Objective To observe the effects of electrical stimulation of paraventricular nucleus(PVN) on gastric mucosal cellular apoptosis,proliferation,and expression of BCL-2,BAX induced by gastric ischemia-reperfusion(GI-R) and the potential mechanisms of protection of PVN on GI-R injury.Methods After electrical stimulation of PVN,the experimental model of GI-R were established by clamping the celiac artery for 30 min and then reperfusing the artery for 30 min,1 h,3 h,or 6 h respectively.We used immunohistochemistry to detect the gastric mucosal cells apoptosis,proliferation and the expression of BCL-2,BAX.Results Compared with GI-R group,the electrical stimulation of PVN markedly decreased gastric mucosal cellular apoptosis,increased the proliferation,and promoted the protein expression of BCL-2,but markedly inhibited the protein expression of BAX at 30 min,1 h,3 h after reperfusion respectively.Conclusion The protective effect of PVN on GI-R injury is associated with up-regulation of expression of BCL-2 and down-regulation expression of BAX,and so inhibited gastric mucosal cellular apoptosis and promoted proliferation.

ObjectiveTo investigate the therapeutic effect of entecavir or adefovir dipivoxil as the antiviral therapy for hepatitis B cirrhosis patients with hepatogenous diabetes. MethodsA total of 80 hepatitis B cirrhosis patients with hepatogenous diabetes who visited Qingdao Hospital of Infectious Diseases were enrolled, and according to the antiviral drug they chose, they were divided into group A and group B, with 40 patients in each group. The patients in group A were treated with oral administration of entecavir 0.5 mg qd, and those in group B were treated with oral administration of adefovir dipivoxil 10 mg qd. The antiviral therapy lasted for 48 weeks. The patients in both groups were given diabetic diets and insulin to control blood glucose, as well as liver-protecting and transaminase-lowering treatments. The changes in biochemical parameters, viral response, diabetes control, and the improvement in liver stiffness after treatment were observed in both groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe viral response showed a significant difference between group A (85%, 34/40) and group B (65%, 26/40) (χ2=4.27, P＜0.05). Compared with group B, group A showed significant improvements in biochemical parameters (P＜0.05). After 48 weeks of treatment, group A had significantly lower levels of blood glucose and glycosylated hemoglobin than group B (blood glucose: 7.53±1.13 mmol/L vs 8.34±1.12 mmol/L, t=3.220, P＜0.05; glycosylated hemoglobin: 7.23%±0.64% vs 7.79%±084%, t=3.354; P＜0.05). After the treatment, liver stiffness showed a significant difference between group A and group B (16.86±5.67 kPa vs 19.47±5.32 kPa, t=2.123, P＜0.05). ConclusionCompared with adefovir dipivoxil, entecavir can improve glycogen metabolism and blood glucose regulation through improving liver function and promoting hepatocyte repair, and finally achieve a better blood glucose control.

OBJECTIVETo recognize the characteristics of desmoplastic small round cell tumor (DSRCT) and improve the standard of diagnosis.

METHODSWe retrospectively reviewed the clinical data on the treatment of 2 patients with DSRCT in terms of their conditions, tissue sources, pathologic characteristics, immunohistochemical methods, clinical manifestation, diagnosis, treatment and prognosis.

RESULTSClinical manifestations were complicated. The 2 patients were mis diagnosed before operation. Their tumors consisted of irregular nests of small and round cells, with nuclear hyperchromatism and scant cytoplasm embedded in a plenty of fibrous connective tissues. The edge of the nest was clear, with different sizes and shapes. Immunohistochemically, the 2 patients were positive for CK or EMA, NSE, des and vim of the epithelium, nerve, muscle and interstitial. They died 9 months after operation.

CONCLUSIONSThe tumor may occur in the abdomen, pelvic cavity and other sites, with different clinical manifestations. Routine examination should be replaced by immunohistochemical test for correct diagnosis of the tumor. Prognosis of most patients is not good.

Adolescent ; Carcinoma, Small Cell ; diagnosis ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasms, Connective Tissue ; diagnosis ; Retrospective Studies

Objective:To assess the clinical value of metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid in pathogenic diagnosis of neurological infectious disease.Methods:Patients who were clinically diagnosed with infectious encephalitis and meningitis and treated in Department of Neurology, Affiliated Hospital of Chifeng University from March 2018 to September 2019 were retrospectively analyzed, including the clinical characteristics and data of mNGS and traditional laboratory test of pathogens.Results:Totally 104 patients with infectious encephalitis and meningitis were eligible for enrollment, and mNGS detected 22 bacterial species(22/104,21.15%), 24 viral species (24/104,23.08%), one fungal species (1/104,0.96%), one parasitic species (1/104,0.96%) and one mycoplasma species (1/104,0.96%).The three leading positive detections were varicella-zoster virus ( n=19), streptococcus ( n=7) and Mycobacterium tuberculosis ( n=4). Combined with traditional pathogen detection methods, clinical manifestations, final diagnosis and treatment results, the number of cases diagnosed by mNGS was 49 cases. The positive rate of the mNGS was 47.12% (49/104).False positives occurred in 21 (20.19%) patients. False negatives occurred in 34 (32.69%) patients. Conclusions:mNGS is more sensitive in evaluating the pathogens causing the infectious encephalitis and meningitis. It has advantages in accurate diagnosis of infectious encephalitis and meningitis.

Anti-CD19 chimeric antigen receptor (CAR)-T cell therapy has achieved 40%-50% long-term complete response in relapsed or refractory diffuse large B-cell lymphoma (DLBCL) patients. However, the underlying mechanism of alterations in the tumor microenvironments resulting in CAR-T cell therapy failure needs further investigation. A multi-center phase I/II trial of anti-CD19 CD28z CAR-T (FKC876, ChiCTR1800019661) was conducted. Among 22 evaluable DLBCL patients, seven achieved complete remission, 10 experienced partial remissions, while four had stable disease by day 29. Single-cell RNA sequencing results were obtained from core needle biopsy tumor samples collected from long-term complete remission and early-progressed patients, and compared at different stages of treatment. M2-subtype macrophages were significantly involved in both in vivo and in vitro anti-tumor functions of CAR-T cells, leading to CAR-T cell therapy failure and disease progression in DLBCL. Immunosuppressive tumor microenvironments persisted before CAR-T cell therapy, during both cell expansion and disease progression, which could not be altered by infiltrating CAR-T cells. Aberrant metabolism profile of M2-subtype macrophages and those of dysfunctional T cells also contributed to the immunosuppressive tumor microenvironments. Thus, our findings provided a clinical rationale for targeting tumor microenvironments and reprogramming immune cell metabolism as effective therapeutic strategies to prevent lymphoma relapse in future designs of CAR-T cell therapy.