Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.

Objective To determine the prognostic factors in systemic sclerosis.Methods Clinical data of definite systemic sclerosis patients were collected,including disease onset age,sex,disease course,Raynaud's phenomenon,skin involvement,gastroesophageal reflux,interstitial pneumonia,cardiac lesions,kidney lesions and scleroderma renal crisis.serum antibodies to scl-70.RNP and anti-centromere antibody were detected.Pulmonary artery pressure was measured by ultrasound cardiography.Cox hazard ratio model was employed to assess the mortality risk of systemic sclerosis patients.Results No difference in Raynaud's phenomenon,gastroesophageal reflux,anti-nuclear antybody,anti-sol-70 antibody,anti-centromere antibody,interstitial pneumonia,diffusion capacity (DLco),coronary artery disease,and peripheral artery atherosclerotic disease could be found between the dead and alive systemic sclerosis patients(P>0.05).Dead systemic sclerosis patients had later disease,onset(older than 60 years old)(P=0.002).Male gender(P=0.023),more diffuse skin involvement(P=0.000),more positive anti-RNP antibody(P=0.014),more pulmonary artery hypertension(P=0.000).more cardiac lesions(P=0.000),more cerebral infarets (P=0.035),more kidney lesions(P=0.000),and more scleroderma renal crisis(P=0.000) could be found jn dead sclerosis patients.Cox regression analysis showed that,onset later than 60 years old(OR=5.441.95% CI 2.126～13.926,P=0.000),male sex (OR=5.531,95%CI 2.014～15.190,P=0.001),anti-RNP antibedy positivity (OR=2.664,95%CI 1.016～6.592,P=0.034),diffuse skin involvement(OR=3.432,95%CI 1.400～8.411,P=0.007),pulmonary artery hypertension (OR=25.718,95% CI 5.954～111.085,P=0.000),cardiac lesions (OR=4.141.95%CI 1.685～10.159,P=0.002),kidney lesions(OR=4.214,95%CI 1.654～10.737,P=0.003) and scleroderma renal crisis (OR=20.677,95% CI 4.161～102.764.P=0.000)were risk factors for mortality in systemic sclerosis.Severe pulmonary hypertension was the most strong predictive factor for mortality in systemic sclerosis (OR=55.809,95% CI 12.879～241.832.P=0.000).Conclusion Aggressive therapy should be given to those systemic sclerosis patients with onset later than 60 years old,male sex,diffuse skin involvement,anti-RNP antibody positivity,cardiac involvement,kidney lesions,scleroderma renal crisis and pulmonary artery hypertension,especially seevere pulmonary hypertension.

Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.

Objective:To ascertain the levels of individual doses to radiation workers arising from occupationally external exposure in China in 2017, with an aim to provide basic data and scientific basis for prevention and control of occupational radiation sickness.Methods:Data on individual doses to monitored workers engaged in medical and industrial applications of radiation sources were collected through National Individual Dose Registry, with statistical analysis being carried out using Kruskal-Wallis H test, Mann-Whitney U test and Bonferroni method. Results:A total of 361 727 radiation workers were investigated in 2017, of which 81.6% was from medical application and 18.4% from industrial application, respectively. The average annual effective dose from medical and industrial applications were 0.353 and 0.270 mSv, respectively, with the former significantly higher than the latter ( Z=48.547, P<0.05). Furthermore, a statistically significant difference was seen in the average annual effective dose for each occupational category of medical application ( H=1 136.217, P<0.05), suggesting that the dose values for the monitored workers in nuclear medicine and interventional radiology were significantly higher than for other four medical categories ( Z=2.877-26.967, P<0.05). These dose values for the radiation workers was 0.361 mSv in tertiary hospitals, 0.397 mSv in secondary hospitals, and 0.308 mSv in primary and unrated hospitals, respectively. The dose values for the monitored workers in industrial radiography and well logging were significantly higher than for other five industrial categories of industrial applications ( Z=4.172-36.908, P<0.05). Conclusions:The average annual effective doses to the of monitored workers meet the relevant national standards. The exposure doses to the workers in nuclear medicine, interventional radiology, industrial radiography and well logging are relatively high. The necessary measures and devices for radiation protection should be further strengthened to reduce occupational exposure of workers.

N 6-methyladenosine (m 6A) methylation modification is defined as the methylation at the N 6 position of adenosine. This dynamic process is regulated by writer, eraser and reader. Accumulating evidence indicates that m 6A methylation modification is involved in the initiation and development of various digestive system neoplasms including proliferation, invasion, metastasis and chemoresistance. A further understanding about the role of m 6A methylation modification in digestive system neoplasms will benefit the development of a novel precise diagnostic and therapeutic strategy and finally improve the overall prognosis of patients.

Objective:To investigate the changes of advanced glycosylation end product(AGEs)/sodium-glucose cotransporter-1(SGLT-1) in intestinal and renal tissues and intestinal flora of mice with diabetes kidney disease.Methods:Twenty KKay mice were divided into diabetic group(DM group, n=10) and diabetic kidney disease group(DKD group, n=10). The concentrations of serum AGEs, lipopolysaccharide(LPS), tumor necrosis factor-α(TNF-α), and intereukin-6(IL-6) were measured. Western blot technique was used to detect the protein expression of AGEs and SGLT-1 in kidney and intestinal tissue, and high-throughput sequencing was used to analyze the difference of intestinal flora. Results:The levels of inflammatory markers TNF-α, IL-6, and serum endotoxin in DKD group were significantly higher than those in DM group( P<0.05). The contents of AGEs in serum and intestine and kidney were increased, and the contents of SGLT-1 in intestine and kidney were increased( P<0.05). Metastats test showed that the abundance of Verrucomicrobia decreased and the abundance of Proteobacteria increased in DKD group( P<0.05). G - bacteria such as Aeromonas, Enterobacter, Morgan, Klebsiella, Serratia, and Burkholderia were relatively dominant, and the abundance of Akkermansia was significantly lower than that in DM group( P<0.05). Conclusion:The increase of AGEs in intestinal tract of DKD mice may induce intestinal dysbacteriosis, especially the increase of Proteobacteria, the decrease of Verrucosa and Wilhelm Ackermann, and the leakage of G-bacteria into the blood to produce intestinal endotoxemia and cause inflammatory reaction, this may be an important factor in the development of DKD. SGLT-1 is elevated in intestinal tissue, which may be involved in the development of DKD.

Objective To clone human Sjogren's syndrome antigen A(SSA)for expressing of antigen SSA-52kD and establishing a new clinical detecting method.Methods According to the human SSA-52kD cDNA sequence reported in GenBank,primers of human SSA-52kD cDNA were designed and synthesized.Human SSA-52kD cDNA was amplified from RNA of cultured Hela cell by reverse transcriptase polymerase chain reaction(RT-PCR).The production of amplification was ligated to PET-30a vector and then transformed into the competent bacteria DH5?to construct the recombinant plasmid PET-30a-SSA-52kD.The recombinant plasmid was digested with Bgl Ⅱ and Hind Ⅲ,and positive clones were sequenced.Results The Human SSA-52kD cDNA fragment containing 1447bp was amplified by RT-PCR.Restriction endonuclease mapping using Bgl II and Hind III showed that the target gene was inserted into the recombinant plasmid.The complete coding sequence of Human SSA-52kD was consistent with that of GenBank through DNA sequencing.Conclusions The full length of human SSA-52kD cDNA was successfully cloned and the recombinant plasmid PET-30a-SSA-52kD was constructed.

In the treatment of non-small cell lung cancer (NSCLC), immunotherapies represented by immune checkpoint inhibitors are developing rapidly. It is the premise of precise treatment to clarify the influencing factors of NSCLC immunotherapy. In the course of immunotherapy for advanced NSCLC, elderly patients can obtain specific effect from immunotherapy; male patients benefit more from monotherapy; when steroid hormones are used for related symptoms caused by tumors, they are poor prognostic factors for patients. The occurrence of immune-related adverse events is a favorable prognostic factor while driving gene mutations and the use of antibiotics will reduce the efficacy of immunotherapy.

Objective:To evaluate the effects of proton pump inhibitors (PPIs) on the clinical outcomes for advanced solid tumor patients treated with immune checkpoint inhibitors (ICIs).Methods:A total of 204 patients with advanced solid tumors who received ICIs in the Affiliated Hospital of Yangzhou University from November 2016 to December 2020 were retrospectively analyzed. The patients were divided into PPIs group ( n=73) and Non-PPIs group ( n=131) according to whether they received PPIs within 1 month before or after the initiation of ICIs treatment. The correlations between the uses of PPIs and the clinical characteristics of patients were explored, and the clinical efficacy of the two groups was evaluated. Kaplan-Meier survival curve was applied to analyze the effects of PPIs uses on overall survival (OS) and progression-free survival (PFS) of patients. The Cox proportional hazards model was used to clarify whether PPIs was an independent indicator of patients′ prognosis. Results:During ICIs treatment of advanced solid tumors, the use of PPIs was not correlated with the patients′ gender, age, tumor type, the score of the United States Eastern Collaborative Group, types of immunotherapy drugs and treatment strategy (all P>0.05). The objective response rate of the Non-PPIs group was better than that of the PPIs group (45.0% vs. 24.7%, χ2=8.286, P=0.004). The disease control rate of the Non-PPIs group was better than that of the PPIs group (75.6% vs. 52.0%, χ2=11.755, P=0.001). In patients with advanced solid tumors, the median OS (3.4 months vs. 6.1 months) and median PFS (2.8 months vs. 4.0 months) in the PPIs group were shorter than those in the Non-PPIs group ( χ2=9.563, P=0.002; χ2=5.761, P=0.016). Univariate analysis showed that among patients with advanced solid tumors treated with ICIs, PPIs uses was significantly correlated with OS ( HR=1.85, 95% CI: 1.24-2.76, P=0.003); PPIs uses( HR=1.65, 95% CI: 1.09-2.51, P=0.019) and age ( HR=1.56, 95% CI: 1.05-2.32, P=0.029) were significantly correlated with PFS. Multivariate analysis showed that PPIs uses was an independent prognostic factor affecting OS ( HR=1.90, 95% CI: 1.27-2.85, P=0.002) and PFS ( HR=1.73, 95% CI: 1.12-2.65, P=0.013). Meanwhile, subgroup analysis discovered that in the course of ICIs treatment of lung cancer patients, the median OS (3.2 months vs. 6.2 months) and median PFS (2.2 months vs. 3.8 months) in the PPIs group ( n=64) were shorter than those in the Non-PPIs group ( n=34) ( χ2=16.187, P<0.001; χ2=5.106, P=0.020). Univariate analysis showed that PPIs uses was associated with OS ( HR=2.97, 95% CI: 1.70-5.22, P<0.001) and PFS ( HR=1.97, 95% CI: 1.09-3.55, P=0.025) in lung cancer patients treated with ICIs. Multivariate analysis showed that PPIs uses was an independent prognostic factor for OS ( HR=3.38, 95% CI: 1.87-6.11, P<0.001) and PFS ( HR=2.31, 95% CI: 1.22-4.38, P=0.010) in lung cancer patients treated with ICIs. Conclusion:The use of PPIs reduces the effect of ICIs in the treatment of advanced solid tumor, especially in lung cancer. PPIs should be used cautiously in patients with advanced solid tumors treated with ICIs.

Objective·To describe the level of multiple symptom distress and physical activity in children and adolescents with cancer,analyze symptom distress profiles,and explicit the relationship between latent profiles and physical activity.Methods·From November 2021 to March 2023,the convenient sample method was used to recruit children and adolescents with cancer aged 10-18 years old,who had been treated for more than 1 month in the Departments of Hematology/Oncology,Shanghai Children's Medical Center and Xin Hua Hospital,Shanghai Jiao Tong University School of Medicine.The questionnaires,including General Information Questionnaire,Memorial Symptom Assessment Scale 10-18(MSAS 10-18)and Modified Chinese Version of Children's Leisure Time Activities Study Survey(CLASS-C),were used.Latent profile analysis was used to identify whether the level of multiple symptom distress in children and adolescents with cancer was population heterogeneity and its explicit characteristics.Whether there were differences in physical activity levels among different profiles of symptom distress was also analyzed.Results· A total of 165 valid questionnaires were collected,with an effective response rate of 91.7％.The symptom distress scores of the top five occurrence rates of symptoms in children and adolescents with cancer were lack of energy with a median of 1(1,2)point,nausea 1(1,2)point,lack of appetite 2(2,3)points,sweat 1(1,2)point,and pain 1(1,2)point.The physical activity level of the patients was mainly light,with a median of 2 530.00(1 577.50,3 721.00)min/week,and moderate to vigorous physical activity was relatively lower[70.00(10.00,197.50)min/week].The patients with cancer could be divided into two latent profiles:"high fatigue-high nausea-high hair loss-high sleepy"and"high fatigue-low nausea-low vomiting-low sleepy",which were named as high symptom distress(n=47,30.6％)and low symptom distress(n=l 18,69.4％)separately.Multivariate Logistic regression analysis showed that patients with acute lymphoblastic leukemia were more likely to be classified as high symptom distress group,and outpatients in the latest hospital visit were more likely to classified as low symptom distress group(both P＜0.05).In addition,patients with high symptom distress had a higher level of light physical activity(P＜0.05),and had a lower level of moderate to vigorous physical activity,but the difference was not statistically significant.Conclusion·There is population heterogeneity in the multiple symptom distress in children and adolescents with cancer.Disease type(acute leukemia)and the way of the latest hospital visit(through outpatient department)are the predictors of symptoms profiles of patients with cancer.Patients who experience high symptom distress have higher level of light physical activity,and perhaps lower level of moderate to vigorous physical activity.