OBJECTIVE: To investigate the HIV-1 integrase inhibitory activity of endophytic fungi from medicinal plant Aquilaria sinensis (Lour.) Gilg. METHODS: HIV-1 integrase inhibitory activity of the isolated endophytic fungi was determined by HIV-1 integrase strand transfer inhibitory activity assay, and the active metabolites of the endophytic fungi with the greatest potential were studied by activity tracking. RESULTS: Among 78 strains of endophytic fungi isolated from A. sinensis, nine strains (11.54%) showed strong inhibitory activity against HIV-1 integrase. Three compounds were obtained from the fermentation of strain HN-AS-8 which was identified to be Chaetomium globosum by HIV-1 integrase strand reaction. Compound 1 inhibited HIV-1 integrase with IC50 value of 35.4 μmol · L-1, and compounds 1 and 3 were for the first time isolated from Chaetomium sp. CONCLUSION: Potential anti-HIV-1 metabolites exist in the endophytic fungi from A. sinensis, which can be new resources for new anti-AIDS drugs.

Objectives To study the clinical diagnostic value of soluble major histocompatibility complex class Ⅰ-related chain A(sMICA) and analyse the relationship of tumor biologic characteristics and sMICA in lung cancer. Methods The experimental level of sMICA was determined by ELISA in 116 lung cancer patients. The level of serum CEA, NSE, CA-199, CYFRA-211, SCC, ProGRP were determined by ELISA only in 91 lung cancer patients without any therapy. The level of sMICA in 50 normal persons was regarded as control group. Results The level of sMICA in lung cancer patients was significantly higher than that in control group (P<0.001); When sMICA cut-off was set as 240.5 ng/L, the sensitivity for the detection of lung cancer was 90.1%, the speciality was 46.9%. The positive rate of sMICA was significantly higher than that of CEA, NSE, CA-199, CYFRA-211, SCC, ProGRP(P<0.001 respectively); The level of sMICA in lung cancer patients with CR and PR after treatment were lower than that before treatment(P<0.05). The level of sMICA in lung cancer patients with relapse was higher than patients without any treatment (P<0.001). Conclusion SMICA may be a potential marker for diagnosing lung cancer with high sensitivity and speciality. It is associated with tumor progression and distant metastasis and may be helpful in the evaluation of diagnosis for lung cancer.

Objective To determine the independent risk factors for sepsis in patients with large area burns.Methods The study enrolled 307 patients with large area burns treated from June 2014 to June 2015.Related variables included age,gender,visit time,emergency eschar open,burn index,tangential excision of eschar during shock stage,delayed resuscitation during shock stage,oxygen pressure(PaO2),carbon dioxide pressure (PaCO2),assisted ventilation mode,mechanical ventilation time,inhalation injury,prophylactic tracheotomy,continuous lactic acid rise,refractory hypernatremia,heart-lung disease history,and diabetes history.Correlation of the variables with the incidence of sepsis was observed.Independent predictors of sepsis in patients with large burns were differentiated using the Logistic regression analysis.Results Delayed resuscitation during shock period (OR =1.747,95％ CI 1.822-7.431,P ＜ 0.05),continuous lactic acid rise (OR =1.758,95％ CI 1.137-4.002,P ＜ 0.05),refractory hypernatremia (OR =2.985,95％ CI 1.074-6.782,P ＜ 0.05),moderate and severe inhalation injury(OR =14.764,95％ CI 0.892-47.323,P ＜ 0.05) and burn index (OR =5.017,95％ CI 1.075-23.572,P ＜ 0.05) were found be independently associated with sepsis in patients with large burns.Conclusions These independent risk factors for sepsis in large area burn patients deserve more attention.Early and timely treatment measures may reduce the incidence of sepsis.

Objective To investigate the effect and mechanism of anti-tumor necrosis factor (TNF)-α on the intestinal mucosal permeability in dextran sulfate sodium (DSS) induced colitis mice.Methods Eighteen C57BL/6J mice were evenly divided into healthy control group,model group and anti-TNF-α treated group.The mice of model group and anti-TNF-α treated group were fed with 5％DSS solution for 7 days.The mice of anti-TNF-α treated group were injected anti-TNF-α (5 mg/kg)intraperitoneally on the first and fourth day; control group and model group were substituted with equal volume saline injection.The mice were sacrificed at 7 days after modeling.The disease activity index (DAI) score was evaluated everyday.The intestinal permeability was examined by Evan′s blue (EB) method and FITC-dextran (FITC-D) method.The colon tissue was collected for observation under microscope and histological index (HI).The small intestinal tissues were examined under electron microscope.The 10％ homogenate of colon and intestinal mucosa was prepared,the activity of myeloperoxidase (MPO),the content of TNF-α and epithelial myosin light chain kinase (MLCK) concentration were determined with kits respectively.The expression of MLCK in intestinal mucosa was tested by Western blot assay.Single factor of variance between groups were analyzed.Results Compared with control group,the DAI of model group increased daily.Compared with model group,the DAI of anti-TNF-α treated group improved.In model group,mice intestinal epithelial cells junctional complex shortened and widened and the cell gap expanded.In anti-TNF-α treated group,the connection structure of mice intestinal epithelial cells was tighter.The activity of HI and MPO and the content of TNF-α of model group were higher than those of control group (P ＝ 0.008,0.006 and 0.001,respectively),all of those of anti-TNF-α treated group were lower than those of model group (P=0.004,0.008 and 0.005,respectively).The F value of three groups was 131.98,218.28 and 58.93,respectively.The contents of EB in mice intestinal wall and serum FITC-D of model group were higher than those of control group (P=0.003 and 0.010),and those of anti-TNF-α treated group were lower model group (P＝0.001 and 0.009).The F value of three groups was 69.36 and 17.96.The MLCK concentration in mice intestinal mucosa of model group [(71.10± 7.52) ng/g] was higher than that of control group [(18.56±9.92) ng/g,P＜0.01],that of anti-TNF-α treated group [(37.56±15.84) ng/g] was lower than model group (P=0.008),and the difference among these three groups was statistically significant (F＝ 17.23).The Western blot results indicated the expression of MLCK in intestinal mucosa of model group was higher than that of control group,and that of anti-TNF-α treated group was lower than model group.Conclusions Anti-TNF-α play an important role in improving colitis,and the intestinal mucosal permeability.The mechanism may be related with the regulation of MLCK expression.

Objective:To analyze the clinical features of post-pancreaticoduodenectomy hemorrhage, and explore effective and practical nursing strategies.Methods:Clinical data of 62 patients with post-pancreaticoduodenectomy hemorrhage from Jan 2014 to Dec 2019 in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed. The bleeding time, location, vital signs, accompanying symptoms and surgical treatment measures and clinical outcomes were analyzed.Results:Among the 62 cases, early (within 24 h) hemorrhage occurred in 19/62 patients (30.6%), and late hemorrhage occurred in 43/62 patients (69.4%). 36/62 patients (58.1%) had arterial bleeding; And 43/62 patients (69.4%) had abdominal hemorrhage. Grade C hemorrhage occurred in 32/62 patients (51.6%). Sentinel hemorrhage occurred in 8/62 patients (12.9%). The manifestation of hemorrhage in 42 patients was bloody fluid from abdominal drainage tube (67.7%). Hemorrhage occurred in 23 patients with pancreatic fistula(37.1%), 12 patients with abdominal infection and other complications (19.4%). Shock symptoms occurred in 41 cases (66.1%) with postoperative hemorrhage. Pancreaticoduodenectomy hemorrhage were early detected in 0.3 h and last detected in 869 h, with a median time of 192.00 (14.63, 297.00) h. 30/62 cases (48.4%) of hemorrhage patients occurred 1 hour before and after nursing shift. When hemorrhage was found, emergency treatments such as blood transfusion to maintain blood volume ( n=47, 75.8%), hemostasis ( n=35, 56.5%) and vasoactive drugs to increase blood pressure ( n=32, 51.6%) were usually given immediately. 31/62 patients (50.0%) underwent emergency secondary surgery within 4 h of hemorrhage, and 45/62 patients (72.6%) were cured by emergency surgical treatment. A written treatment pre-plan for surgical nurses was established. Conclusions:Surgical nurses should be familiar with the clinical manifestations of post-pancreaticoduodenectomy hemorrhage, and improve the alarming ability of identifying the complications of post-operative hemorrhage. The establishment of an emergency pre-plan for surgical nurses could help to treat such patients timely and effectively.

In tumor immunotherapy, the study of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) provides a new approach for the comprehensive treatment of advanced lung cancer. About 20％ of patients with non-small cell lung cancer could benefit from lung cancer immunotherapy, while those with high PD-L1 expression will benefit more. At present, there are few related studies on PD-1 expression at home and abroad, and the detection of PD-1/PD-L1 expressions is mostly concentrated in tumor tissues. With the research progress of liquid biopsy technology, the convenience and accuracy of peripheral blood testing are also receiving more and more attention. However, there are still few biological indicators for predicting the efficacy of tumor immunotherapy, and the uniform standard and accuracy of testing still need more clinical practice and exploration. This article reviews the research on the expressions of PD-1 and PD-L1 in tissues and peripheral blood of patients with lung cancer, aiming to provide reference for the treatment of lung cancer with immune checkpoint blockers.

OBJECTIVETo study the application of multi-slice spiral CT angiography (MSCTA) after endoluminal exclusion of aortic diseases.

METHODS16-slice CT angiography was performed in 15 patients with aortic dissection and 4 patients with aortic aneurysm after endovascular exclusion. Two observers analysed the images and interpreted the outcomes and complications after endovascular exclusions of aortic dissection and aortic aneurysm.

RESULTSIn 19 patients, thrombus was found in all the false lumens of aortic dissection and the outer-stent cavity of aortic aneurysm. However, one patient with aortic aneurysm graft thrombosis; 4 patients had endo-leak (3 with type I endo-leak, 1 with type III endo-leak complicating graft deformation); one achieved perfusion recovery, and one experienced thrombolysis of superior mesenteric artery.

CONCLUSIONMSCTA can be an objective tool for the post-operative evaluation of endovascular exclusion of aortic diseases.

Adult ; Aged ; Aneurysm, Dissecting ; diagnostic imaging ; surgery ; Angiography ; Aortic Aneurysm, Abdominal ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Tomography, Spiral Computed ; methods

OBJECTIVETo investigate the role of nuclear factor erythroid 2-related factor 2 (Nrf2) as a key transcription factor of cytoprotection against inflammation in the spinal cord upregulation of matrix metalloproteinase-9 (MMP-9), tumor necrosis factor-α(TNF-α) after spinal cord injury (SCI).

METHODSWild-type Nrf2(+/+) and Nrf2(-/-)-deficient mice were subjected to a murine SCI model induced by the application of vascular clips (force of 10 g) to the dura after a three-level T8-T10 laminectomy. The wet/dry weight ratio was used to reflect the percentage of water content of impaired spinal cord tissue at 48 h after SCI. The mRNA levels of MMP-9 were determined using reverse-transcriptase polymerase chain reaction (RT-PCR), and the protein levels of TNF-α and MMP-9 were detected by enzyme-linked immunosorbent assay at 24 h after SCI. Furthermore, gelatin zymography analysis was used to show MMP-9 activity of spinal cord tissue at 24 h after SCI. Software SPSS 16.0 was used for the statistical analysis.

RESULTSAfter SCI, spinal cord water content, the expression of TNF-α and MMP-9 all increased in both injured Nrf2(+/+) and Nrf2(-/-) mice compared with their respective sham-operated mice. However, Nrf2(-/-) mice were shown to have more severe spinal cord edema, more TNF-α expression, more production and activity of MMP-9 compared with their wild-type Nrf2(+/+) counterparts after SCI (P < 0.05).

CONCLUSIONSThe results suggest that Nrf2 plays an important protective role in limiting the spinal cord upregulation of TNF-α and MMP-9 after SCI. It may be a new therapeutic target of SCI.

Animals ; Disease Models, Animal ; Female ; Genotype ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Mice ; Mice, Inbred ICR ; Mice, Knockout ; NF-E2-Related Factor 2 ; genetics ; Spinal Cord ; metabolism ; Spinal Cord Injuries ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To investigate the geographic distribution panem of patients with anorectal atresia/stenosis in China.in order to provide clue for research on its etiology.Methods Data were collected from Chinese Birth Defects Monitoring Network(CBDMN),which was a hospital-based congenital malformations registry system.From 2001 to 2005,all fetuses with more than 28 weeks of gestation and neonates up to 7 days of age,were monitored.Two-dimensional graphic cluster method was used to divide monitoring stations into difierent classes with the incidence rates of anorectal atresia/stenosis.Results The overall incidence of anorectal atresia/stenosis was 3.17 per 10000 during 2001 to 2005.The incidence was higher in Eastern than that in Mid or Western paas of China and tbe difierence was statistically significant(z=2.50,3.69;P=0.012,＜0.001).The monitoring stations were grouped into 6 classes.Class I was with Helongjiang,Jilin and Liaoling;Class Ⅱ was with Fujian,Guangdong,Hainan,Guangxi,and South Hunan and Jiangxi;ClassⅢwas with Beijing,Tianjin,Hebei,Shandong,and Noah Jiangsu and Anhui;Class Ⅳ was with Zhejiang,Shanghai,South Anhui and Jiangsu,Noah Hunan and Jiangxi,Hubei,Henan,Shanxi and Inner Mongolia,Class V was with Ningxia,Gansu and Qinghai;and Class Ⅳ was with Shaanxi,Sichuan,Chongqing,Yunnan,Guizhou.Xinjiang and Tibet.Conclusion Our findings discovered the geographic distribution patterns of patients with anorectal atresia/stenosis in China.It is important to further analyze the relevant environmental factors attached to it so a beRer regional monitoring system for anorectal atresia/stenosis can be operated.

OBJECTIVE: To assess the association of CYP2C19 and CYP3A5 gene polymorphisms with the risk of myocardial infarction. METHODS: Five hundred patients with myocardial infarction and 500 healthy controls were randomly selected. Fluorescent PCR and Sanger sequencing were used to detect the CYP2C19 and CYP3A5 gene polymorphisms. Logistic regression was used to analyze the correlation between the polymorphisms and myocardial infarction. Quanto software was used to evaluate the statistical power. RESULTS: The two groups had significant difference in the frequency of AG, GG genotypes and A allele of the CYP2C19 gene rs4986893 locus and the AA, AG, GG genotypes and G allele of the CYP3A5 gene rs776746 locus ( P<0.05), but not in the frequency of genotypes and alleles of CYP2C19 gene rs4244285 and rs12248560 loci, and the AA genotype of the rs4986893 locus. After correction for age, gender, and body mass index, Logistic regression indicated that the AG genotype and A allele of the CYP2C19 gene rs4986893 locus, and the GG genotype and G allele of CYP3A5 gene rs776746 locus are associated with susceptibility of myocardial infarction, while rs4986893 GG genotype and AA and AG genotypes of rs776746 may confer a protective effect. Based on the sample size and allele frequency, analysis with Quanto software suggested that the result of this study has a statistical power of 99%. CONCLUSION CYP2C19 and CYP3A5 gene polymorphisms may increase the risk for myocardial infarction.
Cytochrome P-450 CYP2C19/genetics* ; Cytochrome P-450 CYP3A/genetics* ; Gene Frequency ; Genotype ; Humans ; Myocardial Infarction/genetics* ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide