Mechanism of gypenoside ⅩⅦ against cerebral ischemia/reperfusion injury based on nuclear factor erythroid 2-related factor 2/antioxidant responsive element signaling pathway / 中华危重病急救医学

Objective:To explore the mechanism of gypenoside ⅩⅦ against cerebral ischemia/reperfusion (I/R) through nuclear factor erythroid 2-related factor 2/antioxidant responsive element (Nrf2/ARE) signaling pathway.Methods:Forty SPF Sprague Dawley (SD) rats were randomly divided into sham operated group, I/R model group, 25, 50 and 100 mg/kg gypenoside ⅩⅦ groups ( n = 8). Gypenoside ⅩⅦ groups were administered 25, 50 or 100 mg/kg (0.01 mL/g) gypenoside ⅩⅦ by intragastric administration for 14 days; the other two groups received the same dose of saline. Rat cerebral I/R model was established by modified line bolt method; rats in the sham operated group underwent the same procedure without producing substantial embolization. After 24 hours of reperfusion, the neurological deficit scores of the rats in each group were assessed. Rat abdominal aortic whole blood was collected and the serum reactive oxygen species (ROS), heme oxygenase-1 (HO-1), γ-glutamylcysteine synthase (γ-GCS), superoxide dismutase (SOD), quinone NADH oxidoreductase 1 (NQO1), and malondialdehyde (MDA) were detected. Then whole brain tissue was harvested and penumbra tissue was isolated from cerebral cortex, the general condition of rat brain tissue and the volume of cerebral infarction were evaluated, the histopathological changes in the brain were observed under light microscopy, the mRNA expressions of Nrf2 and Keap1 were measured by real-time fluorescent quantitative polymerase chain reaction (RT-qPCR), the protein expressions of Nrf2 and Keap1 were determined by Western blotting. Results:After 24 hours of reperfusion, compared with the sham operated group, the score of neurological deficit and infarct volume were significantly increased, the NQO1, SOD and γ-GCS levels in serum were significantly decreased, MDA, HO-1 and ROS levels in serum were significantly increased, the Nrf2 and Keap1 mRNA and protein expressions in the ischemic penumbra were significantly increased in rats from I/R model group. Compared with the I/R model group, the neurological deficit scores (1.50±0.53, 1.37±0.52 vs. 2.75±0.46) and brain infarct volume [(19.8±5.1)%, (21.4±6.4)% vs. (42.3±5.8)%] were significantly reduced, serum NQO1, SOD, HO-1 and γ-GCS were significantly increased [NQO1 (ng/L): 186.05±10.38, 220.75±16.22 vs. 131.36±5.95, SOD (kU/L): 63.23±5.30, 72.70±8.62 vs. 36.75±6.55, HO-1 (ng/L): 60.57±7.93, 60.35±4.72 vs. 42.72±4.95, γ-GCS (kU/L): 8.81±0.53, 8.72±0.69 vs. 6.80±0.56], serum MDA and ROS levels were significantly reduced [MDA (μmol/L): 5.94±0.66, 5.61±0.53 vs. 10.88±1.34, ROS (kU/L): 69.11±4.23, 67.12±4.52 vs. 104.43±7.54], the mRNA and protein expressions of Nrf2 and Keap1 in the ischemic penumbra were significantly increased in rats from 50 mg/kg and 100 mg/kg gypenoside ⅩⅦ groups [Nrf2 mRNA (2 -△△Ct): 1.90±0.13, 2.13±0.18 vs. 1.48±0.11, Keap1 mRNA (2 -△△Ct): 1.78±0.11, 1.85±0.10 vs. 1.43±0.10, Nrf2/β-actin: 0.73±0.04, 0.79±0.03 vs. 0.60±0.03, Keap1/β-actin: 0.71±0.01, 0.76±0.03 vs. 0.61±0.01], all the comparative differences were statistically significant (all P < 0.01); 25 mg/kg gypenoside ⅩⅦ had no significant effect. Conclusion:Gypenoside ⅩⅦ (50 mg/kg and 100 mg/kg) may play a role in anti-cerebral I/R injury by regulating NQO1, SOD, HO-1, γ-GCS, ROS and MDA through Nrf2/ARE signaling pathway.

Effect of air pollution on mortality among residents in Hangzhou City / 预防医学

Objective@#To examine the effects of air pollution on overall mortality, mortality of respiratory diseases, and mortality of circulatory diseases among residents in Hangzhou City.@*Methods@#Residents' mortality data in Hangzhou City from 2014 to 2016 were captured from Zhejiang Provincial Chronic Disease Surveillance Information Management System, and the ambient air quality in Hangzhou City from 2014 to 2016 were collected from Hangzhou Environmental Monitoring Center, while the meteorological monitoring data during the study period were collected from Hangzhou Meteorological Bureau. The effects of PM2.5, PM10, NO2 and SO2 on overall mortality, morality of respiratory diseases and mortality of circulatory diseases were evaluated a generalized additive model (GAM) based on Poisson distribution, and the risk of mortality was described with excess risk (ER) and its 95%CI.@*Results@#The daily M (QR) overall deaths, deaths from respiratory diseases and deaths from circulatory diseases were 111 (30), 16 (9) and 37 (14) persons in Hangzhou City from 2014 to 2016, respectively. A 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 resulted in 0.47% (95%CI: 0.23%-0.70%), 0.37% (95%CI: 0.21%-0.53%), 1.06% (95%CI: 0.50%-1.61%) and 3.08% (95%CI: 2.18%-3.99%) rises in the risk of overall mortality, 0.60% (95%CI: 0.04%-1.16%), 0.45% (95%CI: 0.06%-0.83%), 2.01% (95%CI: 0.84%-3.20%) and 6.06% (95%CI: 3.80%-8.37%) rises in the risk of mortality of respiratory diseases, and 0.45% (95%CI: 0.08%-0.83%), 0.44% (95%CI: 0.17%-0.71%), 1.43% (95%CI: 0.49%-2.37%) and 3.66% (95%CI: 2.13%-5.22%) rises in the risk of mortality of circulatory diseases, and the greatest effect was observed at a 2-day lag. Multi-pollutant model analysis showed that, after adjustment for PM2.5, NO2 and PM2.5+NO2+SO2, a 10 μg/m3 increase in SO2 resulted in an elevated risk of mortality of respiratory diseases than a single-pollutant model.@*Conclusions@#The air pollutants PM10, PM2.5, NO2, and SO2 correlated positively with the risk of overall mortality, mortality of respiratory diseases and mortality of circulatory diseases in Hangzhou City from 2014 to 2016, and the co-existence of multiple pollutants enhanced the effect of SO2 on mortality of respiratory diseases.

Assessment of pulmonary functions among the elderly in Hangzhou City / 预防医学

Objective@#To investigate the pulmonary functions among the elderly in Hangzhou City, so as to provide insights into the management of respiratory diseases among the elderly. @* Methods@#Permanent residents at ages of 60 to 75 years were sampled from Hangzhou City from November to December 2020. The pulmonary function was tested using a portable pulmonary function monitor, including large airway function parameters [forced expiratory volume (FVC), forced expiratory volume in a second (FEV1) and FEV1/FVC], and small airway function parameters [maximum expiratory flow rate at 75% vital capacity (MEF75%), the maximum expiratory flow rate at 25% of vital capacity (MEF25%) and the forced expiratory flow rate (FEF25%-75%) at 25% to 75% of vital capacity]. The pulmonary functions were compared among the elderly with different genders, ages and body mass index (BMI).@*Results @#Totally 314 participants were recruited, including 126 men (40.13%), with a mean age of (68.49±4.47) years and mean BMI of (23.51±2.79) kg/m2. The mean FEV1, FVC, FEV1/FVC, MEF25%, MEF75% and FEF25%-75% were (1.97±0.53) L, (2.51±0.72) L, (79.79±11.47)%, (0.98±0.53) L/s, (3.84±1.65) L/s and (1.99±0.91) L/s among the participants, respectively. Higher FEV1 [(2.22±0.55) vs. (1.79±0.43) L, P<0.05], FVC [(2.92±0.75) vs. (2.24±0.55) L, P<0.05], MEF75% [(4.19±1.82) vs. (3.59±1.49) L/s, P<0.05] and FEF25%-75% [(2.14±1.07) vs. (1.90±0.77) L/s, P<0.05] were tested among men than among women, and lower FEV1 [(1.75±0.46) L], FVC [(2.27±0.64) L], MEF25% [(0.88±0.57) L/s], MEF75% [(3.39±1.45) L/s] and FEF25%-75% [(1.79±0.96) L/s] were tested among the elderly at ages of 70 to 74 years. The proportion of large and small airway dysfunctions was 40.45% among the participants. @* Conclusions@# The proportion of large and small airway dysfunctions was 40.45% among the elderly in Hangzhou City, and poor pulmonary functions were tested among the women and the advanced elderly.

Treatment experience of neck tumor surgeries involving carotid artery / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate surgical treatment of carotid artery diseases in neck tumor surgery. Methods:A retrospective analysis of the clinical data on carotid artery treatment was conducted in the five cases of neck tumor surgeries treated at Department of Surgical Oncology, the First Peoples Hospital of Lanzhou from March 2010 to May 2020. Surgical methods, including carotid artery resection and ligation, tumor-involved artery resection and vascular reconstruction, and tumor peeling and carotid rupture repairing were used, respectively. Results:Five cases were successfully operated on. One case of carotid artery ligation was followed by intermittent dizziness and decreased contra-lateral limb strength after the surgery. The remaining patients exhibited no neurological complications. A patient with cervical low-grade myofibroblastoma developed into lung metastases 8 months after the surgery. Another patient with cervical lymph node metastases in papillary thyroid cancer developed into lung metastases 24 months after the surgery. Conclusion:Currently, surgical methods for clinical treatment of diseased carotid arteries include carotid artery resection and ligation, simple tumor peeling, tumor invasion artery resection and vascular reconstruction, and interventional therapy. Each surgical method has its own advantages and disadvantages. Therefore, the choice of treatment depends on the patient's specific conditions, physician's clinical experience, and the equipment available.

Protocol for the development of the Expert consensus on sedation and analgesia for neurocritical care patients (2023) / 中华危重病急救医学

To further standardize the sedation and analgesia treatment for neurocritical care patients, the National Center for Healthcare Quality Management in Neurological Diseases and Chinese Society of Critical Care Medicine organized national experts in this fields to form Working group of the Expert consensus on sedation and analgesia for neurocritical care patients in order to update the Expert consensus on sedation and analgesia for patients with severe brain injury (2013) based on evidence-based medicine. This update aims to provide scientific guidance for the clinical diagnosis and treatment of neurocritical care patients. The working group followed the definition of clinical practice guidelines by the Institution of Medicine (IOM) and the World Health Organization guidelines development handbook and Guidelines for the formulation/revision of clinical guidelines in China (2022) to register and draft the Expert consensus on sedation and analgesia for neurocritical care patients. The working group will strictly adhere to the consensus development process to formulate and publish the Expert consensus on sedation and analgesia for neurocritical care patients (2023). This protocol primarily introduces the development methodology and process of the Expert consensus on sedation and analgesia for neurocritical care patients (2023), including the purpose of the update, the target population, the composition of the consensus development working group, the presentation and collection of clinical questions, evidence evaluation and summarization, and the generation of recommended opinions. This will make the consensus development process more standardized and transparent.

Weaning and extubation in neurocritical care patients / 中华危重病急救医学

Due to primary diseases of neurocritical care unit (NCU) patients, they have particularities with low level of consciousness, poor airway protective ability, damaged respiratory drive and respiratory motor conduction pathway. Such patients have higher rates of weaning difficulty, delayed extubation, extubation failure and tracheostomy. There are several guidelines on weaning and extubation for intensive care unit (ICU) patients, while there are no guidelines for for NCU patients. Therefore, we reviewed current guidelines and recommendations on weaning and extubation in both ICU and NCU patients suggesting considerations of neurological condition, level of consciousness and presence of airway protective reflexes before extubation, moreover, we introduced researches about protocols of weaning for NCU patients and related predictors.

Application research of multi-dimensional interaction combined with PBL teaching in emergency and critical care nursing practice teaching / 中华医学教育探索杂志

Objective:To explore the value of multi-dimensional interaction combined with problem-based learning (PBL) teaching in the nursing practice teaching of emergency and critical care.Methods:A total of 110 nursing students who practiced in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to March 2020 were selected as the control group, and the traditional teaching was adopted. In addition, 89 nursing students who practiced from June 2020 to December 2020 were selected as the research group, and multi-dimensional interaction combined with PBL teaching was adopted. The teaching quality was assessed through the comprehensive scores of the nursing students (departure examination + regular performance assessment) and nursing students' feedback on the teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The comprehensive scores of the nursing students in the research group were higher than those in the control group, and the difference was statistically significant ( P<0.001). Compared with the control group, the nursing students in the research group believed that multi-dimensional interaction combined with PBL teaching could improve nursing knowledge and skills, overall clinical nursing ability, self-management ability, clinical thinking ability, and the ability to analyze, judge and solve clinical nursing problems, group cooperation ability, communication ability between doctors, nurses and patients, emergency ability and rescue ability, and professional quality, with statistically significant differences ( P<0.001). Conclusion:Multi-dimensional interaction combined with PBL teaching can improve the theoretical and clinical practice level of nursing interns, and at the same time help to cultivate nursing talents with excellent comprehensive quality.

Retrospective analysis of the pre-audit results for prescriptions of Chinese patent medicines in a second-level hospital / 药学实践杂志

Objective Analyze the pre-audit results of Chinese patent medicine prescriptions in a second-level hospital, suggest the risks of taking Chinese patent medicines and promote the safe and standardized use of Chinese patent medicines. Methods A total of 31542 outpatient and emergency prescriptions of Kongjiang hospital in April 2021 were collected, combined with the review of the instructions and relevant data, classify the toxic components of Chinese patent medicines, and summarize and analyze the problems of drug use. Results The types of problems in the prescription of Chinese patent medicine and chemical medicines were different, mainly including repeated medication and wrong usage and dosage. Insufficient warnings on toxic medicinal ingredients in the instructions of Chinese patent medicines and the imperfect knowledge base of audit software increased the risk of using Chinese patent medicines. Conclusion It is necessary to improve the knowledge base of the prescription audit system, strengthen the high-alarm management of Chinese patent medicines containing toxic ingredients, and improve the public's understanding of the rational use of Chinese patent medicines.

Investigation on pH value of towels in public places in Hangzhou City / 预防医学

Objective@#To investigate the pH value of towels in public places in Hangzhou City, so as to provide the evidence for improving health supervision of towels in public places.@*Methods@#One three- and higher-star hotel, one less than three-star hotel, one express hotel, one barber shop and one beauty shop were selected from 13 counties (districts) of Hangzhou City in 2021, and 3% to 5% of all cleaned and disinfected towels that planned to be used were randomly sampled. The type of public places and towels cleaning and disinfection were collected using the basic investigation form provided in the Public Place Health Risk Factors Surveillance Program (2021 version), and the pH value of towels was measured according to the national criteria Textiles-determination of pH of aqueous extract (GB/T 7573-2009). According to the national criteria of Hygienic indicators and limits for public places (GB 37488-2019), a pH value of 6.5 to 8.5 was defined qualified, and the rates of qualified pH values was estimated for towels sampled from different places and with different cleaning and disinfection types.@*Results@#Totally 64 public places were investigated, and 807 towels were measured for pH values, with a median pH value of 7.3 (interquartile range, 0.7). A total of 655 towels had qualified pH values (81.16%). The rates of qualified pH values were 84.95%, 75.56%, 73.21%, 85.61% and 88.81% for towels sampled from the three- and higher-star hotel, less than three-star hotel, express hotel, barber shop and beauty shop, respectively (χ2=19.307, P=0.001). The rate of qualified pH values for self-cleaned and -disinfected towels was significantly higher than for towels with outsourcing cleaning and disinfection services (88.28% vs. 77.18%; χ2=14.973, P<0.001). The rate of qualified pH values was 83.82% for towels with outsourcing cleaning and disinfection services sampled from the three- and higher-star hotel, and was both 100.00% for self-cleaned and -disinfected towels sampled from the less than three-star hotel and beauty shop.@*Conclusion@#The cleaning quality of towels remains to be improved in public places in Hangzhou City, and health supervisions on towels are recommended to be improved in public places.

Clinical value of marker genes in the diagnosis of salivary gland mammary secretory carcinoma / 中华内分泌外科杂志

Objective:To investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of mammary analogue secretary carcinoma of salivary gland (MASC) .Methods:From Jan. 2018 to Jan. 2021, 28 cases of salivary gland MASC were collected in Ningbo Diagnostic Pathology Center, and 10 cases of acinar cell carcinoma and 10 cases of adenoid cystic carcinoma were selected as controls. Immunohistochemical envision method was used to detect the expression of S-100,, DOG-1, CD117, SOX-10, Mammaglobin and Vimentin, and fluorescence in situ hybridization was used to detect the fusion gene of ETV6-NTRK3.Results:The S-100 protein, SOX-10 and Vimentin of MASC of salivary gland were diffusingly positive (28/28) , Mammaglobin (22/28) and CD117 (19/28) were partially positive, and DOG-1 was negative. ETV6-NTRK3 fusion transcription was successfully detected in 26 of 28 salivary gland MASC cases, of which 23 were positive and 3 were negative.Conclusions:Salivary gland MASC is a low-grade malignant epithelium tumor. Comprehensive detection of the expression levels of S-100 protein, SOX-10, DOG-1, Mammaglobin and CD117 is of great value for the diagnosis and differential diagnosis of MASC. FISH detection of ETV6-NTRK3 gene fusion has important reference value for definite diagnosis.

Risk factors of major intraoperative bleeding and postoperative bleeding associated with endoscopic submucosal dissection for gastric neoplasms / 中华医学杂志(英文版)

BACKGROUND@#Endoscopic resection bleeding (ERB) classification was proposed by the authors' team to evaluate the severity of intraoperative bleeding (IB) during endoscopic submucosal dissection (ESD). This study aimed to evaluate the application of ERB classification and to analyze the risk factors of major IB (MIB) and postoperative bleeding (PB) associated with ESD for gastric neoplastic lesions.@*METHODS@#We retrospectively enrolled a total of 1334 patients who underwent ESD between November 2006 and September 2019 at The First Medical Center of Chinese People's Liberation Army General Hospital. All patients were divided into the non-MIB group (including ERB-0, ERB-controlled 1 [ERB-c1], and ERB-c2) and the MIB group (including ERB-c3 and ERB-uncontrolled [ERB-unc]) according to the ERB classification. Risk factors of major MIB and risk factors of PB were analyzed using a logistic regression model.@*RESULTS@#Among the 1334 patients, 773 (57.95%) had ERB-0, 477 (35.76%) had ERB-c1, 77 (5.77%) had ERB-c2, 7 (0.52%) had ERB-c3, and no patients had ERB-unc. The rate of PB in patients with IB classifications of ERB-0, ERB-c1, ERB-c2, and ERB-c3 were 2.20% (17/773), 3.35% (16/477), 9.09% (7/77), and 2/7, respectively. In multivariate analysis, proximal location (odds ratio [OR]: 1.488; 95% confidence interval [CI]: 1.045-3.645; P = 0.047) was the only significant risk factor of MIB. Chronic kidney disease (CKD) (OR: 7.844; 95% CI: 1.637-37.583; P = 0.010) and MIB (ERB-c3) (OR: 13.932; 95% CI: 2.585-74.794; P = 0.002) were independent risk factors of PB.@*CONCLUSIONS@#Proximal location of lesions was a significant risk factor of MIB. Additionally, CKD and MIB (ERB-c3) were independent risk factors of PB. More attention should be paid to these high-risk patients for MIB and PB.

Anesthesia management of living small bowel transplantation / 中华麻醉学杂志

Objective:To summarize the anesthesia management of living small bowel transplantation.Methods:Severn patients undergoing living and allogeneic small bowel transplantation for the first time were selected.The intraoperative hemodynamics, indexes of blood gas analysis, body temperature and blood transfusion and volume of liquid infused were analyzed.Postoperative outcomes were tracked.Results:Six cases survived and were successfully discharged from hospital successfully, and one patient died.In the operation room, 71% patients were successfully extubated after surgery.Compared with the values during anatomical separation period, Hb during vascular anastomosis and intestinal reconstruction periods and concentration of Ca 2+ during intestinal reconstruction period were significantly decreased, and the blood glucose concentration during vascular anastomosis period were increased ( P<0.05 or 0.01). Compared with the values during vascular anastomosis period, the blood glucose concentration was increased significantly during intestinal reconstruction period ( P<0.05). Crystalloid solution (57±30) ml/kg and colloid solution which mainly containing 20% albumin (15±13) ml/kg were infused mainly during anatomical separation and vascular anastomosis periods in all the patients. Conclusion:The condition of successful living small bowel transplantation is fully evaluation and preparation before surgery.Intravenous-inhalational anesthesia combined with transverses abdominis plane block and rational infusion of colloid solution with vasoactive drugs to maintain hemodynamics stability and monitor blood gas, body temperature, active adjustment of electrolytes and internal environment and stable body temperature can be helpful in maintaining perioperative stable vital signs during the perioperative period, removing the tracheal tube early at the end of surgery, and reducing the development of postoperative complications in patients undergoing living small bowel transplantation.

Clinical study on Wanfu-Qutong Decoction combined with esomeprazole tablets for atrophic gastritis / 国际中医中药杂志

Objective:To evaluate the clinical efficacy of Wanfu-Qutong Decoction combined with esomeprazole in the treatment of chronic atrophic gastritis (CAG). Methods:A total of 106 CAG patients who met the inclusion criteria from June 2017 to June 2019 were randomly divided into two groups with 53 in each group. The control group took esomeprazole magnesium enteric coated tablets, and the observation group took Wanfu-Qutong Decoction on the basis of the control group. Both groups were treated continuously for 3 months. TCM syndrome score was performed before and after treatment, and the new Sydney system intuitive simulation score method was used to score the histopathology of gastric mucosa. The levels of gastrin 17 (G-17), pepsinogen (PGⅠ , PGⅡ) and the PG Ⅰ/Ⅱ were measured by ELISA. Results:The total effective rate was 96.2% (51/53) in the observation group and 79.2% (42/53) in the control group. There was significant difference between the two groups ( χ2=7.414, P<0.01). After treatment, the scores of epigastric pain, fullness, liking temperature and pressing, vomiting clear water, eating less and staying foolish, and limb burnout in the observation group were significantly lower than those in the control group ( t values were 2.788, 3.632, 3.816, 1.590, 2.183, 2.103, respectively, all Ps<0.05), and the scores of chronic inflammatory reaction, inflammatory activity, atrophy degree, dysplasia and intestinal metaplasia in the mucosa were significantly lower than those in the control group ( t values were 2.983, 2.106, 2.106, 3.773, 1.922, 3.095, respectively, all Ps<0.05). After treatment, the serum G-17 [(14.47 ± 3.06) pmol/L vs. (10.67 ± 2.47) pmol/L, t=10.510] and PG Ⅰ [(130.31 ± 14.79) μg/L vs. (102.36 ± 12.63) μg/L, t=8.178] and PG Ⅰ/Ⅱ [(10.45 ± 0.48) vs. (9.17 ± 0.72), t=2.104] in the observation group were significantly higher than those in the control group ( P<0.01 or P<0.05). Conclusion:Wanfu-Qutong Decoction combined with esomeprazole tablets can effectively improve the clinical symptoms of CAG patients, regulate the levels of G-17, PG Ⅰ , PG Ⅱ and PGⅠ/Ⅱ, and promote the repair of gastric mucosa.

Rate of active immune response to hepatitis B vaccine in adult hepatitis B recipients after liver transplantation and its correlation with CD4 level before vaccination / 临床肝胆病杂志

ObjectiveTo investigate the main clinical influencing factors for the rate of active immune response to hepatitis B vaccine in adult hepatitis B recipients after liver transplantation. MethodsAnalysis was performed for the clinical follow-up data of 15 hepatitis B recipients after liver transplantation who received hepatitis B vaccine in Peking University International Hospital from May 2019 to November 2020, and all patients received liver transplantation at least 3 years before and had a CD4 level of 300-800 cells/u before vaccination. Each dose of vaccination was 40 μg recombinant hepatitis B vaccine (Saccharomyces cerevisiae), with a total of 4 injections at 0, 1, 6, and 8 months. Anti-HBs ≥100 mIU/L after four injections which lasted for 12 weeks without attenuation was considered successful response. Pearson correlation analysis and Kendall correlation analysis were used to investigate the correlation between CD4 level before vaccination and vaccine response rate; a linear regression analysis was used to investigate whether CD4 level before vaccination could predict the titer of anti-HBs after active vaccine immunization; a logistic regression analysis was used to investigate whether CD4 level before vaccination could predict vaccine response. ResultsOf all patients at week 12 of monitoring, 6 patients had response, among whom 1 had an anti-HBs level of ＞1000 mIU/L and 5 had an anti-HBs level of ≥100 mIU/L, and the antibody titer did not attenuate till week 16; the response rate of hepatitis B vaccine was 40%. The 6 patients with response had a mean CD4 level of ≥592 cells/u before vaccination, while the 9 patients without response had a mean CD4 level of ≤500 cells/u before vaccination. CD4 level before vaccination was strongly correlated with the response rate of hepatitis B vaccine (Pearson correlation analysis: r=0.767, P=0.001; Kendall correlation: r=0.717, P=0.001). ConclusionCD4 level before vaccination is a key clinical factor affecting the response rate of hepatitis B vaccine after liver transplantation.

Comparison of clinicopathological characteristics of main and accessory lesions in patients with synchronous multiple early esophageal cancer and intraepithelial neoplasia / 中华消化内镜杂志

Objective:To compare the clinicopathological characteristics of main and accessory lesions in patients with synchronous multiple esophageal lesions (SMEL, i. e. early esophageal cancer and intraepithelial neoplasia) and to explore their correlation.Methods:Data of 80 patients with SMEL treated by endoscopic resection in The First Medical Center of Chinese PLA General Hospital from November 2006 to September 2019 were retrospectively analyzed, and the clinicopathological characteristics as well. The lesions were divided into main and accessory lesions, and their correlation in macroscopic type, lesion location, pathological type and invasion depth in 70 patients with double SMEL were investigated.Results:The age of 80 patients with SMEL was 61.3±8.32 years, more common in males (83.8%, 67/80). Fifty-seven patients (71.2%) had a history of smoking and drinking, respectively. There was a positive correlation between the size of main and accessory lesions in the 70 patients with double SMEL ( r=0.464, P<0.001). The macroscopic type ( P=0.115), location ( P=0.340) and depth of invasion ( P=0.555) of the main and accessory lesions were not correlated, but the pathological type had high correlation ( P<0.001). The consistency rate was 50.0% (35/70). Conclusion:Most SMEL patients are elderly males with a history of smoking and drinking. When one lesion is found, there is high possibility of multiple lesions. Physicians should be aware of the correlation between main and accessory lesions to avoid missed diagnosis.

Effects of Fe₃O₄ on the denitrification performance of Pseudomonas stutzeri / 生物工程学报

Biological denitrification is the most widely used technology for nitrate removal in wastewater treatment. Conventional denitrification requires long hydraulic retention time, and the nitrate removal efficiency in winter is low due to the low temperature. Therefore, it is expected to develop new approaches to enhance the denitrification process. In this paper, the effect of adding different concentrations of Fe₃O₄ nanoparticles on the denitrification catalyzed by Pseudomonas stutzeri was investigated. The maximum specific degradation rate of nitrate nitrogen improved from 18.0 h⁻¹ to 23.7 h⁻¹ when the concentration of Fe₃O₄ increased from 0 mg/L to 4 000 mg/L. Total proteins and intracellular iron content also increased along with increasing the concentration of Fe₃O₄. RT-qPCR and label-free proteomics analyses showed that the relative expression level of denitrifying genes napA, narJ, nirB, norR, nosZ of P. stutzeri increased by 55.7%, 24.9%, 24.5%, 36.5%, 120% upon addition of Fe₃O₄, and that of denitrifying reductase Nap, Nar, Nir, Nor, Nos increased by 85.0%, 147%, 16.5%, 47.1%, 95.9%, respectively. No significant difference was observed on the relative expression level of denitrifying genes and denitrifying reductases between the bacteria suspended and the bacteria adhered to Fe₃O₄. Interestingly, the relative expression level of electron transfer proteins of bacteria adhered to Fe₃O₄ was higher than that of the bacteria suspended. The results indicated that Fe₃O₄ promoted cell growth and metabolism through direct contact with bacteria, thereby improving the denitrification. These findings may provide theoretical support for the development of enhanced denitrification.

SURF4 maintains stem-like properties via BIRC3 in ovarian cancer cells / 부인종양

Objective@#As cancer stem cells (CSCs) are considered as the origin of tumor development, recurrence, and drug resistance, we aimed to explore the mechanism related to modulating stemness in CSCs, thus facilitating to search for new therapeutic strategy for ovarian cancer. @*Methods@#In this study, ovarian cancer stem cells (OCSCs) induced from cell line 3AO and A2780 were enriched in serum-free medium (SFM). The effect of SURF4 on CSC-like properties was evaluated by sphere-forming assays, re-differentiation assays, quantitative real-time polymerase chain reaction, flow cytometry, Western blotting, cell viability assays and in vivo xenograft experiments. The downstream molecule participating in SURF4 maintaining stemness was screened by RNA-sequencing and identified by the experiments of gene function. @*Results@#SURF4 was upregulated expressed in OCSCs. Knockdown of SURF4 reduced the expression of the related stem markers (SOX2 and c-MYC), inhibited self-renewal ability, and improved the sensitivity to chemotherapeutic drugs (paclitaxel and cisplatin) in OCSCs.SURF4 knockdown also inhibited tumorigenesis in nonobese diabetic/severe combined immunodeficiency mice. BIRC3 expression was controlled by SURF4, and BIRC3 showed the similar effect as SURF4 did, and BIRC3 overexpression partially recovered stem-like properties abolished by SURF4 knockdown. @*Conclusion@#Our findings suggest that SURF4 possesses the ability to maintain stemness of OCSCs via BIRC3, and may serve as a potential target in stem cell-targeted therapy for ovarian cancer.

Research progress in predictive biomarkers related to tumor immunotherapy / 国际肿瘤学杂志

Tumor immunotherapy is a treatment method mainly for programmed cell death-1 (PD-1) and its ligand PD-L1. PD-1/PD-L1 inhibitors have obvious clinical benefits and long-lasting responses in a variety of tumors. But overall response rates are still low. Studies show that PD-L1 and tumor mutation burden can predict the effect of immunotherapy. MSI-H/dMMR, TP53 and KRAS mutations are positively correlated with the effect of immunotherapy. While MDM2/4, EGFR, ALK and other genes are negatively correlated with the effect of immunotherapy.

SURF4 maintains stem-like properties via BIRC3 in ovarian cancer cells / 부인종양

Objective@#As cancer stem cells (CSCs) are considered as the origin of tumor development, recurrence, and drug resistance, we aimed to explore the mechanism related to modulating stemness in CSCs, thus facilitating to search for new therapeutic strategy for ovarian cancer. @*Methods@#In this study, ovarian cancer stem cells (OCSCs) induced from cell line 3AO and A2780 were enriched in serum-free medium (SFM). The effect of SURF4 on CSC-like properties was evaluated by sphere-forming assays, re-differentiation assays, quantitative real-time polymerase chain reaction, flow cytometry, Western blotting, cell viability assays and in vivo xenograft experiments. The downstream molecule participating in SURF4 maintaining stemness was screened by RNA-sequencing and identified by the experiments of gene function. @*Results@#SURF4 was upregulated expressed in OCSCs. Knockdown of SURF4 reduced the expression of the related stem markers (SOX2 and c-MYC), inhibited self-renewal ability, and improved the sensitivity to chemotherapeutic drugs (paclitaxel and cisplatin) in OCSCs.SURF4 knockdown also inhibited tumorigenesis in nonobese diabetic/severe combined immunodeficiency mice. BIRC3 expression was controlled by SURF4, and BIRC3 showed the similar effect as SURF4 did, and BIRC3 overexpression partially recovered stem-like properties abolished by SURF4 knockdown. @*Conclusion@#Our findings suggest that SURF4 possesses the ability to maintain stemness of OCSCs via BIRC3, and may serve as a potential target in stem cell-targeted therapy for ovarian cancer.

Evaluation of the teaching environment among the primary and secondary schools in China / 中国学校卫生

Objective@#To evaluate the current status of the primary and secondary schools’ teaching environment in China and associated factors,and to provide the support for making differentiated interventional stategies.@*Methods@#Data regarding to information of the primary and secondary schools was obtained by random inspection from the National Health and Family Planning Commission in 2018. Chi-square test was used to compare differences of qualified rates between groups. Spearman correlation analyses was applied to examine the correlations among population density, per capita GDP and qualified rates.@*Results@#Among the total of 37 531 schools, the overall qualified rate of teaching environmental sanitation of primary and secondary schools in 2018 was 59.1%. The qualifying rate in urban areas (60.3%) was higher than that of rural areas (59.4%) and towns (56.7%). Primary schools (59.8%) had higher qualifying rates than junior high schools (58.2%) and senior high schools (51.8%). In terms of each evaluation item, the qualifying rates of school furniture equipment including desks and chairs were the lowest, while the qualifying rates of dormitory ventilation ranked highest. Large variations among provinces were observed for the qualifying rates for school furniture equipment, as well as blackboard illumination. Those provinces with higher per capita GDP and higher population density had higher the qualifying rates for school furniture equipment.@*Conclusion@#The overall qualifying rate of Chinese primary and secondary schools’ teaching environment is low. Among all the evaluation measures, qualifying rates of dormitory ventilation are relatively good, while school furniture equipment needs to be improved. Notably, strengthened and targeted management should be applied to improve schools’ teaching environment in new era.