Objective To construct programmed cell death protein-ligand 1(PD-LI)^hi tolerogenic dendritic cell (tol-DC) derived from bone marrow of DA rats and identify its immunological function. Methods DA rat bone marrow cells were extracted, combined with recombinant mouse granulocyte macrophage colony-stimulating factor and recombinant mouse interleukin (IL)-4, and cultured for 6 days in vitro to induce the differentiation of bone marrow cells into immature dendritic cells (imDC). Lipopolysaccharide was used to stimulate cell maturation and cultured for 2 days to collect mature dendritic cells (mDC). PD-L1 lentiviral vector virus stock solution or equivalent dose lentiviral stock solution was added, and PD-L1^hitol-DC and Lv-imDC were collected after culture for 2 days. The morphology of PD-L1^hitol-DC was observed by inverted phase contrast microscope and transmission electron microscope. Real-time fluorescence quantitative reverse transcription polymerase chain reaction, Western blotting and flow cytometry were used to detect the expression level of specific markers on cell surface. CD8⁺T cells derived from Lewis rat spleen were co-cultured with imDC, mDC, Lv-imDC and PD-L1^hitol-DC, respectively. The levels of inflammatory factors in the supernatant of each group were detected by enzyme-linked immunosorbent assay. The apoptosis of T cells and the differentiation of regulatory T cells (Treg) in each group were analyzed by flow cytometry. Results The morphology of PD-L1^hitol-DC modified by PD-L1 gene was consistent with tol-DC characteristics, and the expression levels of CD80, CD86 and major histocompatibility complex (MHC) on the surface were low. After mixed culture with CD8⁺ T cells, the levels of IL-10 and transforming growth factor (TGF) -β1 in the supernatant of PD-L1^hitol-DC group were higher, the levels of tumor necrosis factor (TNF) -α and IL-17A were lower, and the apoptosis of T cells and Treg differentiation were increased. Conclusions Overexpression of PD-L1 through lentiviral vectors may successfully induce the construction of bone-marrow derived PD-L1^hitol-DC in DA rats, promote the secretion of anti-inflammatory factors and T cell apoptosis, induce the differentiation of Treg, and inhibit the immune response of allogeneic CD8⁺T cells, which provides experimental basis for the next organ transplantation immune tolerance study.

Objective:To establish a machine learning-based risk prediction model for perimenopausal depressive symptoms and to identify associated risk factors.Methods:A total of 1 105 women aged 45 to 55 years were selected from the 2020 China Health and Retirement Longitudinal Study (CHARLS) dataset.Three machine learning algorithms, including Random Forest, XGBoost and Adaptive Boosting (AdaBoost), were employed to construct prediction models for perimenopausal depressive symptoms. Descriptive statistics and between-group comparisons were performed using SPSS 24.0.And Python 3.10 software was used to build the risk prediction model. Model performance was assessed using receiver operating characteristic (ROC) curves and calibration plots, and the optimal model was identified accordingly. The Shapley additive explanation (SHAP) algorithm was then used to analyze feature importance and the influence of each predictor on the outcome.Results:Among the 1 105 perimenopausal women, 671(60.7%)were categorized in the non-depressive group and 434 (39.3%) in the depressive group. The Random Forest model demonstrated the best overall predictive performance among the three machine learning models, achieving an area under the ROC curve (AUC) of 0.793 and a calibration error of 0.181. SHAP analysis revealed that annual household income was the strongest risk factor in the Random Forest model, with a relative importance of 0.048, followed by cognitive function(0.047), self-rated health status(0.046), life satisfaction(0.043), sleep duration(0.041).Conclusions:The Random Forest based model effectively predicts the risk of perimenopausal depressive symptoms. Annual household income, cognitive function, self-rated health, and life satisfaction are risk factors for depressive symptoms in perimenopausal women.

Objective:To establish a machine learning-based risk prediction model for perimenopausal depressive symptoms and to identify associated risk factors.Methods:A total of 1 105 women aged 45 to 55 years were selected from the 2020 China Health and Retirement Longitudinal Study (CHARLS) dataset.Three machine learning algorithms, including Random Forest, XGBoost and Adaptive Boosting (AdaBoost), were employed to construct prediction models for perimenopausal depressive symptoms. Descriptive statistics and between-group comparisons were performed using SPSS 24.0.And Python 3.10 software was used to build the risk prediction model. Model performance was assessed using receiver operating characteristic (ROC) curves and calibration plots, and the optimal model was identified accordingly. The Shapley additive explanation (SHAP) algorithm was then used to analyze feature importance and the influence of each predictor on the outcome.Results:Among the 1 105 perimenopausal women, 671(60.7%)were categorized in the non-depressive group and 434 (39.3%) in the depressive group. The Random Forest model demonstrated the best overall predictive performance among the three machine learning models, achieving an area under the ROC curve (AUC) of 0.793 and a calibration error of 0.181. SHAP analysis revealed that annual household income was the strongest risk factor in the Random Forest model, with a relative importance of 0.048, followed by cognitive function(0.047), self-rated health status(0.046), life satisfaction(0.043), sleep duration(0.041).Conclusions:The Random Forest based model effectively predicts the risk of perimenopausal depressive symptoms. Annual household income, cognitive function, self-rated health, and life satisfaction are risk factors for depressive symptoms in perimenopausal women.

Objective To evaluate the expression differences of C-reactive protein(CRP),procalcitonin(PCT)and cytokines[interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin(IL)-10,IL-6,IL-4,IL-2,IL-17 A,and IFN-γ/IL-10]in human immunodeficiency virus(HIV)infection,tuberculosis(TB)infec-tion and HIV/TB co-infection in order to provide evidence for early clinical diagnosis of HIV/TB co-infection.Methods Medical records and clinical information of 103 patients with HIV(HIV group),42 patients with TB(TB group)and 67 patients with HIV/TB co-infection(HIV/TB group)were collected from January 2021 to September 2022.CRP,PCT and cytokines were detected in all patients,and their expression differ-ences among the three groups were analyzed.Receiver operating characteristic(ROC)curves were drawn and screening ability was evaluated.Results Compared with HIV group and TB group,CRP,PCT,IFN-γ,IL-10,IL-6 levels and IFN-γ/IL-10 in HIV/TB group were increased,with statistical significance(P＜0.001).Bon-ferroni correction results showed that CRP,PCT,IFN-γ,IL-6 levels and IFN-γ/IL-10 were significantly differ-ent between HIV and HIV/TB groups(all P＜0.001).ROC curve analysis showed that the area under the curve of CRP,PCT,IFN-γ,IL-6 and IFN-γ/IL-10 combined detection was 0.826,which was higher than that of single detection.Conclusion CRP,PCT,IFN-γ,IL-6,IFN-γ/IL-10 combined detection can help the early screening of HIV infection and HIV/TB co-infection.

Objective:To analyze the proportion of patients with acute primary angle-closure glaucoma (PACG) after the outbreak of coronavirus disease 2019 (COVID-19) in patients undergoing glaucoma surgery and the factors influencing morbidity.Methods:A cross-sectional study was performed.The cluster sampling method was used to collect 141 glaucoma patients hospitalized for glaucoma surgery after the outbreak of COVID-19 in Xuzhou First People's Hospital from December 16, 2022, to January 16, 2023, and 231 glaucoma patients hospitalized for surgery in the same 1-month period from 2019 to 2020, 2020 to 2021, 2021 to 2022 through the hospital information system.Ninety-two eyes of 92 patients with acute PACG after the outbreak were selected as a study group, and 21 eyes of 21 patients with acute PACG hospitalized during the same 1-month period from 2021 to 2022 were selected as a control group.The proportion of patients with different types of glaucoma during the observation period was analyzed.The proportion of patients with acute PACG and the clinical characteristics of acute PACG were analyzed, including age, sex, visual acuity, intraocular pressure (IOP), and anterior chamber angle status.Epidemiological data such as the use of anti-cold medications, and changes in living habits and moods (including daily water intake and anxiety) of patients after COVID-19 infection were obtained by telephone follow-up.Anxiety levels of patients in the study group were assessed using the Hospital Depression and Anxiety Scale (HADS).The triggering factors of acute PACG attack after the COVID-19 outbreak were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Xuzhou First People's Hospital (No.xyyll[2023]114).Written informed consent was obtained from each subject.Results:The proportion of acute PACG patients in Xuzhou First People's Hospital within one month after the outbreak in 2022 to 2023 increased significantly compared with the same period in 2021 to 2022, 2020 to 2021 and 2019 to 2020, and the differences were statistically significant ( χ2=31.066, 33.331, 20.804; all at P<0.001).There was no statistical significance in the distribution of the number of eyes with different grades of visual acuity, IOP, the number of eyes with IOP ≥30 mmHg (1 mmHg=0.133 kPa), and the distribution of the number of eyes with different anterior chamber angles between the two groups (all at P>0.05).Patients in the control group had no history of COVID-19 infection or use of cold medicines at disease onset.During disease onset, all 92 (100%) patients in the study group had positive COVID-19 nucleic acid test results, of which 57 (61.96%) patients had a history of oral anti-cold medication use.During the same period, 49 (100%) hospitalized patients with other types of glaucoma had positive COVID-19 nucleic acid test results, of which 20 (40.82%) patients had a history of oral cold medication.There was a statistically significant difference in the proportion of patients taking oral cold drugs between acute PACG and other types of glaucoma in the study group ( χ2=5.764, P=0.016).During the outbreak of COVID-19, the study group reported that the daily water intake had increased to varying degrees than before.In the study group, 76 patients had anxiety, accounting for 82.6%.Multiple linear regression analysis showed that IOP=19.052+ 0.009×daily water intake+ 0.858×HADS score ( R2=0.780), and the standardized coefficients of daily water intake and HADS score were 0.542 and 0.452, respectively.Daily water intake had a greater effect on IOP than HADS score. Conclusions:The proportion of acute PACG patients among hospitalized surgical glaucoma patients increased significantly after the COVID-19 outbreak, which is related to risk factors such as oral anti-cold medications containing vasoconstrictors or antihistamines, increased daily water intake, anxiety and other lifestyle, and mood changes.

Objective:To compare the therapeutic effects of ultrasound-guided radiofrequency ablation (RFA) and surgical resection on salivary gland mixed tumor with diameter ≤3 cm, and to analyze the feasibility and clinical value of RFA in the treatment of salivary gland mixed tumor.Methods:A retrospective study was conducted on 43 patients with salivary gland mixed tumor whose diameter ≤3 cm were treated in the First Affiliated Hospital of Zhengzhou University from March 2020 to March 2022.According to the treatment method, they were divided into an ablation group of 20 cases and a resection group of 23 cases. The complete ablation rate of the ablation group was evaluated, the postoperative absorption of ablation foci in the ablation group was recorded, and the perioperative indexes and the incidence of postoperative complications of the two groups were compared. The long-term prognosis of the two groups was followed up, and the incidence of recurrence, malignant metastasis and appearance recovery were evaluated.Results:In the ablation group, the complete ablation rate was 100.00% (20/20). The lesion volume reduction rates at 1, 3, 6 and 12 months after operation were -(39.60±16.18)%, (8.61±8.10)%, (31.87±14.68)% and (58.64±14.82)%, respectively. The operation time, recovery feeding time, postoperative hospital stay and intraoperative bleeding in the ablation group were less than those in the resection group, and the differences were statistically significant (all P<0.001). Postoperative complications occurred in 2 cases in the ablation group and 9 cases in the resection group. There was significant difference in the total incidence of postoperative complications between the two groups(χ 2=4.768, P=0.029). There was 1 case of recurrence in the ablation group, and no facial depression or protuberance occurred 1 year after operation. There was no recurrence in the resection group, one year after operation, the incidence of facial depression and facial protuberance was 13.04%(3/23) and 0, respectively.There was no malignant metastasis in both groups. Conclusions:Ultrasound-guided RFA is safe and effective in the treatment of mixed tumors of salivary gland with diameter ≤3 cm, and the therapeutic effect is not significantly different from that of surgery. With minimal trauma and good cosmetic effect, it has a great application prospect.

Decompensated liver cirrhosis has various life-threatening complications such as spontaneous bacterial peritonitis, hepatic encephalopathy, and sepsis, and the development of such complications is closely associated with bacterial translocation. Pathological bacterial translocation in patients with liver cirrhosis is caused by the impairment of intestinal barrier function, and thus bacteria can cross the intestinal barrier and enter the mesenteric lymph nodes or other sites. Therefore, a better understanding of the association between intestinal barrier and bacterial translocation in liver cirrhosis can provide new theoretical support for the treatment of liver cirrhosis. This article discusses the four major components of the intestinal barrier, namely the mechanical barrier, the immune barrier, the chemical barrier, and the biological barrier, as well as their changes during bacterial translocation.

Objective To evaluate the effect of propofol on microcirculation in a rabbit model of hemorrhagic shock and resuscitation.Methods Twenty-four adult male rabbits,weighing 1.7-2.1 kg,aged 4-6 months,were equally randomized into sham operation (group S),hemorrhagic shock and resuscitation (group HS/R),or propofol (group P) groups.Hemorrhagic shock was induced by withdrawing blood from the left common carotid artery until mean arterial pressure was reduced to 40-50 mmHg which was maintained for 30 min.The animals were then resuscitated by infusion of shed blood and normal saline (2 times the volume of shed blood) in HS/R and P groups,and in addition propofol 20 mg · kg-1 · h-1 was infused intravenously in group P.Before blood-letting,immediately before resuscitation,and at 30 and 60 min after onset of resuscitation,arterial blood samples were collected for blood gas analysis,and pH value and lactic acid concentrations were recorded.Side-stream dark field imaging was employed to acquire the images of mesenteric microcirculation.Microcirculatory parameters like total vessel density,perfused vessel density,proportion of perfused vessels,and microvascular flow index were recorded.Results Compared with group S,pH value was significantly decreased,and lactic acid concentrations were increased immediately before resuscitation,and at 30 and 60 min after onset of resuscitation,and the total vessel density,perfused vessel density,proportion of perfused vessels,and microvascular flow index were decreased immediately before resuscitation in HS/R and P groups (P＜0.05).There was no significant difference in the parameters mentioned above between group HS/R and group P (P＞0.05).Conclusion Propofol exerts no effect on microcirculation in a rabbit model of hemorrhagic shock and resuscitation.

Objective To investigate the effects of different depth of anesthesia on sublingual microcirculation. Meth?ods ASA gradeⅠ-Ⅱpatients (n=20) were scheduled for elective thyroid surgery and included in the prospective observa?tional study. Midazolam 0.05 mg·kg, sufentanil 0.3μg·kg-1 and rocuronium 0.6 mg·kg-1 were administrated intravenously to induce anesthesia which was then maintained by continuous intravenous infusion of propofol. Target medication concentra?tion increased 0.5 mg·L-1, regulated based on BIS. The patients underwent endotracheal intubation and mechanical ventila?tion. Sublingual microcirculations were evaluated by sidestream dark field (SDF) imaging at T1 (BIS baseline ), T2 (50 0.05). Conclusion When BIS value sit between 40 and 50, it can best inhibit stress response and attenuate the agitation of microcirculation.

[Objective] To investigate the effect of naringin at different doses on the neuropathie pain produced by lumbar 5 spinal nerve ligafion (L5 SNL). [Methods] Using the method of behavioral test, we tested the 50% paw withdrawal threshold before and after intragastrieal application of naringin in the rats with L5 SNL. [Results] Naringin at 30, 90, 100 mg/kg but not at 10 mg/kg increased the 50% paw withdrawal threshold of 1.5 SNL rats significantly. Single application of Naringin (at 30 or 90 mg/kg) inhibited mechanical allodynia for around 6 hours, and the inhibitory effect persisted for 4 days after the cessation of the drug when naringin (30 mg/kg, daily) was consecutively applied for 7 days. [Conclusion] Intragastrical of naringin could relieve the neuropathic pain produced by peripheral nerve injury.