Objective To test whether cardiosphere-derived cells(CDCs)were sufficient to decrease manifestations of heart failure with preserved ejection fraction(HFpEF)in hypertensive rats.Methods DS rats(Charles River,Wilmington,Massachusetts)were fed 0.3% NaCl(low-salt)diet until 7 weeks of age.At that time,the diet was switched to an 8% NaCl(high-salt)diet in rats by random assignment.DS rats fed the low-salt diet constituted the control group(n=20).At 13 to 14 weeks of age,rats with the high-salt diet were randomized to receive allogeneic rat CDCs or PBS.Echocardiography long-axis images of the left ventricular systolic and diastolic dimensions.Sirius red was used to assess fibrosis and proliferation.Results E/A ratio increased in the PBS-treated group compared with the control group and the CDCs-treated group [(1.20±0.30)vs.(1.70±0.20)or(1.80±0.16),t=0.782,0.844,all P<0.001].LAA kept increasing in the PBS-treated group[(27.20±1.10)mm2 vs.(19.80±0.76)mm2 or(17.80±0.82)mm2,t=0.892,0.774,all P<0.001].The time constant of isovolumic LV pressure fall was prolonged in placebo-treated animals compared with CDCs-treated animals and control rats[(6.2±0.3)×103 mmHg/s vs.(9.4±0.4)×103 mmHg/s,t=0.382,P=0.024;(6.2±0.3)×103 mmHg/s vs.(9.1±0.5)×103 mmHg/s,t=0.883,P=0.022].LVEDP was 2-fold higher in placebo-treated group than in CDC-treated and control animals[(17±10)mmHg vs.(8±3)mmHg,t=0.922,P=0.003;(17±10)mmHg vs.(9±4)mmHg,t=0.922,P=0.004].A dramatic improvement of survival was observed in CDC-treated rats(Kaplan-Meier survival curves)(P=0.027).Cardiac myofibroblasts increased dramatically in PBS-treated(110/field vs.46/field,P<0.001).Inflammatory cytokines expression siginficantly increased in PBS-treated group.Conclusion CDCs improves survival in a rat model of HFpEF through reducing inflammation and fibrosis.

Objective To investigate whether cardiosphere-derived cells (CDCs)can protect ischemia-reperfusion in acute myocardial infarction,and to explore its mechanism.Methods 7 -10 week-old female Wistar-Kyoto (WKY)rats were used for all in vivo experiment.Ischemia was induced for 45 min to allow reperfusion. Twenty minutes (or two hours)later,CDCs (or PBS control)were injected into the LV cavity with an aortic cross-clamp.After 48 hours and 2 weeks,representative echocardiography long-axis images of the left ventricular (LV) systolic and diastolic dimensions,the protein level of activated caspase-3 were observed,the apoptosis rate of myo-cardial cells and the infarct area of the heart were determined in those groups.Results Rats underwent 45 minutes of ischemia,followed by either 20 minutes or 120 minutes (delayed injection)of reperfusion prior to infusion of CDCs (cells per 100μL)or PBS control (100μL)into the LV cavity during aortic cross-clamp.Ejection fraction,as meas-ured by echocardiography,was significantly preserved in CDCs-treated animals at 48 hours with a 20 -minute,but not a 120-minute,delay of infusion(28.0% vs 38.0%,χ2 =7.340,P=0.008).CDCs-treated animals reduced percentage of infarct mass(6.2% vs 13.4%,χ2 =4.226,P=0.002;6.2% vs 13.5%,χ2 =1.853,P=0.003), infarct mass(6.2% vs 13.4%,χ2 =2.220,P=0.002;6.2% vs 13.5%,χ2 =3.119,P=0.003)treated with PBS control.CDC-treated animals reduced infarct size,relative to those of animals treated with PBS control(45.0% vs 24.0%,χ2 =4.825,P=0.008),less thinning of the LV anterior wall(1.96mm vs 1.45mm,t=0.897,P=0.028). Protein expressions of MMP-8 and CXGL7 were elevated in the infarct zone of hearts treated with CDCs(MMP-8:0.74 vs 0.56,t=0.657,P=0.014;CXGL7:0.44 vs 0.81,t=0.791,P=0.010).Conclusion CDCs is suggested to be a promising cell source to repair acute myocardial infarction through inhibiting apoptosis and reduce proinflam-matory cytokine expression.

Enteral nutrition is an indispensable part of the treatment for critically ill patients. Various authoritative guidelines point out that early enteral nutrition is the key to improve the prognosis of disease. The key to improve and promote standardized enteral nutrition for criti-cally ill patients is the application of guidelines in the clinical practice. Based on clinical practice and theoretical basis, the authors propose a new insight into enteral nutrition and a new nutritional strategy of "individual treatment, circular evaluation, channel basis, quality-quatity balance, step-up achievement" for critically ill patients on basis of a 5W1H mindset.

Objective: To investigate the protective effect of glucose regulatory protein 78 (GRP78) on cardiomyocytes in atrial fibrillation and its mechanism. Methods: HL-1 cardiomyocyte cell line was cultured from June 2016 to March 2017 at Harbin Medical University Central Laboratory.The cells were randomly divided into 4 groups: control group, pacing group, pacing+ GRP78cDNA group, pacing+ GRP78siRNA group.The following indicators were detected: (1)oxidative stress: flow cytometry was used to detect the content of reactive oxygen species (ROS) in each group; (2)Ca²⁺ overload and cell electrophysiology: flow cytometry was used to detect Ca²⁺ content in each group; (3)cell structure reconstruction: cell apoptosis was detected by flow cytometry. Results: The ROS production in the pacing group was significantly higher than that in the control group [(28.8±0.5)% vs.(4.5±0.8)%, F=27.91, P<0.01]. The number of ROS in the GRP78siRNA group was significantly higher than that in the pacing group [(71.1±0.3%) vs.(28.8±0.5)%, F=34.12, P<0.01]. The ROS content of the GRP78cDNA group was lower than that of the pacing group [(26.1±2.7)% vs.(28.8±0.5)%, F=26.60, P<0.01]. Pacing significantly increased Ca²⁺ concentration in HL-1 cells; GRP concentration in HL-1 cells in the GRP78siRNA group was significantly higher than that in the pacing group [(72.53±2.5)AM vs.(39.23±1.9)AM, F=19.50, P<0.05]. The intracellular Ca²⁺ concentration in the GRP78cDNA group was significantly lower than that in the pacing group [(31.23±0.57)AM vs.(39.23±1.9)AM, F=28.17, P<0.01]. The survival rate of the GRP78cDNA group was significantly higher than that of the pacing group [(87.9±0.4)% vs.(80.1±0.5)%, F=19, P<0.05]. Conclusion GRP78 protein reduces intracellular calcium overload by reducing ROS production in myocardial cells during atrial fibrillation.It can alleviate the oxidative stress of cardiomyocytes and improve the survival rate of cardiomyocytes, and has protective effect on cardiomyocytes.

Objective:To establish a prediction model of risk factors for early Q-T interval prolongation after acute myocardial infarction (AMI), which helps prevent and reduce the occurrence of acute malignant events.Methods:This is a case-control study. A total of 100 patients with Q-T interval prolongation after AMI who received treatment at Heilongjiang Provincial Hospital from January 2018 to December 2022 were included in this study. An additional 100 patients without Q-T interval prolongation after AMI who concurrently received treatment in the same hospital were also included in this study. Two model groups, including model group 1 (with Q-T interval prolongation, n = 50) and model group 2 (without Q-T interval prolongation, n = 50), and two test groups, including test group 1 (with Q-T interval prolongation, n = 50) and test group 2 (without Q-T interval prolongation, n = 50), were designated. Logistic regression analysis was performed to construct a prediction model of risk factors for Q-T interval prolongation. The area under the receiver operating characteristic curve was determined to evaluate the prediction model. The value of the prediction model was validated in the test groups. Results:Multivariate logistic regression showed that female gender ( OR = 2.307, 95% CI: 0.09-0.91, P = 0.041) and heart failure ( OR = 3.087, 95% CI: 1.15-8.27, P = 0.025) were independent risk factors for early Q-T interval prolongation after AMI. The area under the receiver operating characteristic curve of the prediction model was 0.770, with a sensitivity of 84.0%, a specificity of 66.0%, the Jordan index of 0.44, and the corresponding optimal critical value of 0.43. This indicates good fit of the model. Conclusion:Female gender and heart failure are independent risk factors for early Q-T interval prolongation after AMI. The model constructed based on the above-mentioned risk factors fits well and has a high predictive value, which helps reduce the occurrence of early Q-T interval prolongation after AMI.

Mesh-related visceral complications caused by mesh erosion after tension-free inguinal hernia repair are one kind of rare long-term complications, but they are easily neglected. Interval time from initial hernia repair to mesh-related visceral complications by preperitoneal and laparoscopic repair is short. Rutkow and transabdominal preperitoneal repair have the highest reported rate. Lichtenstein has the longest interval time and the lowest reported rate. The most frequently eroded organs are sigmoid colon, bladder and small intestine. The common clinical manifestations of sigmoid colon erosion are hematochezia, abdominal wall fistula and colitis, hematuria and recurrent urinary tract infection in bladder erosion cases, intestinal obstruction and abdominal wall fistula in intestinal erosion case, sigmoid-bladder fistula and intestinal-bladder fistula in multiple organ erosion cases. Resection or repair of corresponding organs with mesh removal have good efficacies in most patients. The authors summarize and analyze researches on mesh-related visceral complications after tension-free inguinal hernia repair from 1994 to 2021, review their advances, in order to raise awareness of such complications in clinicians.

OBJECTIVETo understand the syphilis infection and its high risk factors among men who have sex with men (MSM) recruited from different channels.

METHODSSupported by the China-Gates Foundation HIV program from July to December 2011, we cooperated with community based organizations to conduct syphilis testing intervention among MSM from 14 cities (Beijing, Shanghai, Tianjin, Chongqing, Harbin, Shenyang, Qingdao, Xi'an, Nanjing, Wuhan, Hangzhou, Changsha, Kunming, and Guangzhou) and one province (Hainan province). Participants were recruited from different channels by the staff of local CBOs, Demographic (e.g. age, marital status, and education) and behavioral (e.g. condom use and sexual partners) data were collected using anonymous questionnaires. Blood samples were also collected to test for syphilis. A total of 34 100 MSM participated in the survey. Participants were excluded from data analysis (1 399, 4.1%) if they did not receive syphilis tests or they completed less than 80.00% of the key questions in the survey. Chi-square tests were used to understand the socio-demographic and behavioral differences between each group. Results of syphilis tests were also compared. Logistic regression models were used to test the statistical significance of these differences.

RESULTSA total of 32 701 MSM were enrolled and received syphilis testing. The average age of participates was 30.96 ± 9.57. And among them, 2 284 cases (7.0%) were recruited from gay bathhouses, 4 774 (14.6%) from gay bars, 6 266 (19.2%) from the internet, 1 997 (6.1%) from the parks/toilets and 17 380 (53.1%) from other channels. MSM recruited from the bathhouses had the highest syphilis infection rate than other 4 groups: gaybars (4.5%, 216/4 774), internet (6.7%, 422/6 266), parks/toilets (8.3%, 166/1 997), other channels (6.4%, 1 103/17 380) (χ² = 164.58, P < 0.001). The multivariate logistic regression analysis showed that being > 20 years of age (P < 0.001), having more than 2 homosexual partners in recent 3 months (8.0% (1 408/17 714), OR (95% CI) = 1.44 (1.04-1.98)), having no sex with females in past 3 months (6.8% (1 446/21 276), OR (95% CI) = 1.25 (1.07-1.46)), and not using condom at last anal sex (8.0% (769/9 668), OR (95% CI) = 1.13 (1.03-1.25)) were associated with a higher probability of being infected with syphilis. Whereas MSM married (7.2% (456/6 305), OR (95% CI) = 0.84 (0.73-0.98)), having a college or a higher education (5.3% (829/15 684), OR (95% CI) = 0.60 (0.53-0.67)), being local residents (6.5% (1 843/28 185), OR (95% CI) = 0.73 (0.61-0.87)) and living in the local province of project cities (6.6% (170/2 593), OR (95% CI) = 0.67 (0.53-0.85)) were protective factors.

CONCLUSIONMSM who were recruited from gay bathhouses have a higher rate of syphilis infection than those in channels relatively. They are older, with low education levels and high-risk sexual behaviors. Tailored interventions are required in the future, especially for MSM from gay bathhouses.

Adult ; China ; Condoms ; Demography ; Homosexuality, Male ; Humans ; Logistic Models ; Male ; Risk Factors ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires ; Syphilis ; Universities

Objective:To study the migration of polyploid tumor cells induced by docetaxel, the characteristics of epithelial-mesenchymal transition, and the killing effect of immune cells on them, in order to explore the potential role of polyploid tumor cells in tumor recurrence.Methods:The human non-small cell lung cancer A549 cells were treated with 1 μmol/L docetaxel for 24 h, and the cells were collected as Doc 1 d group. After drug removal, the cells were cultured in fresh and complete medium for 3 or 5 days, then the cells were collected as Doc 3 d group or Doc 5 d group respectively. The A549 cells were treated with DMSO for 24 h as control group. Immunofluorescence staining was used to detect cell morphology, flow cytometry was used to analyze cell ploidy, scratch test was used to detect cell migration, Western blotting was used to detect the expression of epithelial-mesenchymal transition related proteins, and lactate dehydrogenase release method was used to evaluate the killing activity of cytokine-induced killer (CIK) cells.Results:Compared with the control group, most of the cells in the Doc 1 d group, Doc 3 d group and Doc 5 d group were apoptotic, a few of the surviving cells were significantly larger, and the nucleus was polynuclear. The proportions of polyploid cell subset (DNA content > 4N) in the control group, Doc 1 d group, Doc 3 d group and Doc 5 d group were (1.93±0.55)%, (22.97±2.37)%, (51.30±12.51)% and (67.87±8.31)% respectively, and the difference among the four groups was statistically significant ( F=26.521, P<0.001). The proportion of polyploid cell subset in Doc 1 d group, Doc 3 d group and Doc 5 d group was significantly higher than that in the control group (all P<0.001). With the prolongation of withdrawal time, the proportion of polyploid cell subset in Doc 3 d group and Doc 5 d group was significantly higher than that in Doc 1 d group ( P=0.009; P=0.004). After 24 h and 48 h culture, the wound healing rates of the control group were both 100%, and the wound healing rates of the Doc 3 d group were (39.10±2.12)% and (46.13±5.32)% respectively, with no significant difference ( t=2.126, P=0.051). Compared with the control group at 24 h and 48 h, the cell migration abilities of Doc 3 d group were significantly lower ( t=49.756, P<0.001; t=30.825, P<0.001). Compared with the control group, the expression of E-cadherin protein decreased gradually in the Doc 1 d group, Doc 3 d group and Doc 5 d group, the expression of Vimentin protein increased gradually, and the expressions of Snail protein and N-cadherin protein did not change significantly. The killing efficiencies of CIK cells against the cells of the control group, Doc 3 d group and Doc 5 d group were (27.27±1.91)%, (17.87±2.35)%, (9.47±0.51)% respectively, and the difference was statistically significant ( F=11.294, P<0.001). The killing efficiency of Doc 3 d group and Doc 5 d group was significantly lower than that of the control group ( P=0.004; P<0.001). The killing efficiency of Doc 5 d group was significantly lower than that of Doc 3 d group ( P=0.003). Conclusion:The migration ability of polyploid tumor cells induced by docetaxel is weakened, but epithelial-mesenchymal transition is likely to occur, and the killing effect of immune cells on them is reduced.

Objective:To investigate the effects of human umbilical cord-derived mesenchymal stem cells (hUC-MSC) and their conditioned medium on proliferation, migration and apoptosis of human non-small cell lung cancer (NSCLC) polyploid A549 cells.Methods:A549 cells in logarithmic phase were selected. After induction treatment with 1 μmol/L docetaxel for 24 h, DMEM/F12 medium with 10% fetal bovine serum was used to culture the cells for 3 d, finally the polyploid A549 cells model was successfully established. After finishing the separation and culture of hUC-MSC, hUC-MSC conditioned medium was prepared. Normally cultured polyploid A549 cells were treated as the control group, conditioned medium cultured polyploid A549 cells were treated as the conditioned medium group. hUC-MSC was co-cultured with polyploid A549 cells, and the ratio of the total number of cells was 2:1 and 5:1, respectively, which were recorded as MSC 1 group and MSC 2 group. Cells in each group were continually cultured for 48 h or 72 h. Proliferation and apoptosis of polyploid A549 cells in each group were detected by using flow cytometry, cell migration ability was detected by using Transwell assay, and the expressions of migration and apoptosis-related proteins were detected by using Western blotting.Results:Polyploid A549 cells model was successfully established and hUC-MSC was cultured separately. The result of cell proliferation detected by flow cytometry showed that at 48 h, the mean fluorescence intensity of the control group, conditioned medium group, MSC 1 group and MSC 2 group was 1 695±305, 2 020±85, 1 259±35 and 1 356±33, respectively, and the difference was statistically significant ( F = 14.00, P < 0.05); at 72 h, the mean fluorescence intensity of the control group, conditioned medium group, MSC 1 group and MSC 2 group was 1 052±77, 1 309±24, 864±201 and 1 103±237, respectively, and the difference was statistically significant ( F = 3.90, P > 0.05). The result of Transwell assay showed that at 48 h, the number of cell migration in the control group, conditioned medium group, MSC 1 group and MSC 2 group was 52±9, 57±12, 68±8 and 75±11, respectively, and the difference was statistically significant( F = 32.16, P < 0.05); the number of cell migration in each experimental group was all higher than that in the control group (all P < 0.05). The percentage of apoptotic cells in the control group, conditioned medium group, MSC 1 group and MSC 2 group was (15.53±4.27)%, (13.77±1.75)%, (3.60±0.50)% and (2.33±0.06)%, respectively, and the difference was statistically significant ( F = 182.36, P < 0.05); there was no statistically significant difference between the control group and conditioned medium group ( P > 0.05); there were statistically significant differences between MSC 1 group and the control group, MSC 2 group and the control group (both P < 0.05). Western blotting results showed that compared with the control group, the expression of migration-related protein matrix metallopeptidase 9 (MMP-9) was increased, the expression of pro-apoptotic protein bax was reduced, the expression of anti-apoptotic protein bcl-xL was increased in conditioned medium group, MSC 1 group and MSC 2 group. Conclusions:hUC-MSC can improve the migration and anti-apoptotic ability of polyploid A549 cells, suggesting that hUC-MSC may affect the survival of tumor cells during the process of chemotherapy damage and repair.

Objective: Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a recently recognized high-risk T lymphoblastic leukemia subgroup. The optimal therapeutic approaches to adult patients with ETP-ALL are poorly characterized. In this study, we explore the efficacy and outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for ETP-ALL. Methods: The clinical data of 23 patients with ETP-ALL receiving allo-HSCT from 2010 to 2018 were retrospectively analyzed. Patients with ETP-ALL were diagnosed based on the characteristic immunophenotypes. Second-generation sequencing was done in all patients. As to the donors, 12 patients had haploidentical donors (Haplo-HSCT) , 7 HLA-matched sibling donors (Sib-HSCT) and 4 HLA-matched unrelated donors (URD-HSCT) . Before transplantation, 19 patients achieved complete remission (CR) and 4 patients without. Results: The main clinical features of ETP-ALL included high white blood cell counts in 5 patients, splenomegaly in 14, lymphadenopathy in 19, and thymus masses in 5. According to cytogenetic and molecular characteristics, 11 patients had gene mutations related to myeloid tumors, and 7 with high risk Karyotype. After first induction regimen, 14/23 patients achieved CR. 5 patients reached CR after more than 2 cycles of chemotherapy, while another 4 patients did not reach CR. After allo-HSCT, 22 patients were successfully implanted. The median time of granulocyte and platelet reconstitution was +12 and +19 days. One patient died of transplant-related infection at +14 days. The estimated 18-month overall survival (OS) and relapse-free survival (RFS) rates were (55.0±14.4) % and (48.1±14.7) % respectively. Transplant-related mortality was 4.3%. The median OS in patients achieving CR before transplantation was 20 months, however, that in patients without CR was only 13 months. OS and RFS between haplo-HSCT and sib-HSCT were comparable (P=0.460 and 0.420 respectively) . Conclusions Allo-HSCT is an effective therapy in some patients with ETP-ALL. Salvage HSCT cannot overcome the poor outcome. Haplo-HSCT and sib-HSCT in ETP-ALL patients have the similar clinical outcome.