Objective To explore the effects of PSE on hemodynamics and Liver function in LCPH. Methods 30 patients with LCPH are treated by PSE. The hemodynamics changes of patients with LCPH are evaluated with color Doppler diasonograph. The changes of main clinical features which is related to LCPH , serum ALT and albumn were investigated . Results The hemodynamics indexs of LCPH are all changed significantly (P0. 05) between four and two weeks after PSE. But the main symptoms, signs of LCPH and liver function are improved after PSE . Conclutions PSE plays an important role in hemdynamics and liver function of LCPH. After PSE, Portal hypertension decreases effectively and liver function is improved.

Objective:To investigate the condition of B cell differentiation from cord blood CD34+CD19-hematopoietic stem/progenitor cells in vitro.Methods:CD34+CD19-cells from cord blood were isolated and purified by using immunomagnetic beads separation system.CD34+CD19-cells supported by murine S-17 stromal cells were stimulated in co-culture with T3 and cytokines.Differentiated B cells were analyzed by flow cytometry.Results:The amplification of the B cells derived from CD34+CD19-hematopoietic stem/progenitor cells in co-culture with T3 and IL-7 reached 198-fold of increase,most of the induced cells expressed CD10 and CD19.Conclusion:In the experimental conditions selected,co-culture of CD34+CD19-cells with T3,IL-7 and murine S-17 stromal cells could stimulate differentiate toward to B cells in vitro.

Objective:To clarify the effect of ubiquitination hepatitis B virus core antigen (Ub-HBcAg) on dendritic cells (DC) autophagy, and to explore the mechanism of autophagy in enhancing DC antigen presentation and inducing hepatitis B virus-specific cytotoxic T lymphocyte (CTL) responses.Methods:Ub-HBcAg lentiviral vector (LV-Ub-HBcAg), lentiviral vector-hepatitis B virus core antigen (LV-HBcAg) and no-load plasmid LV (LV) were constructed and packaged. DC2.4 cells were divided into LV-Ub-HBcAg group, LV-HBcAg group and LV group. The blank control group (NC group) was also set. The protein expression of autophagy-related protein P62, microtubule associated protein 1 light chain 3 beta (LC3B), autophagy related 5(ATG5) and Beclin-1 were detected by Western blotting. The expressions of co-stimulatory molecules such as CD86, CD80 and major histocompatibility complex (MHC)-Ⅱ were detected by flow cytometry. Cell counting kit-8 (CCK-8) method was used to detect T lymphocytes proliferation. The non-radioactive lactic acid dehydrogenase (LDH) release method was applied to detect the killing ability of CTL. Statistical analysis was conducted by independent sample t test. Results:The relative protein expressions of LC3B-Ⅱ/LC3B-Ⅰ, Beclin-1 and ATG5 in NC group were 0.445±0.076, 0.522±0.026 and 0.761±0.038, respectively, which were all lower than those in LV-Ub-HBcAg group (0.926±0.021, 0.919±0.016 and 1.451±0.028, respectively). The relative protein expression of P62 in the NC group was higher than that in LV-Ub-HBcAg group ((1.875±0.016) vs (0.647±0.121)). The differences were all statistically significant ( t=6.102, 9.842, 17.490 and 10.590, respectively, all P<0.01). The expressions of CD86 (75.51%), CD80 (83.35%), MHC-Ⅱ (66.66%) in the LV-Ub-HBcAg group were high, and those in the NC group were 8.03%, 7.49%, 0.04%, respectively. The specific CTL killing rate ((65.310±2.091)%) of the LV-Ub-HBcAg group was significantly higher than both NC group ((14.400±0.497)%) and LV-HBcAg group ((54.870±1.443)%), and the differences were both statistically significant ( t=23.690 and 4.111, respectively, both P<0.05). Conclusion:Ub-HBcAg promotes the DC autophagy, up-regulates the expressions of costimulatory molecules on cell surface of DC to induce the maturation and activation, and then stimulates T lymphocyte to induce a stronger specific CTL response under the effort of ubiquitination.

Objective:To investigate the correlation between serum microRNA (miR)-15a-5p and prognosis, neoadjuvant chemotherapy (NAC) response in patients with locally advanced gastric cancer (LAGC).Methods:The clinical data of 122 patients with LAGC who underwent surgery after NAC in Eastern Theater Air Force Hospital of the Chinese People′s Liberation Army from May 2016 to April 2020 were analyzed retrospectively. The general clinical data and laboratory examination results of the patients were recorded. The expression level of serum miR-15a-5p was detected by real-time fluorescence quantitative polymerase chain reaction, and the relationship between the expression of miR-15a-5p and different clinical characteristics in patients with LAGC was analyzed. The pathological response was evaluated by Becker tumor regression grading, in which patients with grade 1a, 1b and 2 were sensitive group and patients with grade 3 were resistant group.Results:The patients with LAGC were divided into high expression (>1.038) and low expression (≤1.038) according to the median miR-15a-5p of 1.038 with 61 cases each. The expression level of serum miR-15a-5p was related to the preference for spicy food, endoscopic ultrasonography (EUS)-T stage and EUS-N stage ( P<0.01 or <0.05). According to the evaluation result of pathological reaction, there were 47 cases in resistance group and 74 cases in sensitive group. The serum miR-15a-5p in resistance group was significantly higher than that in sensitive group: 1.69 (1.39, 1.97) vs. 0.99 (0.96, 1.02), and there was statistical difference ( Z =-8.55, P<0.01). The receiver operating characteristic curve analysis result showed that the area under the curve of serum miR-15a-5p predicting NAC response was 0.959 (95% CI 0.929 to 0.990), the optimal cut-off value was 1.049, the sensitivity was 100.0%, and the specificity was 85.1%. Multivariate Logistic regression analysis result showed that miR-15a-5p was an independent risk factor for NAC response in patients with LAGC ( HR = 1 880.840, 95% CI 123.510 to 28 641.846, P<0.01). Kaplan-Meier survival curve analysis result showed that the median overall survival time and median progression free survival time in patients with high expression of miR-15a-5p were significantly shorter than those in patients with low expression of miR-15a-5p (19 months vs. 62 months and 12 months vs. 51 months), and there were statistical differences (log-rank χ2 = 41.99 and 61.97, P<0.01); the 10-year overall survival rate and 10-year progression free survival rate in patients with high expression of miR-15a-5p were significantly lower than those in patients with low expression of miR-15a-5p (4.9% vs. 52.5% and 24.6% vs. 85.2%), and there were statistical differences (log-rank χ2 = 33.70 and 45.32, P<0.01). Multivariate Cox regression analysis result showed that R 0 resection and miR-15a-5p were the independent risk factors affecting the overall survival time and progression free survival time in patients with LAGC (overall survival time: HR = 1.945 and 3.487, 95% CI 1.033 to 3.660 and 2.112 to 5.759, P<0.05 or <0.01; progression free survival time: HR = 2.427 and 6.335, 95% CI 1.069 to 5.510 and 3.341 to 12.013, P<0.05 or <0.01). Conclusions:The increase of serum miR-15a-5p level is related to NAC response and poor prognosis in patients with LAGC. It can be used as a reliable biomarker to predict the prognosis and NAC response of LAGC.

Objective:To explore the clinical significance of different endovascular interventional therapies in extracranial artery dissection and summarize their therapeutic experiences.Methods:Forty-two patients with extracranial artery dissection underwent endovascular interventional therapies in our hospital from August 2016 to January 2021 were chosen. In these 42 patients (26 with simple intravascular dissection and 16 with dissecting aneurysms), the dissection located in carotid C1 or C2 segment was noted in 37 patients and that in vertebral artery V2 segment was noted in 5 patients. According to the nature, location, and scope of lesions, different endovascular interventional therapies (such as overlapping braided vascular stent implantation, flow-diverter stents implantation, intracranial covered stent implantation and embolism of aneurysm) were adopted. DSA results immediately after surgery and DSA follow-up results 6 months after surgery were evaluated, and the occurrence of adverse events during and within 24 h after surgery was observed and recorded.Results:In the 26 patients with simple intravascular dissection, 3 patients showed vascular occlusion by DSA angiography (1 patient accepted sequential stent implantation [2 Neuroform EZ stents] and 2 patients accepted sequential stent implantation [Neuroform EZ+Wallstent stent] after recanalization; in the left 23 patients, 21 received overlapping braided stent implantation (19 patients had 2 Wallstent stents and 2 patients had 2 LVIS stents) and 2 patients had intracranial covered stent implantation (single Willis stents). Among the 16 patients with dissecting aneurysm, overlapping braided stents were implanted (11 patients had 2 Wallstent stents, 4 patients had single flow-diverter stent, and 1 patient had single Willis stent). The stents were successfully placed in all patients intraoperatively. Immediately after surgery, DSA showed that the stents were well attached, and the blood flow of the responsible vessels was unobstructed; no postoperative complications such as bleeding, vascular occlusion or acute thrombosis were noted. After 6 months of follow-up, all patients had smooth blood flow in the diseased vessels, complete aneurysm occlusion, and no obvious stenosis in the stents.Conclusion:Endovascular interventional therapy is safe and effective for extracranial artery dissection; stent placement should be selected according to the characteristics of the dissection.

Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.