Objective: To explore the function of serum leptin in COPD patients with malnutrition, and to investigate the relationship between leptin and TNF-?. Methods: A total of 81 subjects (47 COPD patients and 34 control subjects) participated in this study. The 47 COPD patients were divided into 2 groups: group COPD Ⅰ (patients without malnutrition during stable disease, n=29), group COPDⅡ(patients with malnutrition during stable disease, n=18).To eliminate the effect of sex differences, all the patients and controls were male. Body mass index (BMI), percent ideal body weight (IBW%), triceps skin-fold thickness (TSF), mid-upper arm circumference (MAC), mid-upper arm muscle circumference(MAMC),serum leptin and tumor necrosis factor-?(TNF-?) levels, serum prealbumin (PA), serum transferrin (TF), serum albumin(Alb),total lymphocytes count (TLC), forced expiratory volume in one second (FEV_1), maximal inspiration pressure(MIP)and maximal expiration pressure(MEP)were measured in all participants. Leptin levels were measured by radioimmunoassay. TNF-? levels were measured by ELISA. The between group difference and correlation of these parameters were analysed. Results: (1)Serum leptin levels were significantly lower in group COPDⅡ (4.07?3.42 ?g/L) than in group COPD Ⅰ(9.72?6.67 ?g/L)and controls(8.21?5.41 ?g/L, P

Objective To compare clinical features,pulmonary functions,chest imaging and prognosis between combined pulmonary fibrosis and emphysema syndrome (CPFE) and idiopathic pulmonary fibrosis(IPF) without emphysematous changes in elderly patients.Methods 88 elderly IPF patients in Beijing hospital from January 2000 to October 2012 were divided into CPFE (n=30) and IPF (n =58) groups according to the CT imaging.Clinical features,blood gas analysis,pulmonary function,chest CT and survival time were compared between the two groups.Results 30 CPFE patients with the mean age of(75.5 ±7.6) years and 58 IPF patients without emphysema with the mean age of(73.7±6.8) years were enrolled.The proportions of male patients,smoking history and mortality were higher in CPFE patients than in IPF group(86.7％ vs.63.8％,28 vs.36,76.7％ vs.43.1％,x2 =5.09,9.74,8.98,P＜0.05 or 0.01).CPFE patients had a higher force vital capacity(FVC) and total lung capacity(TLC) as compared with IPF group [(2.6±0.9) L vs.(2.1± 0.5) L,(5.4±1.9) L vs.(4.4±1.1) L,t=2.69,2.35,P＜0.01 or 0.05].There were no significant differences in forced expiratory volume in one second(FEV1) and the diffusion capacity for carbon monoxide(DLCO) between the two groups.The main type of emphysema by HRCT scan were centrilobular emphysema in CPFE patients.There were lower median survival time in CPFE group than in IPF group [(3.0±0.2) years vs.(4.0±1.0) years,x2=4.50,P＜0.05].Conclusions The majority of elderly CPFE patients are males and smokers.The lung volume is increased in elderly CPFE patients as compared with IPF patients.Centrilobular emphysema is the primary type in CPFE patients.The prognosis is worse in elderly CPFE patients than in IPF patients.

Oral hydroxycamptothecin nanosuspension (HCPT-Nano) with high supersaturated dissolution level, high permeation and well physical stability, was manufactured by microprecipitation-high press homogenization method. Its pharmaceutical properties were investigated, such as size and distribution, zeta potential, particle shape, physical existence condition, supersaturated dissolution level and so on. Particle size was measured by laser diffraction, and the mean diameters before and after lyophilization were 138 +/- 11.72 nm and 175 +/- 12.74 nm, respectively, for HCPT-Nano. Zeta potentials of HCPT-Nano was over -20 mV. The nanoparticles, being observed by transmission electron microscopy (TEM), were claviform or column in shape. DSC and X-ray diffraction revealed that HCPT existed in the form of crystal for HCPT-Nano. And HCPT-Nano could maintain higher supersaturated dissolution level for long time. So it supplied the possibility of improving oral bioavailability of HCPT when combining together admoveatur of P-gp inhibitor, CsA.

Objective:To analyze the relations of blood-brain barrier (BBB) integrity with clinical features and their response to immunotherapy in patients with autoimmune encephalitis (AE).Methods:One hundred and forty-seven AE patients confirmed in Department of Neurology, First Affiliated Hospital of Zhengzhou University from August 2015 to December 2021 were chosen; their clinical and laboratory data were collected retrospectively. In accordance with cerebrospinal fluid (CSF) albumin/serum albumin (QAlb) value of 7, patients were classified into normal BBB group ( n=101, QAlb value ≤7.00) and damaged BBB group ( n=46, QAlb value >7.00). Modified Rankin Scale (mRS) and Clinical Assessment Scale for Autoimmune Encephalitis (CASE) were used to evaluate the severity on admission and 30 d after first-line immunotherapy; and good immunotherapy responsiveness was defined as CASE or mRS scores 30 d after first-line immunotherapy lower than those at admission. Differences of general data, clinical manifestations, CSF and peripheral blood biochemical results, and response to immunotherapy between the two groups were compared and analyzed. Results:The damaged BBB group had significantly higher proportions of patients with decreased consciousness level (58.7% vs. 37.6%), increased CSF protein, increased immunoglobulin G (IgG) and increased 24 h intramural IgG synthesis rate, and significantly higher fibrinogen in peripheral blood than normal BBB group ( P<0.05). On 30 th d of treatment, mRS scores of patients in damaged BBB group were significantly higher than those of patients in normal BBB group ( P<0.05), and the differences of CASE scores and mRS scores before and after treatment in damaged BBB group were significantly lower than those in normal BBB group (0.50±0.46 vs. 3.24±2.93, 0.70±0.62 vs. 1.15±1.04, P<0.05). In damaged BBB group, good immunotherapy response rate in patients receiving single immunotherapy was significantly lower than that in patients receiving two or three combinations of first-line immunotherapy ( P<0.05). Conclusion:BBB integrity is closely related to clinical characteristics and response to immunotherapy of AE; combined first-line immunotherapy is recommended for AE patients with BBB injury.

Objective:To evaluate the efficacy and safety of chidamide combined with curcumin in the treatment of cutaneous T-cell lymphoma (CTCL) .Methods:Human CTCL cell lines HH and HuT-78 were cultured in vitro and treated with gradient concentrations of chidamide (0.4, 0.8, 1.6, 3.2, and 6.4 μmol/L) and curcumin (1.25, 2.5, 5, 10, and 20 μmol/L) alone or in combination, and the combination index (CI) of chidamide and curcumin for HH and HuT-78 cells was evaluated. Cultured HH/HuT-78 cells were divided into chidamide group (treated with 0.4 μmol/L chidamide), curcumin group (treated with 10 μmol/L curcumin), combination group (treated with 0.4 μmol/L chidamide + 10 μmol/L curcumin), and solvent control group (treated with dimethyl sulfoxide) ; after 48-hour treatment, the MTS assay was performed to evaluate the cell viability, flow cytometry to detect cell apoptosis and analyze cell cycle, and real-time quantitative PCR (RT-PCR) and Western blot analysis were conducted to determine the mRNA and protein expression of apoptosis-related genes nuclear factor (NF) -κB p65, B-cell lymphoma 2 (Bcl-2), and caspase-3, respectively. A tumor-bearing mouse model was established with HH cells in immunodeficient mice. These tumor-bearing mice were randomly divided into 4 groups: chidamide group (gavaged with 10 mg/kg chidamide), curcumin group (gavaged with 100 mg/kg curcumin), combination group, and solvent control group. The treatment was administered daily for 12 days, and body weight and tumor size were measured. On day 13, these mice were sacrificed, and tumor tissues were collected. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining was performed to detect apoptosis of tumor cells, and RT-PCR and Western blot analysis were conducted to determine the expression of apoptosis-related genes and proteins. Differences among multiple groups were analyzed using one-way analysis of variance, and multiple comparisons were performed using least significant difference- t test. Results:The CI values of chidamide (0.4 - 6.4 μmol/L) combined with curcumin (1.25 - 20 μmol/L) were all < 1, indicating a synergistic effect. After 48-hour treatment, the proliferation rates of HH and HuT-78 cells were significantly lower in the combination groups than in the chidamide groups and curcumin groups (all P < 0.05) ; HH and HuT-78 cells both showed significantly increased apoptosis rates in the combination groups compared with the chidamide groups, curcumin groups and control groups (HH cells: 70.47% ± 7.87% vs. 31.95% ± 9.43%, 37.23% ± 10.74%, 11.76% ± 5.65%, all P < 0.001; HuT-78 cells: 28.31% ± 1.70% vs. 21.29% ± 3.61%, 18.74% ± 1.82%, 3.18% ± 1.00%, all P < 0.001) ; in both HH and HuT-78 cells, the combination groups exhibited significantly increased caspase-3 mRNA expression and cleaved protein levels (all P < 0.05), but significantly decreased mRNA and protein expression of NF-κB p65 and Bcl-2 compared with the control groups, chidamide groups, and curcumin groups (all P < 0.05). On day 13 in the in vivo experiment, the tumor volume was significantly lower in the combination group (107.00 ± 43.10 mm 3) than in the control group (1 833.00 ± 281.20 mm 3), chidamide group (453.30 ± 91.71 mm 3), and curcumin group (548.50 ± 90.72 mm 3, all P < 0.05) ; the apoptosis level of tumor cells detected by TUNEL staining was significantly higher in the combination group than in the chidamide group, curcumin group, and control group (all P < 0.05) ; compared with the chidamide group, curcumin group, and control group, the combination group showed significantly increased expression of caspase-3 mRNA and cleaved caspase-3 protein (all P < 0.05), but significantly decreased mRNA and protein expression of NF-κB p65 and Bcl-2 (all P < 0.05). During the treatment period, there was no significant difference in the body weight of mice among the 4 groups ( P < 0.05) ; after sacrifice of the mice, no abnormalities were found in histopathological manifestations of their resected visceral tissues, blood routine test results, or liver and kidney function indicators. Conclusion:The combination of chidamide and curcumin had a synergistic antitumor effect on CTCL, which may be related to the inhibition of cell proliferation and induction of tumor cell apoptosis.

Background: Total knee arthroplasty (TKA) is a common surgical procedure for patients with knee osteoarthritis. The patellar component plays a crucial role in knee biomechanics and can influence postoperative outcomes. This study aimed to investigate the relationship between radiological indices of patellar height and patient outcomes following TKA. Methods: A retrospective analysis was conducted on patients who underwent TKA for osteoarthritis. Radiographic measurements of patellar height, including the Insall-Salvati (IS) ratio, modified Blackburne-Peel (mBP) ratio, Caton-Deschamps ratio, and plateaupatellar angle (PPA), were obtained. Clinical outcomes were assessed using the Knee Society Score (KSS) and the Forgotten Joint Score-12 (FJS-12). Patient satisfaction and postoperative complications were also evaluated. Statistical analyses, including correlation analysis and multiple regression models, were performed to determine the association between radiological indices and patient outcomes. Results: The study included 330 cases that met the inclusion criteria. The analysis revealed significant correlations between different radiological indices of patellar height and patient outcomes. Lower postoperative PPA was correlated with worse KSS and range of motion scores. A decreased mBP ratio was associated with poorer FJS-12 responses and higher risks of dissatisfaction and patellar clunk or crepitus. Increased IS ratio was linked to a lower likelihood of incidental giving way of the knee. Advanced age was associated with reduced dissatisfaction and incidental giving way probabilities. Conclusions The findings of this study demonstrate that radiological indices of patellar height can predict patient outcomes following TKA. Assessing patellar height using various radiographic measurements provides valuable information for surgical planning and prognostic evaluation. Understanding the impact of patellar height on clinical outcomes can aid in optimizing TKA procedures and improving patient satisfaction. These findings emphasize the importance of considering patellar height as a predictive factor in TKA and highlight its potential role in guiding postoperative management and rehabilitation strategies.

Objective:To investigate the clinical significance of tumor budding as an indicator of postoperative distant organ metastasis after radical gastrectomy in elderly patients diagnosed with gastric cancer.Methods:The clinical and pathological data of 124 elderly patients who experienced metastasis after undergoing radical gastrectomy were retrospectively analyzed.The analysis was conducted from March 2015 to June 2022, focusing on the clinicopathological factors that influenced the occurrence of postoperative distant metastasis in these patients.Tumor budding in gastric cancer tissues was assessed using hematoxylin-eosin staining, and its clinical significance was analyzed.Results:The tumor budding grade of gastric cancer tissues showed a significant correlation with vascular invasion( χ2=6.731, P=0.009), the number of lymph node metastases( rs=0.481, P<0.001), and the time of distant metastasis( rs=-0.450, P<0.001).In the univariate analysis, factors such as tumor budding grade, tumor size, vascular invasion, postoperative chemotherapy, cancerous nodule, preoperative serum carbohydrate antigen 125, and the number of lymph node metastases were found to influence distant metastasis-free survival after radical gastrectomy in elderly patients(all P<0.05).The multifactorial analysis also indicated that tumour outgrowth grade was an important independent prognostic factor for postoperative distant metastasis in elderly gastric cancer patients( HR=3.731, P<0.001). Conclusions:The findings of this study indicate that tumor budding may serve as a potential marker for predicting distant organ metastasis in elderly patients who have undergone radical gastrectomy.This discovery holds significant clinical implications.

Objective:To investigate the regulatory effects and mechanism of mannan-binding lectin (MBL) on adipogenic differentiation of 3T3-L1 preadipocytes.Methods:3T3-L1 preadipocytes were induced to differentiate into adipocytes in vitro, and stimulated with different concentrations of MBL (0, 1, 10, 20 μg/ml). Firstly, changes in cell proliferation ability were detected by CCK-8. Then lipid accumulation was analyzed by Oil red O staining and intracellular triglyceride content determination. Further, the expression of adipogenic differentiation-related factors PPARγ and C/EBPα at protein and mRNA levels were detected by Western blot and qRT-PCR, respectively. Finally, Western blot was used to analyze the expression and phosphorylation of Akt, a signal molecule related to adipogenic differentiation. Results:MBL at the concentrations of 0, 1, 10 and 20 μg/ml had no effect on the proliferation of 3T3-L1 preadipocytes. The level of triglyceride in MBL treatment groups decreased in a dose-dependent manner on 3 d after 3T3-L1 preadipocyte differentiation. Results of Oil red O staining showed that the number of lipid droplets in MBL treatment groups reduced significantly, and the absorbance values also decreased significantly in a concentration-dependent manner. Western blot and qRT-PCR results showed that the expression of PPARγ and C/EBPα at both protein and mRNA levels in MBL treatment groups decreased significantly in a dose-dependent manner, and the phosphorylation level of Akt was significantly down-regulated as well.Conclusions:MBL regulates the adipogenic differentiation of 3T3-L1 preadipocytes via Akt signaling pathway.

Objective:To characterize the epidemic of influenza in Beijing from 2022 to 2023 and the variation of gene and antigenicity of hemagglutinin (HA) of influenza A H3N2 virus, so as to provide scientific basis for influenza prevention and control in Beijing.Methods:Statistical analysis was carried out on the result of influenza pathogenic monitoring in Beijing from week 14, 2022 to week 20, 2023, and 79 strains of influenza A H3N2 virus were selected at different time and population sources, and their genetic variation and evolution characteristics were analyzed through HA gene amplification sequencing and antigenicity analysis.Results:From week 14, 2022 to week 20, 2023, 24 244 throat swabs of influenza like cases were collected in Beijing, and 4 987 influenza virus nucleic acid positive cases were detected, including 2 749 influenza A H3N2 positive cases, with a detection rate of 11.34%. Among the 79 strains, 50 strains (63.29%) showed low response, 94.44% of the strains from August to November 2022 had low response, and 54.10% of the strains from February to March 2023 had low response, with a statistically significant difference ( χ2=8.079, P=0.004). Compared with the vaccine strain A/Darwin/9/2021, the HA gene sequence of 79 strains of influenza A H3N2 showed nucleotide similarity of 97.47% to 98.47% and amino acid similarity of 97.05% to 98.17%. Genetic evolution analysis showed that the 18 strains isolated from August to November 2022 were all distributed in the 3C.2a1b.2a.1a.1 branch, while the 61 strains isolated from February to March 2023 all belonged to the 3C.2a1b.2a.3a.1 branch. Compared with the vaccine strain, there were multiple site mutations distributed at multiple antigenic determinants and receptor binding sites in A, B, C, D, and E. All strains had potential glycosylation sites of 8NST, 22NGT, 38NAT, 45NSS, 63NCT, 126NWT, 133NGT, 246NST, 285NGS, 483NET, while one strain missed 165NVT glycosylation sites; 55 strains between February and March 2023 missed 122NES glycosylation sites. Conclusions:The HA gene locus of influenza A H3N2 virus detected in Beijing from week 14, 2022 to week 20, 2023 showed multiple mutations, continuous monitoring of this subtype variation is crucial.

Objective:To analyze the clinical features and immunotherapy responsiveness of patients with myelin oligodendrocyte glycoprotein immunoglobulin G-antibody associated disease (MOGAD) with epilepsy, and display the risk factors of epilepsy in MOGAD.Methods:Eighty-nine patients with MOGAD diagnosed at the First Affiliated Hospital of Zhengzhou University between October 2019 and May 2023 were enrolled and classified into 2 groups upon MOGAD with ( n=29) or without epilepsy ( n=60). The Expanded Disability Status Scale (EDSS) and Clinical Assessment Scale for Autoimmune Encephalitis (CASE) were used for evaluation of severity, and EDSS or CASE scores on the 30th day after first-line immunotherapy initiation lower than that on admission were defined as well treatment responsiveness. The differences of general data, clinical manifestations, cerebrospinal fluid (CSF) and peripheral blood biochemical examination results, and immunotherapy reactivity between the 2 groups were thoroughly explicated. In addition, the risk factors of epilepsy in MOGAD were analyzed by univariate and multivariate Logistic regression analysis. Results:Compared with patients with MOGAD without epilepsy, patients with MOGAD with epilepsy were characterized by lower age of onset [24.5(10.3, 34.0) years vs 11.0(6.5, 20.0) years, Z=-2.348, P=0.019], higher percentage of male patients [43.3%(26/60) vs 75.9%(22/29), χ 2=8.326, P=0.004], higher virus infection rate [28.3%(17/60) vs 51.7%(15/29), χ 2=4.645, P=0.031], higher incidence of prodromal symptoms [11.7%(7/60) vs 34.5%(10/29), χ 2=6.586, P=0.010], higher blood-brain barrier breakdown rate [35.0%(21/60) vs 58.6%(17/29), χ 2=4.458, P=0.035], higher percentage of CSF albumin level>450 mg/L [48.3%(29/60) vs 75.9%(22/29), χ 2=6.056, P=0.014] and higher creatine kinase level [45.50(28.50, 69.75) U/L vs 57.50(41.75, 97.25) U/L, Z=-2.349, P=0.019]; more epilepsy [0(0) vs 29/29 (100.0%), χ 2=89.000, P<0.001] and disturbance of consciousness [0(0) vs 6/29(20.7%), χ 2=10.224, P=0.001] as clinical manifestations, and more cerebral cortex lesions [30/60(50.0%) vs 25/29(86.2%), χ 2=10.856, P=0.001] on magnetic resonance imaging. Nevertheless, the patients with MOGAD without epilepsy were featured with more visual impairment [23/60(38.3%) vs 3/29(10.3%), χ 2=7.406, P=0.007], limb weakness [18/60(30.0%) vs 1/29(3.4%), χ 2=8.209, P=0.004], sensory disturbance [15/60(25.0%) vs 0(0), Fisher exact probability test, P=0.002] and more cervical cord lesions [22/60(36.7%) vs 4/29(13.8%), χ 2=4.946, P=0.026] on magnetic resonance imaging. Immunotherapy responsiveness was relatively poor in the MOGAD with epilepsy group [EDSS score lower than that on admission: 15/29(51.7%) vs 46/60(76.7%), χ 2=5.641, P=0.018; CASE score lower than that on admission: 16/29(55.2%) vs 47/60(78.3%), χ 2=5.072, P=0.024] compared with the MOGAD without epilepsy group. Male was the independent risk factor of epilepsy in MOGAD ( OR=7.078, 95% CI 1.709-29.326, P=0.007). Conclusions:Compared with patients with MOGAD without epilepsy, patients with MOGAD with epilepsy reported more male patients, lower age of onset and higher incidence of prodromal symptoms, blood-brain barrier dysfunction rate, virus infection rate, CSF albumin level and creatine kinase level; clinical phenotypes were mainly meningoencephalitis and more cerebral cortex lesions were shown on magnetic resonance imaging. MOGAD with epilepsy was closely related to poor immunotherapy responsiveness, and gender was found to be the independent risk factor for epilepsy in MOGAD.