Objective:To investigate the negative effect of the IL-10 on monocyte-derived DC maturation and differation iv vitro,and the potentiation of the TNF-? or sCD40L to inhibit or reverse the IL-10′s inhibitory effect on monocyte-derived DC.Methods:The expression of the surface molecules on DC was detected by FACS analysis.The potentiation to stimulate T cell proliferation was assayed by 3H-TdR incorporation,and IL-12 secretion in the DC supernatant measured by ELISA.Results:In vitro DC-inducing system IL-10 had an obviously negative effect on the maturation as well as the potentiation to stimulate the T cell proliferation and IL-12 secretion of the immature monocyte-derived DC,and IL-10 could drive monocyte-derived DC differentiate into the macrophages.The negative effect was also correlative to the concentration of the added IL-10;The results also showed that IL-10 hadn′t any negative effect on mature DC induced by sCD40L,but to some extent could reduce the mature DC induced by TNF-? to produce IL-12;Furthermore the inhibitory effect of IL-10 can′t be reversed by adding TNF-? or sCD40L after IL-10 was added to the DC-inducing culture system for three days.Interesting by adding sCD40L not TNF-? to the DC-inducing culture system with IL-10 at the same time can inhibit the negative effect of IL-10 completely.Conclusion:IL-10 is an important biological factor produced in tumor microenvironment for escaping the attack of the immune system by repressing maturation,potentiation to costimulate the T cells and IL-12 secretion of the immature monocyte-derived DC.The reverse effect of TNF-? and sCD40L on IL-10 negative effect on monocyte-derived was different.All together suggested that CD40 signal has important values to obtain the therapeutic DC for the tumor immune intervention.

Objective:To investigate the relationship among health cognition, dietary habits and health levels in population receiving health examinations.Methods:A cross-sectional survey was carried out in 55 339 subjects who underwent the health examinations at the Third Xiangya Hospital of Central South University in 2022. Exploratory factor analysis was used to classify dietary patterns, variance component analysis was employed to validate the questionnaire′s validity, and reliability analysis was conducted to test the questionnaire′s reliability. For continuous data, analysis of variance was used, while chi-square tests were applied for categorical data. Furthermore, a structural equation model for health cognition was constructed to analyze the interrelationships between health cognition, dietary patterns and health levels in the subjects.Results:The health cognition level of men was significantly higher than that of women (19.40±2.96 vs 19.26±2.96, F=34.11, P<0.001). The health cognition level of people aged≥50 years was 19.89±3.17, the highest among all age groups ( F=434.93, P<0.001). The health cognition level of overweight people was 19.53±2.95, higher than that of other weight groups ( F=84.09, P<0.001). The mental health assessment results in men were significantly better than that in women (11.98±3.79 vs 12.76±4.21, F=521.07, P<0.001), women generally had better health indicators than men. Participants aged 50 years and above had the best mental health indicator assessments, scored 11.13±3.26 ( F=1 053.30, P<0.001). And the mental health indicator assessments in overweight people was the best, while it was the worst in subjects with lower body mass index (12.04±3.84 vs 13.31±4.38, F=104.05, P<0.001). According to the structural equation model, the overall effect of health cognition on the health level of the population undergoing health examinations was 0.66. At the same time, there was a partial intermediary effect between health cognition and health level, the direct effect of health cognition on dietary patterns was 0.31, and the direct effect of dietary patterns on health level was 0.61. Conclusion:Health cognition has both direct and indirect effects on the health status in population receiving health examinations.

Objective:To investigate the effect of different primary sites of colorectal cancer on early recurrence after radical resection of metastatic tumor clinical risk score (CRS).Methods:The data of colorectal cancer liver metastasis (CRLM )surgically resected between Jan 2015 and Feb 2020 were retrospectively analyzed at Li Huili Hospital and Ningbo University People's Hospital. Risk factors leading to early recurrence after CRLM resection were analyzed by univariate analysis, and the significant results were then subjected to multifactorial analysis by COX regression model. Kaplan-Meire method was used to analyze the effect of primary site on disease-free survival at 1 year after CRLM resection in different CRS subgroups.Results:A total of 209 patients were included in the study, including 143 patients with primary tumors in the left colon and 66 in the right colon. One hundred and three (49.3%) patients with recurrence within 1 year.Univariate analysis showed that primary tumor site, neoadjuvant chemotherapy, and CRS were correlated with recurrence. Multivariate analysis showed that right colon cancer, poor efficacy of neoadjuvant therapy, and high risk of CRS were independent risk factors (all P<0.05). Patients with an overall low CRS risk group and low CRS after treatment, had a higher recurrence rate (all P<0.05) within 1 year when primary tumor located right colon. Conclusion:The location of the primary tumor in the right colon is an independent risk factor for recurrence within 1 year after radical surgery in patients with CRLM.

AIM:To explore the core target and mechanism of α-Linolenic acid(ALA)in improving neuroinflammation through network pharmacology combined with in vitro experiments.METHODS:Pharmacological studies have shown that ALA has anti-inflammatory,antioxidant,and neuroprotec-tive properties.The targets of α-Linolenic acid were obtained from PharmMapper and Swiss Tar-get Prediction databases,the targets of neuroin-flammation were searched from GeneCards,TTD and OMIM databases,and the potential targets of ALA and neuroinflammation were obtained from Wayne diagram.Protein interaction network(pro-tein-protein interaction,PPI)of potential targets was constructed by STRING website,and the core targets in PPI were screened by Cytoscape 3.8.0 software.At the same time,potential targets are imported into DAVID database,GO and KEGG data were obtained and the results were visualized.Autodock vina and Pymol software were used to dock the selected core targets with ALA and visual-ize the results.An in vitro model of neuroinflamma-tion was constructed,and cell growth status,oxida-tive stress,and migration or repairing capacity were determined by CCK-8 analysis,SOD,MDA and cell scratches,and the expression of IL-6,iba 1,COX-2(PTGS2),and iNOS proteins was determined by ELISA or Western blot experiments.RESULTS:Network pharmacology analysis revealed 46 poten-tial targets of ALA for neuroinflammation,and 10 core targets,including IL-6 and PTGS 2.With 232 entries enriched by GO enrichment analysis and 70 signaling pathways enriched by KEGG enrichment analysis,molecular docking showed that ALA can form hydrogen bonding with COX-2.Experiments showed that ALA could improve cell viability,allevi-ate cell oxidative stress levels,and promote cell mi-gration and motor repair in an in vitro model of neuroinflammation.CONCLUSIONS:ALA may im-prove neuroinflammation by alleviating oxidative stress and inhibiting IL-6 and COX-2 protein expres-sion.

Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.

ZHANG Zhongjing's Zhenwutang is a classic formula for warming Yang and excreting water. It is composed of Aconiti Lateralis Radix Praeparata， Poria， Atractylodis Macrocephalae Rhizoma， Paeoniae Radix Alba， and Zingiberis Rhizoma Recens. Physicians of later generations have inherited and developed this formula by detailed recording and application. This paper adopted bibliometrics method to analyze Zhenwutang in terms of history， indications， dosage， drug processing， usage， and modification. The results showed that Zhenwutang was most widely used in Ming and Qing dynasties. Many physicians have inherited ZHANG Zhongjing's theory regarding the application of Zhenwutang in disease treatment， and a few physicians have used it to treat diphtheria and water-related diseases. Some physicians modified this formula to treat maculae， intermittent dysentery， jaundice and so on. Zhenwutang was mainly used to treat diseases of the circulatory system， respiratory system and urinary system in modern clinical practice. The processing of herbal medicines in this formula was clear. Specifically， the raw material of Aconiti Lateralis Radix Praeparata needed to be processed and peeled， while those of Poria， Atractylodis Macrocephalae Rhizoma， Paeoniae Radix Alba， and Zingiberis Rhizoma Recens can be used directly. Although being different， most of the dosages were consistent with those in Treatise on Febrile Diseases. According to the textual research， it is suggested that the reference dosage of this prescription in clinical practice is 41.25 g for Poria， Paeoniae Radix Alba， and Zingiberis Rhizoma Recens， respectively， 27.5 g for Atractylodes macrocephala， and 15 g for Aconiti Lateralis Radix Praeparata. The medicinal materials should be decocted in 1 600 mL water to reach a volume of 600 mL. After removal of the residues， the decoction should be taken warm with 140 mL each time， three times a day. The textual research of Zhenwutang is expected to provide a theoretical reference for the clinical application and formulation of Zhenwutang.

Objective To investigate and evaluate the safety and efficacy of the aortic-mitral annular enlargement technique (double annular enlargement) in patients with small-size valve prostheses after prior valve surgery. Methods The clinical data of patients who underwent double valve annular enlargement in Wuhan Asia Heart Hospital from April 2020 to April 2022 were retrospectively analyzed. Results A total of 30 patients were collected, including 2 males and 28 females aged 9-78 (52.71±3.53) years. All patients had previous heart valve surgery, including 1 patient receiving the third heart surgery. All patients were operated on successfully and there were no postoperative in-hospital deaths. There was no postoperative bleeding which needed a secondary open-chest hemostasis, and one patient underwent permanent pacemaker implantation due to postoperative sick sinus syndrome. The mean diameter of the implanted prosthetic aortic valve was 24.23±1.60 mm, which was significantly larger than that of the preoperative aortic valve (21.03±1.90 mm, P＜0.001). The mean diameter of the implanted prosthetic mitral valve was 28.33±1.21 mm, which was significantly larger than that of the preoperative mitral valve (25.43±0.84 mm, P＜0.001). The mean peak gradient difference across the prosthetic aortic valve on postoperative echocardiography was 18.17±6.44 mm Hg, which was significantly lower than that of the preoperative aortic valve (82.57±24.48 mm Hg, P＜0.001). The mean peak gradient difference of the postoperative prosthetic mitral valve was 12.73±5.45 mm Hg, which was significantly lower than that of the preoperative mitral valve (19.43±8.97 mm Hg, P=0.003). Conclusion The double annular enlargement technique is safe and effective for reoperation in patients with a history of valve surgery with a small aortic root to obtain both a larger size prosthetic valve for a larger orifice area and stability of the mitral-aortic valve union, resulting in good postoperative hemodynamic characteristics and clinical outcomes.

Objective To investigate and evaluate the safety and effectiveness of the Chimney technique in mitral valve reoperation. Methods The clinical data of mitral valve reoperation patients who underwent Chimney surgery in Wuhan Asia Heart Hospital from 2019 to 2021 were retrospectively analyzed. Results A total of 26 patients were collected, including 7 males and 19 females, aged 27-67 (53.46±11.18) years. All patients had previous mitral valve surgery, including 23 mitral valve replacements and 3 mitral valve repairs. All patients received Chimney technique using the ideal artificial sized mitral valve, and 1 patient died of neurological complications in hospital. The cardiopulmonary bypass time and the aortic cross-clamping time were 231.11±77.05 min and 148.50±52.70 min, respectively. The mean diameter of the implanted mitral valve prosthesis was 29.08±0.68 mm, which was statistically different from pre-replacement valve prosthesis size of 26.69±0.77 mm (P＜0.001). The mean transvalvular pressure gradient of the prosthetic mitral valve measured on postoperative echocardiography was 14.77±5.34 mm Hg, which was statistically different from preoperative value of 20.92±9.83 mm Hg (P=0.005). Conclusion The Chimney technique is safe and effective for reoperation in patients with small mitral annuli, which can not only reduce the risk of reoperation, but also obtain larger prosthetic valve implants with good hemodynamic characteristics and clinical outcomes.