Objective To study tannins of Corylus heterophylla from Heilongjiang Province. Methods The constituents were separated and purified repeatedly by macroporons resin chromatography methods and their structures were identified by 1H-NMR, 13C-NMR, FAB-MS, and 1H-1HCOSY spectra, and chemical methods as well. Results Three tannins were obtained from C. heterophylla. They were heterophylliin D (Ⅰ), roxbin A ( Ⅱ ), and rugosin F ( Ⅲ ). Conclusion Heterophylliin D ( Ⅰ ) is isolated from the extract of C. heterophylla leaves as a new dimmer tannin firstly.

Object To study tannin components in the leaves of Corylus heterophylla Fisch. Methods They were identified by (()~1H-NMR), (()~(13)C-NMR), FAB-MS, CD, 2-dimensional (()~1H-()~1HCOSY) spectra, and chemical methods. Results Four compounds were obtained from the plant. They are a new one, heterophylliin B (Ⅰ) and three known tannins, tellimagrandin Ⅱ (Ⅱ), casuarictin (Ⅲ), and casuarinin (Ⅳ).Conclusion Heterophylliin B is an ellagitannin dimer.

Child ; Hemolytic-Uremic Syndrome ; therapy ; Humans ; Plasma Exchange

Objective:To explore the distribution characteristics of respiratory pathogens in patients with community-acquired pneumonia in Lianyungang.Methods:A total of 612 patients admitted to the second people′s Hospital of Lianyungang City because of community-acquired pneumonia (CAP) in 2019 were selected as subjects. Sputum or pharyngeal swabs were collected to extract nucleic acids, and 13-fold nucleic acids of respiratory pathogens were detected by PCR capillary electrophoresis fragment analysis. SPSS statistical software and GraphPad5.0 statistical mapping software were used for statistical analysis.Results:The physical examination rate of respiratory pathogens in the adult group was 82.0% in winter, 48.4% in spring, 28.0% in autumn, 20.0% in summer, χ 2=38.473, P=0.000. The positive rate of nucleic acid detection was significantly different in different seasons, among which the physical examination rate of respiratory pathogens in winter was the highest. The physical examination rate of respiratory pathogens in the juvenile group was 86.0% in spring, 76.2% in winter, 71.3% in summer and 66.7% in autumn, χ 2=7.946, P=0.047 . The positive rate of nucleic acid detection was calculated according to gender grouping. The comparison of nucleic acid positive rate between adult group and juvenile group in different seasons: 86.0% vs 48.4% in spring, χ 2=19.436, P=0.000; 71.3% vs 20.0% in summer, χ 2=22.180, P=0.000; 66.7% vs 28.0% in autumn, χ 2=13.485, P=0.000; 76.2% vs 82.0% in winter, χ 2=0.758, P=0.384. Except in winter, the detection rate of nucleic acid of pathogens in the juvenile group was significantly higher than that in the adult group. Conclusions:The nucleic acid detection rate and etiological distribution characteristics of respiratory pathogens are different in patients with community-acquired pneumonia in different seasons and different age groups. 13 kinds of multiple detection methods of respiratory pathogens can provide favorable laboratory data support for the diagnosis and treatment of clinical CAP patients.

Objective:To investigate the clinical features of primary biliary cholangitis (PBC) with thyroid disease (TD) and the association between TD and PBC.Methods:From 2005 to 2017, clinical data of PBC patients from the affiliated hospital of Qingdao university were retrospectively analyzed. All PBC patients were divided into 2 groups according to whether they have TD. The general conditionsand clinical manife-stations in the two groups were analyzed. T-test, nonparametric test, Chi-square test and Fisher's exact test-swere applied to compare datain subgroups. Results:A total of 148 PBC patients were involved in to our study, of which 45 cases (30.4%) had TD. PBC patients with TD showed a higher incidence of Sj?gren's synd- rome (SS) (33.3% vs 17.5%, χ2=4.545, P=0.033). Moreover, there was a higher positive rate of anti-SP100 and anti-SSB antibody in PBC patients with TD (20.0% vs 5.8%, χ2=5.440, P=0.020; 20.0% vs 2.9%, χ2=10.087, P=0.001) compared with patients without. PBC patients without TD presented a higher incidence of abdominal distension and jaundice (29.1% vs 11.1%, χ2=5.629, P=0.018; 23.3% vs 8.9%, χ2=4.241, P=0.039) compared to patients with TD. The ratio of patients with elevated total bilirubin (TBiL), direct bilirubin (DBiL), or increased alkaline phosphatase (ALP) was higher in PBC without TD group(40.8% vs 17.8%, χ2=7.405, P=0.007; 43.7% vs 17.8%, χ2=9.147, P=0.002; 69.9% vs 51.1%, χ2=4.811, P=0.028). Correspondingly, PBC patients without TD was associated with a higher probability of cirrhosis and portal hypertension (40.8% vs 22.2%, χ2=4.731, P=0.030; 25.2% vs 8.9%, χ2=5.183, P=0.023). Conclusion:TD has no effect on the natural history of PBC. PBC patients with TD are associated with a lower probability of liver fibrosis, portal hypertension and cholestasis symptoms but a higher incidence of SS when compared with PBC patients without TD. Multi-disciplinary approach should be implemented to the mag-nagement of PBC.

ObjectiveTo investigate the impact of cancer-associated fibroblasts （CAFs） on immunotherapy and liver metastasis in colorectal cancer （CRC）. MethodsThe single-cell sequencing data （GSE205506） of CRC patients with mismatch repair deficiency （MMRd） were downloaded from the gene expression omnibus database， and R software was used to preprocess the original sequencing data and establish the umap of fibroblast subpopulations， with each subpopulation named based on signature genes. GraphPad was used for the statistical analysis of the proportion of each fibroblast subpopulation， and the key subpopulations with significant differences were analyzed among CRC patients before and after PD-1 immunotherapy， as well as between the patients with pathological complete response （pCR） and those without pCR （non-pCR） after treatment. The analysis of differentially expressed genes and the gene pathway enrichment analysis were performed for the key subpopulations. The TCGA database was used to perform a prognostic and survival analysis of the signature genes of key CAF subpopulations， and RNA sequencing data were used to score and calculate the proportion of key CAF subpopulations in the primary lesions of CRC patients with liver metastasis. The independent-samples t test was used for comparison of normally distributed continuous data between two groups； the Kaplan-Meier method was used to plot survival curves， and the log-rank test was used to calculate survival rates. CellPhoneDB software was used to analyze the receptor-ligand interaction between fibroblast subpopulations and tumor cells， and in vitro cell experiments were used to validate the effect of NRG1， a key ligand molecule， on the migration and invasion abilities of CRC cells. ResultsAfter PD-1 immunotherapy for CRC patients， there was a significant reduction in the proportion of F6_MMP1⁺CAFs （P<0.001）， which was only observed in patients achieving complete remission after immunotherapy. F6_MMP1⁺CAFs were upregulated， as well as the genes and signaling pathways associated with tumor migration and invasion， and in addition， there was a significant increase in F6_MMP1⁺CAFs in the tumor tissue of CRC patients with liver metastasis （P<0.000 1）. As a ligand， NRG1 expressed by F6_MMP1⁺CAFs interacted with ERBB3 receptor expressed by tumor cells， and the in vitro experiments confirmed that NRG1 promoted the migration and invasion abilities of tumor cells by activating the ERBB signaling pathway （P<0.05）. ConclusionF6_MMP1⁺CAFs may affect the efficacy of PD-1 immunotherapy in CRC patients and play an important role in promoting liver metastasis in CRC. F6_MMP1⁺CAFs， along with NRG1 that is produced by them and can promote tumor metastasis， can be used as potential therapeutic targets and prognostic markers for CRC.