AtMYB72 aggravates photosynthetic inhibition and oxidative damage in Arabidopsis thaliana leaves caused by salt stress.

MYB transcription factor is one of the largest families in plants. There are more and more studies on plants responding to abiotic stress through MYB transcription factors, but the mechanism of some family members responding to salt stress is unclear. In this study, physiological and transcriptome techniques were used to analyze the effects of the R2R3-MYB transcription factor AtMYB72 on the growth and development, physiological function, and key gene response of Arabidopsis thaliana. Phenotypic observation showed that the damage of overexpression strain was more serious than that of Col-0 after salt treatment, while the mutant strain showed less salt injury symptoms. Under salt stress, the decrease of chlorophyll content, the degree of photoinhibition of photosystem II (PSII) and photosystem I (PSI) and the degree of oxidative damage of overexpressed lines were significantly higher than those of Col-0. Transcriptome data showed that the number of differentially expressed genes (DEGs) induced by salt stress in overexpressed lines was significantly higher than that in Col-0. GO enrichment analysis showed that the response of AtMYB72 to salt stress was mainly by affecting gene expression in cell wall ectoplast, photosystem I and photosystem II, and other biological processes related to photosynthesis. Compared with Col-0, the overexpression of AtMYB72 under salt stress further inhibited the synthesis of chlorophyll a (Chla) and down-regulated most of the genes related to photosynthesis, which made the photosynthetic system more sensitive to salt stress. AtMYB72 also caused the outbreak of reactive oxygen species and the accumulation of malondialdehyde under salt stress, which decreased the activity and gene expression of key enzymes in SOD, POD, and AsA-GSH cycle, thus destroying the ability of antioxidant system to maintain redox balance. AtMYB72 negatively regulates the accumulation of osmotic regulatory substances such as soluble sugar (SS) and soluble protein (SP) in A. thaliana leaves under salt stress, which enhances the sensitivity of Arabidopsis leaves to salt. To sum up, MYB72 negatively regulates the salt tolerance of A. thaliana by destroying the light energy capture, electron transport, and antioxidant capacity of Arabidopsis.

Clinical Prediction Model for Diabetic Kidney Disease Based on Optical Coherence Tomography Angiography / 中山大学学报(医学科学版)

ObjectiveTo construct and validate a clinical prediction model for diabetic kidney disease （DKD） based on optical coherence tomography angiography （OCTA）. MethodsThis study enrolled 567 diabetes patients. The random forest algorithm as well as logistic regression analysis were applied to construct the prediction model. The model discrimination and clinical usefulness were evaluated by receiver operating characteristic curve （ROC） and decision curve analysis （DCA）， respectively. ResultsThe clinical prediction model for DKD based on OCTA was constructed with area under the curve （AUC） of 0.878 and Brier score of 0.11. ConclusionsThrough multidimensional verification， the clinical prediction nomogram model based on OCTA allowed for early warning and advanced intervention of DKD.

Effect of the axial load on the dynamic response of the wrapped CFRP reinforced concrete column under the asymmetrical lateral impact load.

This study investigated the impact of axial load on the dynamic response of reinforced concrete (RC) members to asymmetrical lateral impact loads. A series of asymmetrical-span impact tests were conducted on circular and square RC members with and without Carbon Fiber Reinforced Polymers (CFRP) while varying the axial compression ratios. The impact process was simulated using ABAQUS software, and the time history curves of deflection and impact were measured. The study found that specific impact loads caused bending and shearing failures. The axial compression ratio ranged from 0.05 to 0.13 when the impact curve reached its maximum deflection before the component's impact resistance decreased. Analysis of the impact point and inclined crack location revealed that axial load affects the maximum local concrete. The speed of inclined crack penetration and inclined cracks take longer to form, with weaker resistance to damage to local concrete when the axial compression ratio is between 0.05 and 0.13. When the axial compression ratio is greater than 0.13, inclined cracks form sooner with more brittle and severe damage to the impact point's concrete. The study also identified key parameters affecting the dynamic response of RC members, including impact height, CFRP layer thickness, axial force, and impact location. Thicker CFRP layers in RC can improve impact resistance, especially when the impact location is farther from the center. However, there is a limit to the impact of axial force on this resistance.

Zero-strain strategy incorporating TaC with Ta2O5 to enhance its rate capacity for long-term lithium storage.

Ta2O5 holds great potential for lithium storage due to its high theoretical capacity and long-life cycling. However, it still suffers from an unsatisfactory rate capability because of its low conductivity and significant volume expansion during the charging/discharging process. In this study, a zero-strain strategy was developed to composite Ta2O5 with zero-strain TaC as an anode for lithium-ion batteries (LIBs). The zero-strain TaC, featuring negligible lattice expansion, can alleviate the volume variation of Ta2O5 when cycling, thereby enhancing the rate capacity and long-term cycling stability of the whole electrode. Further, the formation of a heterostructure between Ta2O5 and TaC was confirmed, giving rise to an enhancement in the electrical conductivity and structural stability. As expected, this anode displayed a reversible specific capacity of 395.5 mA h g-1 at 0.5 A g-1 after 500 cycles. Even at an ultrahigh current density of 10 A g-1, the Ta2O5/TaC anode delivered a high capacity of 144 mA h g-1 and superior durability with a low-capacity decay rate of 0.08% per cycle after 1000 cycles. This zero-strain strategy provides a promising avenue for the rational design of anodes, sequentially contributing to the development of high-rate capacity and long cycling LIBs.

Application of Optical Genome Mapping Technology in Detecting Complex Chromosomal Rearrangement / 中山大学学报(医学科学版)

ObjectiveTo investigate the application of optical genome mapping （OGM） technology in detecting complex chromosomal rearrangement. MethodsWe recruited five patients who were diagnosed as complex chromosomal rearrangement at the Reproductive Medicine Center of the Sixth Affiliated Hospital of Sun Yat-sen University from January 2022 to June 2023. They underwent OGM， nanopore sequencing and pre-implantation genetic testing （PGT）. The results were compared with the results of karyotype and chromosomal microarray analysis （CMA）/ copy number variation sequencing （CNV-Seq）. ResultsOGM could detect translocation， invert inversion， and triplet translocation， which were consistent with the results of OGM and CMA/ CNV-Seq. But OGM could not detect Robertsonian translocation. ConclusionBecause of its ultra-long reads， OGM realizes the detection across repetitive regions， and it has great advantages when applied in patients with complex chromosome rearrangement or uncertain karyotype analysis. It can accurately locate breakpoints.

Phenolic derivatives from root bark of Schisandra sphenanthera / 中国中药杂志

This paper aimed to study the chemical constituents from the root bark of Schisandra sphenanthera. Silica, Sephadex LH-20 and RP-HPLC were used to separate and purify the 80% ethanol extract of S. sphenanthera. Eleven compounds were identified by ~1H-NMR, ~(13)C-NMR, ESI-MS, etc., which were 2-[2-hydroxy-5-(3-hydroxypropyl)-3-methoxyphenyl]-propane-1,3-diol(1), threo-7-methoxyguaiacylglycerol(2),4-O-(2-hydroxy-1-hydroxymethylethyl)-dihydroconiferylalcohol(3), morusin(4), sanggenol A(5), sanggenon I(6), sanggenon N(7), leachianone G(8),(+)-catechin(9), epicatechin(10), and 7,4'-dimethoxyisoflavone(11). Among them, compound 1 was a new compound, and compounds 2-9 were isolated from S. sphenanthera for the first time. Compounds 2-11 were subjected to cell viability assay, and the results revealed that compounds 4 and 5 had potential cytotoxicity, and compound 4 also had potential antiviral activity.

Construction of predictive model for renal allograft rejection based on clinical multimodal ultrasound features / 中华超声影像学杂志

Objective:To construct a nomogram for predicting the occurrence of renal allograft rejection based on the combination of multimodal ultrasound features and clinical data.Methods:The ultrasound findings and clinical characteristics of 102 patients with transplanted kidneys who underwent renal biopsy in the General Hospital of Eastern Theater Command from January 2021 to March 2022 were analyzed retrospectively. Patients were divided into rejection group and nephropathy group according to Banff transplant kidney pathological diagnostic criteria (2017 edition). Multivariate Logistic regression was used to screen independent predictors related to the status of rejection, and nomograms were drawn based on the independent predictors. The internal validation of the nomogram was carried out by Bootstrap method, and the ROC curve and calibration curve were utilized to evaluate the diagnostic efficacy of the nomogram.Results:Blood urea nitrogen concentration, renal aortic resistance index, absolute time to peak and cortical echo were independent predictors of rejection( OR=1.073, 1.078, 0.843, 0.205; all P<0.05). Incorporating blood urea nitrogen concentration, renal aortic resistance index, absolute peak time and cortical echo, the nomogram was constructed. The AUC of the predictive model was 0.814(95% CI=0.722-0.905) and the cutoff value was 0.67(corresponding to a total score of about 157 points). Both internal verification (AUC=0.788) and calibration curve demonstrated the clinical usefulness of the nomogram. Conclusions:The nomogram for predicting the occurrence of rejection in renal allograft patients based on multimodal ultrasound features and clinical data can guide the individualized treatment of patients with renal dysfunction.

Effects of R-loops on Genome Stability / 中国生物化学与分子生物学报

The R-loop is a three-stranded nucleic acid structure, which consists of a RNA: DNA hybrid and a DNA single strand. R-loop can be divided into two types: physiological and pathological. The physiological R-loop is involved in many physiological processes such as DNA replication, transcription, and gene expression regulation, while the pathological R-loop induces DNA damage and genome rearrangement. There are many factors that affect the formation of R-loops. Unregulated R-loops destroy genomic stability by interfering with DNA replication and double-strand DNA break repair, and can cause cancer. Therefore, the regulation of R-loops is very important. RNA/ DNA helicase Senataxin (SETX), DEAD-box helicase 5 (DDX5), ribonuclease H (RNase H) and DNA topoisomerase I (topo) play an important role in regulating the balance of R-loops in vivo. Among them, SETX is one of the most characteristic R-loop decomposing enzymes, which can dissolve the R-loops produced during transcriptional termination sites, replication-transcriptional conflicts and DNA damage repair. Senataxin mutations will lead to ataxia with eye movement apraxia type 2 (AOA2) and amyotrophic lateral sclerosis type 4 (ALS4). Currently there are still many unsolved issues, although many in-depth studies of R-loops have been carried out. Therefore, the structure and function of physiological and pathological R-loops still need to be further explored. This review mainly focuses on the definition and classification of R-loops, the factors that affect the formation of R-loops, the influence of R-loops on genomic stability and R-loop-related diseases, and explores the possibility of using R-loops as a therapeutic target in the future.

Age Estimation Based on DNA Methylation and Its Application Prospects in Forensic Medicine / 法医学杂志

With the improvement of DNA methylation detection techniques, studies on age-related methylation sites have found more age-specific ones across tissues, which improves the sensitivity and accuracy of age estimation. In addition, the establishment of various statistical models also provides a new direction for the age estimation of tissues from different sources. This review summarizes the related studies of age estimation based on DNA methylation from the aspects of detection technology, age-related cytosine phosphate guanine site and model selection in recent years.

Chemical constituents from Salacia polysperma / 中国中药杂志

Nine compounds were isolated from the 90% ethanol extract of Salacia polysperma by silica gel, Sephadex LH-20 column chromatography, together with preparative HPLC methods. Based on HR-ESI-MS, MS, 1D and 2D NMR spectral analyses, the structures of the nine compounds were identified as 28-hydroxy wilforlide B(1), wilforlide A(2), 1β,3β-dihydroxyurs-9(11),12-diene(3),(-)-epicatechin(4),(+)-catechin(5),(-)-4'-O-methyl-ent-galloepicatechin(6), 3-hydroxy-1-(4-hydroxy-3-methoxy-phenyl)propan-1-one(7),(-)-(7S,8R)-4-hydroxy-3,3',5'-trimethoxy-8',9'-dinor-8,4'-oxyneoligna-7,9-diol-7'-aldehyde(8), and vanillic acid(9). Compound 1 is a new oleanane-type triterpene lactone. Compounds 1, 3, 4, 7-9 were isolated from the Salacia genus for the first time. All compounds were assayed for their α-glucosidase inhibitory activity. The results suggested that compound 8 exhibited moderate α-glucosidase inhibitory activity, with an IC_(50) value of 37.2 μmol·L~(-1), and the other compounds showed no α-glucosidase inhibitory activity.

A new xanthone from hulls of Garcinia mangostana and its cytotoxic activity / 中国中药杂志

Eight compounds were isolated from ethyl acetate fraction of 80% ethanol extract of the hulls of Garcinia mangostana by silica gel, Sephadex LH-20 column chromatography, as well as prep-HPLC methods. By HR-ESI-MS, MS, 1D and 2D NMR spectral analyses, the structures of the eight compounds were identified as 16-en mangostenone E(1), α-mangostin(2), 1,7-dihydroxy-2-(3-methy-lbut-2-enyl)-3-methoxyxanthone(3), cratoxyxanthone(4), 2,6-dimethoxy-para-benzoquinone(5), methyl orselinate(6), ficusol(7), and 4-(4-carboxy-2-methoxyphenoxy)-3,5-dimethoxybenzoic acid(8). Compound 1 was a new xanthone, and compound 4 was a xanthone dimer, compound 5 was a naphthoquinone. All compounds were isolated from this plant for the first time except compounds 2 and 3. Cytotoxic bioassay suggested that compounds 1, 2 and 4 possessed moderate cytotoxicity, suppressing HeLa cell line with IC_(50) va-lues of 24.3, 35.5 and 17.1 μmol·L~(-1), respectively. Compound 4 also could suppress K562 cells with an IC_(50) value of 39.8 μmol·L~(-1).

Clinical study on the diagnosis of early keratoconus based on ocular morphological parameters with different corneal diameters / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the diagnostic value of ocular morphological parameters under different corneal diameters for early keratoconus.METHODS: A retrospective case-control study. A total of 201 patients(201 eyes)who were treated in our hospital from January 2019 to March 2022 were included. They were divided into 135 cases(135 eyes)in the control group(patients with history of refractive error)and 66 cases(66 eyes)in the subclinical keratoconus group. The Pentacam anterior segment analyzer was used to determine the horizontal central curvature of corneal posterior surface(Kf), posterior vertical central curvature of corneal posterior surface(Ks), average curvature of corneal posterior surface(Km), Posterior I-S ratio, corneal posterior surface height after the thinnest point(PE at the thinnest point), maximum posterior elevation from best fit sphere(MPE from BFS), maximum posterior elevation from best fit toric ellipsoid(MPE from BFTE), posterior asphericity asymmetry index(AAI), thinnest point thickness of the cornea(TCT), central corneal thickness(CCT), depressed corneal thickness(DCT), pachymetric progression index average(PPIavg), Ambrósio relational thickness maximum(ARTmax)and Belin D value. The differences of each parameter between the two groups were analyzed. Receiver operating characteristic(ROC)curves were analyzed to determine the best diagnosis point. The control group was further divided into groups according to the corneal diameter: corneal diameter ≤11.0mm, 11.1mm≤ corneal diameter ≤11.5mm, 11.6mm≤ corneal diameter ≤12.0mm, corneal diameter ≥12.1mm. The differences of each parameter among these groups were compared. Pearson correlation analysis was used to analyze the correlation between corneal diameter and other parameters.RESULTS: There were significant differences in posterior I-S ratio, PE at the thinnest point, MPE from BFS, MPE from BFTE, posterior AAI, TCT, DCT, PPIavg, ARTmax, Belin D value between the subclinical keratoconus group and the control group(P&#x0026;#x003C;0.05). Sensitive index of Pentacam to diagnosis subclinical keratoconus were Belin D value, posterior I-S ratio, PPIavg, posterior AAI and MPE from BFTE(AUC≥0.9). In the control group, there was no significant difference in posterior I-S ratio, MPE from BFTE, posterior AAI, TCT, CCT, and DCT among different corneal diameter groups (P&#x0026;#x003E;0.05), and there was no significant correlation with corneal diameter(all P&#x0026;#x003E;0.05).CONCLUSION: The Belin D value, posterior I-S ratio, PPIavg, posterior AAI, MPE from BFTE obtained by Pentacam are sensitive indicators for the diagnosis of early keratoconus, among which posterior I-S ratio, posterior AAI, MPE from BFTE are less affected by corneal diameter. They play an important role in the early diagnosis of keratoconus under different corneal diameters.

Yinlai Decoction Protects Microstructure of Colon and Regulates Serum Level of D-Lactic Acid in Pneumonia Mice Fed with High-Calorie and High-Protein Diet / 中国结合医学杂志

OBJECTIVE@#To investigate the effect of Yinlai Decoction (YD) on the microstructure of colon, and activity of D-lactic acid (DLA) and diamine oxidase (DAO) in serum of pneumonia mice model fed with high-calorie and high-protein diet (HCD).@*METHODS@#Sixty male Kunming mice were randomly divided into 6 groups by the random number table method: normal control, pneumonia, HCD, HCD with pneumonia (HCD-P), YD (229.2 mg/mL), and dexamethasone (15.63 mg/mL) groups, with 10 in each group. HCD mice were fed with 52% milk solution by gavage. Pneumonia mice was modeled with lipopolysaccharide inhalation and was fed by gavage with either the corresponding therapeutic drugs or saline water, twice daily, for 3 days. After hematoxylin-eosin staining, the changes in the colon structure were observed under light microscopy and transmission electron microscope, respectively. Enzyme-linked immunosorbent assay was used to detect the protein levels of DLA and DAO in the serum of mice.@*RESULTS@#The colonic mucosal structure and ultrastructure of mice in the normal control group were clear and intact. The colonic mucosal goblet cells in the pneumonia group tended to increase, and the size of the microvilli varied. In the HCD-P group, the mucosal goblet cells showed a marked increase in size with increased secretory activity. Loose mucosal epithelial connections were also observed, as shown by widened intercellular gaps with short sparse microvilli. These pathological changes of intestinal mucosa were significantly reduced in mouse models with YD treatment, while there was no significant improvement after dexamethasone treatment. The serum DLA level was significantly higher in the pneumonia, HCD, and HCD-P groups as compared with the normal control group (P<0.05). Serum DLA was significantly lower in the YD group than HCD-P group (P<0.05). Moreover, serum DLA level significantly increased in the dexamethasone group as compared with the YD group (P<0.01). There was no statistical significance in the serum level of DAO among groups (P>0.05).@*CONCLUSIONS@#YD can protect function of intestinal mucosa by improving the tissue morphology of intestinal mucosa and maintaining integrity of cell connections and microvilli structure, thereby reducing permeability of intestinal mucosa to regulate the serum levels of DLA in mice.

Numerical study on existing RC circular section members under unequal impact collision.

Traffic accidents and derailed train-related incidents have occurred more often than ever in recent years, resulting in some economic damage and casualties. Reinforced concrete (RC) constructions often involve derailed train and vehicle accidents. Rarely are such side collisions studied in previous studies. To do this, high-fidelity simulation-based finite-element (FE) models are created in this paper to accurately simulate the collision of circular RC members with a derailed train. The reinforced concrete member structure is common in high-speed railway stations. The impact energy of the impact body is significant, causing structural member failure. It analyses the dynamic behavior of reinforced concrete members under unequal span impact loads. Numerical implementations of impact issues are discussed from the perspective of geometric, contact, and material properties. The reliability and precision of the ABAQUS code to solve impact issues are verified by comparing failure modes, impact, and deflection time history experimental outputs. By analysing the impact response characteristics, used the control variables to study the failure process and mode (including the characteristics of impact and reaction forces, deflection time history curve, impact force-deflection curve, and bearing reaction force-deflection curve). The reinforcement ratio, impact velocity, concrete strength, and slenderness ratio significantly affect shear crack pattern and development. Changes in impact velocity and slenderness ratio also affect member failure modes.

Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease.

Background and Aims: We compared lung function parameters in nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD), and examined the association between lung function parameters and fibrosis severity in MAFLD. Methods: In this cross-sectional study, we randomly recruited 2,543 middle-aged individuals from 25 communities across four cities in China during 2016 and 2020. All participants received a health check-up including measurement of anthropometric parameters, biochemical variables, liver ultrasonography, and spirometry. The severity of liver disease was assessed by the fibrosis (FIB)-4 score. Results: The prevalence of MAFLD was 20.4% (n=519) and that of NAFLD was 18.4% (n=469). After adjusting for age, sex, adiposity measures, smoking status, and significant alcohol intake, subjects with MAFLD had a significantly lower predicted forced vital capacity (FVC, 88.27±17.60% vs. 90.82±16.85%, p<0.05) and lower 1 s forced expiratory volume (FEV1, 79.89±17.34 vs. 83.02±16.66%, p<0.05) than those with NAFLD. MAFLD with an increased FIB-4 score was significantly associated with decreased lung function. For each 1-point increase in FIB-4, FVC was diminished by 0.507 (95% CI: -0.840, -0.173, p=0.003), and FEV1 was diminished by 0.439 (95% CI: -0.739, -0.140, p=0.004). The results remained unchanged when the statistical analyses was performed separately for men and women. Conclusions: MAFLD was significantly associated with a greater impairment of lung function parameters than NAFLD.

Ultrasound-Guided Continuous Thoracic Paravertebral Block Improves Patient's Quality of Recovery After Open Hepatectomy: A Randomized, Double-Blind, Placebo-Controlled Trial / 中国医学科学杂志(英文版)

Background Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy. We hypothesize that these effects may improve the quality of recovery (QoR) after open hepatectomy. Methods Seventy-six patients undergoing open hepatectomy were randomized to receive a continuous thoracic paravertebral block with ropivacaine (CTPVB group) or normal saline (control group). All patients received patient-controlled intravenous analgesia with morphine postoperatively for 48 hours. The primary outcome was the global Chinese 15-item Quality of Recovery score on postoperative day 7, which was statistically analyzed using Student's t-test. Results Thirty-six patients in the CTPVB group and 37 in the control group completed the study. Compared to the control group, the CTPVB group had significantly increased global Chinese 15-item Quality of Recovery scores (133.14 ± 12.97 vs. 122.62 ± 14.89, P = 0.002) on postoperative day 7. Postoperative pain scores and cumulative morphine consumption were significantly lower for up to 8 and 48 hours (P < 0.05; P = 0.002), respectively, in the CTPVB group. Conclusion Perioperative CTPVB markably promotes patient's QoR after open hepatectomy with a profound analgesic effect in the early postoperative period.

Captopril related kidney damage: renal afferent arteriolar responses to angiotensin II and inflammatory signaling / 生理学报

Captopril can have nephrotoxic effects, which are largely attributed to accumulated renin and "escaped" angiotensin II (Ang II). Here we test whether angiotensin converting enzyme-1 (ACE1) inhibition damages kidneys via alteration of renal afferent arteriolar responses to Ang II and inflammatory signaling. C57Bl/6 mice were given vehicle or captopril (60 mg/kg per day) for four weeks. Hypertension was obtained by minipump supplying Ang II (400 ng/kg per min) during the second 2 weeks. We assessed kidney histology by periodic acid-Schiff (PAS) and Masson staining, glomerular filtration rate (GFR) by FITC-labeled inulin clearance, and responses to Ang II assessed in afferent arterioles in vitro. Moreover, arteriolar H2O2 and catalase, plasma renin were assayed by commercial kits, and mRNAs of renin receptor, transforming growth factor-β (TGF-β) and cyclooxygenase-2 (COX-2) in the renal cortex, mRNAs of angiotensin receptor-1 (AT1R) and AT2R in the preglomerular arterioles were detected by RT-qPCR. The results showed that, compared to vehicle, mice given captopril showed lowered blood pressure, reduced GFR, increased plasma renin, renal interstitial fibrosis and tubular epithelial vacuolar degeneration, increased expression of mRNAs of renal TGF-β and COX-2, decreased production of H2O2 and increased catalase activity in preglomerular arterioles and enhanced afferent arteriolar Ang II contractions. The latter were blunted by incubation with H2O2. The mRNAs of renal microvascular AT1R and AT2R remained unaffected by captopril. Ang II-infused mice showed increased blood pressure and reduced afferent arteriolar Ang II responses. Administration of captopril to the Ang II-infused mice normalized blood pressure, but not arteriolar Ang II responses. We conclude that inhibition of ACE1 enhances renal microvascular reactivity to Ang II and may enhance important inflammatory pathways.

The relationship between the lipid profiles and inflammation in patients with sepsis / 中华危重病急救医学

Objective:To explore the relationship between the changes in the lipid profiles and the intensity of inflammatory response and disease severity in patients with sepsis, in order to find a biomarker that can quickly evaluate the condition and prognosis of sepsis.Methods:A retrospective analysis was performed on 449 patients with sepsis admitted to department of critical care medicine of the First Affiliated Hospital of Zhengzhou University from October 2019 to May 2021, and 355 patients without sepsis hospitalized in the same period served as the control. The general demographic data, blood lipid and other clinical indicators within 24 hours after admission were collected and compared between the two groups. Bivariate correlation study was used to analyze the relationship between blood lipid levels and inflammation indicators and severity of illness in patients with sepsis. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of each blood lipid component on the 28-day mortality of patients with sepsis. According to the results of ROC curve analysis, the blood lipids were divided into two groups with different levels, and the Kaplan-Meier survival curve was used to compare the cumulative survival rates of the two groups without end-point event (the 28-day mortality was the end-point event).Results:Compared with non-septic patients, the levels of plasma total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were significantly lower in patients with sepsis [TC (mmol/L): 2.93±1.33 vs. 4.01±1.14, HDL-C (mmol/L): 0.78±0.47 vs. 1.16±0.40, LDL-C (mmol/L): 1.53±1.00 vs. 2.71±0.98, all P < 0.05]. In patients with sepsis, plasma cholesterol levels were correlated with the degree of inflammation and severity of the disease to varying degrees, but the HDL-C had the strongest correlation with interleukin-6 (IL-6; r = -0.551, P = 0.000), procalcitonin (PCT, r = -0.598, P = 0.000), sequential organ failure assessment (SOFA; r = -0.285, P = 0.000). The ROC curve analysis showed that among all blood lipid components, HDL-C had the highest predictive value for 28-day mortality of sepsis patients, and the area under the ROC curve (AUC) was 0.718, when the best cut-off value was 0.69 mmol/L, the sensitivity and specificity were 67.3% and 65.2% respectively, and the positive predictive value and negative predictive value were 60.6% and 71.5% respectively. According to Kaplan-Meier survival curve analysis, the mortality of sepsis patients with HDL-C ≤ 0.69 mmol/L was significantly higher than the patients with HDL-C > 0.69 mmol/L, and the difference was statistically significant ( P < 0.000 1). In addition, the 28-day mortality [59.73% (135/226) vs. 28.70% (64/223)], the incidence of multiple organ dysfunction [41.15% (93/226) vs. 31.84% (71/223)], the probability of requiring mechanical ventilation and vasoactive drugs [mechanical ventilation: 56.64% (128/226) vs. 46.18% (103/223); vasoactive drugs: 54.42% (123/226) vs. 38.57% (86/223)], the positive rate of microbial culture [45.58% (103/226) vs. 35.43% (79/223)], and the probability of drug-resistant bacteria [19.91% (45/226) vs. 10.31% (23/223)] in the low HDL-C group of sepsis patients were all higher than the high HDL-C group, the differences were statistically significant (all P < 0.05). Conclusions:Plasma cholesterol levels, especially the HDL-C levels, can well reflect the intensity of inflammation and the severity of the disease in patients with sepsis. And the HDL-C levels can be used as a good biomarker for predicting the short-term prognosis of sepsis.

Investigation on the current situation of safety protection of medical staffs for the prevention and treatment of infectious diseases in medical institutions in Jiangsu Province / 中华劳动卫生职业病杂志

Objective: To investigate the current situation of safety protection of medical staffs in medical institutions in Jiangsu Province, and to provide scientific basis for strengthening the safety protection of infectious diseases and protecting the occupational health of medical staffs. Methods: From September to October 2020, 1274 medical staffs in 43 medical and health institutions were randomly selected as the subjects. The self-made questionnaire for infectious disease prevention and protection was used to analyze the pre-job training and exposure to occupational harmful factors of the respondents. The influencing factors of using protective equipment and occupational injury were analyzed by binary logistic regression. Results: A total of 1216 valid questionnaires were collected with effective recovery of 95.4%. There were 312 males (25.7%) and 904 females (74.3%) , with an average age of (35.8±9.2) years and average working years of (13.6±9.9) years. Among them, 1143 (94.0%) had participated in pre-job training, 535 (44.0%) thought they were exposed to occupational harmful factors of infectious disease prevention, 1082 (89.0%) used protective equipment in daily operation, and 462 (38.0%) had occupational injury. According to binary logistic regression analysis, the utilization rates of protective equipment for medical staffs in Centers for Disease Control and Prevention (OR=2.473, 95%CI: 1.327-4.607, P=0.004) , 30-39 years old (OR=1.586, 95%CI: 1.038-2.426, P=0.033) , 40-49 years old (OR=2.257, 95%CI: 1.243-4.098, P=0.007) , 50 years old and above (OR=5.879, 95% CI: 1.755-19.692, P=0.004) and pre-job training (OR=2.580, 95%CI: 1.301-5.116, P=0.007) were higher than their respective control groups. And medical staffs with graduate degree or above (OR=0.342, 95%CI: 0.167~0.699, P=0.003) had lower utilization rate of protective equipment. Female (OR=1.902, 95%CI: 1.364-2.654, P<0.001) , 30-39 years old (OR=1.589, 95%CI: 1.157-2.181, P=0.004) , bachelor degree (OR=2.070, 95%CI: 1.419-3.021, P<0.001) , exposure to occupational harmful factors (OR=2.753, 95%CI: 2.086-3.634, P<0.001) were the risk factors for occupational injury of medical staffs. Centers for Disease Control and Prevention (OR=0.129, 95%CI: 0.086-0.194, P<0.001) and wearing protective equipment according to regulations (OR=0.597, 95%CI: 0.431-0.827, P=0.002) were the protective factors for occupational injury of medical staffs. Conclusion: At present, the occupational injury rate of medical staffs in Jiangsu Province is high due to various factors in the prevention and control of infectious diseases. It is necessary to pay attention to occupational safety protection, strengthen pre-job training and actively advocate "standard prevention", so as to reduce the exposure risk of harmful factors and promote occupational health of medical staffs.

Research progress on basic immunology of organ transplantation in 2021 / 器官移植

In recent years, the science and technology of organ transplantation have developed rapidly, which has been widely applied worldwide. However, multiple challenges remain to be resolved by clinicians, such as functional damage and immune rejection of transplant organs, immune deficiency caused by extensive use of immunosuppressants, chronic allograft dysfunction and adverse reactions. This article introduced relevant key research results published in 2021, taking the function and mechanism of immune cell subsets in the process of organ transplantation rejection or immune tolerance, and the research and application of new materials and drugs in organ transplantation as the main clues. The latest research progresses on regional immune response, especially the application of tissue-resident memory T cell in organ transplantation, were briefly summarized, and the future development of transplantation immunology was prospected.