Objective:To analyze phylogenetic structure and molecular characteristics of H5N6 avian influenza virus (AIVs) isolated from live poultry market (LPM).Methods:Oropharyngeal and cloacal swabs from poultry, and environmental samples were collected from LPM in Urumqi in December 2018, AIVs were isolated and identified by inoculation of chicken embryo, hemagglutination test and RT-PCR, the viral whole genome was amplified with the universal primers of influenza A virus, and then sequenced, pairwise sequence alignments, phylogenetic and molecular characteristics analysis were performed by BLAST, Clustal W, MEGA-X and DNAStar software.Results:Six strains of H5N6 AIVs were isolated from poultry samples, the identity between the viral genes was high (99.4%-100.0%), so the isolates were the same source. BLAST analysis revealed that the viral NP sequence had the highest identity (99.7%) with H5N6 AIVs isolated from poultry in Suzhou, while the sequence of the remaining 7 viral genes had the highest identity (99.0%-100.0%) with H5N6 AIVs isolated from environment in Guangdong during 2017 to 2018. Phylogenetic analysis showed that the viral HA belonged to Clade 2.3.4.4C, and the viral HA, NA, PB1, PA, NP, and MP were all clustered together with H5N6 AIVs isolated from mink in Eastern China in 2018, while the PB2 and NS were clustered together with H5N6 AIVs isolated from environment in Guangdong from 2017 to 2018. The HA cleavage site contained multiple basic amino acid residues, which was highly pathogenic AIVs (HPAIVs). S137A and T160A mutations of HA could increase binding to human-type receptor SAα2, 6-Gal. Additionally, the viral multiple mutations, including 59-69 deletion in NA, the L89V, G309D, R477G, I495V, I504V, D391E, and A661E in PB2, as well as the P42S, D92E, and 80-84 deletion in NS1, could enhance the viral virulence and pathogenicity to mammals. Conclusions:The 6 strains of H5N6 HPAIVs isolated from LPM have relatively close genetic relationship with H5N6 AIVs isolated from mink in Eastern China and environment in Guangdong during 2017 to 2018, the viral multiple mutations could increase its pathogenicity to mammals, which could pose a potential risk to public health.

Objective:To explore the application effect of psychosomatic comfort based on double C theory in improving the psychological state, comfort level and sleep quality of patients after choledocholithiasis surgery.Methods:Using the convenient sampling method, a total of 120 patients with choledocholithiasis who underwent surgical treatment in Department of General Surgery in Fuyang People's Hospital of Anhui Province were selected as the research subjects from March 2020 to December 2021. The patients were divided into the observation group and the control group by odd-even grouping method, with 60 cases in each group. The control group was given routine nursing intervention mode, while the observation group was given the psychosomatic comfort model based on double C theory. The intervention effects of the two groups were compared by using Inpatient Psychological Scale (IPS) and the Chinese version of General Comfort Questionnaire (GCQ) .Results:Before intervention, there was no statistically significant difference in IPS and GCQ scores between the two groups ( P>0.05) . After the intervention, the IPS score of the observation group was lower than those of the control group, and the difference was statistically significant ( P<0.05) . The GCQ score of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The psychosomatic comfort based on double C theory is helpful to improve the postoperative psychological state of patients with choledocholithiasis and improve the comfort of them.

BACKGROUND: Heat shock proteins (HSP), especially the HSP 70 family, may play certain roles in the immunophysiology of some skin diseases such as psoriasis, pemphigus, and lichen planus. HSPs generally induce down-regulation of the process of apoptosis that is considered to be one of the acantholysis-producing pathways in pemphigus. OBJECTIVE: We planned to examine possible roles of HSPs 70/105 in the blistering process in pemphigus vulgaris (PV) and pemphigus foliaceus (PF), in connection with the detection results of apoptosis in local tissue specimens. METHODS: Immunohistochemical stainings and Western blot analysis were performed for the detection and semiquantitation of HSPs 70/105 in skin specimens from lesional, nonlesional, and normal control sites. Hoechst 33342 staining was simultaneously carried out to examine features of apoptosis in lesional skin specimens. RESULTS: The findings on expression of HSP were as follows. In PV, the expression of HSP 70 was minimum or negative; however, in PF, the expression was obvious and recognizable in lesional and perilesional normal skin. In contrast, HSP 105 was not detected in all cases of PV and PF. The features of apoptosis were evident at the lesional skin of all cases of pemphigus with acantholytic changes. CONCLUSION: PV and PF had different relative intensities of HSPs in lesional tissue stainings, especially in cases with HSP 70. This suggests that there may be subtle differences in the mechanisms causing acantholysis between PV and PF.
Acantholysis ; Apoptosis ; Benzimidazoles ; Blister ; Blotting, Western ; Down-Regulation ; Heat-Shock Proteins ; Hot Temperature ; HSP70 Heat-Shock Proteins ; Humans ; Lichen Planus ; Pemphigus ; Psoriasis ; Skin ; Skin Diseases

Exosomes are vesicles with a double globular membrane of lipids that can be secreted by a variety of cells, including stem cells. Exosomes have unique biological characteristics and irreplaceable powerful functions which play an important role in intercellular communication. The various cytokines, signal proteins, lipids and regulatory nucleic acids contained in stem cell exosomes can play a protective role against the injury of kidney, liver, heart, blood vessels and nerves. Stem cell exosomes delay the process of intervertebral disc degeneration by inhibiting the apoptosis of nucleus pulposus cells and increasing the synthesis of extracellular matrix, etc. The mechanism of its role is mainly through miRNA and related signaling pathways. Exosomes contain complex components. Although the mechanism of action of exosomes in intervertebral discs has been preliminarily explored, the components contained in exosomes are complex and the specific situation has not been fully understood, which still needs further study. In this review, the characteristics and functions of stem cell exosomes, extraction, identification and storage methods, the impacttovarious other tissues, as well as the effects on intervertebral discs and their mechanisms were elaborated in order to provide a basis for the study of intervertebral disc degenerative diseases.

Objective To compare the CT findings of poor-differentiated gastric neuroendocrine carcinomas (PD-NECs) and poordifferentiated gastric adenocarcinomas (PD-ADCs),and to increase the diagnostic accuracy rate.Methods In this retrospective study that enrolled 29 gastric PD-NECs and 29 gastric PD-ADCs,whose diagnoses were proven pathologically,we assessed their clinical characteristics and CT findings and then used univariate and multivariate analyses for statistical comparisons.Results The univariate analysis revealed that gastric PD-NECs were significantly smaller (P =0.002),more often showed well-defined margins (P＜0.001),and more frequently accompanied with intact overlying mucosa on CT when compared with gastric PD-ADCs (P ＜0.001).In the multivariate analysis,the presence of intact overlying mucosa (OR=0.028,95 ％ CI:0.001-0.863,P =0.041) and tumor-to-mucosa HU ratio on the arterial phase (OR=0.015,95 ％ CI:0.000-0.495,P =0.019) were two independent factors affecting the identification of gastric PD-NECs and gastric PD-ADCs.Receiver operating characteristic analysis (ROC) showed that the value of tumor-to-mucosa H U ratio on the arterial phase in differentiating them was moderate (AUC=0.72).Conclusion Gastric PD-NECs have better-defined margin,more intact overlying mucosa and higher tumor-to-mucosa HU ratio on the arterial phase than gastric PD-ADCs.

Objective To summarize the CT imaging features of peritoneal metastasis of gastric cancer (GC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 78 GC patients with peritoneal metastasis who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2013 to September 2016 were collected.All the patients underwent plain and enhanced scans of CT,and imaging data were converted to the multiplanar reformation (MPR) and maximum intensity projection (MIP).Observation indicators:(1) CT imaging features of primary lesion of GC;(2) CT diagnostic accurary and imaging features of GC with peritoneal metastasis;(3) CT imaging features of lymph nodes and other abdominal organ metastasis;(4) treatment and follow-up.Patients selected treatment plan according to results of laboratory and imaging examinations and patient's will.Follow-up using outpatient examination,telephone interview and correspondence was performed to detect the treatment method and patients' prognosis up to December 2016.The survival time was from post-treatment to death or end of follow-up.Measurement data with skewed distribution were described as M (range).Results (1) CT imaging features of primary lesion of GC:primary tumor location of 78 patients:tumor located in the antrum,leather bottle stomach,gastric cardia,lesser curvature,gastric antrum and body and greater curvature were detected in 40,11,9,9,5 and 4 patients,respectively.All the 78 patients were in T4 stage,including 43 with T4a stage and 35 with T4b stage.(2) CT diagnostic accurary and imaging features of GC with peritoneal metastasis:of 78 patients,57 were found with peritoneal metastasis by CT examinations before chemotherapy,15 with peritoneal metastasis by exploratory laparotomy or open surgery and 6 with peritoneal metastasis by follow-up CT re-examinations after gastrectomy.Seventy-two patients were diagnosed as GC with peritoneal metastasis by CT scans,and final diagnosis,missed diagnosis and overdiagnosis were detected in 78,9 and 3 patients,respectively.The precision,sensitivity,specificity,positive and negative predictive values of CT diagnosis were respectively 98.7％,88.5％,99.6％,95.8％ and 98.9％.Location and manifestation of 78 GC with peritoneal metastasis patients:① Peritoneal effusions:71 patients were accompanied with peritoneal effusions,including 21 with the slight peritoneal effusions and 50 with moderate and massive peritoneal effusions.② Greater omentum thickening:greater omnentum of 59 patients showed sheet,flocculent and nodular thickening,with a mass and cake-like change.③ Peritoneal thickening:54 patients had peritoneal thickening,with the main of nodulelike and thick lines-like thickening;thickening occurred mainly in around the liver,peritoneal cavity and pelvic floor;11 patients were found with obvious left anterior renal fascia thickening.④ Mesenteric thickening:46 patients were found with mesenteric thickening and edema,showing increased fat density with multi-node shadow.⑤ Lesser omentum and hepatogastric ligament:18 patients were found with increased fat density of lesser omental bursa,showing striped and nodular shadow.⑥ Transverse mesocolon:increased local fat density with striped-and nodular-like changes were seen in 15 patients after coronal and sagittal planes reconstruction,including 5 with local wall thickening of transverse colon.⑦ Ovary:8 patients had ovarian metastases,including 6 with bilateral metastases and 2 with unilateral metastasis;diameter of metastatic tumor was 3-12 cm.⑧ Intestinal canal:6 patients had local intestinal wall thickening,including 3 in small intestine and 3 in transverse colon,thickening tissues were mainly located in the mesentery,showing obvious intestinal wall enhancement.⑨ Liver capsule node:2 patients showed multi-node abnormal enhanced lesions under liver capsule.(3) CT imaging features of lymph nodes and other abdominal organ metastasis:78 patients were accompanied with lymph nodes enlargement,including 41 in N2 stage and 37 in N3 stage;liver metastases were detected in 13 patients;5 had adrenal metastases,including 3 with bilateral metastases and 2 with unilateral metastasis;4 had lower GC invading the pancreatic head and body;2 had upper GC invading the liver and spleen;1 had leather bottle stomach invading the pancreatic head and neck,and inducing to obstruction of biliary tract.(4) Treatment and follow-up:of 78 patients,62 underwent systemic chemotherapy,6 underwent systemic chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy,5 underwent systemic chemotherapy and local radiotherapy and 5 underwent palliative operations due to gastrointestinal tract obstruction or bleeding.Of 78 patients,69 were followed up for 15 months (range,3-21 months),and 9 lost to follow-up.The median survival time of 69 follow-up patients was 12 months (range,3-19 months).Conclusions CT imaging features of peritoneal metastasis of GC show specific sites of metastasis and performance.Combining with CT axial images and images of coronal and sagittal planes reconstruction,adjusting appropriate window width and level would be benefit to observe primary lesions of GC and peritoneal metastasis.

Purpose To detect the expression of PP1A and GSDME and the abundance of CD8+T lymphocytes in colorectal cancer,and to explore the correlation and clinical significance of PP1A and GSDME mediated pyroptosis.Methods GEPIA da-tabase was applied to analyze the mRNA expression of PP1A and GSDME in colorectal cancer and normal tissues.Western blot assay was used to detect the expression of PP1A in colorectal cancer and the corresponding normal mucosa.Immunohisto-chemistry was applied to detect the expression of PP1A and GS-DME and CD8+T lymphocytes abundance in 107 colorectal car-cinomas and normal mucosa adjacent to the carcinomas.Spearman rank correlation was used to analyze the correlation between PP1A,GSDME and CD8+T cells abundance.Results The GEPIA database search showed that mRNA expression of PP1A and GSDME in colorectal cancer differed compared to normal tissues(P＜0.05).Western blot analysis showed that the relative expression of PP1A in colorectal cancer tissue was significantly higher than that in para-cancerous tissues(0.937 vs 0.643,P＜0.001).Immunohistochemical results showed that the expression of PP1A in colorectal cancer tissues was signifi-cantly higher than that in normal mucosa(P＜0.05).The ex-pression of GSDME in cancer tissue was closely correlated with patients'age,clinical stage and mismatch repair proteins(P＜0.05),and the distribution of CD8+T cells in the cancer infil-tration front was significantly higher than that in the normal mu-cosa,and the distribution of CD8+T cells in the cancer was cor-related with pT stage,clinical stage and lymph node metastasis.Spearman correlation analysis showed that PP1A was negatively correlated with GSDME expression(r=-0.196,P＜0.05).The overall survival PP1A-positive colorectal cancer patients was worse than that of PP1A-negative patients(P＜0.05),and the prognosis of patients was correlated with the degree of differentia-tion,lymph node metastasis,pT stage and clinical stage.Posi-tive expression of PP1A,degree of differentiation,clinical stage,pT stage and lymph node metastasis are independent risk factors affecting the prognosis of colorectal cancer patients.Conclusion PP1A is highly expressed in colorectal cancer and negatively correlated with GSDME-mediated cell pyroptosis,and the differ-ential expression of both is closely related to the progression and prognosis of colorectal cancer,which can be used as a potential indicator for judgment of the prognosis of colorectal cancer pa-tients.The differential distribution of CD8+T cells may be asso-ciated with GSDME-mediated cell pyroptosis and tumor develop-ment.

Objective To investigate the effects of sulforaphane(SFN)in regulating the macrophage glycolysis via the arachidonate 5-lipoxygenase(ALOX5)/nuclear factor kappa B(NF-κB)signaling pathway on the progression of diabetic nephropathy(DN).Methods Bioinformatics analysis was used to identify the target genes of SFN in the treatment of DN.Human proximal tubular epithelial cell line(HK-2 cells)was induced with 30 mmol/L high glucose(HG)to create an in vitro model of DN.HK-2 cells were divided into the following groups:normal glucose(NG)group,HG group,HG+SFN(3 mmol/L)group,HG+ALOX5 group,HG+SFN(3 mmol/L)+ALOX5 group,HG-treated macrophages+HK-2 group,HG+SFN(3 mmol/L)treated macrophages s+HK-2 group,HG+ALOX5 transfection treated macrophages+HK-2 group,HG+SFN(3 mmol/L)+ALOX5 transfection treated macrophages+HK-2 group.CCK-8 assay was used to detect cell viability,Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL)method was used to detect cell apoptosis;glucose and lactate levels in the cells were measured using assay kits;Western blot was performed to detect the expression of ALOX5,NF-κB,and glycolysis-related proteins hexokinase-2(HK2),pyruvate kinase M2(PKM2),glucose transporter 1(GLUT1)in each group.Diabetic nephropathy(DN)mouse models were established using streptozotocin(STZ)and treated with SFN(0.5 mg/kg).Various biochemical parameters were measured in the mice,and kidney tissue pathology was examined using H&E staining.Western blot was used to detect the expression of glycolysis-related proteins(HK2,PKM2,GLUT1)in kidney macrophages.Results Bioinformatics analysis revealed ALOX5 as the target gene of SFN in treating DN.Compared to the HG group,SFN treatment enhanced HK-2 cell viability and in-hibited apoptosis(P<0.05);concurrently,SFN treatment suppressed HG-induced macrophage glycolysis-related protein and attenuated macrophage-mediated HK-2 cellular injury(P<0.05).Western blot results showed that SFN inhibited the expression of ALOX5 and NF-κB(P<0.05).The mouse experiment results showed that SFN treatment improved kidney function and pathological changes in the kidney of DN mice,and inhibited the related protein expression of acrophage glycolysis in kidney tissue(P<0.05).Conclusion SFN improves the progression of DN by inhibiting the expression of macrophage glycolysis-related protein through the ALOX5/NF-κB signaling pathway.

Objective To explore the relationship between serum thrombospondin-1(TSP-1),cathepsin S(Cat S),and Visfatin in patients with acute myocardial infarction(AMI)and myocardial microcirculation dis-orders after PCI and their clinical prognostic value.Methods A total of 90 AMI patients who underwent PCI treatment in the hospital from June 2021 to June 2023 were enrolled in the study.They were grouped into a microcirculation disorder group(62 cases)and a normal group(28 cases)based on their myocardial microcir-culation status.According to their postoperative prognosis,they were grouped into a good prognosis group(50 cases)and a poor prognosis group(40 cases).The risk factors of poor prognosis were analyzed by Logistic re-gression,and the predictive value of serum TSP-1,Cat S and Visfatin was analyzed by receiver operating char-acteristic(ROC)curve.Results The serum levels of TSP-1,Cat S,and Visfatin in the microcirculation disor-ders group were higher than those in the normal group,and those in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P＜0.05).Elevated levels of serum TSP-1,Cat S,and Visfatin were risk factors for poor prognosis in AMI patients after PCI(P＜0.05).The efficacy of combined detection of serum TSP-1,Cat S,and Visfatin levels for predicting the prog-nosis of AMI patients after PCI was higher than that of single detection(Zcombinedprediction-TSP-1=2.245,P=0.025,Z combined prediction-Cat S=2.101,P=0.036,Z combined prediction-Visfatin=2.252,P=0.024).Conclusion The serum levels of TSP-1,Cat S and Visfatin are obviously increased in AMI patients with myocardial microcirculation disorders after PCI,and the combination of the three has relatively high efficacy in predicting the prognosis of AMI pa-tients after PCI.