Abstract: Inflammatory bowel disease (IBD), whose pathogenesis remains elusive, is a group of autoimmune diseases characterized by chronic, progressive, and lifelong inflammation of the digestive tract. The pathogenesis of IBD remains elusive. Although a number of drugs have been developed to treat IBD, their effects are merely anti-inflammatory. In addition, current treatments for IBD are easily susceptible to resistance in clinical practice. Mesenchymal stem cells (MSCs) have been reported to have the ability to migrate to the site of inflammation, with potent immunoregulatory effects, and to rebalance the immune microenvironment and restore the integrity of the epithelial barrier with significant value of application, particularly for patients who are refractory to classic medicines. In this paper, we reviewed the clinical applications, mechanisms and engineerable properties of MSC products and their exosomes to provide some reference for the use of MSCs and their exosomes in the treatment of IBD.

Objective To investigate the correlation between the characteristics of peritumoral edema and the aggressiveness of breast invasive ductal carcinoma in preoperative magnetic resonance imaging(MRI).Methods A total of 79 patients(79 lesions)who underwent radical mastectomy in the First Affiliated Hospital of Ningbo University from January 2020 to May 2021 and were pathologically diagnosed as invasive ductal carcinoma were included in invasive ductal carcinoma group,and 45 patients(49 lesions)with benign breast lesions were included in benign lesion group during the same period.The difference of peritumoral edema between two groups and the relationship between different pathological features of invasive ductal carcinoma and peritumoral edema were compared.Results The peritumoral edema in benign lesion group was significantly less severe than that in invasive ductal carcinoma group(χ2=25.330,P<0.05).The tumor size of invasive ductal carcinoma group was positively correlated with the degree of peritumoral edema(r=0.381,P<0.05).There were significant differences in molecular type,histological grade,T stage,lymph node metastasis and Ki-67 expression level among patients with different peritumoral edema grades(P<0.05).Ki-67 expression level and the number of lymph node metastasis were positively correlated with the degree of peritumoral edema(r=0.348,0.273,P<0.05).Conclusion The degree of peritumoral edema in MRI correlates with the aggressiveness of breast invasive ductal carcinoma and can be used as one of the tools to evaluate breast carcinoma.

【Objective】 To perform pre-transfusion examination and major crossmatch test using CD47 anti-idiotypic antibody (CD47 AID) (method 1) and reagent lack of anti-IgG4 anti-human globulin(method 2) in patients treated with CD47 monoclonal antibodies, and evaluate the feasibility of method 1 by comparing the transfusion efficacy of patients after cross matching with two methods. 【Methods】 Post-drug samples were collected from 18 clinical subjects treated with CD47 monoclonal antibody in our hospital. Antibody screening and major crossmatch test were performed using method 1 and method 2, and the difference of ΔHb (post-transfusion Hb minus pre-transfusion Hb) was compared after transfusion. The differences in ΔHb after transfusion were analyzed between the test group using method 1 and the control group without CD47 monoclonal antibody using ordinary microcolumn gel method. 【Results】 There was no significant difference in ΔHb between the test group using method 1 and test group using method 2 (8.40±0.71 vs 7.36±0.94, P>0.05). No significant difference was noticed in ΔHb between the test group using method 1 and the control group without CD47 monoclonal antibody (8.40±0.71 vs 6.59±0.77, P>0.05). 【Conclusion】 In the test group, major crossmatch test with method 1 has the same transfusion efficacy as the test with method 2. Method 1 is simple and easy to operate, and the results are objective and accurate. It is recommended to use method 1 for pre-transfusion antibody screening and major crossmatch tests for patients using CD47 monoclonal antibody.

ObjectiveTo explore the cumulative incidence of diabetes mellitus and its influencing factors among the diabetes mellitus high-risk groups in Minhang District of Shanghai, and to provide a basis for the development of community-based diabetes mellitus early prevention and treatment strategies in Shanghai. MethodsThe data of this study were collected from the screening project of diabetes mellitus high-risk groups in Minhang District of Shanghai, which was carried out from 2016‒2017. A total of 12 278 people were screened, of which 10 442 were at high risk based on the results of blood glucose diagnosis except those with diabetes. People diagnosed with abnormal fasting blood glucose, impaired fasting blood glucose and abnormal glucose tolerance were classified into the abnormal blood glucose group, and those with normal fasting blood glucose were classified into the normal blood glucose group. In 2023, the cumulative incidence of diabetes mellitus in the 2 groups was followed up, furthermore, the influencing factors of diabetes mellitus were analyzed. ResultsA total of 8 774 cases within the high-risk groups were followed up in 2023, of which 808 cases progressed to diabetes. Of the 8 774 cases, the cumulative incidence of diabetes mellitus in the abnormal blood glucose group (n=2 163) was 16.37% (354/2 163), and that in the normal blood glucose group (n=6 611) was 6.87% (454/6 611), and the difference in cumulative incidence of diabetes mellitus between the 2 groups was statistically significant (χ²=175.88, P<0.001). A history of impaired glucose regulation (OR=2.828, 95%CI: 2.177‒3.675), family history of type 2 diabetes (OR=1.294, 95%CI: 1.047‒1.600), hypertension (OR=1.268, 95%CI: 1.083‒1.485), dyslipidemia (OR=1.205, 95%CI: 1.003‒1.448), overweight/obesity (OR=1.526, 95%CI: 1.300‒1.792) were positively correlated with the cumulative incidence of type 2 diabetes, while female gender (OR=0.785, 95%CI: 0.675‒0.914) and sedentary lifestyle (OR=0.506, 95%CI: 0.374‒0.685) were negatively correlated with the cumulative incidence of type 2 diabetes. ConclusionBlood glucose monitoring should be strengthened in diabetes mellitus high-risk groups with an impaired glucose regulation history, a family history of type 2 diabetes, hypertension, and dyslipidemia, so as to achieve early detection of diabetes. Timely intervention measures should be taken for high-risk population with unhealthy lifestyle or overweight/obesity.

Objective:To explore the antiviral activity of the small-molecule compound AM679 in hepatitis B virus (HBV) replication and infection cell models.Methods:The positive regulatory effect of AM679 on EFTUD2 expression was validated by qPCR and Western blotting. HepAD38 and HepG2-NTCP cells were treated with AM679 (0.5, 1, and 2 nmol/L). Negative control, positive control, and AM679 combined with the entecavir group were set up. HBV DNA intra-and extracellularly, as well as the expression levels of intracellular HBV total RNAs and 3.5kb-RNA changes, were detected with qPCR. Hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) levels were measured in the cell supernatant by an enzyme-linked immunosorbent assay (ELISA). The t-test method was used for the statistical analysis of the mean difference between groups.Results:EFTUD2 mRNA and protein expression levels were significantly increased in HepAD38 and HepG2-NTCP cells following AM679 treatment, with a statistically significant difference ( P ?

In the backdrop of the new era,enhancing Party building in public hospitals,particularly the united front work,holds great significance for elevating medical service standards,fostering harmonious doctor-patient relationships,consoli-dating mechanisms of unity,and promoting the high-quality development of hospitals.In this case study with the First Affiliated Hospital of Soochow University,the authors explored how public hospitals can effectively conduct united front work in the context of strengthening Party construction and leveraging this work to promote comprehensive development in all aspects of the hospital.

Objective:To systematically evaluate the effect of cognitive behavioral therapy (CBT) in elderly patients with depression.Methods:The randomized controlled trials on the effect of CBT in elderly patients with depression, published until December 15, 2022, were searched in PubMed, CINHAL, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, WanFang Data, and VIP. Two researchers independently screened the literature, extracted data, and used the revised Cochrane risk of bias tool for randomized trials (ROB 2.0) to evaluate the quality of the included studies. Statistical analysis was conducted using Stata 16.0, and the quality of evidence was rated using Appraisal of Guidelines for Research and Evaluation (GRADE) predictor software.Results:A total of 11 randomized controlled trials were included, with a total of 833 elderly patients with depression. Randomized effect models were used to analyze outcome indicators such as depression, anxiety, and quality of life by combining effect quantities. Meta-analysis and GRADE evidence quality showed that compared to the control group, medium quality evidence showed that CBT could relieve depression in elderly depression patients with a statistical difference [ SMD=-1.58, 95% CI (-2.16, -0.99), P<0.05]. Low quality evidence suggested that CBT could alleviate anxiety in elderly depression patients also with a statistical difference [ SMD=-2.25, 95% CI (-4.04, -0.47), P<0.05]. Very low quality evidence indicated that CBT did not significantly improve the quality of life in elderly depression patients compared to conventional or pharmacological treatment [ SMD=-0.09, 95% CI (-2.07, 1.88), P>0.05] . Conclusions:Existing evidence suggests that CBT can alleviate depression and anxiety in elderly depression patients, but its improvement in quality of life is not yet significant. Treatment feedback and forms of CBT may become a research focus in recent years on intervention for elderly depression patients.

Objective:To explore whether disrupted colonization of the gut microbiota in early life accelerates the development of obesity later in life through programming adipose thermogenesis.Methods:Neonatal mice were treated with a mixture of antibiotics (ABX), and 16S rRNA sequencing confirmed that ABX treatment disrupted the establishment of gut microbiota. The mice were monitored for changes in body weight and fat content at weaning, adulthood, and under a high-fat diet (HFD) to assess obesity phenotypes. Additionally, glucose tolerance and insulin tolerance tests were conducted, along with measurements of blood glucose and lipid levels, to evaluate changes in glucose and lipid metabolism. The expression of uncoupling protein 1 (UCP1) in adipose tissue was assessed through immunohistochemistry and Western blotting to evaluate alterations in adipocyte thermogenic capacity.Results:The analysis of 16S rRNA sequencing technology revealed that ABX treatment significantly reduced both α- and β-diversity of the gut microbiota. Compared to untreated mice, the microbial composition in ABX treated mice showed significant differences, with a notable reduction in the abundance of beneficial bacteria, including Lachnospiraceae_NK4A136_group and Akkermansia muciniphila ( A. muciniphia). Subsequent monitoring indicated that ABX treatment did not affect body weight or fat content during the lactation period. However, a significant decrease in surface temperature was observed in the ABX group, specifically in the interscapular region. Immunohistochemistry and Western blot of UCP1 demonstrated impaired thermogenic capacity in adipose tissue. Interestingly, the impaired thermogenesis persisted in adult mice, leading to a decreased cold tolerance, although no changes of metabolic dysfunction, including body weight, body fat percentage, serum insulin and triglyceride levels, glucose tolerance, and insulin sensitivity. Upon switching to HFD, ABX-exposed mice exhibited significant increases in body weight, fat mass, and serum glucose, indicating a greater susceptibility to obesity. Further thermographic analysis and UCP1 detection suggested that this susceptibility to obesity was also linked to impaired thermogenic capacity in adipose tissue. Conclusion:Early-life gut microbiota is a critical determinant of long-term adipose thermogenesis. Disruption of the microbiota enhances the effect of diet-induced obesity.

Objective:To summarize the single-center experience of serial transverse enteroplasty (STEP) in children with intestinal failure.Methods:The clinical data of 13 children who underwent STEP surgery at our department from Jan 2016 to Dec 2022 was retrospectively analyzed.Results:Eight children were females ,5 were males. There were 10 premature infants and 3 full-term infants. The gestational age was 26 +3-39 +5 weeks, and the birth weight was 860 -3 700 g. The median age of surgery was 12 months, the median length of small intestine was 70 (50-130) cm, the diameter of preoperative intestinal dilation was about 4.5 to 7.5 cm, and the operation interval was 2.5 to 3.0 cm. Continuous transverse enteroenteroplasty resulted in an average increase of 75% (66% to 100%) in the length of the dilated intestinal segment. The total length of the small intestine increases by 16.0% (12.5%-30.0%). After the operation, 12 of the 13 children (92.3%) were removed from parenteral nutrition to achieve intestinal adaptation of the remaining bowel, and the mean time of withdrawal from parenteral nutrition was 138(20-1 011) days after the operation. Intestinal dilatation occurred in 2 patients, and gastrointestinal bleeding occurred in 4 patients, which healed after conservative treatment. Conclusions:STEP operation is suitable for children with short intestinal length and obvious expansion of intestinal tube. STEP can not only reduce the diameter of the enlarged intestine, but also extend the length of the intestine, increase the feeding tolerance, improve the clinical effect of enteral nutrition, and shorten the time for children to achieve intestinal adaptation.

One case of COVID-19 infection secondary to pulmonary mucormycosis in a recipient of simultaneous pancreas-kidney transplantation was described. Early identification of the pathogen was achieved by metagenomic next-generation sequencing. On the basis of disease status and liver function changes, targeted treatments included intravenous amphotericin B liposome, amphotericin B nebulization& gargling and subsequently a maintenance therapy of oral posaconazole. This regimen resulted in the absorption of lung infection, stabilization of transplanted pancreas function and reduced levels of creatinine and urea as compared to pre-infection period. The therapeutic efficacy was decent.