Objective: To examine the mediating effect of nighttime sleep duration on pain and frailty among elderly patients with comorbidity of chronic diseases, so as to provide insights into frailty control among the elderly. Methods: Demographic information, pain and nighttime sleep duration of the elderly at ages of 60 years and older were collected from the China Health and Retirement Longitudinal Study 2020. Frailty were evaluated using frailty index. The mediating effect of sleep duration for pain and frailty was analyzed using the Process program compiled by HAYSS and colleagues, and the significance of the mediating role was tested using the Bootstrap test. Results: A total of 2 246 elderly patients with comorbidity of chronic diseases were enrolled, including 1 195 males (53.21%) and 1 051 females (46.79%), with a median age of 65.00 (interquartile range, 8.00) years. There were 504 cases with frailty (22.44%), with a median pain score of 0 (interquartile range, 1.00) points, and a mean nighttime sleep duration of (6.44±1.55) hours. Mediating analysis showed that pain affected frailty directly and positively with the effect value of 0.089 (95%CI: 0.066-0.112), and also affected frailty by nighttime sleep duration directly and positively with the effect value of 0.047 (95%CI: 0.036-0.058), with the mediating effect contributed 34.56% of the total effect. Conclusion Pain can directly or indirectly affect frailty among elderly patients with comorbidity of chronic diseases through nighttime sleep duration.

Objective To study the expression and significance of Th17 and Tc17 cells in the peripheral blood,skin and lung in a murine model of bleomycin (BLM)-induced systemic sclerosis (SSc).Methods Thirty female BALB/c mouse were randomly divided into 3 groups,including a control group ( A group),a injected with BLM 4 week without pulmonary fibrosis(PF) group( B group) and with obviously PF group(C group).Pathological changes of skin and lung were detected.The proportion of CD4+,CD8+,CD4+IL-17+(Th17),CD8+IL-17+(Tc17) cells in the peripheral blood,skin and lung of mouse was determined by flow cytometry.The mRNA expressions of RORγt,IL-17A in skin and lung of mouse were evaluated by real-time PCR.Enzyme linked immunosorbent assay(ELISA) was used to measure the levels of IL-17 in serum.Results Dermal hydroxyproline(HYP) contents and the score of PF were significantly increased in C group [ (3.07±1.26) μg/mg,4.0±1.41 ]and B group [ (2.43±0.61) μμg/mg,1.50±0.76]as compared with A group [ (1.45±0.40) μg/mg,0.60±0.70 ],and pulmonary HYP contents was obviously increased in C group than in A and B groups,all P＜0.05.Compared with the A group,the percentage of CD4+ and Th17 cells in the peripheral blood,skin and lung of B and C groups,Tc17 cells of C group was significantly increased,and CD8+ cells was significantly decreased(all P＜0.05).The ratio of Th17/CD4+CD8+ in the peripheral blood,skin and lung of B and C groups [ ( 1.41 ±0.36)％,( 1.79±0.77)％ ],[ (2.58±1.07)％,(5.23±2.34)％ ]and [ (3.50±1.20)％,(4.02±1.32) ％ ]was significantly increased compared with A group (0.71±0.25)％,(1.15±0.59)％,(0.99±0.46)％.The ratio of Tc17/CD4+CD8+ in the lung of C groups( 1.62±0.53) ％ and in the skin of B and C groups [ (1.70±0.70) ％,( 1.63±0.63 ) ％ ]was significantly increased compared with A group [ ( 1.00±0.47 ) ％,( 1.1 1 ±0.34 ) ％ ],all P＜0.05.Compared with the A group,the mRNA levels of IL-17A,RORγt in skin of B and C groups,and in lung of C group were higher and the levels of IL-17 in serum was significantly increased,all P＜0.05.Th17 cells and the levels of IL-17 in blood were positive correlation with dermal and pulmonary inflammation,fibrosis and H YP contents,all P＜0.01.The frequency of Th17 and Tc17 cells in skin and lung respectively had a positive correlation with dermal and pulmonary inflammation,the score of fibrosis,and HYP contents of skin and lung,all P＜0.01.Conclusion Th17 and Tc17 cells were significantly increased in the peripheral blood,skin and lung of a murine model of SSc,and Th17 cells is dominated.They correlated with the inflammation and fibrosis of skin and lung,and may participate in the pathogenesis of SSc through secrete IL-17.

Objective To investigate the relationship between the severity of insomnia and the curative effect in acute stage in patients with major depressive disorder (MDD). Methods The Insomnia Severity Index (ISI) was used to evaluate and group the severity of insomnia in the 57 patients with MDD. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The 24－item Hamilton Depression Scale (HAMD24) was used to evaluate depressive symptoms, and the effect of acute stage (4～6 weeks) was evaluated with its reduction rate. The difference of curative effect was compared among patients with different insomnia levels. Results There was a significantly different recovery rate in acute stage in 3 groups of patients with mild, moderate and severe insomnia ( X2=22.34,P＜0.01). The severity of insomnia in patients with MDD (PSQI) was negatively correlated with the curative effect of acute stage (r=－0.44,P＜0.01). The total score, anxiety/somatization factor score, retardant factor score and despair factor score were significantly higher in severe insomnia group than in the moderate and mild insomnia groups after acute treatment (P＜0.01). Conclusion The severity of insomnia in patients with MDD can predict the curative effect in acute stage. The depressive patients with severe insomnia have residual anxiety/somatization, retardant, feelings of despair and other symptoms more obvious than mild and moderate insomnia patients after acute treatment.

In order to explore tick proteins as potential targets for further developing vaccine against ticks, the total proteins of unfed female Dermacentor silvarum were screened with anti-D. silvarum serum produced from rabbits. The results of western blot showed that 3 antigenic proteins of about 100, 68, and 52 kDa were detected by polyclonal antibodies, which means that they probably have immunogenicity. Then, unfed female tick proteins were separated by 12% SDS-PAGE, and target proteins (100, 68, and 52 kDa) were cut and analyzed by LC-MS/MS, respectively. The comparative results of peptide sequences showed that they might be vitellogenin (Vg), heat shock protein 60 (Hsp60), and fructose-1, 6-bisphosphate aldolase (FBA), respectively. These data will lay the foundation for the further validation of antigenic proteins to prevent infestation and diseases transmitted by D. silvarum.
Animals ; Antigens/*chemistry/immunology ; Arthropod Proteins/*chemistry/immunology ; Electrophoresis, Polyacrylamide Gel ; Female ; Ixodidae/*chemistry/immunology ; Molecular Weight ; Rabbits ; Tandem Mass Spectrometry

Objective:To explore the expression levels, clinical significances and prognostic evaluation value of T-cell immunoglobulin mucin-3 (Tim-3) and galectin-9 (Gal-9) in bone marrow cells of patients with newly diagnosed acute lymphocytic leukemia (ALL).Methods:Bone marrow samples from 30 newly diagnosed ALL patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2016 to September 2018 were selected, and peripheral blood samples from 20 healthy volunteers during the same period in the First Affiliated Hospital of Xinjiang Medical University were treated as the controls. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect mRNA relative expression levels of Tim-3 and Gal-9. Differences in mRNA expression of Tim-3 and Gal-9 among ALL patients with varied clinicopathological characteristics were compared. Overall survival (OS) analysis was performed by using the Kaplan-Meier method, Cox proportional hazards model was used to make univariate and multivariate survival analysis.Results:mRNA relative expression levels of Tim-3 and Gal-9 in 30 newly diagnosed ALL patients were higher than those in the healthy control group (2.86±0.47 vs. 0.45±0.05, t = 21.65, P<0.05; 9.79±0.58 vs. 0.96±0.23, t = 63.24, P<0.05). mRNA relative expression level of Tim-3 had statistically significant differences in patients with different ages, France-America-Britain (FAB) Cooperative Group classification, hazard grades and central nervous system invasion (all P<0.01). There were statistically significant differences in mRNA relative expression level of Gal-9 for patients with different ages, FAB Cooperative Group classification, white blood cell count (WBC), central nervous system invasion and NOTCH1 mutation (all P<0.01). All patients were grouped by mRNA relative expression levels of Tim-3 and Gal-9, and patients in high Tim-3 expression group (≥2.86) had worse overall survival (OS) compared with that for patients in low Tim-3 expression group (<2.86) ( P = 0.048). Patients in high Gal-9 expression group (≥9.79) had worse OS compared with that for patients in low Gal-9 expression group (<9.79) ( P = 0.031). Moreover, the OS in Tim-3 and Gal-9 both high expression group was worse than that in Tim-3 and Gal-9 both low expression group and in the low expression group of either of them (all P<0.05). There was no statistically significant difference in OS between the high Tim-3 expression with low Gal-9 expression group and the high Gal-9 expression with low Tim-3 expression group ( P > 0.05). Multivariate Cox regression analysis revealed that peripheral blood WBC≥11.4×10 9/L, BCR-ABL gene mutation, central nervous system invasion, and high expression of Tim-3 and Gal-9 were independent risk prognostic factors of OS for newly diagnosed ALL patients (all P<0.05) . There was a positive correlation between the expression levels of Tim-3 and Gal-9 ( r = 0.788, P<0.01). Conclusions:The high expression of Tim-3 and its ligand Gal-9 are independent effecting factors of poor prognosis in newly diagnosed ALL patients. The expression levels of Tim-3 and Gal-9 can be served as a potential prognostic indicator for ALL patients.

Through an occupational hygiene survey of an occupational acute severe organic fluoride poisoning accident caused by the leakage of pilot test materials, the cause of the incident was analyzed, the diagnosis of the occupational disease was established, and the measures to be taken by the enterprise were discussed, aiming to provide reference for the occupational health management and prevention of similar poisoning accidents in chemical industry.