Objective To investigate the predictive value of quantitative parameters of contrast-enhanced ultrasound (CEUS) in evaluating kidneys from donation after brain death (DBD) for the occurrence of delayed graft function (DGF) in recipients. Methods The clinical data of 134 DBD donors and 202 corresponding kidneys and recipients were retrospective analyzed. The recipients were divided into DGF group (n=39) and non-DGF group (n=163) according to the renal function after kidney transplantation. Conventional ultrasound, CEUS parameters, and clinical data were compared between the two groups. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off values for predicting DGF using CEUS parameters, clinical parameters, and their combination, based on the highest Youden index. The predictive ability of different parameters for DGF was evaluated. Results There were statistically significant differences in cortical peak intensity (PIc), medullary peak intensity (PIm), donor albumin (ALB), serum creatinine (Scr) after admission, and the Na⁺ concentration of recipients between the two groups (all P<0.05). The area under the curve (AUC) for predicting DGF using the combination of CEUS parameters PIc and PIm was 0.711, with an optimal cut-off value of 0.193 and a Youden index of 0.382. The AUC for predicting DGF using the combination of CEUS parameters PIc, PIm and clinical parameters was 0.808, with an optimal cut-off value of 0.191 and a Youden index of 0.517. The sensitivity and specificity were 0.769 and 0.613 for the former, and 0.769 and 0.748 for the latter, respectively. The AUC for predicting DGF using CEUS parameters PIc and PIm combined with clinical parameters was significantly higher than that using CEUS parameters PIc and PIm (P<0.05). Conclusions The CEUS quantitative parameters PIc and PIm have good predictive value in assessing kidneys from DBD donors for DGF in recipients, and the diagnostic efficacy is better when combined with clinical parameters.

Objective　To analyze the epidemiological characteristics and infection sources of six human Streptococcus suis infection outbreaks in Shenzhen in 2023, and to provide a reference for effective prevention and control of the epidemic. Methods　Field epidemiological methods were used to investigate the disease onset and medical consultation process, exposure history of household and farmer market pork stalls, and other relevant factors. Data on patient demographics, clinical profiles, epidemiological characteristics, and common exposure cases were collected. Blood, cerebrospinal fluid, and environmental samples were collected for pathogen detection and genotyping. Spatial-geographical analysis of infection characteristics was performed using the professional mapping software ArcMap. Results　In 2023, a total of six cases were reported in Shenzhen, all of which were severe hospitalized cases with no deaths. Among them, five cases were of the meningitis type, and one was of the common type. All patients improved and were discharged after treatment. All six cases were male, with a median age of 47.5 years, and all had a history of direct exposure to raw pork through hand-skin wounds. Two cases were engaged in raw pork sales, while four were non-occupationally exposed individuals. Of the six cases, four were identified as Streptococcus suis serotype 2, and two were serotype 14. The positive rate of raw pork and environmental samples was 8.45% (6/71). Field epidemiological investigation found these six outbreaks were mainly directed toward three slaughterhouses in Guangming District, Bao'an District, and Longgang District. However, different genetic typing results suggested sporadic cases. Conclusions　These six outbreaks in Shenzhen in 2023 were all sporadic individual cases, showing characteristics such as multiple-point sporadic occurrences, diversified case composition, and primarily meningitis-type clinical manifestations. Although the genetic typing of the samples varied, the epidemiological investigation indicated three slaughterhouses as potential sources, providing a scientific basis for source control. In infectious disease epidemic source tracing, gene sequencing combined with field epidemiological surveys is more conducive to determining the source of infection and the relationship between transmission.

Objective To explore the value of serum soluble transferrin receptor(sTFR)and urinary tryp-sin inhibitor(Bikunin)in assessing the short-term prognosis of patients with hepatitis B virus related acute on chronic live failure(HBV-ACLF).Methods A total of 103 patients with HBV-ACLF admitted to Weifang People's Hospital from January 2019 to December 2022 were collected as HBV-ACLF group,who were classi-fied into early stage group(n=46),middle stage group(n=34)and late stage group(n=23)according to the disease progression,and classified into good prognosis group(n=67)and poor prognosis group(n=36)according to clinical outcomes at 30 d after hospital admission.At the same time,65 patients with chronic hep-atitis B virus infection were selected as chronic hepatitis B group and 65 healthy volunteers were selected as control group were enrolled in the study.The clinical medical records of research objects were collected at the time of admission.Serum sTFR and Bikunin levels were detected by enzyme-linked immunosorbent assay.Spearman rank correlation analysis was performed to analyze the association between serum sTFR,Bikunin and disease progression.Multivariate Logistic regression analysis was performed to analyze factors affecting short-term poor prognosis of patients with HBV-ACLF.Receiver operating characteristic(ROC)curve was used to assess the predictive value of serum sTFR and Bikunin on prognosis.Results Serum sTFR and Bikun-in levels were lower in HBV-ACLF group and chronic hepatitis B group than those in control group,and those in HBV-ACLF group were lower than those in chronic hepatitis B group,and the differences were statistically significant(P＜0.05).Model for End-Stage Liver Disease(MELD)score was higher in HBV-ACLF group and chronic hepatitis B group than that in control group,and that in HBV-ACLF group was higher than that in chronic hepatitis B group,and the differences were statistically significant(P＜0.05).Compared with early stage group,serum sTFR and Bikunin levels decreased in middle stage group and late stage group,and those in late stage group were lower than those in middle stage group,and the differences were statistically significant(P＜0.05).MELD score increased in middle stage group and late stage group,and that in late stage group was higher than that in middle stage group,and the differences were statistically significant(P＜0.05).Serum sTFR and Bikunin in HBV-ACLF patients were associated with MELD score(r=-0.638,-0.592,P＜0.05),which were also associated with severity of disease(rs=-0.722,-0.671,P＜0.05).Elevated HB-sAg,elevated quantitative HBV DNA,middle and late stages of HBV-ACLF and elevated MELD score were independent risk factors for poor short-term prognosis in patients with HBV-ACLF(OR＞1,P＜0.05),while elevated serum sTFR and Bikunin were protective factors for poor short-term prognosis in patients with HBV-ACLF(OR＜1,P＜0.05).Serum sTFR and Bikunin both had some predictive value for poor short-term prog-nosis,and the predictive value of the combination was greater than that of single indicator(Z=2.139,2.165,P＜0.05).Conclusion Serum sTFR and Bikunin levels are decreased in patients with HBV-ACLF,which are associated with disease progression and short-term prognosis.Early combined detection of two indicators could predict the risk of poor prognosis in patients with HBV-ACLF at 30 d after hospital admission.

Objective:To analyze the prognostic outcomes of 1 147 patients who underwent liver transplantation at Qingdao University Affiliated Hospital and to summarize measures to enhance the efficacy of liver transplantation.Methods:A retrospective analysis was conducted on the clinical and follow-up data of 1 147 liver transplant patients at Qingdao University Affiliated Hospital.Results:The overall postoperative 1-, 3-, and 5-year survival rates for the 1 147 liver transplant patients were 87.20%, 73.40%, and 65.60%, respectively. The survival rates for benign disease liver transplant recipients were 88.01%, 84.98%, and 81.39% at 1, 3, and 5 years post-transplant, respectively, compared to recipients transplanted for malignancies of 78.11%, 64.41%, and 60.06% (all P<0.001). Among the mid vs more recent period, patients' 1-year and 3-year postoperative survival rates were 84.20%, 70.80% vs 90.50%, 71.70%, respectively,significantly in favor of recently enrolled patients ( P=0.022). In the complex surgery group, patients' 1-, 3-, and 5-year survival rates were 82.70%, 65.50%, 56.70%, while in less complicated group, it was 89.00%, 76.50%, 69.20% ( P<0.001). The primary causes of death for benign disease recipients were multi-organ failure (4.1%), while in recipients with malignant disease primary cause of death was tumor recurrence (23.7%). Postoperative complications included primary graft dysfunction, delayed graft function recovery, portal vein thrombosis, hepatic artery thrombosis, biliary stricture, post-transplant lymphoproliferative disorder, and graft-versus-host disease, with occurrence rates of 1.05%, 6.89%, 1.92%, 0.44%, 2.00%, 0.61%, and 0.44%, respectively. Conclusions:With the continuous improvement in surgical techniques and perioperative care levels, the 3-year survival rate of recipients at our center has increased. Malignant diseases and complex liver transplantation remain crucial factors affecting recipient prognosis, highlighting the need to further enhance comprehensive treatment capabilities for patients with malignant diseases and complex surgeries.

Objective:To investigate the effect of long non-coding RNA (lncRNA) GHET1 on autophagy and drug resistance to cisplatin in head and neck squamous cell carcinoma (HNSCC).Methods:Transcriptome sequencing (RNA-seq) data and the related clinical information of tumor samples from 504 HNSCC patients and 43 matched paracancerous tissues (> 2 cm from the tumor primary site margin) were downloaded from the Cancer Genome Atlas (TCGA) database. The data was updated in August 2022. R software was used to analyze the differences of GHET1 expression in cancer tissues, paracancerous tissues and 43 HNSCC matched samples. The data of 32 middle and advanced HNSCC patients who were eligible for surgery in Fujian Cancer Hospital from January 2019 to June 2023 were collected, and the differences of GHET1 expression between 14 patients insensitive to chemotherapy and 18 sensitive to chemotherapy were compared. Human HNSCC cell lines FaDu and Cal27 were selected to establish cisplatin-resistant HNSCC cell lines FADU-DDP-R and CAL27-DDP-R. The cells were transfected with siRNA targeting GHET1 (corresponding siRNA group), and the control group was transfected with negative control siNC. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression level of GHET1 and Beclin-1mRNA. The expressions of Beclin-1, LC3-Ⅰ/Ⅱ, p63 and GAPDH protein were detected by using Western blot. The autophagy inhibitor 3-methyladenosine (3-MA) was used to treat FADU-DDP-R and CAL27-DDP-R cell lines; the half inhibitory concentration ( IC50), the expression differences of GHET1, Beclin-1 mRNA and autophagy related protein of cisplatin were compared between the drug-resistant cell lines and the drug-resistant cell lines of the 3-MA group. Results:In TCGA database, the relative expression level of GHET1 in 504 HNSCC tissues was higher than that in 43 paracancerous tissues, and the difference was statistically significant ( Z = 2.57, P < 0.05); the relative expression level of GHET1 in 43 HNSCC tissues was higher than that in the paired paracancerous tissues, and the difference was statistically significant ( t = 3.24, P = 0.002). The relative expression level of GHET1 in HNSCC of 18 patients in chemotherapy-sensitive group and 14 patients in chemotherapy-insensitive group was 1.01±0.12 and 2.05±0.26, respectively, and the expression of GHET1 in the chemotherapy-insensitive group was higher than that in the chemotherapy-sensitive group ( t = 15.45, P < 0.001). IC50 of FaDu and FADU-DDP-R cell lines was (35.6±1.9) μmol/L and (86.2±2.7) μmol/L, respectively, and the difference was statistically significant ( t = 26.64, P < 0.001). The IC50 of Cal27 and CAL27-DDP-R cell lines was (68.8±8.9) μmol/L and (115.0±8.2) μmol/L, respectively, and the difference was statistically significant ( t = 6.60, P < 0.01). The relative expression levels of GHET1 in FaDu and FADU-DDP-R cell lines were 1.00±0.10 and 3.57±0.07, respectively ( t = 33.85, P < 0.001), and the relative expression level of GHET1 in FADU-DDP-R cell lines was higher than that in FaDu cell lines. The relative expression levels of GHET1 in Cal27 and Cal27-DDP-R cell lines were 1.00±0.08 and 2.06±0.11, respectively ( t = 13.25, P < 0.001), and the relative expression level of GHET1 in Cal27-DDP-R cell lines was higher than that in Cal27 cell lines. Western blot showed that the relative expression levels of autophagy related proteins Beclin-1, LC3-Ⅰ, LC3-Ⅱ and p63 in FADU-DDP-R and CAL27-DDP-R cell lines were higher than those in FaDu and Cal27 cell lines (all P < 0.05). The results of qRT-PCR showed that the relative expression levels of GHET1 in FADU-DDP-R cell lines in the control group and siGHET1 group were 1.00±0.12 and 0.20±0.06, respectively ( t = 10.52, P < 0.001). The relative expression levels of GHET1 in CAL27-DDP-R cell lines in the control group and siGHET1 group were 1.00±0.09 and 0.51±0.03, respectively ( t = 8.90, P < 0.001). The relative expression level of GHET1 in the knockdown group of the 2 cell lines was lower than that of the corresponding drug-resistant cell lines. The relative expression levels of Beclin-1 mRNA in FADU-DDP-R cell line in the control group and siGHET1 group were 1.00±0.09 and 0.60±0.07, respectively ( t = 6.08, P < 0.01); the relative expression levels of Beclin-1 mRNA in Cal27-DDP-R cell lines in the control group and siGHET1 group were 1.00±0.14 and 0.65±0.04, respectively ( t = 4.31, P < 0.05); the relative expression levels of Beclin-1 mRNA in drug-resistant cell lines after knocking down GHET1 were lower than those in corresponding drug-resistant cell lines. Western blot showed that the relative expression levels of Beclin-1, LC3-Ⅰ, LC3-Ⅱ and p63 in the knockdown group of drug-resistant cell lines were lower than those in the corresponding drug-resistant cells group. The cisplatin IC50 of drug-resistant cell lines in siGHET1 group was lower than that of the corresponding drug-resistant cell lines (all P < 0.05), and the cisplatin IC50 of drug-resistant cell lines in 3-MA group was lower than that of the corresponding drug-resistant cell lines (all P < 0.05). Conclusions:LncRNA GHET1 could induce the resistance to cisplatin by activating the autophagy in HNSCC.

Aim To investigate the correlation between serum remnant lipoprotein cholesterol(RLP-C),triglyc-eride levels(TG)and coronary heart disease(CHD)in middle-aged people.Methods A total of 439 middle-aged in-dividuals who were hospitalized in the Department of Cardiology of Liuzhou People's Hospital from January 2015 to Decem-ber 2022 and underwent coronary angiography were selected as the research subjects.They were divided into CHD group(190 cases)and control group(249 cases)according to the results of coronary angiography.The general clinical data and laboratory tests of the subjects were collected,and RLP-C was calculated based on blood lipid profile.Bivariate Spearman correlation,multivariate Logistic regression,and restricted cubic spline graph were used to analyze the correlation between RLP-C,TG,and CHD in these middle-aged participants.Receiver operating characteristic(ROC)curve was used to evaluate the value of RLP-C and TG in predicting CHD.Results The age in CHD group was older than that in control group,proportion of male,proportion of smoking history,incidence of hypertension,incidence of diabetes,inci-dence of hyperlipidemia,body mass index(BMI),systolic blood pressure(SBP),fasting blood glucose(FBG),glycosy-lated hemoglobin(HbA1c),TG,low density lipoprotein cholesterol(LDLC),RLP-C were higher than those in control group,while high density lipoprotein cholesterol(HDLC)was lower than that in control group(P＜0.05).The Spearman correlation analysis results showed positive correlation between RLP-C,TG,LDLC and CHD(r=0.227,0.279,and 0.105,respectively,P＜0.05),and negative correlation between HDLC and CHD(r=-0.340,P＜0.001)in these stud-ied population.Multivariate Logistic regression analysis showed that whether as continuous or categorical variables,RLP-C and TG were independent risk factors for CHD(P＜0.05),HDLC was independent protective factor for CHD(P＜0.05).Compared with lowest quartile group,The OR(95％CI)of CHD incidence in 3rd and 4th quartile group of RLP-C were 2.648(1.364～5.144)and 2.847(1.468-5.520)respectively;The OR(95％CI)of CHD incidence in 3rd and 4th quartile group of TG were 3.043(1.520-6.092)and 3.520(1.811～6.842)respectively.The restricted cubic spline graph revealed that RLP-C,TG were positively nonlinearly correlated with CHD(P for overall＜0.001,P for nonlin-ear=0.002,0.001,respectively).Subgroup analysis showed that the relationship between RLP-C,TG and CHD was more significant in females than in males.ROC curve analysis showed that the areas under the curve(95％CI)of RLP-C,TG in predicting CHD were 0.632(0.580-0.685)(P＜0.001)and 0.663(0.612-0.713)(P＜0.001)in general,meanwhile,0.735(0.659-0.811)(P＜0.001)and 0.740(0.666-0.813)(P＜0.001)in females.Conclusion RLP-C and TG are independent risk factors for CHD in middle-aged people,and their correlation with CHD are greater than that of LDLC.They may become the main targets for the prevention and treatment of CHD,and should be given clinical attention.

This article reports a patient with hepatic coma who underwent artificial liver support therapy and liver transplantation successfully， and the patient recovered well in the later stage after active treatment. This article also discusses the timing of liver transplantation.

Medicinal plants are a valuable source of essential medicines and herbal products for healthcare and disease therapy. Compared with chemical synthesis and extraction, the biosynthesis of natural products is a very promising alternative for the successful conservation of medicinal plants, and its rapid development will greatly facilitate the conservation and sustainable utilization of medicinal plants. Here, we summarize the advances in strategies and methods concerning the biosynthesis and production of natural products of medicinal plants. The strategies and methods mainly include genetic engineering, plant cell culture engineering, metabolic engineering, and synthetic biology based on multiple "OMICS" technologies, with paradigms for the biosynthesis of terpenoids and alkaloids. We also highlight the biosynthetic approaches and discuss progress in the production of some valuable natural products, exemplifying compounds such as vindoline (alkaloid), artemisinin and paclitaxel (terpenoids), to illustrate the power of biotechnology in medicinal plants.

BACKGROUND:It has been demonstrated that osteoclast activation plays an important role in skeletal system-related diseases.The mechanism of regulation of osteoclast activation by extracellular vesicles carrying non-coding RNA has not been fully elucidated. OBJECTIVE:To review and summarize relevant literature in and outside China,and to review the regulation of osteoclast activation by different non-coding RNAs in extracellular vesicles in different diseases,so as to provide a certain direction for subsequent research. METHODS:"Non-coding RNA,miRNA,lncRNA,circRNA,snoRNA,osteoclasts,extracellular vesicles,exosome,microparticle,apoptotic bodies"were used as search terms to search the databases of CNKI,WanFang,and VIP."Extracellular vesicles,exosome,microparticle,apoptotic bodies,non-coding RNA,miRNA,lncRNA,circRNA,snoRNA,osteoclast"were used as search terms to search PubMed.Finally,71 articles were included. RESULTS AND CONCLUSION:(1)The activation of osteoclasts is affected by many factors,among which the specific mechanism of non-coding RNA regulating osteoclast activation is not clear.(2)Extracellular vesicles can be secreted by osteoblasts,bone marrow mesenchymal stem cells,tumor cells and other cells.As a carrier of intercellular communication,extracellular vesicles can carry non-coding RNA to regulate osteoclast activation.(3)In the current studies on the regulation of osteoclast activation by extracellular vesicles carrying non-coding RNA,most of the diseases are osteoporosis,followed by tumor bone metastasis,and most types of non-coding RNA are miRNA.(4)There are relatively few studies on the regulation of extracellular vesicles carrying lncRNA and circRNA and snoRNA on osteoclast activation,and the regulatory mechanism is mainly ceRNA mechanism.(5)In conclusion,an in-depth study of the regulatory mechanism of extracellular vesicles carrying non-coding RNA on osteoclast activation is helpful to find key targets for the treatment of skeletal system-related diseases.

BACKGROUND:Compared with traditional two-dimensional culture,three-dimensional microtissue culture can show greater advantages.However,more favorable cultivation methods in three-dimensional culture still need to be further explored. OBJECTIVE:To evaluate the cell behavior of microtissue and its ability to promote cartilage formation under two three-dimensional culture methods. METHODS:Cartilage-derived microcarriers were prepared by chemical decellularization and tissue crushing.DNA quantification and nuclear staining were used to verify the success of decellularization,and histological staining was used to observe the matrix retention before and after decellularization.The microcarriers were characterized by scanning electron microscopy and CCK-8 assay.Cartilage-derived microtissues were constructed by combining cartilage-derived microcarriers with human adipose mesenchymal stem cells through three-dimensional static culture and three-dimensional dynamic culture methods.The cell viability and chondrogenic ability of the two groups of microtissues were detected by scanning electron microscopy,live and dead staining,and RT-qPCR. RESULTS AND CONCLUSION:(1)Cartilage-derived microcarriers were successfully prepared.Compared with before decellularization,the DNA content significantly decreased after decellularization(P<0.001).Scanning electron microscope observation showed that the surface of the microcarrier was surrounded by collagen,maintaining the characteristics of the natural extracellular matrix of cartilage cells.CCK-8 assay indicated that microcarriers had no cytotoxicity and could promote cell proliferation.(2)Scanning electron microscopy and live and dead staining results showed that compared with the three-dimensional static group,the three-dimensional dynamic group had a more extended morphology of microtissue cells,and extensive connections between cells and cells,between cells and matrix,and between matrix.(3)The results of RT-qPCR showed that the expressions of SOX9,proteoglycan,and type Ⅱ collagen in microtissues of both groups were increased at 7 or 14 days.The relative expression levels of each gene in the three-dimensional dynamic group were significantly higher than those in the three-dimensional static group at 14 days(P<0.05).At 21 days,the three-dimensional static group had significantly higher gene expression compared with the three-diomensional dynamic group(P<0.001).(4)The results showed that compared with three-dimensional static culture microtissue,three-dimensional dynamic culture microtissue could achieve higher expression of chondrogen-related genes in a shorter time,showing better cell viability and chondrogenic ability.