similar (P>0.05). The total HAMA scores of patients and family members in remote visit group were significantly lower than those in conventional visit group in the second week when the patients were admitted to BICU (Z=-3.195, -3.018, P<0.01) and discharged from BICU (Z=-2.118, -2.380, P<0.05). At discharge from BICU of patients, the scores of each dimension in Visiting Effect Evaluation Scale of the patients in the two groups were similar (P>0.05); while scores of 3 dimensions including patient safety information, diagnosis and treatment quality information, and psychological support information in Visiting Effect Evaluation Scale of family members in remote visit group were significantly higher than those in conventional visit group (Z=-2.372, -2.209, -2.174, P<0.05), and only the scores of visit perception of family members were close to those in conventional visit group (P>0.05). At discharge from BICU of patients, the C-CCFSS scores of the family members in remote visit group was 99 (98, 108), which were significantly higher than 98 (97, 100) in conventional visit group (Z=-2.545, P<0.05). Within the first week after the discharge of patients from BICU, the scores of Satisfaction Survey and Evaluation Scale During Hospitalization of patients in remote visit group were 99 (98, 100), which were significantly higher than 96 (94, 98) in conventional visit group (Z=-5.213, P<0.01). Conclusions: In the management of visits to severely burned patients in the post-pandemic era, application of the standard communication system-based continuous home remote visit mode can improve the visit effect and satisfaction, and effectively alleviate the anxiety of patients and their family members.

[Effects of density on growth and gene transcription characteristics of Rehmannia glutinosa]

The present study analyzed the effects of planting density on the development, quality, and gene transcription characte-ristics of Rehmannia glutinosa using 85-5 and J9 as materials with three planting densities of 5 000, 25 000, and 50 000 plants/Mu(1 Mu≈667 m~2). The agronomic characteristics of leaves and tuberous roots, the content of catalpol and acteoside, and the changes of gene expression were determined. The results showed that the leaf size, the diameter of tuberous root, leaf biomass, tuberous root number, and tuberous root biomass per plant at low density were significantly higher than those of medium and high densities. The content of catalpol and acteoside in leaves was higher at high density. The content of catalpol in tuberous roots was higher at low density, and the change trend was similar to that in leaves, while the content of acteoside in tuberous roots was higher at high density. Transcriptome analysis found that about 1/2 of the expansin genes could change regularly in response to density treatment, which was rela-ted to the development of tuberous roots. The change trend of the gene expression of multiple catalytic enzymes involved in the biosynthesis of catalpol and acteoside was consistent with that of their content, which was presumedly involved in the accumulation and regulation of density-responsive medicinal components. Based on the analysis of the development, medicinal components, and gene expression characteristics of R. glutinosa at different densities, this study is expected to provide an important basis for regulating the quality and yield of medicinal materials of R. glutinosa by managing the planting density.

[Identification and expression analysis of NRT1 family genes in Rehmannia glutinosa]

NRT1 family proteins play an important roles for absorbing and transporting of nitrate in different plants. In order to identify the NRT1 family genes of Rehmannia glutinosa, this study used 11 NRT1 homologous proteins of Arabidopsis as probe sequences and aligned with the transcriptome data of R. glutinosa by using NCBI BLASTN software. Resulting there were 18 NRT1 proteins were identified in R. glutinosa. On basis of this, a series of the molecular characteristics of R. glutinosa NRT1 proteins including the conserved domains, the transmembrane structure, the subcellular location and phylogenetic features were in detail analyzed. At same time, it were systematically analyzed that the temporal and spatial expression patterns and characteristics of R. glutinosa NRT1 family genes in response to different stress factors. The results indicated that 18 R. glutinosa NRT1 family genes with the length of coding region from 1 260 bp to 1 806 bp, encoded proteins ranging from 419 to 601 amino acids, and all of they owned the domains of typical peptide transporter with 7 to 12 transmembrane domains. These R. glutinosa NRT1 family proteins mostly were found to locate on cellular plasma membrane, and belonged to the hydrophobic proteins. Furthermore, the evolutionary analysis found that the 18 R. glutinosa NRT1 protein family could be divided into two subfamilies, of which 14 NRT1 family genes might occur the positive selection, and 4 genes occur the passivation selection during the evolution process of R. glutinosa. In addition the expression analysis showed that 18 R. glutinosa NRT1 family genes have the distinct expression patterns in different tissues of R. glutinosa, and their expression levels were also obvious difference in response to various stress. These findings infield that 18 R. glutinosa NRT1 family proteins might have obviously different functional roles in nitrate transport of R. glutinosa. In conclusion, this study lays a solid theoretical foundation for clarifying the absorption and transport molecular mechanism of N element during R. glutinosa growth and development, and at same time for deeply studying the molecular function of R. glutinosa NRT1 proteins in absorption and transport of nitrate.

Age-Related Changes of Material Mechanics and Bone Material Parameters of Rat Skulls

Abstract

Objective To study the relationship between material mechanics and bone material parameters of rat skulls and their correlation with age by examination of the parameters. Methods Forty-eight healthy male SD rats were divided into 2, 4, 6, 8, 17, 26, 52 and 104 week groups according to their age. Each group had six rats. The right cranium was compressed by KD Ⅱ-0.2 microcomputer controlled electronic universal testing machine, and material mechanics parameters （ultimate load, compression strength and compression modulus） were measured, then the skull slices were cut off and scanned by Micro-CT system to detect bone material parameters （skull thickness, bone mineral density, bone volume, and trabecular thickness）. Results The differences in ultimate load, compression strength and compression modulus among all groups had statistical significance （P<0.05）, and were positively correlated with age within 26 weeks （P<0.05）. The differences in skull thickness, bone mineral density, bone volume and trabecular thickness among all groups had statistical significance （P<0.05）, and were positively correlated with age within 52 weeks （P<0.05）. All material mechanics parameters were positively correlated with bone material parameters （P<0.05）. Conclusion There is a positive correlation between bone material parameters （skull thickness, bone mineral density, bone volume, trabecular thickness）, material mechanics parameter （skull ultimate load, compression strength, compression modulus） and age in a certain range, which can be used to infer age.

[The involvement of neuropilin-1 in primary immune thrombocytopenia]

Objective: To explore the relationship between the expression of neuropilin-1 (NRP-1) on Treg cells and its ligands semaphorins-3A (Sema3A) , transforming growth factor-β(1) (TGF-β(1)) as well as the balance of type 1 helper T cells (Th(1)) and type 2 helper T cells (Th(2)) cells. Methods: This study enrolled 62 patients with immune thrombocytopenia (ITP; 33 and 29 newly diagnosed and chronic ITP, respectively) from March 2014 to May 2015. Consequently, 30 healthy people in the same period were selected as the normal control group. The expression of NRP-1 in Treg cells was detected via flow cytometry. The Sema3A, TGF-β(1), IFN-γ, and IL-4 levels in plasma were detected by enzyme-linked immunosorbent assay. The real-time polymerase chain reaction technique was used to detect the mRNA expression levels of NRP-1, Sema3A, and TGF-β(1). The one-way analysis of variance and independent sample t-test was used for comparison between three and two groups, respectively. Correlations among the mRNA expression levels of NRP-1, Sema3A, and TGF-β(1) were assessed via Spearman correlation coefficients. Results: Treg cells in the newly diagnosed ITP group significantly increased compared with those in the chronic ITP and normal control groups. The expression of NRP-1 decreased[ (0.15 ± 0.03) %, (0.33 ± 0.15) %, and (0.46 ± 0.06) %; P<0.01], the plasma Sema3A level increased[ (8.10 ± 1.32) μg/L, (7.41±1.30) μg/L, and (2.88±0.82) μg/L; P<0.01], and the plasma TGF-β(1) level decreased[ (16.50±3.36) μg/L, (35.17±10.26) μg/L, and (41.00±10.02) μg/L; P<0.01]. Moreover, the level of plasma IFN-γ increased[ (17.21+2.80) ng/L, (10.23+1.59) ng/L, and (8.18+3.27) ng/L; P<0.01], and the ratios of Th(1)/Th(2) (IFN-γ/IL-4) increased (1.29±0.30, 0.72±0.16, and 0.61±0.27; P<0.01) . The mRNA expressions of NRP-1 and Sema3A in the newly diagnosed ITP and chronic ITP groups were lower than that in the normal control group (P<0.01) . Consequently, the NRP-1 mRNA expression was positively correlated with Sema3A and TGF-β(1) mRNA expression in the newly diagnosed ITP group. Conclusion: NRP-1 played an essential role in the pathogenesis of ITP.

Congenital Short-Bowel Syndrome Is Associated With a Novel Deletion Mutation in the CLMP Gene: Mutations in CLMP Caused CSBS

Objective: To describe the clinical presentation and novel mutation in the coxsackie and adenovirus receptor-like membrane protein (CLMP) gene in a Chinese family with congenital short bowel syndrome (CSBS). Methods: We collected clinical data from a Chinese family with inherited CSBS, and performed whole exon sequencing of the children and their parents. The pathogenic sites of candidate genes were targeted, and the detected exon deletions were verified by quantitative PCR. Results: Two siblings in this family presented with bilious vomiting, and were diagnosed with CSBS on laparotomy. Two siblings and their parents underwent complete exome sequencing of the peripheral blood. Both children had CLMP gene exons 3-5 homozygous deletion mutation, while the parents had a heterozygous mutation. Conclusion: This study identified a novel mutation of the CLMP gene in a Chinese family with CSBS. Identification of this mutation can help with genetic counseling and prenatal diagnosis of CSBS.

[Progress in research of Fusobacterium nucleatum and upper gastrointestinal cancer]

With the development of multi-omics and high throughput sequencing technology, studies have shown that the disorder of microbiota is related to various cancers. Nevertheless, the research on the relationship between upper digestive tract cancer or precancerous lesions and gastrointestinal microecology is still less. Fusobacterium nucleatum, one of the oral symbiotic bacteria, is also an opportunistic pathogen, which can promote the formation of tumor microenvironment and can be used as a new biomarker for the early detection and early diagnosis of cancer. In this study, by searching CNKI, Wanfang data, PubMed and Embase databases, it was found that the abundance of F. nucleatum in cancer tissues is higher than that in paracancerous tissues and associated with poor prognosis. The research of relationship between F. nucleatum and precancerous lesions needs to be carried out urgently. In addition, the types of specimens, sequencing technology, strain subtypes, carcinogenic mechanism and other directions still need to be explored.

Identification and Expression Profile Analysis of Chemosensory Genes From the Antennal Transcriptome of Bamboo Locust (Ceracris kiangsu)

Studies of chemosensory genes are key to a better understanding of intra- and interspecific communications between insects and their environment and provide opportunities for developing environmentally friendly pesticides to target pest species. The bamboo locust Ceracris kiangsu Tsai (Orthoptera: Acrididae) is one of the most important bamboo leaf-eating insects in southern China. However, the genes underlying olfactory sensation are lacking in the bamboo locust. In this study, the transcriptomes of male and female C. kiangsu antennae were sequenced and analyzed. A total of 125 chemosensory genes, including 91 odorant receptors (ORs), 13 ionotropic receptors (IRs), 13 odorant-binding proteins (OBPs), six chemosensory proteins (CSPs), and two sensory neuron membrane proteins, were identified based on sequence alignment and phylogenetic analyses. The expression patterns of all candidate genes on the antennae of males and females, maxillary palps, tarsi, wings, and thoraxes-abdomens were confirmed by real-time quantitative PCR. The analyses demonstrated that most genes are highly expressed in the antennae, and 35 ORs, 7 IRs, 10 OBPs, and 1 CSP exhibit significantly male-biased expression patterns, indicating their potential functions in mating behavior and the recognition of female sex pheromones. In addition to the antennal-predominant genes, some were abundant in the maxillary palps and some in the non-olfactory tissues, suggesting their different functions in the olfactory system of C. kiangsu. Our research offers an extensive resource for investigating the chemoreception mechanism of C. kiangsu. Further studies of olfactory function will provide comprehensive methods and original strategies for integrated pest management.

[The effect of booster dose vaccination 21- to 32-years after primary vaccination with hepatitis B vaccine in the population born from 1986 to 1996 in Zhengding County of Hebei Province]

Objective: Aanalysis the effect of booster one dose of hepatitis B vaccine after 21-32 years of primary immunization in Zhengding Country of Hebei Province. Methods: A total of 322 participants who were born between 1986 and 1996, received a full course of primary vaccination with plasma-derived hepatitis B vaccine (HepB), had no experience with booster vaccination, were HBsAg, anti-HBcnegative, had anti-HBs<10 mIU/ml, completed the booster and had laboratory results were enrolled between August 2017 to February 2018. A simple random method was uesd to randomly assigned 322 subjects to two groups, receiving a booster dose of HepB derived from either Saccharomyces cerevisiae ［HepB (SC), (151 cases)］ or Chinese hamster ovary-derived HepB ［HepB (CHO), (171 cases)］, the dose was 20 μg. Blood samples were collected 30 days after boosting and quantitatively tested for the geometric mean concentration (GMC) of anti-HBs to assess immunological effect. The related influencing factors of GMC and seroconversion rates of anti-HBs were analyzed by multiple linear regression and multivariate logistic regression models. Results: The 266 subjects (82.61%) had anti-HBs≥ 10 mIU/ml, and GMC was (131.63±12.94) mIU/ml.The seroconversion rates of anti-HBs in the anti-HBs<2.5 mIU/ml group and 2.5-10 mIU/ml group were 74.54% (161 cases) and 99.06% (105 cases), respectively (P<0.001).The seroconversion rates of anti-HBs after one dose of HepB (CHO) was higher than that of one dose of HepB (SC), the seroconversion rates were 87.13% (149 cases) and 77.48% (117 cases), respectively (P=0.023). Participants boostered with HepB (CHO) was the factor influencing the effect of strengthening immunization compared with boostered with HepB (SC), and OR (95%CI) was 1.91 (1.02-3.56) (P=0.042).Compared with anti-HBs<2.5 mIU/ml, prebooster anti-HBs was between 2.5 mIU/ml and 10 mIU/ml was the related factor of seroconversion rates of anti-HBs after booster immunization, and OR (95%CI) was 36.15 (4.91-266.02) (P<0.001). Conclusion: Participants boostered withone dose of HepB had a good immune response. Pre-booster anti-HBs concentration and a variety of vaccine were related factors of immune response.

[Performance of high-risk HPV typing test in early diagnosis of cervical cancer]

Objective: To evaluate the performance of High-risk HPV typing detection in cervical cancer screening. Methods: A total of 3 231 women were recruited as the subjects of cervical cancer screening from Jiyuan city of Henan provinces from June to July 2017. All women underwent HPV DNA test. The women with cytological examination ≥ASCUS or cytological examination negative and HPV 16/18 positive underwent colposcopy biopsy and pathological examination. Pathological diagnosis was used as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value(NPV) as well as corresponding 95% confidence interval (CI) of HR-HPV and HPV 16/18 were calculated. Results: The mean age of 3 231 subjects selected in this study was 46.84±10.00 (21-64) years old. 524 subjects had the positive results of HR-HPV, including 91 of HPV16 and 15 of HPV18. Pathological test result CIN2+ was the gold standard. The sensitivity and specificity of HR-HPV for cervical precancer lesions screening were 93.75 (95%CI: 79.85-98.27) and 84.56% (95%CI: 83.26-85.77), respectively. To compared with HR-HPV, HPV16/18 had low sensitivity (65.63%, 95%CI: 48.31-79.59)and higher specificity (97.44%, 95%CI: 96.83-97.93). After age stratification by age 30 and 45, the sensitivity of HPV 16/18 was same with HR-HPV (100%, 95%CI: 34.24-100.00), the specificity of HPV 16/18 was higher than HR-HPV (98.71%, 95%CI: 96.27-99.56 vs 84.48%, 95%CI: 79.27-88.58) in<30 age group.The sensitivity of HR-HPVin 30-45 and ≥45 age group were higher than HPV16/18 (85.71%, 95%CI: 48.69-97.43 vs 71.43%, 95%CI: 35.89-91.78, 95.65%, 95%CI: 79.01-99.23 vs 60.87%, 95%CI: 40.79-77.84), but the specificity werelower than HPV16/18 (86.89%, 95%CI: 84.58-88.90 vs 98.51%, 95%CI: 97.51-99.11、83.49%, 95%CI: 81.81-85.04 vs 96.80%, 95%CI: 95.94-97.48). Conclusions: HR-HPV detection has relatively high sensitivity and specificity in cervical cancer screening. For >30 years old women, HR-HPV is more recommended in cervical cancer screening. Therefore, HR-HPV detection is an effective method for cervical cancer screening.

[Progress in research of influencing factors of oral microbiome and association between oral microbiome and upper gastrointestinal cancer]

The composition of human oral microorganism is numerous and complex and is easily affected by many factors. With the development of metagenomic technology, the important role of oral microbiome in the development of tumor has attracted extensive attention. A literature retrieval was conducted through PubMed, Embase, CNKI and WanFang database for an analysis on the characteristics of oral bacteria and its association with oral cancer, esophageal cancer and gastric cancer. The results indicated that oral microbiome can be influenced by age, gender, race, and lifestyle. Specific oral bacteria were associated with high risk of upper gastrointestinal cancer, indicating a potential role of oral microbiota to be the biomarker for upper gastrointestinal cancer. This paper summarizes the progress in the research of the association between oral microbiome and upper gastrointestinal cancer, showing a new direction for the exploration of microbiological etiology of upper gastrointestinal cancer and providing scientific evidence for the optimization of early detection and treatment of upper gastrointestinal cancer.

NLRC3 silencing accelerates the invasion of hepatocellular carcinoma cell via IL-6/JAK2/STAT3 pathway activation

Nucleotide-binding domain, leucine-rich repeat family with a caspase activation and recruitment domain 3 (NLRC3) participates in both immunity and cancer. The aim of this study was to determine the role of NLRC3 in human hepatocellular carcinoma (HCC) and the underlying mechanisms. We collected human liver tissues from nonalcoholic steatohepatitis (NASH), HCC, and adjacent normal tissues to characterize the pattern of NLRC3 expression by real-time quantitative polymerase chain reaction and immunohistochemistry. Then, we used the HCC cell line, HuH-7, transfected with small interfering RNA to silence the NLRC3 expression. 5-Ethynyl-2'-deoxyuridine assay, scratch assay, and transwell invasion assay were used for assessing proliferation, migration, and invasion, respectively. Flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay were conducted to assess cell apoptosis. The expression of NLRC3 was reduced in human HCC tissues, compared with normal liver and nonalcoholic steatohepatitis tissues. After knocking down of NLRC3, the proliferation, migration, and invasion were increased in HuH-7 cells. And flow cytometry and TUNEL assay showed that HuH-7 cell apoptosis was suppressed after NLRC3 knockdown. As for the underlying mechanisms, knockdown of NLRC3 in HuH-7 cells was associated with the activation of Janus kinase 2/signal transducers and activators of transcription 3 (JAK2/STAT3) pathway under interleukin-6 (IL-6) stimulation. NLRC3 expression was downregulated in human HCC tissues. NLRC3 silencing in HuH-7 cells can promote the proliferation, migration, and invasion of hepatocellular carcinoma cells. JAK2/STAT3 pathway activation induced by IL-6 may be the underlying mechanism for HCC when NLRC3 expression is silenced. And the invasion of HuH-7 cells was partially suppressed by the STAT3 specific inhibitor (cryptotanshinone). Therefore, NLRC3 may play a significant role in HCC and might be a therapeutic target for the treatment of HCC.

Application of Sequential Changes of Dural Thickness and Biomechanical Parameters in Postmortem Interval Estimation

Abstract

Objective To study the relations of the dural thickness and the biomechanical parameters with postmortem interval （PMI） of human cadavers, and to explore the feasibility of the two indexes used for PMI estimation. Methods Dural samples were collected at different postmortem intervals of 6 h, 12 h, 18 h, 24 h, 30 h, 36 h, 48 h, 60 h, 72 h, 84 h and 96 h, then fabricated into 4.0 cm×1.0 cm A and B test specimens. The thickness of the A test specimen was measured, and the biomechanical parameters, such as ultimate load, maximum force deformation, tensile strength, elastic modulus and fracture force, were measured. The regression equations of thickness, biomechanical parameters and PMI were fitted respectively, and the difference between the predicted value and actual measured value of PMI was verified by the verification group. The B test specimen was fixed with 10% neutral formaldehyde solution, then tissue sections were prepared to observe its morphological changes. Results From 6 h to 96 h after death, the dural thickness decreased gradually, the collagen fibers gradually changed from clear arrangement to mutual fusion, and the number of nuclei decreased gradually. The dural thickness, ultimate load, tensile strength, elastic modulus and fracture force decreased sequentially, among which the dural thickness, ultimate load, elastic modulus and fracture force had a correlation with PMI （P<0.05）. In the return test, the difference between the predicted value and actual measured value of PMI in the verification group had no statistical significance （P>0.05）. Conclusion The dural thickness, ultimate load, elastic modulus and fracture force change sequentially from 6 h to 96 h after death. The regression equation established by the relationship between the changes and PMI can be used for PMI estimation.

[The clinical decision-making value of prostate specific antigen and its derived indicators in prostate imaging reporting and data system version 2 3 lesions]

Objective: To explore the decision-making value of clinical data in prostate imaging reporting and data system version 2 (PI-RADS V2) 3 lesions, and to compare the diagnostic value of related data for prostate cancer (PCa) and clinically PCa(csPCa). Methods: From March 2016 to October 2018,a subset of 121 men with 121 PI-RADS 3 index lesions were retrospectively analyzed. There were 31 PCa lesions and 14 csPCa lesions, aged from 46 to 91 years with a mean age of (71±9) years. The clinical data of the age, prostate specific antigen (PSA), free PSA (fPSA), f/tPSA, PSA density (PSAD) and prostate volume (PV) were compared between PCa group and non-PCa group, csPCa group and non-csPCa group using univariate analysis, respectively.The receiver operating characteristic (ROC) curve was used to evaluate the efficiency of statistically data in detecting PCa and csPCa in men with PI-RADS 3 index lesions. Results: The differences of PSA, f/tPSA and PSAD were all statistically significant (Z=-2.004, -2.527, -2.623, all P<0.05) between PCa group and non-PCa group, and they were all also statistically significant(Z=-2.415, -2.158, -2.870, all P<0.05) between csPCa group and non-csPCa group. Both PSAD had the best diagnostic efficiency, the ROC curve of detecting PCa and csPCa was 0.658 and 0.736, respectively. If used PSAD>0.20 μg·L(-1)·ml(-1) as the biopsy threshold, the sensitivity, specificity, positive predictive value and negative predictive value of csPCa were 78.6%, 58.9%, 20.0%, 95.4%, and 54.5% (66/121) of the enrolled men can avoid biopsy, resulting only 3 cases of csPCa missed. Conclusion: PSA, f/tPSA, PSAD, especially PSAD can improve the detection efficiency of PCa,especially csPCa in PI-RADS 3 lesions, assisting clinical decision-making.

P267 Dextrocardia with single ventricle and symptomatic erythrocytosis: a case report

Introduction

Dextrocardia is a rare cardiac anomaly which refers to a right-sided location of the heart within the thoracic cavity. Dextrocardia may be associated with other complex cardiac malformations which could result in cyanosis. We reported a case of cyanotic dextrocardia with symptomatic erythrocytosis.

Case Report

A 54-year-old Asian male was admitted to hospital with the complaint of numbness and tingling of limbs for one month. There was no history of chronic cardio-cerebrovascular diseases or diabetes. On examination vital signs were as follows: blood pressure 112/73 mmHg, pulse 72 beats/min, oxygen saturation 85% on room air, temperature 37.1°C, respiratory rate 18 breaths/min. Cardiac physical examination was indicative of dextrocardia: the apex of the heart was located in the right side of the chest accompanied with a systolic murmur at the apex. Other pertinent examinations showed cyanosis of lips, flushing of face and limbs, and a normal neurological examination. Echocardiography and computed tomography (CT) demonstrated heterotaxy and dextrocardia, normal atriums, common mitral valve, lengthy leaflets of tricuspid valve, dilated single ventricle, double-inlet and outlet left ventricle, mild atrioventricular valve regurgitation (AVVR) and no pulmonary stenosis. Laboratory data showed increased hemoglobin of 19.9 g/dl and hematocrit of 58.8%, decreased oxygen partial pressure of 49.5mmHg and oxygen saturation of 81.3%.

The patient was diagnosed with erythrocytosis perhaps secondary to cyanotic congenital heart disease and was given intravenous drip of normal saline to resolute the hyperviscosity status. He refused bone marrow aspiration and surgical evaluation for single-ventricle palliation. During the 16-month follow up, no other symptoms emerged except for mild numbness of limbs.

Conclusion

Dextrocardia with single ventricle malformation can remain symptom free for a long time until the emergence of complications such as secondary erythrocytosis. It is important to give an early diagnosis and complete evaluation, and echocardiography is an effective method to detect this anomaly.

Abstract P267 Figure. The echo and CT images of this case

[Ibrutinib combined with CAR-T cells in the treatment of del (17p) chronic lymphocytic leukemia with BCL-2 inhibitor resistance: a case report and literature review]

目的

总结伊布替尼联合嵌合抗原受体T细胞（CAR-T）治疗TP53基因异常超高危慢性淋巴细胞白血病（CLL）/小细胞淋巴瘤（SLL）的经验，提高对此类疾病的认识。

方法

报告1例伴del（17p）CLL/SLL患者BCL-2抑制剂耐药后，采用伊布替尼联合CAR-T成功治疗并顺利桥接异基因造血干细胞移植（allo-HSCT）的治疗经过，并进行文献复习。

结果

患者为年轻女性，发病初表现为全身浅表淋巴结肿大，淋巴结活检病理确诊为SLL，无del（17p）；2年后疾病快速进展为CLL/SLL，伴del（17p），骨髓造血衰竭。采用BCL-2抑制剂维奈托克治疗2个月余肿大淋巴结明显缩小，3个月后疾病快速进展，脾脏增大至肋缘下16 cm，颈部淋巴结增大融合，并出现上腔静脉压迫综合征，考虑维奈托克耐药；遂更换为BTK抑制剂伊布替尼治疗，2个月余疾病达部分缓解（PR），联合靶向CD19的CAR-T治疗，细胞因子释放综合征（CRS）1级，1个月后达骨髓及外周血完全缓解（CR），且微小残留病（MRD）阴性，2个月后桥接allo-HSCT。

结论

TP53基因异常CLL/SLL临床进展快、易耐药、预后差，伊布替尼联合CAR-T治疗可快速达CR。

[Status of non-steroidal anti-inflammatory drugs use in areas with a high incidence of upper gastrointestinal cancer in China: a multi-center cross-sectional survey]

Objective: To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods: This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ(2) test and Cochran-Armitage trend analysis method. Results: Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). Conclusion: The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.

Bacterial Communities and Virulence Associated with Pine Wood Nematode Bursaphelenchus xylophilus from Different Pinus spp

Bursaphelenchus xylophilus, the causal agent of pine wilt disease, is a destructive threat to pine forests. The role of bacteria associated with B. xylophilus in pine wilt disease has attracted widespread attention. This study investigated variation in bacterial communities and the virulence of surface-sterilized B. xylophilus from different Pinus spp. The predominant culturable bacteria of nematodes from different pines were Stenotrophomonas and Pseudomonas. Biolog EcoPlate analysis showed that metabolic diversity of bacteria in B. xylophilus from P. massoniana was the highest, followed by P. thunbergii and P. densiflora. High-throughput sequencing analysis indicated that bacterial diversity and community structure in nematodes from the different pine species varied, and the dominant bacteria were Stenotrophomonas and Elizabethkingia. The virulence determination of B. xylophilus showed that the nematodes from P. massoniana had the greatest virulence, followed by the nematodes from P. thunbergii and P. densiflora. After the nematodes were inoculated onto P. thunbergii, the relative abundance of the predominant bacteria changed greatly, and some new bacterial species emerged. Meanwhile, the virulence of all the nematode isolates increased after passage through P. thunbergii. These inferred that some bacteria associated with B. xylophilus isolated from different pine species might be helpful to adjust the PWN’s parasitic adaptability.

[Therapeutic effect of combined use of interferon alpha-1b, interleukin-2 and thalidomide on reversing minimal residual disease in acute myeloid leukemia]

目的

探讨干扰素α-1b、白细胞介素2联合沙利度胺（“干白沙”方案）对急性髓系白血病（AML）患者微小残留病（MRD）的影响。

方法

对2016年7月至2018年6月收治的18例（17例来自郑州大学附属肿瘤医院，1例来自平顶山市第一人民医院）处于血液学完全缓解但MRD阳性的AML患者应用不同剂量的“干白沙”方案，监测其MRD水平变化。

结果

18例患者接受常规剂量“干白沙”方案1~2个月，7例患者MRD转阴，3例患者MRD水平明显下降，3例MRD水平升高，5例复发。MRD水平升高的3例患者接受加量的“干白沙”方案，2例MRD转阴，1例MRD水平下降。“干白沙”方案干预治疗MRD阳性AML总有效率为72.2%。根据治疗前MRD水平分组，MRD≥1.0%的患者有效率为57.1%（4/7），MRD<1.0%的患者有效率为81.8%（9/11）。

结论

“干白沙”方案可使血液学完全缓解但MRD阳性的AML患者MRD转阴或下降，增加方案药物剂量后疗效增加，疗效与治疗前MRD水平可能呈负相关。

[Discussion of correlation between histogram analysis of quantitative diffusion weighted imaging and Gleason score of prostate cancer]

Objective: To discuss the correlation between histogram analysis of quantitative mono-exponential, bi-exponential and diffusion kurtosis models in diffusion weighted imaging and the Gleason score of prostate cancer, and evaluate the application value and diagnostic efficiency in identifying low and high grade prostate cancer. Methods: A total of 50 patients with histologically confirmed as prostate cancer were examined from May 2015 to May 2016 in the Second Affiliated Hospital of Soochow University using DWI performed at 3.0 T with an extended b-value range from 0 to 2 000 s/mm(2). Data were post-processed by whole tumor histogram analysis,the ROI was manually drown in DWI (b=1 000 s/mm(2)) step by step along the outline of cancer, and quantitative analysis were performed respectively by mono-exponential, bi-exponential and diffusion kurtosis models for quantification of apparent diffusion coefficients (ADCs), diffusivity D, pseudo-diffusivity D(*), perfusion fraction f, diffusion coefficients by non-Gaussian distribution (D(k)) and kurtosis coefficient (K).Then the histogram analysis was performed to get the mean, median, 25th percentile, 75th percentile, skewness and kurtosis. The correlation between histogram analysis results of these quantitative parameters and Gleason score of prostate cancer were evaluated by Spearman correlation coefficient. The diagnostic performance of histogram analysis results of each quantitative parameters in identifying low (Gleason score≤6) and high (Gleason score>6) grade prostate cancer was performed by comparing the area under the ROC curve and the curve values. Results: The values of ADC, D and D(k) (mean, median, 25th, 75th) were negatively correlated with Gleason score of prostate cancer (r value was -0.388--0.624, P<0.05). The values of D (skewness and kurtosis) had a certain correlation with Gleason score of prostate cancer (r value were 0.413 and 0.402, P<0.05). The histogram analysis results of D(*) and f had no statistically significant correlation with Gleason score of prostate cancer (P>0.05). The values of K (mean, median, 25th, kurtosis) were positively correlated with Gleason score of prostate cancer (r value was 0.423-0.699,P<0.05). The diagnostic efficiency of histogram analysis results of these quantitative parameter values in identifying low and high grade prostate cancer showed that the ADC (median), D (25th), D(k) (mean) and K (25th) had a larger area under the curve, and were 0.844, 0.873, 0.815, and 0.919 respectively, the differences of area under the curve between any two of these parameters above were not statistically significant (all P>0.05). Conclusions: The quantitative parameters of three diffusion models (ADC, D, D(k), K) in DWI are all related to the Gleason score of prostate cancer, but in the differential diagnosis of low and high grade prostate cancer, the diagnostic efficacy of mono-exponential model is sufficient. The more complex model such as bi-exponential and diffusion kurtosis may complement it in other ways.

[The expression of CRLF2 in adult Ph negative acute B lymphocytic leukemia and its prognostic significance]

目的

检测CRLF2蛋白在初诊成人非Ph阳性急性B淋巴细胞白血病（B-ALL）中的表达情况，探讨CRLF2蛋白的表达与患者临床特征、疗效及预后的关系。

方法

收集郑州大学附属肿瘤医院血液科2016年4月1日至2017年12月31日收治的103例初治成人B-ALL患者骨髓标本，应用流式细胞术CD45/SSC设门检测原始细胞CRLF2表达率，将CRLF2表达率≥20%定义为高表达组，<20%定义为低表达组，比较两组患者的临床特征及预后差异。

结果

CRLF2高表达组中位总生存（OS）、无病生存（DFS）时间分别为9.0和4.25个月，CRLF2低表达组分别为15.5和10.25个月，差异有统计学意义（P值分别为0.007、0.000）。CRLF2高表达组18个月OS率、DFS率分别为38.6%和25.1%，CRLF2低表达组分别为57.8%和42.3%，差异有统计学意义（P值分别为0.047、0.016）。多因素分析显示CRLF2高表达是影响患者OS（HR=2.991，95%CI 1.429~6.261，P=0.004）和DFS（HR=2.374，95%CI 1.146~4.960，P=0.041）的独立危险因素。

结论

合并CRLF2高表达的成人初治B-ALL患者预后不良。

[Diffuse pulmonary meningotheliomatosis: a case report and literature review]

Objective: To analyze the clinical features, diagnosis and differential diagnosis of diffuse pulmonary meningotheliomatosis (DPM), a rare subtype of minute pulmonary meningothelial-like nodules (MPMN), so as to improve the understanding of this disorder. Methods: The clinical data of a patient diagnosed as DPM admitted in department of Respiratory Medicine, Peking University Third Hospital in August 2016 were reported and the related literatures were reviewed. With "pulmonary meningothelial-like nodules" , "minute pulmonary meningothelial-like nodules" or "diffuse pulmonary meningotheliomatosis" as the search terms, and the search time before November 1st 2017 for Wanfangdata, China National Knowledge Infrastructure (CNKI), and PubMed.Twenty-five articles were retrieved, among which 6 English (all case reports) articles were found with the search term "diffuse pulmonary meningotheliomatosis" involving 10 cases, and the other 19 articles (1 Chinese, 18 English) about MPMN mainly discussed non-DPM cases,including 13 case reports and 6 pathological/genetic studies. Results: A 68-year old female was admitted to the hospital because of intermittent cough and expectoration for more than 3 years and aggravation for 3 weeks. Her pulmonary CT showed diffuse minute nodules distributed randomly throughout both lungs, and did not improve after treatment with oral Moxifloxacin for 2 weeks. A video-assisted thoracoscopic biopsy was performed. The specimens showed MPMN and no other lesions, which confirmed the final diagnosis of DPM. She was followed without any medication therapy and her pulmonary CT showed stabilization of the lesions one year later. DPM was considered as a rare type of MPMN. A total of 11 cases were analyzed, including 10 cases reported in the literature. The patients included 1man and 10 women, aged 51 to 75 years, with an average age of (64±8) years. Among the 11 patients, 8 denied a history of smoking or of occupational exposure, 7 presented with dyspnea, shortness of breath, or fatigue, and 8 had mild abnormalities of pulmonary function test. The pulmonary CT of all the patients showed randomly distributed, diffuse bilateral small solid or ground-glass nodules, with the diameters less than 5 millimeters, some of which were cavitated. Only 1 patient had pulmonary thromboembolism, while the other 10 did not have any other lung diseases. All the patients were histologically diagnosed, 8 by open lung biopsies, 2 by transbronchial lung biopsy, and 1 by CT-guided fine needle aspiration. Three patients were followed for 12-92 months and the lung lesions were all stable. Conclusions: As a rare subtype of MPMN, DPM lacks specificity of clinical manifestations, and presents with diffuse bilateral small solid or ground-glass nodules, distributed randomly throughout both lungs. An early correct diagnosis depends on biopsy.

Oxaliplatin-rapamycin combination was superior to mono-drug in treatment of hepatocellular carcinoma both in vitro and in vivo

The presented study aimed to investigate the antitumor efficacy of combination of oxaliplatin with rapamycin, an mTOR inhibitor, in hepatocellular carcinoma (HCC). The activation status of mTOR pathway was first examined in HCC cell lines HepG2, BEL7402, and HuH7 using Western blotting. Effects of rapamycin, oxaliplatin, and their combination on the proliferation of HCC cells were determined in vitro using MTT assay and in vivo using a nude mice model bearing HepG2 xenografts. Drug-induced cell apoptosis was examined by flow cytometry. Expression of apoptosis-related protein was determined by Western blotting. We observed that mTOR pathway was activated in all three cell lines used in the current study. MTT assay demonstrated that oxaliplatin in combination with rapamycin synergistically inhibited the proliferation of HCC cells. The combination regimen reduced terminal tumor burden more efficiently than the corresponding monotherapy. The percentages of apoptotic cells and the expression levels of apoptosis-related proteins including cleaved caspase-9, -3, and PARP were significantly higher in combination-treatment groups than those in mono-drug-treatment groups. The ratios of Bax/Bcl-2 in cells exposed to both oxaliplatin and rapamycin were significantly increased compared to those in cells subjected to oxaliplatin or rapamycin alone treatment. Results obtained in the presented study suggested that combination of oxaliplatin and rapamycin was superior to mono-drug and may have a potential value in treatment of HCC.

[Airway inflammation and small airway wall remodeling in neutrophilic asthma]

OBJECTIVE

To investigate the distribution of airway inflammation phenotype in patients with bronchial asthma (asthma), and to analyze clinical characteristics, inflammatory cytokines, pulmonary small vessels remodeling and small airway wall remodeling in patients with neutrophilic asthma.

METHODS

Sixty-three patients with asthma were enrolled from January 2015 to December 2015 in Peking University Third Hospital. Clinical data including gender, age, body mass index (BMI), pulmonary function tests (PFTs), asthma control test (ACT) were recorded. All the patients underwent sputum induction. The cellular composition of the sputum was evaluatedand the concentration of active MMP-9 in the sputum tested. Blood routine tests were done and the concentration of IgE, periostin, and TGF-beta1 levels were measured in serum by enzyme-linked immunosorbent assay (ELISA). Small airway wall remodeling was measured in computed tomography (CT) scans, as the luminal diameter, luminal area, wall thickness and wall area % adjusted by body surface area (BSA) at the end of the 6th generation airway, in which the inner diameter was less than 2 mm. Small vascular alterations were measured by cross-sectional area (CSA), and the total vessel CSA < 5 mm² was calculated using imaging software.

RESULTS

The distributions of airway inflammatory phenotypes of the asthmatic patients were as follows: neutrophilic asthma (34.9%, 22/63), eosinophilic asthma (34.9%, 22/63), mixed granulocytic asthma (23.8%, 15/63), and paucigranulocytic asthma (6.3%, 4/63). The neutrophilic subtype patients had a significantly higher active MMP-9 level in sputum compared with the eosinophilic phenotypepatuents, as 179.1 (74.3, 395.5) vs. 50.5 (9.7, 225.8), P<0.05. Sputum neutrophil count was negatively correlated with FEV1%pred (r=-0.304,P<0.05), and positively correlated with active MMP-9 level in sputum (r=-0.304, P<0.05), and positive correlation trend with airway wall thickness (r=0.533, P=0.06). There was a significantly negative correlation of active MMP-9 level in sputum with FEV1%pred (r=-0.281, P<0.05), in positive correlation with small airway wall area (%)(r=0.612, P<0.05), and inpositive correlation trend with airway wall thickness (r=0.612, P=0.06). Neutrophils count in peripheral blood was positively correlated with neutrophil counts in sputum.

CONCLUSION

Neutrophil count in airway is related to lung function in asthmatic patients. Neutrophils may accelerate small airway wall remodeling through the release of active MMP-9. Neutrophil count in peripheral blood is related to neutrophils count in sputum, which may be used as a substitute for evaluating inflammatory phenotype.

[Study on herbal textual evolution and flavonoids and their pharmacological of Spatholobi Caulis]

Spatholobi Caulis, the vine stem of Spatholobus suberectus and widely used in China and Southeast Asian nations, has the effects on nourishing the blood and promoting blood flow, regulating menstruation and relieving pain, and invigorating the nerves. Through consulting the herbal textual and local chronicles, we summarized the original textual research and medicinal evolution on Spatholobi Caulis to analyze the changes of varieties in different historical periods. Further, the major active ingredient in Spatholobi Caulis was discussed. According to the literature to date, 60 flavonoids compounds have been isolated and could be divided into isoflavones, dihydroflavones, flavanols, dihydroflavonols, procyaninides, chalcones, pterocarpans, isoflavanols, isoflavanones and aurone according to their molecular structures. These indicative ingredients in Spatholobi Caulis showed pharmacological activities on regulation of the blood system, anti-tumor, anti-oxidation, anti-virus, anti-bacteria and inhibition of melanin deposition. This review will provide reference and basis for the sustainable use of resources and industry development on Spatholobi Caulis.

[Clinical significance of targeting drug-based molecular biomarkers expression in ovarian clear cell carcinoma]

Objective: To assess the expression level of targeting drug-based molecular biomarkers in ovarian clear cell carcinoma (OCCC) tissues and its clinical significance. Methods: A total of 63 OCCC patients included 40 primary OCCC and 23 recurrent OCCC for secondary cytoreductive surgery (SCS), who had received primary surgeries at Fudan University Shanghai Cancer Center between January, 2008 and December, 2015 were enrolled, and immunohistochemistry SP method was used to test human epidermal growth factor receptor (EGFR), human epidermal growth factor receptor-2 (HER2), aurora kinase A (AURKA), breast cancer susceptibility gene 1 (BRCA1), BRCA2 and programmed death-ligand 1 (PD-L1)protein expression in paraffin-embedded tissues. Results: The positive rates of EGFR, HER2, AURKA,BRCA1, BRCA2 and PD-L1 in primary and recurrent tumor tissues were respectively 20% (8/40) vs 30% (7/23) , 22% (9/40) vs 35% (8/23) , 38% (15/40) vs 35% (8/23) , 42% (17/40) vs 39% (9/23) , 20% (8/40) vs 22% (5/23) , 25% (10/40) vs 17% (4/23) , and there were no significant differences between primary and recurrent OCCC (all P>0.05). χ(2)-test or Fisher exact analysis revealed that HER2 expression in recurrent tumor tissues had a relationship with chemoresistance (P<0.05), while the expression of other biomarkers showed no significant relationship with chemoresistance (all P>0.05). Further, Kaplan-Meier survival analysis showed that patients with HER2 and AURKA-positive expression had a significantly shorter progression-free survival time in primary OCCC (4 months vs 10 months, log-rank test, P<0.05 for HER2; and 4 months vs 10 months, P<0.05 for AURKA); and a shorter overall survival time after SCS in recurrent OCCC (10 months vs 44 months, P<0.05 for HER2; and 13 months vs 43 months, P<0.05 for AURKA). However, multivariate Cox proportional hazards regression analysis indicated that none of these 6 biomarkers was independent risk factor of progression-free survival time of primary OCCC or overall survival time after SCS for recurrent OCCC (P>0.05). Conclusion: HER2 and AURKA could serve as prognostic factors in ovarian clear cell carcinoma.

Alleviatory effect of spent Pleurotus eryngii Quel substrate on replant problem of Rehmannia glutinosa Libosch

Rehmannia glutinosa Libosch. is a medicinal plant cultivated at a commercial scale in China. However, replanting problems result in a severe decline in both the biomass and quality of its roots, which are of greatest medicinal value. This study attempted to remediate the replant soil using spent Pleurotus eryngii Quel substrate for alleviating this issue, and to investigate the underlying mechanisms. Results showed that R. glutinosa grew successfully in fresh soil and remedial replant soil, while no roots were harvested in the unremedied replant soil. Overall, the nutritional status in the remedial soil was higher than that of the unremedied and fresh soil, while the concentration of allelopathic phenolic acids was lower. When planted in unremedied soil, the growth of five plant pathogens was induced and one beneficial fungus was suppressed. When planted in remedied soil, four out of the five pathogens were suppressed, while two beneficial fungi were identified in the remedial soil. This study suggests that the spent P. eryngii substrate significantly alleviates the replant problem of R. glutinosa, and that the alleviatory function reflects a synergetic effect, including the supplementation of soil nutrition, the degradation of allelochemicals, and the remediation of unbalanced microbial community.