Objective The aim of this study was to analyze the predictive value of an immune scoring model based on im-mune cell infiltration for the efficacy and prognosis of immunotherapy in early gastric cancer.Methods The gene expression data and related clinical parameters of 167 early gastric cancer patients were downloaded from the Cancer Genome Atlas(TCGA)as the training set.The clinical information of 92 early gastric cancer patients who first visited our hospital from January 2017 to January 2020 was collected as a validation set.The infiltration of 22 immune cells in tumor tissues was calculated by the Cibersort software.The key pre-dictive factors for early gastric cancer patients were further screened and determined by lasso analysis and multivariate Cox regression analysis.The eligible immune cells were used to construct the prognostic risk scoring model and verify it.Based on the risk model,a nomograph model was established to predict the probability of death and treatment failure in early gastric cancer patients,and evaluate the differentiation,accuracy,and reliability of the model.Results There was no statistically significant difference in the general infor-mation of patients between the training set and the validation set(P＞0.05).Compared with normal tissues,the content of CD8+T cells,activated memory CD4+T cells,M0 macrophages,M1 macrophages,resting dendritic cells,and activated dendritic cells in early gastric cancer tumor tissues decreased.The contents of regulatory T cells(Treg cells)and eosinophils increased,and the difference was statistically significant(P＜0.05).The LASSO analysis further screened five types of infiltrating immune cells,including activated memory CD4+T cells,M1 macrophages,Treg cells,activated dendritic cells and eosinophils.The survival curve results showed that the immune scoring model could effectively distinguish the survival time of patients.The total score of the prognostic nomogram model was 274,corresponding to risk of death of 72%.The total score of the treatment effect nomograph model was 307,corresponding to a 75%risk of ineffective treatment.The model validation results showed that the nomograph model has high discrimination,accuracy and reli-ability.Conclusion The immune scoring model based on immune cell infiltration has a certain predictive value for the efficacy and prognosis of immunotherapy in patients with early gastric cancer.

Objective:To explore the relationship between 18F-fibroblast activation protein inhibitor (FAPI)-42 SUV max of primary gastric cancer and clinicopathological factors of patients. Methods:Fifty-one patients (31males, 20 females, age: 51(47, 65) years) with gastric cancer who underwent 18F-FAPI-42 PET/CT before surgical resection in Nanfang Hospital, Southern Medical University from February 2022 to January 2023 were analyzed retrospectively. The clinicopathological factors that might affect tumor SUV max (including gender, age, tumor location, pathological type, histological grade, Lauren classification, vascular and(or) neural invasion, programmed cell death-ligand 1 (PD-L1) expression, pathologic(p)T stage, pN stage and pTNM stage) were evaluated by the univariate analysis (Mann-Whitney U test or Kruskal-Wallis rank sum test) and multivariate analysis (multiple linear regression analysis). Results:The sensitivity of 18F-FAPI-42 PET/CT in the diagnosis of patients with primary gastric cancer was 82.35% (42/51). The diagnostic sensitivities for early gastric cancer (T1) and locally advanced gastric cancer (T2-T4) were 59.09%(13/22) and 100%(29/29), respectively. The SUV max of primary lesion was 4.90(1.71, 12.51). The univariate analysis showed that SUV max of primary gastric cancer was related to tumor location ( z=-2.00, P=0.046), pT stage ( H=36.94, P<0.001), pN stage ( z=-3.89, P<0.001), pTNM stage ( H=31.49, P<0.001) and vascular and(or) nerve invasion ( z=-5.22, P<0.001), but not related to pathological type, histological grade, Lauren typing, and PD-L1 expression ( z values: from -1.78 to -0.09, all P>0.05). pT stage was found to be a significant independent factor for SUV max in primary gastric lesion by multivariate analysis ( t=2.52, P=0.015). Conclusions:The 18F-FAPI-42 SUV max of primary tumor was related to tumor location, pT stage, pN stage, pTNM stage, and vascular and(or) nerve invasion; pT stage is an independent factor affecting tumor SUV max. The ability of 18F-FAPI-42 PET/CT to detect gastric cancer is mainly affected by pT stage.

As of 2020， there are more than 120 million diabetic patients in China. Diabetic wounds is one of the common complications of diabetes with increasing incidence and has the potential to cause disability and mortality. Traditional Chinese medicine （TCM） has a long history in treating diabetic wounds， demonstrating significant efficacy and safety. In recent years， increasing researchers have explored the mechanisms of polysaccharides from TCM in the repair of diabetic wounds. Polysaccharides are the main active ingredients of TCM and employ one or more blood sugar-lowering mechanisms. However， most studies focus on the repair mechanism of single polysaccharides， and there is little in-depth discussion and summary. To provide a new therapy for diabetic wounds， which meets international standards and has the characteristics of TCM， and provide reference for the clinical treatment of diabetic wounds， we reviewed relevant literature to summarize the mechanisms of TCM polysaccharides in treating diabetic wounds. The mechanisms include inhibiting inflammation to improve wound microenvironment， lowering blood sugar， promoting fibroblast migration and proliferation， regulating wound growth factor to promote angiogenesis， inhibiting oxidative stress response， and regulating immune function. Finally， we put forward some possible research directions in the future.

Objective: To investigate the anti-inflammatory effect of polysaccharide from atractylodes atractylodes(PAMK) on rheumatoid arthritis(RA) rats and its effect on Toll like receptor 4/nuclear factor kappa-B(TLR4/NF-κB) signaling pathway. Methods: RA rat model was induced by type Ⅱ collagen, after successful modeling, the rats were divided into model group, positive drug group(Tripterygium wilfordii polyglycoside tablet), PAMK low-dose and high-dose groups, normal control group was also set, with 12 rats in each group. Tripterygium wilfordii polyglycoside tablets or Atractylodes macrocephala polysaccharide were administered intragastric administration, once a day for 4 weeks. The body weight, paw swelling rate and arthritis index of rats were measured; the thymus index and spleen index were calculated; HE staining was used to observe the histopathological changes of synovial membrane of ankle joint; The levels of interleukin-1β(IL-1β), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in serum and synovial tissue of ankle were determined by ELISA; The expression levels of total protein TLR4, MyD88, phosphorylated NF-κB p65(Ser536) and nuclear protein NF-κB p65 in synovial tissue of ankle were detected by Western blot. Results: Compared with the normal control group, synovial hyperplasia and unclear layers were observed in the model group, body weight decreased(P<0.05), paw swelling rate, arthritis index, thymus index and spleen index increased(P<0.05), the levels of IL-1β, IL-6 and TNF-α in serum and synovial tissue of ankle, and the protein expressions of TLR4, MyD88, p-NF-κB p65 and NF-κB p65 in synovial tissue of ankle increased(P<0.05). Compared with model group, the histomathological changes of synovial of ankle joint in positive drug group and PAMK high-dose group were significantly improved, body weight increased(P<0.05), paw swelling rate, arthritis index, thymus index and spleen index decreased(P<0.05), the levels of IL-1β, IL-6 and TNF-α in serum and synovial tissue of ankle, and the protein expressions of TLR4, MyD88, p-NF-κB p65 and NF-κB p65 in synovial tissue of ankle decreased(P<0.05), however, there were no significant differences in the above indexes between PAMK low-dose group and model group(P>0.05). Conclusion PAMK can reduce the inflammatory response and improve RA, and the mechanism may be related to the inhibition of TLR4/NF-κB signaling pathway activation.

Objective:To assess the left ventricular (LV) myocardial mechanical dysfunction in patients with cirrhosis using ultrasonic layer-specific strain imaging and to explore its value in clinical application.Methods:A total of 80 consecutive cirrhosis patients without cardiovascular diseases were prospectively enrolled from October 2020 to March 2021 in Sichuan Provincial People′s Hospital, 39 of whom were assigned to the compensated group and 41 were assigned to the decompensated group according to the occurrence of portal hypertension. Forty-three healthy volunteers during the same period were randomly recruited as the control group. Transthoracic echocardiography was performed to assess the LV configuration and functional parameters. LV global longitudinal strain in endocardial, middle and epicardial myocardium (GLSendo, GLSmid, GLSepi), and longitudinal strain (LS) in basal, middle and apical segments, and peak strain dispersion (PSD) were obtained using ultrasonic layer-specific strain imaging. ΔLS was calculated by the formula of GLSendo-GLSepi. Then, the differences of related parameters among three groups were compared.Results:①Conventional echocardiography: compared with the control group, the interventricular septum end-diastolic thickness (IVSTd), left ventricular posterior wall end-diastolic thickness (LVPWd), left ventricular mass (LVM) and LVM index (LVMI) were increased in compensated and decompensated groups (all P<0.05), while no significant differences in conventional echocardiographic parameters were identified between the two cirrhosis groups (all P>0.05). ②Global layer-specific strain: compared with the control group, GLSendo, GLSmid, GLSepi and ΔLS were decreased and PSD was increased in compensated and decompensated groups (all P<0.05); Moreover, the decompensated group showed a more impaired GLSendo, GLSmid and GLSepi than compensated group (all P<0.05), whereas there were no significant differences of ΔLS and PSD between the two groups(all P>0.05). ③Segmental layer-specific strain: compared with the control group, LS values of three layers in compensated and decompensated groups were reduced at basal, middle and apical levels (all P<0.05); Compared with the compensated group, LS values of three layers in decompensated group tended to be reduced at above there levels, but only apical segments had significant differences (all P<0.05). Conclusions:There are different degrees of LV mechanical dysfunction in patients with variable severity of cirrhosis. Ultrasonic layer-specific strain imaging has the potential to quantitatively assess the state of cardiac involvement in patients with cirrhosis and to provide visual evidence for the early and accurate diagnosis of myocardial injuries.

Objective:To investigate the pathogenic spectrum of hand, foot and mouth disease(HFMD)from 2017 to 2019 in Guangzhou, and analyze molecular epidemiological characteristics of coxsackievirus A6 (CV-A6).Methods:Enterovirus A71 (EV-A71), CV-A16, CV-A6 and enterovirus were tested by reverse transcription-quantitative polymerase chain reaction(RT-qPCR). The CV-A6 representative samples were isolated and the VP1 region of isolates were amplified and analized by Mega5.0 and SeqMen.Results:A total of 7 578 enterovirus-positive specimens were detected from 2017 to 2019, 320 specimens were positive for EV-A71, 1481 specimens were positive for CV-A16, 3171specimens were positive for CV-A6, and 2606 specimens were positive for other enterovirus. Children under the age of 5 years were the most vulnerable population, and the male/female incidence ratio was 1.56∶ 1.The incidence occurred in all seasons, one peak between May and July, the other between September and November. The virus was isolated from 80 CV-A6 positive specimens and the full length of VP1 gene region was sequenced and nucleotide sequence similarity analysis was performed. The nucleotide homology in the VP1 region was 93%-100%, and the amino acid homology was 98%-100%. The nucleotide homology with the CV-A6 prototype strain (Gdula) VP1 region was 79%-81%, and the amino acid homology was 95%-97%. The nucleotide homology with the representative strain of D3 subtype was 92%-98%, and the amino acid homology was 98%-100%. Phylogenetic tree shows that all CV-A6 belonged to the sub-genotype D3 and distributed in multiple branches.Conclusions:CV-A6 is emerging as one of the major pathogen causing HFMD in Guangzhou, and all insolates belonged to D3 subtype. Closely monitoring the molecular characteristics of CV-A6 and changes in the pathogen spectrum can provide scientific basis for HFMD prevention and control.

Objective: To find out the source and the epidemic pattern of norovirus outbreak in July, 2016 to June, 2017 in Guangzhou. Methods: The stool samples and clinical information of diarrhea cases were collected by the sentinel hospitals and CDCs; a real-time RT-PCR method was used to detect the norovirus nucleic acids from the samples, the positive ones were amplified and sequenced; the partial sequences of norovirus were aligned by an online BLAST alignment, and a phylogenetic tree was constructed by a neighbor-joining method . Results: A total of 854 cases with infectious diarrhea were reported by Guangzhou diarrhea surveillance network from July, 2016 to June, 2017; the gender ratio (male versus female) was 1∶0.67; 78.33% of the cases were preschool children under the age of 7 years. Totally 220 samples were detected norovirus G II+ (25.76%, including 5 double-positive samples with G I+ ). GII.Pe-GII.4.Sydney_2012 was the prevalent genotype in the second half of 2016 (94.64%), which was replaced by GII.P16-GII.2 in the first half of 2017 (67.65%). Since September 2016, the reported number of norovirus-caused diarrhea epidemic was increased gradually; the peak of epidemic curve emerged in February to March of 2017, and the number started to decrease since April. In May to June there were only 2-3 epidemics reported monthly. All the endemics from September to November 2016 were caused by genotype GII.Pe-GII.4.Sydney_2012; the endemics from December 2016 to April 2017 were mainly caused by genotype GII.P16-GII.2. Some samples from kitchen workers and babysitters were detected GII+ , which was consistent with the result of the cases′ samples. Conclusions It was the first time that the novel GII.P16-GII.2 recombinant strain outbroke occurred in Guangzhou City and homology analysis also suggested that GII.P16-GII.2 was the main source of those epidemics in 2016 -2017 winter and spring season. Furthermore, The kitchen workers and babysitters may have played an important role in the spread of norovirus.

Objective To observe the clinical effect of Yiqi Huatan prescription in the treatment of patients with systolic hypertension ( qi -deficiency and phlegm type ) .Methods 120 patients with systolic hypertension (qi-deficiency and phlegm type) were selected,and they were randomly divided into observation group and control groupaccording to randomized,double-blind method,with 60 cases in each group.The control group received conventional western medicine treatment , the observation group was given compound Qima capsule combined with conventional western medicine .After treatment , the treatment effect was evaluated , and the levels of inflammatory factors were observed.Results The total effective rate between the two groups had no statistically significant difference (χ2 =0.565,P>0.05).The systolic blood pressure and diastolic blood pressure in the observation group after treatment were (129.77 ±5.56)mmHg,(79.48 ±4.83)mmHg,respectively,which were significantly lower than before treat-ment [(171.15 ±18.81)mmHg,(94.42 ±8.71)mmHg] and those in the control group after treatment [(135.48 ± 7.81)mmHg,(83.81 ±5.29)mmHg] ( t=6.223,8.936,12.365,8.114,all P<0.05).After treatment,the levels of CRP,IL-6,TNF -in the observation group were (3.07 ±0.28) mg/L,(0.08 ±0.04) ng/L and (5.08 ± 1.03)ng/L,respectively,which were significantly lower than before treatment [(5.24 ±0.49) mg/L,(0.22 ± 0.05)ng/L,(9.42 ±2.49)ng/L,t=6.248,9.246,8.335,5.234,5.012,6.214,all P<0.05] and those in the control group after treatment [(4.18 ±0.19)mg/L,(0.12 ±0.05)ng/L,(6.11 ±2.07)ng/L,t=9.246,5.112, 5.012,all P<0.05].Conclusion Yiqi Huatan prescription in the treatment of systolic hypertension of qi -deficiency and phlegm type can achieve good therapeutic effect , the mechanism may be related with reducing inflammatory factors.

Objective:To analyze the immune function regulation and clinical effect of dust mite drops desensitization treatment on children with allergic rhinitis.Methods:80 patients with allergic rhinitis and adenoid hypertrophy treated in our department from January 2012 to June 2014 were selected and randomly divided into experimental group and control group.Control group was treated with ebastine and levocabastine treatment, the experimental group was treated with sublingual containing Dermatophagoides Farinae Drops on the basis of control group.The level of IL-2,IL-6,house dust mite specific IgE (sIgE),dust mite IgE (T-IgE),house dust mite specific IgG4 ( sIgE in) ,blood addicted eosinophile cells ( EOS) ,and induced sputum EOS level were compared between the two groups before treatment and after 2 years treatment.Results:The level of IL-2 in the two groups was significantly higher than that before treatment,the level of IL-6 was significantly lower than that before treatment ( P<0.05 ) .After treatment, the level of IL-2 in the experimental group was significantly higher than that in the control group, the level of IL-6 was significantly lower than that in the control group( P<0.05 ).After treatment, the level of sIgE, T-IgE, blood EOS and induced sputum EOS in the two groups were significantly lower than before treatment,the level of sIgG4 were significantly higher than those before treatment (P<0.05).After the treatment,the level of sIgE, T-IgE, blood EOS and induced sputum EOS in experimental group were significantly lower than control group,and the level of sIgG4 was significantly higher than that in control group ( P<0.05).After treatment,the asthma symptom scores and nasal symptom scores of the two groups were significantly lower than before treatment (P<0.05),and those index of experimental group after treatment were significantly lower than control group ( P<0.05 ).Conclusion: Combine the basis of conventional therapy plus with Dermatophagoides Farinae Drops in the treatment of allergic rhinitis and adenoid hypertrophy children can effectively regulate the immune function of the patients,has good clinical efficacy.

OBJECTIVE:To investigate the affordability of essential medicines in public health and medical institutions of Shanghai Qingpu district after the implementation of the national essential medicines,and provide the basis for subsequent formula-tion and improvement of relevant policies. METHODS:Based on the WHO/HAI standardized approach,a survey on the affordabili-ty of 30 essential medicines was conducted in public health and medical institutions of Shanghai Qingpu district in aspects of equip-ping staffing,drug availability and the relativity in different levels of public health and institutions for investigation and evaluation. RESULTS:The equipping rate of 30 essential medicines in Shanghai Qingpu District varied from 53.33%-86.67%,while the date of original drugs varied from 16.67%-53.33%,the equipping rate in secondary and tertiary hospitals was high. The availability of 30 essential medicines with Approved Drug Names in secondary and tertiary hospitals (77.78%) was generally higher than that in community health service center(63.00%),while the availability of original drugs was relatively low. The essential medicines with more than 50% relativity in community health service center and tertiary hospitals were only 6 kinds of drugs. CONCLUSIONS:The equipping rate and availability of essential medicines in primary health and medical institutions are lower than that of second-ary and tertiary hospitals in Qingpu district,as well as the relativity. It is suggested to further improve equipping policy for essential medicines from the relativity to improve match rate of production place;while further study and improvement for generic drugs from bioequivalence to improve its bioequivalence with original drugs and ensure clinical efficacy.