Acute pancreatitis(AP)is an autopeptic disease,which can be accompanied by systemic inflammation and multiple organ failure.Mesenchymal stem cells(MSCs)have been used in the treatment of AP and have shown good application potential.MSCs can act through multiple mechanisms to reduce pancreatic inflammation and enhance tissue repair.These mechanisms include homing to injury sites,anti-inflammatory and immunomodulatory effects,oxidative stress reduction,inhibition of apoptosis and suppression of autophagy.Additionally,MSCs can mitigate multi-organ damage associated with AP,impacting lungs,intestines,heart and other organs.Research on the application of MSCs in treating AP is predominantly at the preclinical animal study stage,with limited clinical investigations reported.This article reviews the mechanisms and research progress of MSCs in the treatment of AP,aiming to provide references for basic research and clinical applications.

BACKGROUND:At present,the clinical application of gastrointestinal stents is relatively common.Conventional self-expanding metal and plastic stents have the problems of easy displacement,difficulty to remove,and postoperative restenosis.With the advantages of biodegradability and low postoperative restenosis rate,biodegradable drug-eluting stents have become the hot spot in the research of gastrointestinal stents.OBJECTIVE:To summarize the research progress of biodegradable drug-eluting gastrointestinal stents and to provide a forecast of biodegradable drug-eluting gastrointestinal stents.METHODS:Relevant articles were retrieved on CNKI,WanFang,PubMed,and Web of Science databases from January 1994 to March 2024.The Chinese and English search terms were"biodegradable,drug-eluting stent,esophageal stent,biliary stent,pancreatic duct stent,intestinal stent,gastrointestinal stent."Finally,64 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)Biodegradable drug-eluting gastrointestinal stent is a medical device that uses biodegradable material as the main body of the stent,carries and locally elutes drugs for different therapeutic purposes,and plays the dual roles of physical support and drug therapy.By adjusting the properties of stent materials,improving manufacturing processes and auxiliary means,the degradation rate of stents can be accelerated or slowed down to meet clinical needs.Drug elution technology uses drug coatings,nanoparticles,and polymer drug-loaded films,as drug-loading platforms to accurately release drugs,increase local drug concentrations in lesions,and reduce drug loss and systemic absorption of toxic drugs.(2)The main structure of biodegradable drug-eluting gastrointestinal stent is one or more functional drugs combined with biodegradable polymers,metals or nanofiber materials.The available functional drugs are divided into anti-inflammatory and antiproliferative,antitumor,lithotripsy,and enzyme inhibitors.(3)Maintaining the stability of the mechanical properties of gastrointestinal stent and precise controlled drug release are the problems that need to be solved at this stage of biodegradable drug-eluting gastrointestinal stent.The development of new biodegradable materials and the continuous innovation of drug-carrying and drug-releasing methods,manufacturing processes and auxiliary means are the future research directions.

Acute pancreatitis(AP),one of the most common acute abdominal conditions in clinical practice,is typically self-limiting.However,approximately 20%of cases progress to severe acute pancreatitis,characterized by persistent systemic inflammatory response syndrome and multiple-organ dysfunction syndrome,with a high mortality rates.The pathogenesis of AP involves complex pathophysiological processes,and in recent years,the role of oxidative stress(OS)in AP has garnered increasing attention.OS refers to an imbalance between reactive oxygen species production and antioxidant capacity following endogenous or exogenous stimuli,which can lead to pancreatic cell injury,exacerbation of inflammatory responses,and organ dysfunction.Notably,antioxidants have demonstrated efficacy in reducing OS-induced pancreatic damage and multi-organ dysfunction in animal models.This article reviews current molecular mechanisms of OS in AP,its role in disease progression and recent advances in antioxidant-based therapeutic strategies for AP.

Objective:To investigate the regulatory effect of zinc finger transcription factor 580 (ZNF580) gene on autophagy and extracellular matrix (ECM) secretion in human pancreatic cancer cells PANC1.Methods:PANC1 cells were transfected with 500 ng/ml short hairpin RNA-ZNF580 (shRNA-ZNF580) and a ZNF580 expression vector with a green fluorescent protein reporter gene (GFP-ZNF580) using lentiviral transfection to establish the ZNF580-silenced group and ZNF580-overexpression group, respectively. PANC1 cells were treated with 10 mmol/L rapamycin (RA), a cell autophagy inducer, and the autophagy inhibitor LY294002 for 2 hours to construct the autophagy-induced group and autophagy-inhibited group, respectively. The autophagy inhibition+ZNF580 silencing group was established by transfecting PANC1 cells with 500 ng/ml sh-ZNF580 using lentiviral transfection while simultaneously adding 10 mmol/L LY294002. PANC1 cells cultured in conventional medium served as control group. The expression levels of ZNF580 protein and autophagy-related proteins ATG7 and LC3 in PANC1 cells from each group were detected by Western blot. The expression changes of ECM secretion-related markers type I collagen (Col-Ⅰ), Col-Ⅲ, fibronectin (FN), and tumor necrosis factor-α (TNF-α) in PANC1 cells were measured by ELISA.Results:Compared with control group, the protein expression levels of ATG7, LC3-Ⅰ, and LC3-Ⅱ in PANC1 cells of the ZNF580-silenced group were significantly decreased (0.40±0.04 vs 0.81±0.13, 0.66±0.08 vs 2.0±0.45, 0.78±0.10 vs 1.89±0.23), while they were significantly increased in the ZNF580-overexpression group (2.07±0.17 vs 0.83±0.09, 1.21±0.37 vs 0.88±0.09, 0.77±0.16 vs 0.37±0.06). The protein expression level of ZNF580 in PANC1 cells of the autophagy inhibition group was significantly down-regulated compared with the control group (0.40±0.15 vs 1.07±0.18), while it was significantly up-regulated in the autophagy induction group (1.59±0.25 vs 0.67±0.09). Compared with the control group, the levels of extracellularly secreted Col-Ⅰ, Col-Ⅲ, FN, and TNF-α in PANC1 cells were significantly decreased in the ZNF580-silenced group (5.02±0.81 vs 8.38±0.83, 6.17±0.83 vs 10.73±1.69, 28.66±2.47 vs 45.20±4.31, 10.09±1.32 vs 19.48±2.77), which were significantly increased in the ZNF580-overexpression group (19.28±2.05 vs 8.38±0.83, 28.29±5.96 vs 10.73±1.69, 103.22±6.37 vs 45.20±4.31, 46.78±6.96 vs 19.48±2.77), significantly decreased in the autophagy inhibition group (5.10±0.66 vs 9.01±1.24, 7.22±0.67 vs 11.83±1.71, 28.45±2.82 vs 43.51±4.38, 12.16±2.13 vs 20.53±3.65, respectively), and significantly increased in the autophagy induction group (20.49±3.68 vs 9.01±1.24, 26.58±3.96 vs 11.83±1.71, 73.18±7.15 vs 43.51±4.38, 41.11±8.87 vs 20.53±3.65). Compared with the autophagy inhibition group and the ZNF580-silenced group, the levels of extracellularly secreted Col-Ⅰ, Col-Ⅲ, FN, and TNF-α in PANC1 cells of the autophagy inhibition+ZNF580 silencing group were significantly decreased (Col-Ⅰ: 3.36±1.25 vs 5.73±0.62 and 5.57±0.35; Col-Ⅲ: 4.15±0.16 vs 6.24±0.90 and 6.71±0.34; FN: 18.31±2.00 vs 26.46±1.18 and 27.09±2.01; TNF-α: 6.81±0.46 vs 9.96±1.87 and 10.62±0.65). All the above differences were statistically significant (all P value <0.05). Conclusions:The transcription factor ZNF580 could positively regulate the levels of autophagy and ECM secretion in PANC1 cells. The combined application of ZNF580 gene silencing and autophagy inhibitors can significantly inhibit ECM secretion in PANC1 cells.

Acute pancreatitis(AP)is an autopeptic disease,which can be accompanied by systemic inflammation and multiple organ failure.Mesenchymal stem cells(MSCs)have been used in the treatment of AP and have shown good application potential.MSCs can act through multiple mechanisms to reduce pancreatic inflammation and enhance tissue repair.These mechanisms include homing to injury sites,anti-inflammatory and immunomodulatory effects,oxidative stress reduction,inhibition of apoptosis and suppression of autophagy.Additionally,MSCs can mitigate multi-organ damage associated with AP,impacting lungs,intestines,heart and other organs.Research on the application of MSCs in treating AP is predominantly at the preclinical animal study stage,with limited clinical investigations reported.This article reviews the mechanisms and research progress of MSCs in the treatment of AP,aiming to provide references for basic research and clinical applications.

Acute pancreatitis(AP),one of the most common acute abdominal conditions in clinical practice,is typically self-limiting.However,approximately 20%of cases progress to severe acute pancreatitis,characterized by persistent systemic inflammatory response syndrome and multiple-organ dysfunction syndrome,with a high mortality rates.The pathogenesis of AP involves complex pathophysiological processes,and in recent years,the role of oxidative stress(OS)in AP has garnered increasing attention.OS refers to an imbalance between reactive oxygen species production and antioxidant capacity following endogenous or exogenous stimuli,which can lead to pancreatic cell injury,exacerbation of inflammatory responses,and organ dysfunction.Notably,antioxidants have demonstrated efficacy in reducing OS-induced pancreatic damage and multi-organ dysfunction in animal models.This article reviews current molecular mechanisms of OS in AP,its role in disease progression and recent advances in antioxidant-based therapeutic strategies for AP.

BACKGROUND:At present,the clinical application of gastrointestinal stents is relatively common.Conventional self-expanding metal and plastic stents have the problems of easy displacement,difficulty to remove,and postoperative restenosis.With the advantages of biodegradability and low postoperative restenosis rate,biodegradable drug-eluting stents have become the hot spot in the research of gastrointestinal stents.OBJECTIVE:To summarize the research progress of biodegradable drug-eluting gastrointestinal stents and to provide a forecast of biodegradable drug-eluting gastrointestinal stents.METHODS:Relevant articles were retrieved on CNKI,WanFang,PubMed,and Web of Science databases from January 1994 to March 2024.The Chinese and English search terms were"biodegradable,drug-eluting stent,esophageal stent,biliary stent,pancreatic duct stent,intestinal stent,gastrointestinal stent."Finally,64 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)Biodegradable drug-eluting gastrointestinal stent is a medical device that uses biodegradable material as the main body of the stent,carries and locally elutes drugs for different therapeutic purposes,and plays the dual roles of physical support and drug therapy.By adjusting the properties of stent materials,improving manufacturing processes and auxiliary means,the degradation rate of stents can be accelerated or slowed down to meet clinical needs.Drug elution technology uses drug coatings,nanoparticles,and polymer drug-loaded films,as drug-loading platforms to accurately release drugs,increase local drug concentrations in lesions,and reduce drug loss and systemic absorption of toxic drugs.(2)The main structure of biodegradable drug-eluting gastrointestinal stent is one or more functional drugs combined with biodegradable polymers,metals or nanofiber materials.The available functional drugs are divided into anti-inflammatory and antiproliferative,antitumor,lithotripsy,and enzyme inhibitors.(3)Maintaining the stability of the mechanical properties of gastrointestinal stent and precise controlled drug release are the problems that need to be solved at this stage of biodegradable drug-eluting gastrointestinal stent.The development of new biodegradable materials and the continuous innovation of drug-carrying and drug-releasing methods,manufacturing processes and auxiliary means are the future research directions.

Objective:To investigate the regulatory effect of zinc finger transcription factor 580 (ZNF580) gene on autophagy and extracellular matrix (ECM) secretion in human pancreatic cancer cells PANC1.Methods:PANC1 cells were transfected with 500 ng/ml short hairpin RNA-ZNF580 (shRNA-ZNF580) and a ZNF580 expression vector with a green fluorescent protein reporter gene (GFP-ZNF580) using lentiviral transfection to establish the ZNF580-silenced group and ZNF580-overexpression group, respectively. PANC1 cells were treated with 10 mmol/L rapamycin (RA), a cell autophagy inducer, and the autophagy inhibitor LY294002 for 2 hours to construct the autophagy-induced group and autophagy-inhibited group, respectively. The autophagy inhibition+ZNF580 silencing group was established by transfecting PANC1 cells with 500 ng/ml sh-ZNF580 using lentiviral transfection while simultaneously adding 10 mmol/L LY294002. PANC1 cells cultured in conventional medium served as control group. The expression levels of ZNF580 protein and autophagy-related proteins ATG7 and LC3 in PANC1 cells from each group were detected by Western blot. The expression changes of ECM secretion-related markers type I collagen (Col-Ⅰ), Col-Ⅲ, fibronectin (FN), and tumor necrosis factor-α (TNF-α) in PANC1 cells were measured by ELISA.Results:Compared with control group, the protein expression levels of ATG7, LC3-Ⅰ, and LC3-Ⅱ in PANC1 cells of the ZNF580-silenced group were significantly decreased (0.40±0.04 vs 0.81±0.13, 0.66±0.08 vs 2.0±0.45, 0.78±0.10 vs 1.89±0.23), while they were significantly increased in the ZNF580-overexpression group (2.07±0.17 vs 0.83±0.09, 1.21±0.37 vs 0.88±0.09, 0.77±0.16 vs 0.37±0.06). The protein expression level of ZNF580 in PANC1 cells of the autophagy inhibition group was significantly down-regulated compared with the control group (0.40±0.15 vs 1.07±0.18), while it was significantly up-regulated in the autophagy induction group (1.59±0.25 vs 0.67±0.09). Compared with the control group, the levels of extracellularly secreted Col-Ⅰ, Col-Ⅲ, FN, and TNF-α in PANC1 cells were significantly decreased in the ZNF580-silenced group (5.02±0.81 vs 8.38±0.83, 6.17±0.83 vs 10.73±1.69, 28.66±2.47 vs 45.20±4.31, 10.09±1.32 vs 19.48±2.77), which were significantly increased in the ZNF580-overexpression group (19.28±2.05 vs 8.38±0.83, 28.29±5.96 vs 10.73±1.69, 103.22±6.37 vs 45.20±4.31, 46.78±6.96 vs 19.48±2.77), significantly decreased in the autophagy inhibition group (5.10±0.66 vs 9.01±1.24, 7.22±0.67 vs 11.83±1.71, 28.45±2.82 vs 43.51±4.38, 12.16±2.13 vs 20.53±3.65, respectively), and significantly increased in the autophagy induction group (20.49±3.68 vs 9.01±1.24, 26.58±3.96 vs 11.83±1.71, 73.18±7.15 vs 43.51±4.38, 41.11±8.87 vs 20.53±3.65). Compared with the autophagy inhibition group and the ZNF580-silenced group, the levels of extracellularly secreted Col-Ⅰ, Col-Ⅲ, FN, and TNF-α in PANC1 cells of the autophagy inhibition+ZNF580 silencing group were significantly decreased (Col-Ⅰ: 3.36±1.25 vs 5.73±0.62 and 5.57±0.35; Col-Ⅲ: 4.15±0.16 vs 6.24±0.90 and 6.71±0.34; FN: 18.31±2.00 vs 26.46±1.18 and 27.09±2.01; TNF-α: 6.81±0.46 vs 9.96±1.87 and 10.62±0.65). All the above differences were statistically significant (all P value <0.05). Conclusions:The transcription factor ZNF580 could positively regulate the levels of autophagy and ECM secretion in PANC1 cells. The combined application of ZNF580 gene silencing and autophagy inhibitors can significantly inhibit ECM secretion in PANC1 cells.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.