Objective:To explore CT and MRI features of the endolymphatic sac tumor (ELST).Methods:The CT and MRI morphology confirmed by surgical pathology for 19 patients with ELST were retrospectively analyzed from June 2011 to May 2019 in Eye & ENT Hospital of Fudan University. The features of CT and MRI included location, size, adjacent structures invasion, CT values, bone destruction, features of T 1WI and T 2WI, enhancement distribution characteristics, dynamic enhancement curve morphology, DWI signal characteristics. The ADC values of the lesions and ipsilateral medial pterygoid muscles were compared using a paired t test. Results:Nineteen ELST patients (one with bilateral diseases) were included. Totally 20 ears (right 9 and left 11) of 13 females and 6 males were studied. The masses with slightly high-density and obscure boundary were located around the vestibular aqueduct at the posterior edge of the petrosal bone. Bone destruction involved mastoid process of the middle ear (16 ears), jugular foramen (11 ears), semicircular canal (10 ears), facial nerve canal (7 ears) and internal auditory canal (9 ears). A large amount of residual bone could be found in the interior of nineteen masses. The CT value was (78.6±21.9) HU. The lesion showed central iso-intensity and peripheral hyperintensity on T 1WI and T 2WI in 16 ears, while no obvious hyperintensity on T 1WI in the other 4 ears. The hyperintensity on T 1WI was around the margin of the lesion in 10 ears, situated at lateral side in 5 ears and all over the lesion in 1 ear. Flow voids signals could be seen in 9 ears as well. Liquid-liquid plane was seen on T 2WI in 2 ears. The solid mass portion which showed iso-intensity on both T 1WI and T 2WI presented marked enhancement on contrast-enhanced T 1WI, while other part of the mass no enhancement. DWI of 14 ears illustrates no evidence of restricted diffusion, and the ADC value [(1.25±0.08)×10 -3 mm 2/s] was slightly higher than that of the medial pterygoid muscles ( t=4.437, P=0.001). The style of time-signal intensity curves of the dynamic contrast-enhanced MRI was rapidly ascending followed by descending curves in 2 ears. Conclusion:Imaging findings of ELST have some characteristics, including located around the vestibular aqueduct at the posterior edge of the petrosal bone, bone destruction, peripheral hyperintensity on T 1WI and no restricted diffusion, which is helpful for its diagnosis.

Objective To investigate the effects of granulocyte macrophage colony-stimulating factor (GM-CSF) combined with interleukin-12 (IL-12) genes on apoptosis of hepatoma cells.Methods The hepatoma cell lines were cultured in vitro and were divided into four groups: GM-CSF transfection group,IL-12 transfection group,GM-CSF and IL-12 co-transfection group,negative control group (empty load group),respectively.The PIB-CMV3-GM-CSF and PIB-CMV3-IL-12 eukayotic expression vector was built,and 36 h after transfection,fluorescence microscope was used to detect the transfection effect;the expression level of IL-12,GM-CSF,p53,p38 and C-JUN mRNA were detected by RT-PCR,and Western blot was used to examine the expression level of IL-12,GM-CSF,p53,p38 and C-JUN protein.In addition,the flow cytometry was applied to detect cell apoptosis.Results Through fluorescence microscope,green fluorescence was observed in cells of GM-CSF transfection group,IL-12 transfection group,GM-CSF and IL-12 co-transfection group,indicating that the plasmid has successfully transferred into cells.In addition,the expression of p53mRNA in empty load group,GM-CSF transfection group,IL-12 transfection group,GM-CSF and IL-12 co-transfection group were 1.2±0.10,4.3±0.98,4.2±0.34,9.2±0.87,and the protein expression were 1.0±0.10,3.6±0.34,3.8±0.30,5.0±0.60.Compared with the empty load group,the expression level of p53 mRNA and protein were significantly increased in the three plasmid transfection groups (P<0.01).The expression of p53 mRNA and protein were significantly increased in co-transfection group than GM-CSF group and IL-12 group (P<0.01),while in the comparison with GM-CSF transfection group and IL-12 transfection group,the expression level of p53mRNA and protein in the co-transfection group could be improved to a higher degree(P<0.01).Meanwhile,p38 C-JUN mRNA expression levels in empty load group,GM-CSF transfection group,IL-12 transfection group,GM-CSF and IL-12 co-transfection group were as follows: 7.5± 0.9,3.5±0.45,3.7±0.25,1.0±0.11,while p38protein expression levels were 10.1±1.03,6.1± 0.67,7.1 ± 0.61,1.0 ± 0.12,respectively,C-JUN mRNA expression levels were 11.2 ± 1.20,4.1 ± 0.19,3.3 ± 0.30,1.0 ± 0.01,separately,C-JUN protein expression levels were 2.25 ± 0.2,1.8 ± 0.13,1.4 ± 0.12,1.0 ± 0.09.P38, C-JUN mRNA and protein levels were significantly reduced in the three plasmid transfection groups compared with the empty load group (P<0.01).The expression of p38,C-JUN mRNA and protein were reduced to a lower degree in co-transfection group than in GM-CSF transfection group and IL-12 transfection group (P<0.01).Flow cytometer showed that the hepatoma cell apoptosis rate of the empty load group,GM-CSF transfection group,IL-12 transfection group,co-transfection group were (3.43±0.9)%,(5.87±1.02)%,(7.32±1.1)%,(17.47±2.11)%,the rates of the three plasmid transfection groups were significantly higher than that of the empty load group (P<0.01).And the apoptosis rate was significantly increased in the co-transfected group compared with other plasmid groups (P<0.01). Conclusion The combination of GM-CSF and IL-12 could significantly accelerate the apoptosis of hepatoma cells by up-regulating the expression of p53,and down-regulating the expression of p38 and C-JUN.

Bisecting N-acetylglucosamine(GlcNAc),a GlcNAc linked to the core β-mannose resi-due via a β1,4 linkage,is a special type of N-glycosylation that has been reported to be involved in various biological processes,such as cell adhesion and fetal development.This N-glycan structure is abundant in human trophoblasts,which is postulated to be resistant to natural killer cell-mediated cytotoxicity,enabling a mother to nourish a fetus without rejection.In this study,we hypothesized that the human amniotic membrane,which serves as the last barrier for the fetus,may also express bisected-type glycans.To test this hypothesis,glycomic analysis of the human amniotic membrane was performed,and bisected N-glycans were detected.Furthermore,our pro-teomic data,which have been previously employed to explore human missing proteins,were ana-lyzed and the presence of bisecting GlcNAc-modified peptides was confirmed.A total of 41 glycoproteins with 43 glycopeptides were found to possess a bisecting GlcNAc,and 25 of these gly-coproteins were reported to exhibit this type of modification for the first time.These results provide insights into the potential roles of bisecting GlcNAc modification in the human amniotic membrane,and can be beneficial to functional studies on glycoproteins with bisecting GlcNAc modifications and functional studies on immune suppression in human placenta.

Objective:To analyze the rule of acupoint selection for acupuncture in relieving postoperative pain based on data mining technology.Methods:Articles about acupuncture for postoperative pain were retrieved from CNKI, SinoMed, VIP, Wanfang, PubMed, Embase and Web of Science databases from establishment to June 6, 2022. Excel 2019 and SPSS Modeler 18.0 software were used to establish acupoints database and conduct the data analysis.Results:Totally 308 articles were obtained, involving 317 acupuncture prescriptions and 173 acupoints. Acupoints of bladder meridian, stomach meridian, large intestine meridian and spleen meridian were used frequently. Zusanli (ST 36), Hegu (LI 4) and Neiguan (PC 6) were high-frequency acupoints with a frequency of ≥50 times. Five-shu acupoint was often selected in specific acupoints. The common sites for acupuncture to relieve postoperative pain were abdomen, perianal, lumbar back and knee. Zusanli (ST 36), Neiguan (PC 6) and other acupoints were commonly used for abdominal postoperative pain, and the most commonly used combination was "Zusanli (ST 36)-Neiguan (PC 6)"; Chengshan (BL 57), Changqiang (GV 1) and other acupoints were often used for perianal postoperative pain, and "Chengshan (BL 57)-Changqiang (GV 1)" was highly correlated combination; Shenshu (BL 23) and Huantiao (GB 30) were commonly used for postoperative pain in the lumbar and back region, and acupoints with high correlation were "Ashi acupoint-Huantiao (GB 30)" and "Shenshu (BL 23)-Huantiao (GB 30)"; Xuehai (SP10) and Liangqiu (ST 34) were commonly used for postoperative pain of knee, and their compatibility had a high correlation.Conclusion:Acupuncture therapy for relieving postoperative pain often selects Yang meridians acupoints, and follows the principle of distal-proximal points combination and acupoint selection along meridians, and pays attention to the use of specific acupoints.

Objective:To construct the evaluation index system of "early clinical contact" education of undergraduate medical students, and to provide guidance for the evaluation of "early clinical contact" education in medical teaching.Methods:The evaluation index system of "early clinical contact" education of undergraduate medical students was constructed by literature research, Delphi expert consultation and analytic hierarchy process, and the weight of each index was determined. Excel 2010 and SPSS 25.0 were used to make data entry and statistical analysis.Results:The enthusiasm of experts in the two rounds of expert consultation were 100.00%(26/26) and 96.15%(25/26) respectively, the expert authority coefficients were 0.900 and 0.920, and the coordination coefficients were 0.255 and 0.175 respectively ( P < 0.05). The evaluation index system included 4 first-class indexes, 12 second-class indexes and 47 third-class indexes. Conclusion:The index system has high scientificity and reliability. After further verification, it can be used as an evaluation tool for the teaching quality of "early clinical contact" education of undergraduate medical students.

Objective To analyze the willingness and influencing factors for usage of pre-exposure prophylaxis(PrEP) among male students who have sex with men (MSM) in universities of Guangxi. Meth-ods 295 MSM students in universities were recruited by Snow-balling methods. Questionnaires were self-administered to collect social demographic information,AIDS related risky sexual behaviors and willingness for usage of PrEP. Logistic regression was employed for univariate and multivariate analysis. Results Of the 295 MSM,58(19.7%)had ever heard PrEP,265(89.8%) said that they would like to use PrEP. Multivari-ate logistic regression analysis showed that those who had found partners through friends ( OR=11.419,95%CI:1.363~95.641), those who would advise his friend to use PrEP ( OR=87.946,95%CI:13.660-566. 222),those who concerned the convenience to gain the medicine ( OR=119.652,95%CI:3.765-3802.184) and those who said that they could take medicine every day ( OR=88.245,95%CI:10.237-760.696) were more likely to accept PrEP. The subjects whose partners would be angry if they stick to use condoms( OR=0.106,95%CI:0.019-0.606),and those who suspected the effectiveness of drugs( OR=0.010,95%CI:0. 001-0.112) were less likely to accept PrEP. Conclusion The acceptability of PrEP is high in university students'MSM. The safety of drugs and the convenience to gain the medicine are the main influencing factors for usage of PrEP.Using of PrEP should be strengthened to the MSM.

Objective To discuss effect of ESWL with different shock wave frequency for kidney stone on success rate and renal injury. Methods Clinical data of 120 cases treated by ESWL were retrospectivly analyzed. Forty cases were treated by ESWL with 60 times/min. Forty cases were treated by ESWL with 90 times/min. Forty cases were treated by ESWL with 120 times/min. All cases were followed up for 1 months after treatment. Success rate and renal injury degree were analyzed. Results Success rates of 3 groups showed no significant difference (P>0.05). At 1 day after treatment, SCr, BUN of 3 groups increased apparently (P<0.01). And group 120 times/min increased most, next was group 90 times/min (P<0.01). At 14 days after treatment, index recovered as those of before treatment. Conclusion Success rates of ESWL with 60 times/min, 90 times/min and 120 times/min are similar, and renal injury degree in-creased with increasing of shock wave frequency.

Objective To discuss association factors of success rate of ESWL. Methods Clinical data of 340 cases treated by ESWL were retrospectivly analyzed. All cases were followed up for 3 months after treatment. Clinical data and follow-up data were analyzed. Association factors of success rate of ESWL were analyzed. Results Single factor analysis showed that course of disease, stone length, breadth, hematuresis were association factors of success rate of ESWL (P<0.05 or P<0.01). Multiple-factor analysis showed that stone length, hematuresis, breadth were association factors of success rate of ESWL (P<0.05 or P<0.01). Conclusion Association factors of success rate of ESWL are stone length,hematuresis and stone breadth.

Objective:To explore the clinical and chest CT features of anti-interferon(IFN)-γ autoantibodies-positive talaromycosis marneffei (TSM) infection in human immune deficiency virus (HIV)-negative patients.Methods:Clinical data and chest CT findings including pulmonary manifestations, bronchial changes, pleural changes, and extrapulmonary manifestations in 54 HIV-negative patients with Talaromyces marneffei (TM) infection and positive anti-interferon-γ(IFN-γ) autoantibody in the First Affiliated Hospital of Guangxi Medical University from December 2012 to September 2019 were retrospectively analyzed. CT score was rated for the degree of lung involvement, and the difference of involvement at different regions of the lung were compared. Results:Of 54 patients, 46 cases had fever, 43 cases had cough and expectoration, 28 cases had cutaneous or subcutaneous lesion, and 19 cases had arthritis or arthralgia. Laboratory tests showed that the value of CD4/CD8 decreased in 29 cases and platelet count increased in 32 cases. Only one of 54 patients had no abnormal findings on chest CT. In the remaining patients, chest CT manifestations were diverse, mainly presenting as fibrous cord-like lesions (87.0%, 47/54), lymph node enlargement (75.9%, 41/54), sporadic nodules (74.1%, 40/54), patchy consolidation (72.2%, 39/54), pleural effusion (59.2%, 32/54), and consolidation lesions associated with air bronchogram (63.0%, 34/54). Most of the lesions showed bilateral distribution (77.8%, 46/54), and involved both peripheral and central regions in 38 cases (70.4%, 38/54). CT score showed that there was no significant difference in the degree of involvement at different regions of the lung.Conclusions:The clinical and imaging manifestations of anti-IFN-γ antibody-positive patients with TM infection are characteristic. Most TSM patients with positive anti-IFN-γ antibody have fever, cough and expectoration. The main features of chest CT are cord focus, nodules, consolidation and pleural effusion. Lymph node enlargement often coexists with the above signs, and most of the lesions are distributed bilaterally.

Objective:To observe the anti-inflammatory and glycometabolic effects of glutathione(GSH)on macrophages in collagen induced arthritis(CIA)mice.Methods:①CIA model establishment and groups:A total of 14 female DBA/1J mice were ran-domly divided into:CIA+PBS group and CIA+GSH group.The mice were sacrificed on the 50th day,collecting serum and isolating bone marrow derived macrophages(BMDM),which were marked as BMDM1.②Trained immunity model establishment and groups:BMDM were isolated from normal DBA/1J mice,and were pretreated with histone H3K27 demethylases inhibitor(GSKJ1)or PBS for 2 h.Then,serum from CIA model mice in vivo was incubated for 24 h,and the samples were grouped as follows:(CIA+GSH)+PBS group,(CIA+GSH)+GSKJ1 group,(CIA+PBS)+PBS group,(CIA+PBS)+GSKJ1 group.Lipopolysaccharide(LPS)was adopted to stimulated cells on the 6th day,which were marked as BMDM2.③RNA sequencing was used to detect differentially expressed genes(DEGs)and their function in BMDM1 and BMDM2.q-PCR was adopted to estimate the mRNA levels of PFK and Idh3g.The culture supernatants were used to measure the protein levels of TNF-α and IL-6 by ELISA.Results:①Compared with CIA+PBS group,the mice in CIA+GSH group showed lighter of joint swelling(P<0.05),less arthritis index(P<0.05),HE staining suggested less inflam-matory cell infiltration,Safranin O-fast green staining showed more chondrocytes,TRAP staining indicated reduced osteoclasts.②In BMDM1,GO analysis showed that DEGs were mainly involved in glutathione derivative metabolic process,IL-6 production,inflammatory response,innate immune response,regulation of primary metabolic process and glycolipid binding,compared with CIA+GSH and CIA+PBS group.In CIA+GSH group,the mRNA level of PFK was significantly decreased(P<0.05),while Idh3g was also significantly up-regulated(P<0.05),and the expression of TNF-α,IL-6 were both reduced(P<0.05)compared with CIA+PBS group.③In BMDM2,GO analysis showed that DEGs were also involved in inflammatory response,activation of innate immune response,regulation of tumor necrosis factor production,positive regulation of IL-6 production,regulation of glycolytic process and 1,3-β-D-glucan binding between CIA+GSH and CIA+PBS group.Furthermore,in(CIA+GSH)+PBS group,PFK was decreased(P<0.05),Idh3g was up-regulated(P<0.05),and IL-6 was also significantly down-regulated(P<0.05)compared with(CIA+PBS)+PBS group.However,there was no significant difference in the expression of Idh3g and PFK,moreover,TNF-α and IL-6 were significantly up-regulated compared with(CIA+GSH)+GSKJ1 group and(CIA+GSH)+PBS group.Conclusion:GSH can regulate glycometabolism and inflammatory response of macrophages via demethylation of histone H3K27,and it can also alleviate CIA in mice.