Objective:To investigate the clinical value of serum levels of secreted frizzled related protein 1 (SFRP1), D-dimer to fibrinogen ratio (DFR), Irisin in predicting prognosis in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) complicated with pulmonary embolism.Methods:Retrospectively AECOPD patients with concurrent pulmonary embolism admitted to the Wuhan No.1 Hospital from January 2021 to December 2023were selected, and divided into a survival group of 50 cases and a death group of 10 cases based on their survival outcomes during hospitalization. Comparing the general clinical data and serum levels of SFRP1, DFR, and Irisin between two groups of patients, a logistic regression model was used to analyze the correlation between the course of AECOPD, SFRP1, DFR, and Irisin levels and adverse prognosis in AECOPD patients with pulmonary embolism. Receiver operating characteristic (ROC) curves were plotted to analyze the value of SFRP1, DFR, and Irisin in predicting adverse prognosis in AECOPD patients with pulmonary embolism.Results:There was a statistically significant difference in the duration of AECOPD between the two groups of patients ( P<0.05). The differences in serum SFRP1, DFR, and Irisin levels between the two groups of patients were statistically significant (all P<0.05). The results of logistic regression analysis showed that SFRP1, DFR, and Irisin ( OR=1.022, 4.991, 0.719) were influencing factors on the prognosis of AECOPD patients with pulmonary embolism (all P<0.05). The ROC curve showed that the area under the curve (AUC) of SFRP1, DFR, and Irisin for predicting adverse prognostic outcomes in AECOPD patients with pulmonary embolism was 0.844, 0.920, and 0.842, respectively. Conclusions:SFRP1, DFR, and Irisin are influencing factors for poor prognosis in AECOPD patients with pulmonary embolism, and have high value in predicting the prognosis of AECOPD patients with pulmonary embolism.

Objective To explore the value of combined application of prenatal ultrasound and MRI in diagnosis of fetal agenesis of corpus callosum (ACC).Methods The fetal brain ultrasound and MRI examination were performed in 1 1 7 fetuses with enlarged posterior horn of lateral ventricle and diaphanous diaphragm reduction or disappearance,and compared with postpartum diagnosis.Results Among the 48 cases of postpartum ACC confirmed by MRI,40 cases were diagnosed by prenatal ultrasound and 45 cases by prenatal MRI,and the sensitivity of the two methods was 83.33%,93.75% respectively(P<0.05).The sensitivity of combined diagnosis was 95.83%. Conclusion Fetal craniocerebral ultrasound combined with MRI can accurately diagnose fetal ACC,especially improve the detection rate of partial corpus callosum deletion,and provide a reliable basis for clinical diagnosis.

AIM:This study utilized CRISPR/Cas9 technology to create Retnlb floxp knock-in mice,followed by the application of the Cre-LoxP recombination system to generate intestinal epithelial-specific Retnlb gene knockout mice(Retnlb-CKO).This model was developed to investigate the pathogenic mechanisms of Retnlb in inflammatory bowel disease.METHODS:Female and male C57BL/6N mice,aged 8 weeks with the Retnlbflox/+genotype,were housed togeth-er for breeding.Offsprings were screened to identify those with the Retnlbflox/flox genotype.These mice were then crossed with Vil1-Cre transgenic mice,which express Cre recombinase specifically in intestinal epithelial cells,resulting in Retnlb-flox/+,Cre+mice.Subsequent crosses between Retnlbflox/+,Cre+mice and Retnlbflox/flox mice produced Retnlbflox/flox,Cre+mice(Retnlb-CKO).Six 8-week-old Retnlbflox/flox,Cre+mice and their littermate Retnlbflox/flox mice were selected for experiments.RT-qPCR and immunohistochemistry were used to assess Retnlb mRNA and protein levels in colonic epithelium.Phenotypic observa-tions included body length,weight,diet,and reproductive capability.Tissue-to-body weight ratios were calculated to ana-lyze growth and development.Intestinal barrier integrity and colonic expression of inflammatory factors were evaluated.RESULTS:The conditional gene knockout mouse model with specific deletion of Retnlb in intestinal epithelial cells was successfully established and validated through genetic identification,mRNA and protein analysis.Compared to Retnlbflox/flox mice,Retnlb-CKO mice exhibited no significant differences in body length,weight,diet,or reproductive capability.There were no differences in the ratios of heart,liver,spleen,lung,kidney,and colon weight to body weight,nor were there morphological differences in various tissues.However,the mRNA expression of tight junction proteins ZO-1,Occlu-din,and Claudin3 in colon tissues of Retnlb-CKO mice was significantly reduced(P<0.01).PAS staining and immunohis-tochemistry revealed a significant decrease in the number of goblet cells and lysozyme-positive cells in the colon tissues of Retnlb-CKO mice(P<0.01).HE staining showed no obvious pathological change in colon tissues of Retnlb-CKO mice.RT-qPCR further demonstrated a significant downregulation of pro-inflammatory factors NLRP3,interleukin-6(IL-6),IL-1β,and tumor necrosis factor-α(TNF-α)in colon tissues(P<0.01),along with significant downregulation of inflamma-tion signaling pathway proteins TLR4,MyD88,and NF-κB(P<0.01).CONCLUSION:A conditional colon epithelial cell Retnlb gene knockout mouse model was successfully constructed and validated.The absence of Retnlb in colon cells led to impaired intestinal barrier function,decreased mRNA expression of pro-inflammatory factors in colon tissue,and downregulation of mRNA expression of inflammatory pathway proteins TLR4,MyD88,and NF-κB.

To explore the optimal therapy time for the treatment of severe coronavirus disease 2019(COVID-19)by traditional Chinese medicine(TCM)and its influence on the therapeutic effect and prognosis. The clinical data,laboratory findings,and outcomes of 64 patients with severe COVID-19 treated with TCM and western medicine in Chongqing from January 20,2020, to March 11,2020 were retrospectively analyzed.Patients were divided into early intervention group[TCM was initiated within 3 days (including day 3) after the first diagnosis of severe type/critical type COVID-19]and late intervention group[TCM was initiated after 7 days (including day 7) after the first diagnosis of severe type /critical type COVID-19].The changes in clinical parameters during the course of disease were compared between the two groups. On day 14,the oxygenation index was 292.5(252.0,351.0)mmHg in the early intervention group,which was significantly higher than that in the late intervention group [246.0(170.0,292.5)mmHg](=0.005).The length of hospital stay [(18.56±1.11)d (24.87±1.64)d,=0.001],duration of ICU stay [(14.12±0.91)d (20.00±1.53)d,=0.000] and time to negativity [(16.77±1.04)d (22.48±1.66)d,=0.001] in the early intervention group were significantly shorter than those in the late intervention group.The intubation rate(7.3%)in the early intervention group was significantly lower than that in the late intervention group(30.4%)(=0.028). Early TCM therapy within three days after a diagnosis of severe COVID-19 can shorten the length of hospital stay,duration of ICU stay,and time to negativity and decrease intubation rate.
Betacoronavirus ; Coronavirus Infections ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Pandemics ; Pneumonia, Viral ; drug therapy ; Prognosis ; Retrospective Studies